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Continuous Positive Airway Pressure (CPAP) Therapy

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Continuous positive airway pressure (CPAP) machine is the most commonly prescribed device for treating sleep apnea disorders.

Obstructive sleep apnea (OSA) causes interruptions or pauses in your breathing, often because your throat or airways briefly collapse or something temporarily blocks them.

A CPAP machine sends a steady flow of oxygen into your nose and mouth as you sleep. This keeps your airways open and helps you breathe normally.

Let’s take a closer look at how this machine works, the pros and cons of using one, and other options for sleep apnea.

Continuous Positive Airway Pressure (CPAP) Therapy

A CPAP machine’s compressor (motor) generates a continuous stream of pressurized air that travels through an air filter into a flexible tube. This tube delivers purified air into a mask that’s sealed around your nose or mouth.

As you sleep, the airstream from the CPAP machine pushes against any blockages, opening your airways so your lungs receive plenty of oxygen.

Without anything obstructing this flow of oxygen, your breathing doesn’t pause. As a result, you don’t repeatedly wake up in order to resume breathing.

CPAP devices all have the same basic components:

  • a motor housed in a base unit
  • a cushioned mask
  • a tube that connects the motor to the mask
  • a headgear frame
  • “elbow” pieces that act as joints
  • adjustable straps that allow you to customize the fit of the device

Different mask types

Mask styles can vary with different CPAP machines. Which type you wear depends in part on your breathing habits, how comfortable the mask is for you to wear, and the kind of sleep apnea disorder you have.

The different types of CPAP masks include the following:

  • Nasal pillow mask. This type of mask has a small cushion that caps over your nostril area. It may also have prongs that fit into your nostrils. This mask allows you to wear your glasses easily. It also works well if you have lots of facial hair that may prevent a larger mask from fitting snugly.
  • Nasal mask. This type is a cushioned mask that covers your whole nose area. It may be a better option if you tend to move around in your sleep. It can deliver a high-pressure airstream.
  • Full mask. This type is shaped like a triangle and covers your mouth and nose. Your doctor might prescribe this kind of mask if you breathe through your mouth when you sleep or if you have a blockage of some kind in your nose.

What’s the difference between CPAP, APAP, and BiPAP machines?

Other types of breathing machines include APAP and BiPAP devices. Here’s how they differ:

  • CPAP device. This device is programmed to produce pressurized air at one steady air pressure level. To change the air pressure, you have to reset the device’s settings.
  • APAP (automatic positive airflow pressure) machine. This kind checks your breathing throughout the night. It automatically adjusts the air pressure to compensate for changes in your sleep position or medications that may have changed your breathing.
  • BiPAP (Bi-level positive airflow pressure). This device has two pressure settings, one pressure for inhaling and a lower pressure for exhaling. It’s used for individuals who can’t tolerate CPAP machines or have elevated carbon dioxide levels in their blood. BiPAP devices can also come with a backup respiratory rate for patients who have central sleep apnea. The backup respiratory rate ensures the person breathes, as the main problem with central sleep apnea is initiating breath.

As with many types of treatments, there are benefits and drawbacks associated with the use of a CPAP machine. Here are a few of the known pros and cons.


The benefits of using a CPAP machine are well-documented. These machines deliver a continuous supply of oxygen to your body as you sleep. By doing so, they help prevent the brief breathing interruptions that are the hallmark of sleep apnea.

The benefits tend to increase with longer-term CPAP use.

Pros of using a CPAP machine

  • improves your ability to sleep without waking up
  • lowers your risk of having a heart attack, stroke, or other cardiovascular event
  • helps lower your blood pressure
  • reduces daytime sleepiness
  • may reduce blood glucose and cholesterol levels


Although a CPAP machine can help prevent breathing interruptions when you sleep, there are also drawbacks with this device. Some people stop using CPAP machines due to the side effects.

Cons of using a CPAP machine

  • discomfort and difficulty falling asleep, especially in the beginning
  • a feeling of claustrophobia or anxiety
  • nasal congestion
  • dry mouth
  • nosebleeds
  • skin irritation or sores where the mask touches the face
  • a feeling of being bloated with air

If you’re enrolled in Medicare Part B and you’ve been diagnosed with sleep apnea, Medicare may pay 80 percent of the cost for your CPAP machine, as long as the doctor who prescribes it is an approved Medicare provider.

You’ll have to pay your deductible and 20 percent of the device, whether you are renting or buying it.

If you have a Medicare Part C (Medicare Advantage) plan, you’ll need to check your plan’s guidelines for purchasing or renting durable medical equipment (DME) like CPAP machines.

Without insurance coverage, breathing machines can cost between $500 and $3,000, depending on whether you’re purchasing a CPAP, APAP, or BiPAP device.

Because of their drawbacks, CPAP devices don’t work for every person with sleep apnea.

If you find that a CPAP machine doesn’t work well for you, talk to your healthcare provider about whether one of these treatment options might be an option:

  • Changing sleeping position. Some people only experience sleep apnea when they sleep on their back. Some products help to keep you on your side by preventing you from rolling over. You could also try simply tying a tennis ball to the back of your sleepwear.
  • Oral appliances. Devices like a mouthguard or an orthodontic retainer can help keep your airways open by putting pressure on your tongue.
  • Hypoglossal nerve stimulation. This surgically implanted device delivers precise electric stimuli to the nerves in your airways. This helps improve the muscle tone of your airways which, in turn, helps your airways to remain open.
  • Neural stimulation. If you have certain types of central sleep apnea, a surgically implanted device can deliver impulses through your phrenic nerve (which runs from your neck to your diaphragm) to stimulate your diaphragm. This helps initiate breathing while you’re sleeping.
  • Nutritional and exercise therapies. Obesity is a risk factor for some kinds of sleep apnea. Changing your diet and exercising more often may help you lose weight and reduce the severity of your symptoms.
  • Surgery. Some children have apnea because their tonsils or adenoids are too big. Surgery to remove them can often resolve the apnea. In adults, surgery isn’t always as effective because it can be difficult to pinpoint the location of the blockage that causes sleep apnea. Still, some surgeries — notably uvulopalatopharyngoplasty (UPPP) and modified radiofrequency tissue ablation (MRTA) — have worked for some people.

CPAP machines treat sleep apnea by delivering a stream of oxygenated air into your airways through a mask and a tube. The pressurized air prevents your airways from collapsing, which allows you to breathe continuously while you sleep.

There are several types of CPAP machines. Which one your healthcare provider prescribes for you will depend on the type of sleep apnea you have, how comfortable it is for you to wear, and what breathing and sleeping habits you have.

While a CPAP machine delivers an airstream at one steady pressure, BiPAP and APAP machines change the pressure according to your needs.

CPAP machines are uncomfortable for some people. If a CPAP device doesn’t work well for you, talk to your healthcare provider about other treatment options that may help keep your airways open while you sleep.

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