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Physician-led support to help you start CPAP and stay with it.
Medically reviewed by Ravali Reddy Inja, M.D. | Review date: [Pending confirmation]
CPAP therapy is the most widely used treatment for obstructive sleep apnea, but a machine on its own does not guarantee better sleep. At PACT Pulmonology, our pulmonology and sleep medicine physicians help Connecticut patients start CPAP, review the data their machine records, and adjust the plan until therapy fits real life.
Whether you are new to CPAP or close to giving up, we see patients in Orange and Guilford, and no referral is needed.
Request an AppointmentCPAP therapy, short for continuous positive airway pressure, treats obstructive sleep apnea with a small bedside machine that delivers a steady stream of pressurized air through a mask while you sleep. The air works like a splint that keeps your throat from collapsing, preventing breathing pauses, snoring, and oxygen drops that disrupt sleep.
The American Academy of Sleep Medicine recommends positive airway pressure as a treatment for adults with obstructive sleep apnea. CPAP is prescribed after a sleep study confirms your diagnosis and shows how severe it is.
Depending on your health history, that may be an in-lab sleep study or a home sleep test.
Used consistently, CPAP can reduce daytime sleepiness, improve concentration and mood, and lower the strain that untreated sleep apnea places on your heart and blood pressure over time.
A CPAP machine takes in room air, filters it, and pushes it gently through a tube to a mask you wear while you sleep. This steady airflow keeps your throat from closing as your muscles relax at night. Your airway stays open, so you breathe normally until morning.
A CPAP setup has four main parts:
Your physician sets the air pressure based on your sleep study. Some machines use one fixed pressure. Others adjust automatically through the night. Your physician can fine-tune the setting over time.
The machine creates the airflow and usually has a humidifier to prevent dryness. It also tracks how often you use it and how well it is working, so your care team can spot problems early.
A lightweight hose carries air from the machine to your mask. Heated tubing can help prevent moisture from building up inside it.
Most machines also have comfort features, such as a ramp that starts the pressure low and builds slowly as you fall asleep. To learn more, see the American Academy of Sleep Medicine’s guide to CPAP on SleepEducation.org.
CPAP delivers one constant pressure whether you breathe in or out. BiPAP, or bilevel positive airway pressure, delivers two pressures: a higher pressure when you inhale and a lower pressure when you exhale.
CPAP is the standard first treatment for obstructive sleep apnea. BiPAP is usually reserved for people who cannot tolerate CPAP or who have certain lung, heart, or neuromuscular conditions.
Feature
CPAP
BiPAP
Pressure delivery
One continuous pressure for inhaling and exhaling
Two pressures: higher on inhale, lower on exhale
How exhaling feels
Some people feel resistance at higher pressures
Exhaling often feels easier because pressure drops
Primary use
First-line treatment for obstructive sleep apnea
CPAP intolerance, or breathing conditions that need extra support
Common candidates
Most adults newly diagnosed with obstructive sleep apnea
People with COPD and sleep apnea, obesity hypoventilation, neuromuscular conditions, or very high pressure needs
Settings
One pressure, or an auto-adjusting range (APAP)
Separate inhale (IPAP) and exhale (EPAP) pressures
Insurance coverage for sleep apnea
Covered after a sleep study confirms the diagnosis
Medicare generally requires that CPAP be tried and shown ineffective first
Masks and tubing
Same mask styles and tubing
Same mask styles and tubing
Because PACT is a pulmonology-led practice, we look at the whole picture. If you live with COPD, asthma, or interstitial lung disease, we evaluate how that condition affects which device and settings are right for you.
1
We review your symptoms and health history and coordinate the right sleep study. If you already have a diagnosis from another provider, we review your results and pick up from there.
2
Your physician prescribes CPAP with pressure settings matched to your results. Your prescription goes to a durable medical equipment (DME) supplier covered by your insurance, which provides your machine, mask, and supplies.
3
We help you find a mask style and size that suits your face shape, sleep position, and breathing habits, and show you how to adjust the headgear for a good seal without overtightening.
4
We review the usage, leak, and breathing event data your machine records. If the numbers show a problem, we address it right away instead of waiting for your next visit.
5
Based on your data and how you feel, we may adjust your pressure, humidity, or mask. You will have a follow-up visit within your first three months, then ongoing check-ins to keep therapy on track. You can also message your care team through MyChartPLUS.
Medicare and many private insurers treat your first 90 days on CPAP as a trial period. To keep coverage, you generally need to use CPAP at least four hours a night on 70% of nights during a consecutive 30-day period within the first three months, and have a follow-up visit between day 31 and day 91 that shows your symptoms are improving.
This is why we track your data early. Problems get solved in week two, not discovered on day 89.
Side Effect
What May Help
Dry mouth or throat
Increase heated humidification, add a chin strap, or switch to a full-face mask if you breathe through your mouth.
Stuffy or runny nose, nosebleeds
Adjust humidity, use heated tubing, try saline spray, or ask your physician about treating nasal congestion.
Mask leaks
Refit or resize the mask, replace worn cushions, or try a different style. Overtightening often makes leaks worse.
