A sleep apnea machine is one of the most common devices used to treat sleep apnea. It sends a steady flow of air pressure through a mask that covers your nose and mouth while you sleep.
A CPAP device is a medical device, and you must have a prescription to receive one. Your doctor may recommend different types of machines, depending on your needs.
CPAP
CPAP machines deliver constant, positive air pressure to the throat and mouth to keep the breathing passages open while you sleep. A mask sits over your nose or mouth and has straps to secure it in place during sleep. Tubing connects the mask to a machine that generates air pressure based on settings prescribed by your doctor.
Getting used to a CPAP machine may take time, and you might experience discomfort at first, such as a dry mouth or leaking mask. Your sleep specialist will help you find a comfortable mask and make adjustments as needed.
Using a CPAP machine consistently has many short- and long-term benefits, including better quality of life, reduced health problems and improved work performance. CPAP is also often the initial treatment recommended for people with obstructive sleep apnea. Your sleep team might recommend other types of treatments, such as weight loss, oral appliances or surgery for certain causes of sleep apnea (such as soft tissue removal or hypoglossal nerve stimulation). Depending on your condition and history, you might need multiple treatment strategies to control sleep apnea.
APAP
Autotitrating positive airway pressure machines change pressure throughout the night, based on your breathing patterns. The device delivers pressurized room air through a tube to a mask that covers your nose, mouth or both.
The machine has advanced sensors that detect episodes of obstructive sleep apnea and other breathing irregularities. If the sensors detect an increase in resistance, software allows the machine to raise the pressure setting until breathing returns to normal. When the device senses that the obstructive or central apnea is over, it lowers the pressure again.
Like CPAP, APAP can help reduce snoring and improve overall health. It’s important to consult with a sleep specialist first, though, to get the right prescription for your needs. Your provider can perform a home sleep study or a sleep clinic test to diagnose your sleep apnea and determine the ideal pressure range.
EPAP
For patients who are unable to tolerate the continuous pressure of a CPAP machine, EPAP (expiratory positive airway pressure) can provide an alternative treatment. This therapy uses negative pressure generated by the patient during exhalation to reposition the upper airway and reduce snoring, apneas, and nocturnal oxygen desaturations. It also appears to decrease the length of apnea events.
In a study, nasal EPAP at 10 cm H2O significantly reduced apneas, snoring, and nocturnal oxygen desaturations. Patients reported less snoring, and they also slept more soundly.
However, EPAP device use can be difficult for many patients, and adherence to this therapy is often poor. Furthermore, adherence in sleep studies is measured by diaries, which may lead to overestimation of true adherence. It is important to remember that even when a sleep apnea machine is used regularly, a comorbid medical condition or a change in lifestyle can negatively impact outcomes. Talk with your doctor about the best option for you.
BiPAP
A bilevel positive airway pressure machine, or BPAP, provides two levels of pressure: a higher level during inhalation and a lower level during exhalation. This dual-level approach reduces the strain on weakened respiratory muscles, making breathing more comfortable and natural.
A BPAP machine can be prescribed for people who have obstructive sleep apnea, COPD and certain chronic conditions that affect breathing like obesity-hypoventilation syndrome or neuromuscular diseases such as muscular dystrophy. Unlike a CPAP, a BPAP doesn’t deliver a constant airway pressure and may not be effective for people who have central sleep apnea.
If you have obstructive sleep apnea, your physician will determine if a CPAP or a BPAP machine is right for you. Your doctor can also explain any other treatment options available for your condition, including the non-invasive ventilation (NIV) mode of a ventilator. This is typically recommended for people who need more than a CPAP machine can provide, and may help to relieve symptoms of ALS.