What Is a CPAP Machine?

If you or your bed partner have undiagnosed or untreated obstructive sleep apnea (OSA), getting a good night’s sleep might feel impossible. The good news is that OSA symptoms, including snoring and low-quality sleep, usually improve and sometimes disappear with regular use of a medical device called a continuous positive airway pressure (CPAP) machine.

We’ll explain what CPAP machines do, how they can help treat OSA, and the benefits of CPAP treatment. We’ll also explain how to use a CPAP machine, address potential problems, explore alternative OSA treatments, and answer some frequently asked questions.

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What Does CPAP Stand For?

CPAP stands for continuous positive airway pressure. 

Often, doctors may also refer to simply PAP therapy, which includes all machines that use pressurized air to treat sleep apnea, such as CPAP machines, APAP (auto-adjusting positive airway pressure) machines and BiPAP (bilevel positive airway pressure) machines.

What Does a CPAP Machine Do?

CPAP machines use pressurized air to keep a person’s airway open. These devices usually have three main components:

• Machine: CPAP machines usually contain a settings display, a motor that generates pressurized air, and a heated humidifier chamber. Depending on the model, devices may be as small as a brick or as large as a shoe box.
• Tube: CPAP machines deliver filtered, pressurized air taken from the room through a flexible plastic tube that is usually 6, 8, or 10 feet long.
• Mask: The tube connects to a mask that sits beneath the nose, fits over the nose, or seals around the nose and mouth. The mask is generally secured by adjustable straps.

There are several kinds of positive airway pressure (PAP) devices, but CPAP machines — which pump air at a continuous, customized pressure setting throughout the night — are typically the first treatment choice Trusted Source UpToDateMore than 2 million healthcare providers around the world choose UpToDate to help make appropriate care decisions and drive better health outcomes. UpToDate delivers evidence-based clinical decision support that is clear, actionable, and rich with real-world insights.View Source for people with moderate to severe OSA.

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What Is a CPAP Machine Used For?

By delivering pressurized air through the nostrils or the mouth, CPAP machines help prevent apneas and hypopneas (disruptions in breathing caused by collapsing or narrowing of the soft tissues in the nose and throat). Unlike some forms of mechanical ventilation, CPAP devices do not breathe for a person. Instead, CPAP users must breathe on their own and, as they do so, pressurized air from the machine acts as a stent Trusted Source UpToDateMore than 2 million healthcare providers around the world choose UpToDate to help make appropriate care decisions and drive better health outcomes. UpToDate delivers evidence-based clinical decision support that is clear, actionable, and rich with real-world insights.View Source to keep relaxed muscles and tissues from collapsing into the airway.

CPAP therapy is the gold standard treatment for OSA. Day-to-day benefits may include less sleepiness and clearer thinking, while long-term benefits Trusted Source Medline PlusMedlinePlus is an online health information resource for patients and their families and friends.View Source can include reduced risk of heart diseases, diabetes, and dementia. Additionally, users may often experience:

• Higher productivity
• Normal breathing during sleep, with normal blood oxygen levels
• Improved blood pressure
• No or reduced snoring
• Increased alertness during the day
• Enhanced ability to focus and retain information

While CPAP therapy is most commonly used to treat OSA, it is also sometimes used to treat breathing-related problems Trusted Source UpToDateMore than 2 million healthcare providers around the world choose UpToDate to help make appropriate care decisions and drive better health outcomes. UpToDate delivers evidence-based clinical decision support that is clear, actionable, and rich with real-world insights.View Source caused by heart failure, respiratory failure, and obesity. For those that need supplemental oxygen, an oxygen concentrator can be added to the CPAP tubing through the use of an oxygen tubing adapter.

“People using CPAP therapy can breathe normally during sleep, with normal oxygen levels and better sleep quality since their airway is protected. CPAP therapy eliminates snoring and may reduce restlessness during sleep.”

Audrey Wells, MD

Sleep Medicine Physician, CPAP Expert, MD

Benefits of CPAP

When used consistently, CPAP therapy is typically more effective than other OSA treatment options. The more severe your sleep apnea symptoms are, the more likely you are to benefit from using a CPAP machine.

CPAP can offer both short- and long-term benefits to your physical and mental health, like: 

