Treatment of Obstructive Sleep Apnea (OSA)

What is Positive Airway Pressure (PAP) Therapy?

Positive Airway Pressure or PAP therapy is the most common and effective therapy prescribed for OSA. Universally considered the gold standard by medical professionals, it can be used to treat people with all levels of OSA—from mild to severe. Unlike risky surgical options, PAP therapy begins working immediately and eliminates sleep apnea when used correctly. There are a number of different forms of PAP therapy but all work by keeping the airway open during the night using a PAP machine.

A PAP machine is an electronic medical device, small enough and quiet enough to sit on your night stand. It takes air from your room, lightly pressurizes it, and delivers it through a flexible tube to a mask you wear on your face while you sleep. This stream of air prevents your airway from closing, so you don’t stop breathing and wake up during the night.

It is crucial that the mask fit and form a seal in order to keep your throat open. A good mask seal will prevent air leaks and maintain the right level of air pressure. The amount of air pressure needed is different for everyone and will be determined by Dr. Weintraub and the sleep technologists from Sleep Well Centers.

PAP Therapy Delivery and Interface Options

Positive Airway Delivery Options

There are several different types of PAP therapy delivery options. Dr. Weintraub and the Sleep Well Centers staff will be able to direct you to the option that best meets your individual needs.

Continuous (CPAP)

CPAP delivers a steady, fixed level of air pressure throughout the night. A sleep study may be necessary to determine the pressure level.

Bi-level (BPAP)

BPAP devices have two levels of pressure: a higher level when you breathe in and  a lower level when you breathe out.
If you have a problem with CPAP, Sleep Well Centers may recommend you try BPAP. It is also recommended when you have OSA along with another breathing disorder as it lessens the amount of effort it takes to breathe during exhalation.

Positive Airway Delivery Interfaces

Your mask is the most important part of PAP therapy—take time to choose the mask that is most comfortable for you. PAP masks are triangular in shape, with a plastic body and a soft silicone seal that touches the face. There are several different types of masks available:

Nasal Mask

This mask only covers your nose and is the most common PAP mask.

Full Face Mask

This mask covers both your nose and your mouth. This type of mask may help if you experience air leaks or have difficulty breathing through your nose.

Nasal Pillows

This mask uses small soft silicone pillows that rest against your nostrils. Using nasal pillows may help if you have air leaks, facial hair, or don’t like the feeling of a mask over your nose or face.
Remember, if your mask has to be pulled tightly to prevent leaks, it is not a good fit. A properly fitted mask should not cause pain or sores on your face! Proper mask fit is essential to CPAP compliance. Sleep Well Center staff will assist you in finding a comfortable mask.

Non-PAP Treatment for Sleep Apnea

In addition to PAP therapy, these lifestyle changes may also help you improve or eliminate OSA:

  • Losing weight if you are overweight
  • Quitting smoking—smoke is a mouth and throat irritant that may make your OSA worse
  • Avoiding alcohol and sedatives (sleeping pills, anxiety and pain medications) that can make your OSA worse
  • Back sleeper? Try sleeping on your side or stomach instead
Although PAP therapy is the gold standard for effective treatment of OSA, some patients may be candidates for alternative therapies such as surgery or dental appliance options.  Talk to your doctor to see if there are alternative treatment options for your specific diagnosis.

Getting Comfortable with PAP Therapy

Some people love their therapy from the first night while others find it takes time to acclimate to their PAP therapy. Dr. Weintraub, your equipment supplier and support groups of other PAP users are available for help and encouragement. Don’t give up!
Individualized options to improve your PAP experience include:
  • Different accessories, such as masks, special pillows, and humidifiers
  • Different programmable settings on your device, such as ramp mode
  • Different forms of PAP therapy