How Does a CPAP Work and What CPAP Alternatives Help Treat Sleep Apnea?

Sleep apnea, particularly obstructive sleep apnea (OSA), is a serious condition that significantly increases health risks if not addressed. The most effective and common treatment is a continuous positive airway pressure (CPAP) machine. Jill Agan, respiratory therapist with UnityPoint at Home, explains how a CPAP machine works and what other options exist for managing sleep apnea.

What is a CPAP Machine?

In OSA, your airways repeatedly narrow or close while you sleep, causing brief pauses in your breathing and low oxygen levels. Untreated, it significantly raises your risk for conditions like high blood pressure, diabetes, stroke, heart disease, dementia, Alzheimer's and early death.

What Does a CPAP Machine Do?

A CPAP machine delivers a gentle, steady flow of air through a mask you wear over your mouth. The air pressure keeps your airway open, which prevents soft tissues from collapsing, stops snoring and allows you to breathe easily throughout the night.

There are several parts to a CPAP machine:

A mask that fits over just your nose or both your nose and mouth
Straps to hold the mask in place on your face
A tube that connects the mask to the main machine
A motor that gently blows air through the tube
An air filter to ensure the air entering your nose or mouth is always clean

Is it Illegal to Change CPAP Pressure?

While not illegal, it’s not safe to change your CPAP pressure.

“It’s prescribed by a doctor for a reason. Adjusting it without medical guidance can make your sleep apnea worse and might void your machine's warranty,” Agan says.

Is CPAP Rainout Dangerous?

CPAP rainout happens when the warm, moist air from your machine cools as it travels through the hose. This causes water droplets to form and collect in the tubing, sometimes splashing into your mask.

While not dangerous, it can disrupt your sleep. However, since water encourages bacterial growth, keeping your CPAP mask and hose clean is important.

Can You Use Purified Water in a CPAP Machine?

Purified water isn't great for long-term CPAP use, because it still contains trace minerals.

Distilled water is always best. It's pure with all minerals removed. This prevents buildup in your machine. If buildup occurs, the humidifier can stop working properly, leading to less moisture for your nasal passages and congestion.

“If you're in a pinch and don't have distilled water, you can use purified water once or twice. However, consistently using purified water damages your machine over time and impacts your sleep therapy,” Agan says.

BiPAP vs CPAP

While both CPAP and bilevel positive airway pressure (BiPAP) machines treat sleep apnea with pressurized air, they deliver it differently. A CPAP provides a constant, single pressure, keeping your airway open while you breathe. A BiPAP, however, offers two pressures: a higher one for inhaling and lower one for exhaling. This is more comfortable for some people and is also used for other respiratory conditions.

APAP vs CPAP

Instead of the single, fixed air pressure from a CPAP, an automatic positive airway pressure (APAP) machine automatically adjusts pressure throughout the night, responding to your breathing patterns as they change.

Body Changes After CPAP

CPAP therapy offers several benefits, including improved mental health, reduced daytime fatigue, and better blood pressure and cardiovascular health for those with OSA.

“While older studies hinted at weight loss with CPAP use, more recent research suggests weight might actually increase for some people,” Agan says.

“Some theories suggest the body uses more energy with untreated OSA, which decreases when using a CPAP, leading to fewer calories burned. Weight gain might also be more common in people with existing blood sugar regulation issues.”

Long-Term Side Effects of Using a CPAP

While CPAP therapy is effective, some users may experience side effects. These can include:

Dry mouth and throat, along with nasal congestion and irritation
Eye irritation and dryness
Potential impact on blood pressure
Skin irritation and pressure ulcers from the mask
Swelling and stomach discomfort

How to Clean a CPAP

Regularly cleaning your CPAP supplies is important since you use them nightly. Follow these simple steps to keep your parts clean:

CPAP Hose: Hand wash once a week. Clean it in the shower by adding dish soap and water, then gently rock it back and forth. Rinse thoroughly with warm water and hang the hose to dry.
CPAP Mask: Clean your mask's frame, seal and headgear. The mask seal is the most important part; wipe it down daily with lotion and alcohol-free baby wipes or a damp cloth. These wipes also work for the mask frame. Wash your headgear with dish soap and water as needed.
Water Chamber: Hand wash the chamber weekly (where you put distilled water) with dish soap and water. Some models are dishwasher safe.

Can You Die from Not Using Your CPAP Machine?

It's extremely unlikely that a CPAP machine can kill you, and there's no evidence that current, FDA-approved devices cause life-threatening complications outside of rare recall events. The benefits of treating sleep apnea far outweigh any minor risks associated with CPAP use, which typically involve discomfort or easily managed side effects.

However, whether you can die from not using your CPAP machine is a more serious issue. While untreated sleep apnea won't typically lead to immediate death from suffocation, it significantly increases your long-term risk for a range of severe and potentially fatal health conditions. These include high blood pressure, heart attack, stroke, irregular heart rhythms, type 2 diabetes and even early death due to the chronic strain and oxygen deprivation it places on your body.

CPAP Alternatives to Treat Sleep Apnea

For those interested in sleep apnea treatment without a CPAP, several alternatives exist. Options for non-CPAP treatment for sleep apnea range from lifestyle modifications, like targeted weight loss to get off a CPAP and advanced medical devices.

One notable alternative is Inspire, an implanted device. Inspire works for sleep apnea by stimulating a nerve to keep the airway open during sleep. While CPAP remains a primary treatment, exploring these alternatives can help those looking for different ways to manage their condition.

How to Get a CPAP Machine Near You

To find CPAP supplies near you, the process typically starts with a medical diagnosis. A CPAP machine requires a prescription from a doctor or sleep specialist to ensure you receive the correct settings for your specific needs.

Once you have a prescription, you'll find CPAP equipment near you through various channels, including:

Local medical supply stores: These often allow you to try on masks and get personalized fitting assistance.
Online retailers: These offer a wide selection and can be a good option for comparing how much a CPAP machine costs across different brands and models.
Sleep clinics: Some clinics have in-house supplies, making it convenient to get your prescription and equipment in one place.

Many health insurance plans cover a significant portion of the cost, classifying CPAP machines as durable medical equipment. It's always a good idea to check with your insurer about their specific requirements and approved suppliers.

Find a CPAP