Red marks or skin irritation
Loosen the straps slightly, try mask liners, or switch to nasal pillows to take pressure off the bridge of your nose.
Bloating or burping (swallowed air)
Your physician may lower or fine-tune the pressure, or consider an auto-adjusting or bilevel device.
Feeling closed in or claustrophobic
Practice wearing the mask while awake, use the ramp feature, or try a minimal nasal pillow mask.
Trouble breathing out against the air
Turn on exhalation pressure relief, use the ramp, or ask about a pressure review or BiPAP evaluation.
Dry or irritated eyes
Usually caused by air leaking near the top of the mask. A refit or different size typically solves it.
Keeping equipment clean also prevents irritation. Wash your mask, tubing, and water chamber with mild soap and water, use distilled water in the humidifier, and replace cushions and filters on the schedule your supplier provides.
If CPAP still isn’t working after adjustments, you have other options.
First, we look at why CPAP isn’t working. Often, a new mask, a pressure change, or a BiPAP trial solves the problem. If not, we discuss these alternatives:
01
A custom mouthpiece made by a dentist moves your lower jaw slightly forward to keep your airway open. It works best for mild to moderate sleep apnea. Learn more about oral appliance therapy.
02
If your sleep apnea happens mainly when you’re on your back, a positioning device that keeps you on your side may help.
03
Losing weight can reduce sleep apnea severity. Options include nutrition support and prescription medication. PACT can connect you with our weight management program.
04
A small implanted device stimulates the nerve that controls your tongue, keeping your airway open during sleep. It’s an option for some adults with moderate to severe sleep apnea who can’t use CPAP. If you may qualify, we refer you to a specialist.
Learn more in our overview of sleep apnea treatment.
Plenty of practices can write a CPAP prescription. PACT Pulmonology focuses on what happens after, so you get the sleep you were promised.
We review your machine data, adjust your settings, and stay involved through your first months and beyond.
COPD, asthma, and other lung diseases can change which device and settings you need.
Dr. Ravali Reddy Inja specializes in sleep medicine and pulmonology and cares for patients with sleep disorders and chronic breathing concerns.
We evaluate BiPAP, oral appliances, positional therapy, weight-related treatment, and nerve stimulation referrals so you are never stuck.
As part of Physicians Alliance of Connecticut, we can coordinate with primary care, endocrinology, and other specialists under one network.
Offices in Orange and Guilford, no referral needed, and secure messaging through MyChartPLUS.
CPAP works by sending a steady stream of pressurized air from a bedside machine, through a tube, into a mask you wear while you sleep. That gentle pressure keeps the soft tissues in your throat from collapsing, so your airway stays open and you can breathe normally all night. Your physician sets the pressure based on your sleep study results and fine-tunes it using data your machine records.
Many people adjust to CPAP within a few weeks, though some need a month or more. Wearing the mask for short periods while awake, using the ramp feature, and using CPAP every night all help. If you are still struggling after the first couple of weeks, do not wait it out. A mask change or pressure adjustment often makes the difference, and early fixes protect your insurance coverage.
CPAP delivers one constant air pressure while you breathe in and out. BiPAP delivers two pressures: higher when you inhale and lower when you exhale, which can make breathing out easier.
CPAP is the standard first treatment for obstructive sleep apnea. BiPAP is typically used when CPAP pressure is hard to tolerate or when a condition such as COPD or obesity hypoventilation affects your breathing.
If you cannot tolerate CPAP, start by talking with your physician, since most problems can be solved with adjustments. If CPAP still does not work, alternatives may include an oral appliance, positional therapy, weight-related treatment, BiPAP, or a referral for hypoglossal nerve stimulation if you qualify. At PACT, we review these options with you so you don’t end up without treatment.
Medicare and most private insurers cover CPAP therapy when a sleep study confirms obstructive sleep apnea. Many plans require proof that you are using the machine, often at least four hours a night on 70% of nights during a 30-day stretch within the first 90 days, plus a follow-up visit with your physician. Coverage details vary, so check your plan and ask our team for help.
Yes. A sleep study is needed to diagnose obstructive sleep apnea, measure its severity, and qualify for insurance coverage of CPAP. Depending on your symptoms and health history, that may be an in-lab sleep study or a home sleep test. Patients with significant lung or heart conditions are often better suited to in-lab testing.
Aim to use CPAP every time you sleep, for the entire night, including naps. Four hours a night is a common insurance minimum, not a treatment goal. Sleep apnea events can happen anytime you sleep, and research links longer nightly use to greater improvements in daytime sleepiness and daily function. Your physician can review your usage data and help you build toward full-night use.
No referral is needed to schedule with PACT Pulmonology. You can request an appointment at our Orange or Guilford office whether you are newly diagnosed, already using CPAP, or ready to explore alternatives. Some insurance plans require a referral for specialist visits, so check your plan before your first appointment.
Whether you are about to start CPAP or ready to stop, talk with a PACT Pulmonology physician first. We will help you get comfortable, track your progress, and find a treatment that works for you.
PACT, LLC & PACT MSO, LLC
322 East Main Street, Suite 1B
Branford, CT 06405