Positive airway pressure (PAP) therapy is the frontline treatment for obstructive sleep apnea. This form of therapy requires that the patient use the PAP device while sleeping on a regular basis. For patients prescribed PAP therapy, Sleep Centers of Texas provides the various PAP devices and related accessories and supplies such as masks, hoses, and filters at its facilities in San Antonio and Ennis. In addition to the initial equipment, Sleep Centers of Texas also provides on an ongoing basis the replacement supplies needed for long-term use of the PAP device.



 What is a PAP device?

A positive airway pressure (PAP) device is an electrical device, small enough to be placed on a nightstand, that takes in air from the room, lightly pressurizes it, and then directs the pressurized air to the individual through tubing and a mask that fits over the nose or mouth. As the individual sleeps with the face or nasal mask on, the flow of pressurized air keeps the airway passages open and eliminates snoring and pauses in breathing caused by the sleep apnea. With use of the PAP device, breathing becomes regular, snoring stops, the patient is not awakened by lack of oxygen, and restful sleep is restored.

What types of PAP devices are available?

If the PAP device delivers continuous pressurized air, it is referred to as a continuous positive airway pressure (CPAP) device. If the device has two levels, an inspiratory and expiratory level, it is referred to as a bi-level PAP device. Additionally, there are other devices that provide variable positive airway pressure (VPAP) and automatic positive airway pressure (APAP). Some PAP devices also come with humidifiers to prevent your nose and throat from becoming dry while you breathe pressurized air during the night.

 How are the settings determined on the PAP device?

If PAP therapy is prescribed, a follow-up titration polysomnography is performed to determine the optimal settings for use of the PAP device. Initially the physician estimates the correct pressure settings for the PAP device based on results of the diagnostic polysomnography. Then during the second study, the technician adjusts the airway pressure higher or lower from the prescribed setting to find the optimal pressure at which the obstructive apneas and/or hypopneas, oxyhemoglobin desaturation, respiratory effort–related arousals, and snoring in all sleep stages are eliminated.