Sleep apnea is a common and potentially serious disorder that causes breathing to start and stop many times throughout the night. Patients with sleep apnea experience relaxation of their upper airway muscles which leads to airway collapse. People who suffer from sleep apnea tend to snore loudly, feel tired during the day, and gasp for air at night.

More than 18 million adults in the U.S. have sleep apnea, according to the National Sleep Foundation. When sleep apnea is left untreated, it can lead to dangerous health problems such as high blood pressure, stroke, and heart attack.

CPAP, which stands for continuous positive airway pressure, is the most common treatment used in people with sleep apnea. The device provides  a steady flow of air to gently keep the airway open and eliminate snoring and pauses in breathing. The majority of patients who use CPAP will be able to sleep through the night without waking up from a lack of oxygen.

Most people end up having success with CPAP machines; however, getting used to the device may be frustrating at first.

Alison Kole, MD, MPH, FCCP, a pulmonologist at Summit Health who specializes in treating patients with sleep apnea, advises her patients not to give up. There are plenty of options that can make CPAP more comfortable. Here are some of the most common questions patients ask her.

Q. How does a CPAP machine work?

When patients with sleep apnea go to bed, the muscles in the upper airway relax too much. This causes part of the airway to collapse, creating a pause in breathing known as “apnea.” CPAP machines correct this problem by generating a fixed pressure of air that keeps the airway open. This prevents breathing from being interrupted throughout the night. The amount of air each patient needs will vary. Your physician will make recommendations on how to set the device.

The air pressure is delivered through a hose that is connected to the CPAP machine on one side. The other side of the tube is attached to a face mask. That mask is placed over the person’s nose and/or mouth. When the mask fits properly, it creates a seal allowing the pressurized air to be delivered directly to the airway.

Q. Why would my doctor recommend a CPAP machine?

If you have symptoms of sleep apnea, such as excessive snoring or daytime fatigue, your doctor will recommend a sleep study. The test is used to diagnose sleep disorders by recording what happens to your body throughout the night.

Physicians generally recommend using a CPAP machine if the sleep study shows that your sleep apnea is moderate to severe. Even patients with mild sleep apnea, however, may benefit from CPAP therapy if they are feeling tired or have serious medical issues such as obesity, diabetes, high blood pressure, coronary artery disease, and stroke. Sleep apnea is very common in patients with these medical problems.

Q. Can you travel with a CPAP machine?

Yes, CPAP machines are portable and can be carried on international flights. All CPAP units come with a travel bag and are compatible with international electricity standards. There is no need to worry that your machine will not work overseas. For patients who travel frequently, there are CPAP units that are more compact, however they are generally not covered by insurance.

Q. Are CPAP machines uncomfortable? Does it take time to get used to them?

The CPAP mask and tubing may look overwhelming at first glance, but two-thirds of patients do not have any trouble using the machine. The remaining one-third of patients can be managed using alternative therapies such as oral appliance therapy, myofunctional therapy, or Inspire therapy.

Q. Are there different options for CPAP masks?

There are several types of masks: nasal pillows, nasal masks, and full face masks. Finding the mask that is right for you is very important. Nasal pillows are cushions that sit in the nostrils. Nasal masks may cover the nose or sit under the nose. Full masks will cover the nose and mouth and are appropriate for patients who find it difficult to breathe well thru their nose only.

Q. Are CPAP Machines dangerous? Are there any side effects?

No, CPAP machines are not dangerous. In fact, it is dangerous not to use a CPAP mask if you have sleep apnea. It is important to clean the mask and tubing regularly with warm soapy water. Change the water daily and always remember to use distilled water.

Currently advertised are cleaning devices that claim to “sterilize” the CPAP machine, either by using ozone or by using UV light. It is important for patients to understand that these devices are not FDA approved, and their claims have not been proven to be true. In fact, these devices may damage the internal components of CPAP machines and potentially expose patients to dangerous chemicals. Thus they are not recommended by physicians at this time.

Q. Will I experience any side effects from using the CPAP Machine?

Some nasal congestion or dry mouth may occur. This is most common if the mask is leaky and does not fit well. If your device has a humidifier, try adjusting the setting or use a nasal saline spray at bedtime. When the mask is noisy, it usually means it is not sealed properly to the face.

If the machine is turned up too high, it may cause patients to swallow air. This can lead to symptoms like gas, belching, or bloating. These side effects can usually be corrected by either adjusting the settings or switching to a different type of sleep apnea machine.

Q. What are the benefits of using a CPAP machine?

People who use CPAP machines can improve their health in many ways.  The device will enhance the quality of your sleep and make you feel less tired during the day. CPAP may help blood pressure control, diabetes control, management of cardiac arrhythmias such as atrial fibrillation, as well as reduce risk of heart attack and stroke. Risk of motor vehicle accidents is reduced, and cost of medical expenses may be reduced.

Q. Are there other types of machines for sleep apnea?

Yes, BiPAP and APAP are alternatives for patients. While CPAP delivers a steady stream of air pressure, APAP stands for auto titrating positive airway pressure and automatically raises or lowers your air pressure as needed during the night.

BiPAP, also known as Bi-level positive airflow pressure, has two separate pressure settings—one each for inhalation and exhalation. Your doctor may recommend this option to you if you are not able to tolerate CPAP or APAP.