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By: Kevin Asp, CRT, RPSGT on September 14th, 2017

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What is PAP Therapy?

Sleep Disorders

PAP therapy, or positive airway pressure therapy, is a general term that health professionals apply to all sleep apnea treatments that provide patients with a stream of compressed air while they sleep to support their airway. Your patient wears a mask while sleeping with PAP therapy. The device then blows pressurized air from the room into the patient's upper airway through the mask with a connected tube.


How Does PAP Therapy Work?

PAP therapy helps keep your sleep apnea patients' airway open and prevents it from collapsing while they sleep, enabling them to breathe normally. For maximum results, your patients should use the PAP device each time they sleep, including naps.

PAP therapy, overall, is an effective and safe treatment, but you should make your patients aware of a few contraindications, such as pneumothorax, bullous lung disease, severe epistaxis (nosebleeds), or cerebrospinal fluid leak.

What PAP Options are Available to Patients? 

There are several different PAP devices on the market, and some are better suited to treat a patient's sleep apnea symptoms than others. To manage your patient's sleep apnea or other sleep condition efficiently, selecting the proper treatment is extremely important.


CPAP (continuous positive airway pressure) is a form of PAP therapy where the machine delivers a steady level of airway pressure determined by the physician through a CPAP mask.

This type of therapy is best suited for those with Obstructive Sleep Apnea (OSA), as the continuous pressure ensures their airways are kept open throughout the night. The more severe a patient's OSA is, the higher pressure is required in order to avoid obstruction during sleep.

CPAP therapy is one of the most common types of sleep apnea treatment on the market today due to their proven effectiveness in treating mild to moderate OSA symptoms. It is also less expensive than alternative PAP treatments, so more insurance providers cover CPAP devices than the more expensive options.


BiPAP™ (Bilevel positive airway pressure) therapy functions similar to a CPAP machine, but with one key difference. This machine utilizes dual pressures: an inhalation pressure (IPAP) and a exhalation pressure (EPAP), which is a lower pressure to match the patient's breathing pattern. These pressures auto-adjust so the user is able to maintain a steady rhythm.

BiPAP devices are better suited for patients with Central Sleep Apnea (CSA). It is also recommended for patients that were previously using a CPAP machine but were unable to tolerate the single continuous pressure settings.


Automatic Positive Airway Pressure (APAP) is one of the three primary types of PAP that delivers air to your sleep apnea patient's airway, helping them breathe while they sleep. Similar to other PAP devices, the APAP device connects to a mask that's connected to a pressure generator.

However, with an APAP device, there are two settings: a high-pressure setting and a low-pressure setting. These settings allow the device to adjust itself automatically to meet the breathing needs of your patients that could change when they're changing sleep positions, or moving in and out of different sleep stages.

APAP Therapy is best suited for those who frequently change their breathing patterns as they sleep, and require different pressure levels throughout the night. It is also recommended for those who have seasonal allergies, as APAP machines can adjust for any added pressure needed due to congestion.

Patients who are gaining or losing weight can also benefit from APAP therapy. If they change their lifestyle and end up losing a lot of weight, they will have less throat fatty tissues that could cause blockage and they likely wouldn't require as high of pressure as they had before. Instead of having to give your patient a new CPAP titration study in order to determine their needed pressure settings, an APAP machine can simply adjust and change pressures with their new needs.

Why is PAP Adherence so Difficult, and What Can I Do About It?

Even though PAP therapy usage is widespread, around 46 to 83 percent of OSA patients are noncompliant with treatment (they don't meet the four or more hour night time use requirement). Because of this, sleep technologists seek tips to improve their patients' adherence rates.

To help with adherence rates, you can download a free essential guide which includes:

  • Educating yourself how to monitor PAP adherence better.
  • Increasing rates of PAP adherence within your clinic or sleep center.
  • Training yourself and employees on how to become a PAP adherence rates leader.

Sleep apnea has many therapies and treatments with PAP therapy included. Therefore, it's essential that you know all the facts before you suggest PAP therapy to your patients.


About Kevin Asp, CRT, RPSGT

Because of the implementation of his best practices of Implementing Inbound Marketing in its Medical Practice, he turned the once stagnant online presence of Alaska Sleep Clinic to that of "The Most Trafficked Sleep Center Website in the World" in just 18 months time. He is the President and CEO of inboundMed and enjoys helping sleep centers across the globe grow their business through his unique vision and experience of over 27 years in sleep medicine.

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