Continuous positive airway pressure (CPAP) is a well-established therapy used to treat various diseases that disrupt sleep. Since 1981 when CPAP therapy was created, CPAP machines have allowed patients to sleep easier and avoid a host of potential complications related to untreated obstructive sleep apnea.
In this blog post, we will define CPAP, discuss who needs to use CPAP, cover some of the basics of using a CPAP machine, and much more. If you have recently been diagnosed with obstructive sleep apnea, or know someone who has, this beginner’s guide is an excellent introduction into CPAP as a treatment option and how CPAP machines work.
First, let’s start by defining CPAP and explore who can benefit from it.
What is CPAP?
According to WebMD, a CPAP machine "blows air with continuous pressure down your throat at night to keep your airways open while you sleep". The pressure from a CPAP machine comes via a small air compressor that pressurizes ambient air. Once the machine has enough pressure built up, it releases the air through a face mask to enter your airway and stent your throat open during sleep.
An easy way to think about CPAP is like this: imagine an empty plastic straw. If the plastic straw is kinked, it is collapsed, so air can no longer flow through it. However, imagine you reinforced this plastic straw by lining the inside of it with a metal stent. The stent would support the plastic straw internally and prevent it from kinking.
In untreated obstructive sleep apnea (which we will discuss below), the airway is more like the empty plastic straw. For various reasons, the airway is more likely to collapse (or kink), thus preventing airflow from the mouth to the lungs. When this happens, effective breathing ceases, and mild suffocation occurs. This process deprives the body of oxygen, which can affect multiple organs.
With CPAP, the airway is more like the straw with the metal stent. The constant flow of air used in CPAP therapy increases the pressure inside the airway, which effectively stents the airway open to prevent collapse. When this occurs, normal breathing resumes and the complications of obstructive sleep apnea are avoided.
Does everyone need to wear CPAP? The short answer is no, but let’s discuss who can benefit from it.
Who Needs to Use a CPAP Machine?
CPAP can be used in both emergent and non-emergent scenarios. In the hospital, patients with congestive heart failure might experience fluid overload in the lungs, which makes it difficult to breathe. In this emergent scenario, CPAP creates enough pressure in the lungs to counterbalance the fluid buildup in the lungs and ultimately improve breathing.
However, in most cases, CPAP is used in non-emergent scenarios for patients with obstructive sleep apnea. In obstructive sleep apnea, the airways are pliable due to obesity or anatomical factors such as a recessed chin. During sleep, the throat muscles become relaxed, so if there is much adipose tissue around the neck or a recessed chin, the throat muscles can collapse under these conditions and cause airway obstruction.
There is another type of sleep apnea called central sleep apnea. Patients diagnosed—strictly speaking—with central sleep apnea are generally not candidates for CPAP because the problem stems from a faulty neural signal pathway, so the signal to breathe is affected. A CPAP machine does not influence brain signals to breathe. Central sleep apnea is serious and is more likely to be treated via a mechanical ventilator with a tracheostomy (putting an artificial airway directly into the neck). That said, some patients experience a mix of central and obstructive sleep apnea, so a CPAP machine might still be indicated based on your doctor’s recommendation.
What About Bilevel (or BIPAP) Machines?
Bilevel (or BIPAP) machines extend the benefit of a CPAP machine by adding large breaths on top of stable airway pressure. Some diseases (like COPD, asthma, pneumonia, or obesity hypoventilation syndrome) are characterized by shallow breathing at night. Even in the absence of airway obstruction, prolonged shallow breathing can become a life-threatening condition if left untreated. Bilevel machines create two levels of pressure (high and low) to support bigger breaths.
That said, Bilevel is a different type of therapy compared to CPAP, so the remainder of this article will stay focused on CPAP.
Benefits of Using a CPAP Machine
Using a CPAP machine can vastly improve your quality of life if you have obstructive sleep apnea. Some of the benefits of using CPAP include:
- Stroke and heart failure prevention
- Lower blood pressure
- Increased mental clarity and concentration during the day
- Reduction or elimination of morning headaches
While reduced headaches and increased mental clarity are great benefits by themselves, the more important benefits are the stroke and heart failure prevention.
If you have been diagnosed with obstructive sleep apnea and need to purchase a machine, here are some of the items you will need:
CPAP Machine: CPAP machines come in 2 varieties: fixed and auto-titrating. Fixed CPAP machines are locked into one pressure level setting that doesn’t change. Auto-titrating CPAP machines adjust the pressure settings based on your specific breathing pattern. Both devices will increase the pressure in your airways to prevent collapse, but the auto-titrating devices are generally more comfortable and can easily adjust to changes in your breathing pattern.
CPAP Masks: CPAP masks come in 3 main varieties: full-face masks, nasal masks, and nasal pillows.
Full Face CPAP Masks
Full-face masks cover the nose and mouth, which is an excellent option if you tend to breathe through your mouth at night.
Nasal CPAP Masks
Nasal CPAP masks only cover your nose, which is an excellent option if you get claustrophobic.
Nasal Pillow Masks
Nasal pillows are a popular choice because they don’t cover your entire nose, they merely sit under your nose like pillows.
Humidification: Some patients experience dry nose and mouth from the constant rush of air. Fortunately, there are many heated humidifiers available to add moisture to the air. When we usually breathe, our nose warms and moisturizes the air, so by the time it enters our lungs, the air matches the warmth and moisture levels of your body.
A heated humidifier effectively acts as a nose during CPAP. Typically, with the constant stream of dry air, your nose will not be able to keep up and sufficiently humidify the air. However, with a heated humidifier, the air is artificially warmed and moisturized with sterile water to bring it closer to your body temperature before entering your airways.
CPAP machines are the first-line treatment option for obstructive sleep apnea. While CPAP therapy takes some getting used to, CPAP machines are life-saving devices that, when used regularly, can prevent a host of diseases and conditions.
If you’ve been diagnosed with obstructive sleep apnea and need to find a CPAP machine for home use, we offer several CPAP machines here on our website and also have many other supplies such as masks and humidifiers. If you have a new prescription and would like to discuss your options, feel free to contact us by phone or email.
Related Respiratory Information
Updated: January 11, 2019
- WebMD. What is CPAP for sleep apnea?https://www.webmd.com/sleep-disorders/sleep-apnea/qa/what-is-cpap-for-sleep-apnea
- Very Well Health. How Does a CPAP Machine Work to Treat Sleep Apnea?https://www.webmd.com/sleep-disorders/sleep-apnea/qa/what-is-cpap-for-sleep-apnea
- Wilkins, R., Stoller, J., & Kacmarek, R. (2009). Fundamentals of Respiratory Care. St. Louis, MO: Mosby Elsevier. https://www.amazon.com/Egans-Fundamentals-Respiratory-Care–11e/dp/0323341365
- Healthline. Nose. https://www.healthline.com/human-body-maps/nose#1 https://www.healthline.com/human-body-maps/nose#1