Continuous positive airway pressure therapy
(CPAP ) uses a machine to help a person who has obstructive
sleep apnea (OSA) breathe more easily during sleep. A
CPAP machine increases air pressure in your throat so that your airway doesn't
collapse when you breathe in. When you use CPAP, your bed partner may sleep
You use CPAP at home every night while you sleep. The
CPAP machine will have one of the following:
- A mask that covers your nose and mouth.
- A mask that
covers your nose only—called nasal continuous positive airway pressure, or
NCPAP (this type of mask is most common).
- Prongs that fit into your
It may take time for you to become
comfortable with using CPAP. If you can't get used to it, talk to your doctor.
You might be able to try another type of mask or make other adjustments.
CPAP is the most effective
nonsurgical treatment for obstructive sleep apnea. It is the first treatment
choice for adults and the most widely used.
CPAP is effective for
treating sleep apnea:
- Research shows that continuous positive airway pressure (CPAP)
decreases daytime sleepiness, especially in those who have moderate to severe sleep
apnea.1, 2, 3
- Studies show that in people who have moderate to severe sleep
apnea, nasal continuous positive airway pressure (NCPAP) lowers
blood pressure during both the day and the
- CPAP is better than other nonsurgical
methods for treating obstructive sleep apnea.6
- People with
coronary artery disease who use CPAP for sleep apnea are less likely to have
heart problems such as heart failure.7
Problems that may occur with CPAP
- Excessive dreaming during early
- Dry nose and sore throat.
congestion, runny nose, and sneezing.
- Irritation of the eyes and
the skin on the face.
- Abdominal bloating.
- Leaks around the mask because it doesn't fit
Nosebleeds are a rare complication of
You can expect mild discomfort in the
morning when you first start using CPAP. Talk with your doctor if you don't
feel comfortable after a few days.
Relieving side effects
You may be able to limit or
stop some of the side effects:
- If your
nose is runny or congested, talk with your doctor about using decongestants or
corticosteroid nasal spray medicines.
- Your doctor may be able to adjust your CPAP
to reduce or eliminate problems.
- Be sure the mask or nasal prongs
fit you properly. Air shouldn't leak around the mask.
- Use a
humidifier or a corticosteroid nasal spray medicine to reduce nasal irritation
- You may want to talk to your doctor about trying other types of CPAP machines.
- One type of machine will start with a low air pressure and slowly increase the
air pressure as you fall asleep. This kind of machine can help reduce
discomfort caused by too much constant pressure in your nose.
bilevel positive airway pressure machine (BiPAP) uses a different air pressure when you breathe in than when you breathe
out. BiPAP may work better than standard CPAP for treating
obstructive sleep apnea in people who have
You may find BiPAP more comfortable than CPAP because you can breathe out against a lower air pressure. As a result, you may be more likely to continue the treatment.
You will have to spend the night at a sleep laboratory to find the air pressure levels that work best for you.
- An auto-titrating continuous positive airway pressure (APAP) can automatically decrease or increase the air pressure as needed. This may make the machine more comfortable and easier to use.
When you are using CPAP, you need
to see your doctor or sleep specialist regularly. You may also need more
sleep studies to adjust the CPAP machine and check
whether the treatment is working.
For best results, keep the machine clean. Follow the manufacturer's instructions for cleaning the equipment.
The machines are expensive. You
may be able to rent a CPAP machine before you buy it. In some cases, you may be
able to rent-to-own a CPAP machine.
BiPAP and APAP machines are usually more expensive than CPAP machines.
The most common problem with
CPAP is that people don't use the machine every night. Or they take off the
mask during the night because it becomes uncomfortable. Even one night of not
using the machine can make you sleepy the next day. If you feel like you want to stop using CPAP for any reason, talk to your doctor. There may be other treatment options for you.
The U.S. Food and Drug Administration (FDA) has approved
some brands of portable CPAP machines. You may be able to
take a smaller CPAP machine on vacations or other types of
Complete the special treatment information form (PDF) (What is a PDF document?) to help you understand this treatment.
Giles TL, et al. (2006). Continuous positive
airways pressure for obstructive sleep apnoea in adults. Cochrane Database of Systematic Reviews
Hensley M, Ray C (2009). Sleep apnoea, search date May
2008. Online version of BMJ Clinical Evidence: http://www.clinicalevidence.com.
Weaver TE, et al. (2012). Continuous positive airway pressure treatment of sleepy patients with milder obstructive sleep apnea: Results of the CPAP Apnea Trial North American Program (CATNAP) randomized clinical trial. American Journal of Respiratory and Critical Care Medicine, 186(7): 677–683.
Barbe F, et al. (2010). Long-term effect of continuous positive airway pressure in hypertensive patients with sleep apnea. American Journal of Respiratory and Critical Care Medicine, 181(7): 718–726.
Marin JM, et al. (2012). Association between treated and untreated obstructive sleep apnea and risk of hypertension. JAMA, 307(20): 2169–2176.
Lam B, et al. (2007). Randomised study of
three non-surgical treatments in mild to moderate obstructive sleep apnoea.
Thorax, 62(4): 354–359.
Milleron O, et al. (2004). Benefits of obstructive
sleep apnoea treatment in coronary artery disease: A long-term follow-up study.
European Heart Journal, 25(9): 728–734.
Khayat RN, et al. (2008). Cardiac effects of
continuous and bilevel positive airway pressure for patients with heart failure
and obstructive sleep apnea. Chest, 134(6): 1162–1168.