CPAP and BiPAP

Continuous positive airway pressure (CPAP) is the most common treatment for obstructive sleep apnea. In obstructive sleep apnea (OSA), the back of your throat relaxes so much while you sleep that it narrows your airway or even blocks it completely. When this happens, your breathing stops or is very shallow for a few seconds or longer.

Continuous [kuhn-TIN-yoo-us] positive airway pressure (CPAP) is the most common treatment for obstructive [uhb-STRUKT-iv] sleep apnea [AP-nee-ah], or OPA. This disorder causes the back of your throat to relax so much while you sleep that it narrows your airway or even blocks it completely. When this happens, your breathing stops or is very shallow for a few seconds or longer. 

These pauses in breathing can happen frequently—up to 30 times or more each hour. The air that makes it through your airway causes snoring, often so loud that it disturbs your bed partner. OSA is a serious health disorder that increases the risk of high blood pressure, heart rhythm problems, heart disease, strokes, and impotence. It also robs you of deep sleep, so you struggle to stay awake during the day. 

CPAP solves this problem by sending a continuous flow of air into your nose as you sleep, creating air pressure that keeps your airway open. For most people, CPAP is an effective treatment for their OSA. Patients using CPAP often report feeling much better and having more energy. 

A bi-level positive airway pressure machine (BiPAP) is very similar to a CPAP machine, with one small difference. Instead of providing the continuous air flow pressure of a CPAP machine, it has a timer that lowers or stops the pressure to allow you to breathe out without exhaling against the air flow. Although CPAP machines are more common, a BiPAP machine is very useful for patients that have a pressure sensitivity. 

CPAP and BiPAP therapy is safe. Any complications can usually be addressed with minor adjustments. Complications may include:

• Skin irritation, if the mask doesn’t fit right or rubs your face
• Sores, if the mask doesn’t fit right or rubs your face
• Eye irritation, if the mask doesn’t fit right causing  air leaks
• Nasal congestion

The potential benefits of CPAP and BiPAP therapy include:

• Reduced risk of several serious health conditions, such as heart disease, stroke and diabetes.
• Better concentration
• Less daytime drowsiness
• Better mood
• Fewer symptoms of depression
• Less snoring

Before you begin CPAP or BiPAP therapy, your physician will help you determine your need for a CPAP or BiPAP device. You may need to be tested in a sleep lab with an overnight sleep test to determine if you have obstructive sleep apnea. While you sleep, the technician may adjust the airflow so it is just right for you—enough to keep your airway open without being too strong. This can happen in the sleep lab test, or in a separate session. 

Make sure you talk to your doctor about what to expect from CPAP or BiPAP therapy, and make sure you ask any questions you might have.

If your doctor prescribes CPAP or BiPAP, you will meet with a home medical equipment (HME) provider. They will help you get a good fit with your new equipment and CPAP mask and answer your questions about using it. Here are some tips: 

• Tell your HME provider whether you sleep on your back, side, or stomach. The HME provider can help you choose the right supplies to make it easier for you to sleep comfortably. 
• Be sure to ask questions about how to adjust the mask and tubing, how to use the features of the equipment, and any other questions you think of. The more you know, the more comfortable you will be as you start the new therapy.
• Make sure you get a good seal between your face and the mask. It’s important to make sure the pressurized air doesn’t leak out of the mask. If it does, it can irritate your eyes.

Once you begin using CPAP or BiPAP therapy every time you sleep, you will probably notice your mood and energy levels are better. At first you might not always get as much sleep as you get used to the mask and air flow. But remember—the quality of your sleep will be much better.  

Of course, as with any change in your life, it can take some time to adjust to CPAP/BiPAP treatment. As your treatment continues, you should begin to feel more rested.

Follow-up with your doctor or medical equipment provider will be based on questions you may have and/or adjustments that need to be made to your equipment.

There will also be some basic maintenance that you will need to perform to keep your machine working right.

Equipment Maintenance

• Every day: Use a damp, soapy cloth to clean the mask seal. 
• Every week: Empty the humidifier chamber and wash it with warm, soapy water. You may soak the chamber with a solution of 1 part vinegar to 3 parts water for 30 minutes—rinse thoroughly. (Do NOT use cleaning chemicals or bleach.) 
• Clean the hose by soaking it in warm, soapy water for 30 minutes. Rinse it thoroughly and hang it to dry. 
• Check the filter to see if it looks dirty. If a filter is blocked, call for a replacement. 

Replacement Timeframes

Manufacturers recommend you replace your supplies as follows: 

• Nasal pillow or mask cushion: monthly
• Air filter: every  1 to3 months
• Mask tubing: every 3 to 6 months
• Headgear, chinstrap, and water chamber: every 6-12 months

Make sure to talk to your insurance provider about how often you may need to get supplies for your CPAP or BiPAP machine. Most insurance providers will allow a replacement of a CPAP or BiPAP machine every 5 years.

Sleep Association