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Sleep Apnea & Treatment

The Basics of Obstructive Sleep Apnea

Obstructive Sleep Apnea or OSA is the most commonly diagnosed form of sleep apnea. Obstructive sleep apnea is when the airway completely closes or partially closes during sleep.

When air, rich in oxygen, is blocked from flowing into the lungs the oxygen cannot be transferred into the blood for use all around the body. Carbon dioxide levels begin to increase while the oxygen levels in blood begins to decrease.

The brain reacts to the low levels of oxygen in the blood and alerts the heart to start pumping faster to get more blood delivered. The reaction is brief, only 3-5 seconds but is enough time to interrupt sleep.

When this cycle occurs over and over throughout the night, the body becomes fatigued. Memory can become impaired, daytime sleepiness occurs and a variety of other commonly known symptoms may appear.


Normal airway, airway is open and air moves through, obstructive sleep apea the airway is blocked and air does not move throughGraphic courtesy of Michigan Medicine

What is PAP (Positive Airway Pressure) Therapy

PAP or Positive Airway Pressure is typically the first choice of physicians and providers choosing to treat a patient with sleep apnea.

With use of a PAP machine, room air is pressurized and delivered to the patient through a hose and mask, helping to open and maintain an open airway while sleeping.  By keeping the airway open, air flows as it should to the lungs, oxygen levels stay within normal ranges and the body can rest well while going through the sleep process as it should, without interruptions.  Positive Airway Pressure (PAP) when routinely used can improve mood, energy levels and overall functions of daily living.

CPAP mask diagramHow a CPAP works: a steady stream of air enters to maintain an open airway.

Why is it Important?

PAP (Positive Airway Pressure) therapy works with the body’s airway muscles during sleep. Depending on how severe a person’s obstructive sleep apnea is depends on the amount of help required. For some only a minimum amount of pressure is needed to keep everything open, for others higher pressures may be required to do the same.  In either case, routine use of PAP therapy is an important tool for treating sleep apnea.

If diagnosed and left untreated, obstructive sleep apnea can increase the risk for a variety of other health issues such as Type II diabetes, cardiovascular disease, stroke and difficulty with weight management.

Types of Positive Airway Pressure Therapy

CPAP (Continuous Positive Airway Pressure)

  • Continuous, fixed, single pressure delivered from the machine
  • A sleep technologist monitors the patient and adjusts the pressures until snoring or apneas are no longer seen

APAP (Auto Positive Airway Pressure)

  • Variable pressures delivered from the machine, usually a set range including a minimum pressure setting and a maximum pressure setting
  • The machine monitors and analyzes the patient’s breathing pattern
  • If the machine determines an apnea has occurred the pressure is increased as needed to manage apnea

BiLevel PAP (Dual Pressure Positive Airway Pressure)

  • Two separate pressures are delivered to the patient:
    • A higher pressure for when the patient breathes in (Inspiration)
    • A lower pressure for when the patient breathes out (Expiration)
  • Used for patients who have a difficult time exhaling against a high pressure, a lower set pressure allows for them to breathe out easier