• Better Sleep Quality: People with OSA wake up many times during the night because of disrupted breathing. Sometimes these interruptions are too quick to notice or remember, but the fragmented sleep causes fatigue during the day. CPAP machines regulate breathing and help minimize wake-ups, leading to better sleep overall.
• Less Daytime Sleepiness: With improved sleep, research suggests that symptoms of daytime fatigue should improve with CPAP treatment. The decrease may be gradual, and depends on consistent use of the CPAP machine. Trusted Source National Library of Medicine, Biotech InformationThe National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information.View Source  
• Improved Mental Health: OSA is correlated with mental health problems, and these may become more pronounced if the condition is left untreated. Trusted Source National Library of Medicine, Biotech InformationThe National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information.View SourceCPAP treatment in people with OSA may help reduce symptoms of depression. Trusted Source National Library of Medicine, Biotech InformationThe National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information.View Source Also, because CPAP leads to improved sleep, cognitive function and focus may improve as well. Trusted Source National Library of Medicine, Biotech InformationThe National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information.View Source  
• Improved Heart Health: Studies suggest that CPAP therapy improves blood pressure and arterial tone quickly in people with OSA. Lowering blood pressure can significantly decrease the risk of stroke. Trusted Source American Academy of Sleep Medicine (AASM)AASM sets standards and promotes excellence in sleep medicine health care, education, and research.View Source Other research indicates that CPAP therapy may reduce heart arrhythmias (events when the heart beats irregularly). Trusted Source National Library of Medicine, Biotech InformationThe National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information.View Source  
• Less Snoring: Snoring is a common and disruptive symptom of OSA. Complaints about snoring from a bed partner often lead to the initial diagnosis.CPAP therapy significantly reduces snoring almost immediately by keeping airways open.
• Better Blood Sugar Control: Research shows that CPAP therapy can help control blood sugar fluctuations in people who have both type 2 diabetes and OSA. Trusted Source European Respiratory ReviewView Source  
• Improved Sexual Function: People with OSA may both experience sexual dysfunction, but recent studies suggest that CPAP therapy may help improve these symptoms with continued use. One study found that erectile dysfunction in men with OSA can be partially reversed with CPAP treatment. Trusted Source SleepMedView Source Another found that women reported less sexual dysfunction after one year of CPAP treatment. Trusted Source National Library of Medicine, Biotech InformationThe National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information.View Source

How Do You Use a CPAP Machine?

In order to get the full benefit from CPAP therapy, you need to use the CPAP machine correctly and consistently. Here are the basic steps for setting up and using the machine: 

1. Choose the Machine: Buying a CPAP machine requires a prescription from your health care provider. You’ll first need to do a sleep study, like an at-home sleep apnea test. After you get your results, the doctor will help you determine the best type of machine and pressure settings based on your diagnosis. To purchase the CPAP machine, you’ll likely use a DME provider, online retailer, or a supplier that works with your insurance company. 

2. Select a Space: You’ll need to find a space near your bed that provides a solid support base for the machine. Make sure that the tube and mask can reach your bed easily, and that there’s an outlet nearby to plug in the machine. 

3. Assemble the Machine: Check all of the parts of the machine for any cracks or damage, and then put together your CPAP machine according to the instructions. Generally you’ll insert a small filter in a compartment of the machine, connect one end of a tube to the machine, and connect the other end to a mask and headgear that fits over your face. Some CPAP machines include a humidifier to prevent dry mouth. Fill this reservoir with distilled water only, and be sure not to exceed the maximum fill line. 

4. Try out the Machine: Once the mask is fitted, make sure the seal is tight and secure, but not uncomfortable. Turn on the machine, relax, and take slow, deep breaths. Make sure that the seal is secure and that there are no leaks. If you feel any discomfort, stop the machine and make adjustments to your mask. Trusted Source Medline PlusMedlinePlus is an online health information resource for patients and their families and friends.View Source  

5. Get Used to the Therapy: The first couple of nights of CPAP therapy are usually the most difficult as you get used to sleeping while using the device. You can set yourself up for success by wearing the mask for ten to thirty minutes at a time during the day while reading or watching TV. If CPAP therapy is still uncomfortable after a few days, talk to your doctor. You may need to change your mask type or pressure settings. Trusted Source National Library of Medicine, Biotech InformationThe National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information.View Source  

Common Issues With CPAP

Some people find that using a CPAP machine is challenging or uncomfortable, especially in the beginning. Some of the most commonly reported issues are:

• Mask discomfort 
• Air leaks 
• Dry mouth 
• Dryness or irritation of the nose 
• Bloating caused by swallowed air 

Many people find CPAP therapy more tolerable after an initial period of adjustment. Acclimation to CPAP treatment normally includes trying different mask types or sizes to get the fit right. Using a high quality mask that fits well and sleeping on a specially designed pillow can also alleviate some of the difficulties of using a CPAP machine.

There are also ways to reduce the discomfort that can accompany CPAP use, including using nasal sprays, making changes to the humidifier setting, and practicing during the day so you can make adjustments when there is no pressure to sleep.

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How Do I Know If I Need a CPAP Machine?

A medical provider can help you determine if you are a candidate for CPAP therapy. It’s important to talk to your doctor if you — or your bed partner — suspect that you have OSA since early treatment can help prevent long-term health problems. Symptoms of OSA include:

• Daytime sleepiness
• Snoring
• Pauses in breathing followed by gasps during sleep 
• Feeling unrefreshed upon waking
• Difficulty paying attention or remembering information
• Morning headaches

In order to determine the severity of your OSA and the appropriateness of CPAP therapy as a treatment, your doctor will likely ask you to participate in an overnight sleep study in a laboratory. You may also be able to confirm the diagnosis of OSA using an at-home sleep apnea test.

Are There Alternatives to a CPAP Machine?

Doctors sometimes recommend other kinds of positive airway pressure devices to people who don’t improve with CPAP therapy or who find it very uncomfortable. These include auto-adjusting PAP (APAP) machines, which change air pressure depending on the needs of the sleeper, and bilevel PAP (BPAP) machines, which alter air pressure during inhalation and exhalation. Additional treatments that can help manage symptoms include:

• Wearing an oral appliance designed to keep your airway open
• Sleeping on your side
• Losing weight
• Avoiding alcohol and smoking
• Surgical treatments

“CPAP alternatives are not always effective. For this reason, confirmatory testing is recommended to determine if OSA is still present.”

Audrey Wells, MD

Sleep Medicine Physician, CPAP Expert, MD

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