CPAP is the most common treatment for all forms of sleep apnea and is occasionally used to treat snoring as well.
A CPAP is a bedside device that works by blowing normal air into your airway through a mask.
The influx of air helps to support the tissues in your airway, acting like a stent to keep your airways open.
CPAP is able to support the airways of people with sleep apnea, regardless of the cause of the sleep apnea.
It is the only current treatment that can effectively manage sleep apnea in such a wide range of patients.
CPAP is considered the GOLD standard of treatment for sleep apnea in sleep medicine.
While CPAP can take some getting use to, most patients who persist past 4 months, adapt to using CPAP; many finding themselves enjoying treatment and not wanting to sleep without their CPAP.
Working towards CPAP compliance can take some time. Finding the right mask is by far the most important aspect of this.
You should work closely with your sleep technician, sleep therapist, sleep scientist or sleep doctor to overcome any hurdles during your CPAP journey.
There are many manufacturers of CPAP devices and masks, many sleep professionals will have a preference for one brand of machine or a few different models of masks- this is typically due to different experiences with the devices and masks, as well as an overall experience for the majority of their patients.
For the most part, all CPAP machines are quite comparable. CPAP masks are more of an individual fit. Everyone has a different shaped face, different sleep positions and skin types. So there is no "best mask", most patients will need to trial at least 2-3 different masks to find the one that is most suitable for them.
CPAP masks come in three main types:
Full Face masks cover the nose and the mouth, with headgear that covers a large part of the back of your head.
Nasal masks cover just the nose, with headgear that typically covers a significant part of the back of your head.
Pillow masks sit inside or on your nostrils only, with minimal headgear.
These masks all retail for around $270-300 each. This price is typically on top of the price of the device.
There is also a hybrid nasal/pillow mask called a cradle mask. This is available from two brands, Dreamwear (which is made by Phillips) and the N30i (made by ResMed). Nasal Cradle masks sit under the nose, cupping it and these mask have the hose at the rear of the head rather than coming from the front of your face.
Both DreamWear and the N30i are now also available is a pillow style, with prongs that sit inside the nostril, as well as a full face version, which also has a section covering the mouth.
There are a few specialised CPAP masks that fall outside these types, please discuss these with your sleep professional.
CPAP devices have come a long way in recent years. There are now several different types of machines, most of which are available through many manufacturers. All of the types of devices are often referred to as simply CPAP and will have comfort features like exhalation relief (reducing the pressure while your breathe out making the sensation of treatment less intense), Humidification (ensuring the additional air intake through CPAP does not dry out your airways), Automatic Start/Stop (the unit can start/stop simply by putting your mask on or taking it off) and Ramp (the pressure starts off low and works its way up to your prescribed pressure over a period of time).
CPAP devices typically have a life span of approximately 5-10 years. Most retailers provide a 2 year warranty, with the option to purchase an extended warranty (for a total warranty period of 5 years), extended warranties typically retail for about $150.
CPAP- CPAP is the original type of positive airway pressure (PAP) device. It supplies a fixed pressure of air, that is set by prescription. Your prescribed pressure can be found by a titration study (with a overnight sleep study while using a CPAP in a hospital), a titration trial (where you take a cpap device home, and the pressure is changed every few days until you find the lowest pressure that treats your apnea events), or most commonly, an Automatic PAP trial (APAP).
CPAP devices retail for about $1600.
APAP- Automatic Positive Airway Pressure is an automatic type of device, which will give you the lowest pressure you need to keep your airways open throughout the night. This pressure will increase if an obstruction occurs and then return down to the level needed to keep your airways open throughout the night. This type of device is typically about $900 more expensive than a CPAP device but is often better tolerated as the pressure is not as high as for a fixed pressure device.
When using an APAP device, the device will tell you what level of pressure you are at or below 90% of the time to manage your condition- this 90% pressure is the pressure we typically use when switching you from APAP to CPAP during an APAP trial.
Most patients will do a four week trial for CPAP, two weeks on APAP, then two weeks on fixed CPAP. This gives you the opportunity to see if the APAP setting is worth the extra financial investment for you.
APAP devices also have a CPAP setting and retail for about $2500.
VPAP/BiPAP- Variable positive airway pressure and Bi level positive airway pressure devices are effectively the same type of device- the names are just different between manufacturers. These are specialised devices that have a higher top pressure than typical CPAP and APAP devices but their defining feature is the ability to set two pressures, one for inhalation and another for exhalation. These varying pressures support respiration when the body is unable to do so properly or when the signalling for respiration gets delayed. Some devices work on a timed algorithm, others are user initiated changes in pressure and some devices are a combination of both. These devices are required to treat Central or Mixed Apnea.
The prices of these devices vary widely, your respiratory or sleep physician should discuss this with you.