CPAP is first-line treatment for obstructive sleep apnea. It is a prescription medical device: get tested first, then mask fit and nightly use decide whether it works.
CPAP (continuous positive airway pressure) blows air through a mask at a set pressure that holds your throat open during sleep. Auto-adjusting machines vary the pressure within a prescribed range; bilevel machines use separate pressures for breathing in and out, for people who need higher pressures or have other breathing problems. Heated humidifiers and heated tubing reduce dryness and congestion. Masks come as nasal pillows (small cushions at the nostrils), nasal masks, and full-face masks for mouth breathers. This shelf also includes travel machines, CPAP pillows and cleaners.
Obstructive sleep apnea is common and often missed. Warning signs: loud, regular snoring; breathing pauses, choking or gasping that someone notices; daytime sleepiness or dozing while driving; morning headaches; waking to pass urine; and high blood pressure that's hard to control. Diagnosis needs a sleep study, often done at home, and in the US the machine and mask need a prescription.
PAP removes most breathing events, and randomized trials show it reduces daytime sleepiness and improves quality of life and mood; the American Academy of Sleep Medicine strongly recommends it for adults with obstructive sleep apnea and excessive sleepiness. It lowers blood pressure modestly (about 2-3 mmHg on average, more with more hours of use). In the large SAVE trial it didn't prevent heart attacks or strokes in people with existing heart disease, but average use was only 3.3 hours a night, and pooled data link 4+ hours a night with fewer repeat events.
Strongly recommends PAP for adults with obstructive sleep apnea and excessive sleepiness, suggests it for impaired quality of life and comorbid hypertension, and requires diagnosis by objective testing plus follow-up of usage data.
2,717 adults with moderate-to-severe sleep apnea and heart or brain vascular disease. With average use of 3.3 hours a night, CPAP did not reduce cardiovascular events over 3.7 years, but it reduced snoring and sleepiness and improved quality of life and mood.
51 trials (4,888 patients). CPAP lowered blood pressure by about 2.5/2.0 mmHg versus inactive control, with about 1.5 mmHg more systolic reduction per extra hour of nightly use; oral appliances gave similar reductions.
4,186 people with heart disease and sleep apnea from three RCTs. Overall CPAP did not change recurrent cardiovascular events (HR 1.01), but in an on-treatment analysis good adherence (4+ hours a night) was linked with lower risk (HR 0.69).