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CPAP - Continuous Positive Airway Pressure

The most commonly prescribed method of treatment for obstructive sleep apnea is continuous positive airway pressure or CPAP. A CPAP machine delivers air pressure of adjustable intensity through a nasal mask worn during sleep.

Nasal CPAP is a well-established treatment that some people adapt to quickly; however, new research shows a failure rate of 46-83% for CPAP. 1

There are 3 types of CPAP devices:

  1. Standard CPAP - Standard CPAP delivers a fixed pressure of room air. The air pressure forms a "splint" preventing the airway from collapsing during sleep. The pressure used is determined during a CPAP titration study.
  2. Bi-level CPAP - Bi-level devices use two different pressures to support the airway - a stronger pressure is delivered during inhalation and a lower pressure is used during exhalation. The change in pressure is determined by the patient's breathing pattern.
  3. Smart CPAP - Smart PAP machines automatically adjust the pressure in response to a patient's needs throughout the night.


Possible Side effects of CPAP treatment include: 4

  • Nasal Congestion
  • Conjunctivitis
  • Sinus Involvement
  • Skin Irritation
  • Gastric Distension - bloating
  • Allergic Reaction
  • Nasal Bleeding
  • Claustrophobia
  • Hearing Loss 3


Residual sleep apnea s common in moderate to severa OSA and is associated with worse outcomes. 2


1. Weaver, Grunstein. Adherence to CPAP. Proc Am Thorac Soc Vol. 5 2008

2. Mulgrew, Ayas, Ryan. Sleep Med 2010

3. McCormick, Worley. The Oehsner Journal 2016

4. Virk, Kotecha. J. Thoracic Disease 2016