What sleep apnea treatment does

Sleep apnea is a condition where your breathing stops and starts repeatedly while you sleep — sometimes dozens of times per hour. Treatment aims to keep your airway open so oxygen reaches your brain and heart all night. The most common approach is a device that gently pushes air into your nose or mouth, but other options exist depending on what's causing your apnea and how severe it is.

You need treatment because untreated sleep apnea strains your heart, raises blood pressure, and increases the risk of heart attack and stroke. It also leaves you exhausted during the day because your sleep is constantly interrupted, even if you don't remember waking up. A doctor has to diagnose it first — usually through a sleep study — before any treatment plan makes sense.

Key Takeaways

  • A CPAP machine, which blows air through a mask to hold your airway open, is the most common and effective treatment for moderate to severe sleep apnea.
  • A sleep study — either in a lab or at home — is required to diagnose sleep apnea and determine which treatment will work best for you.
  • Other options include dental devices that reposition your jaw, positional therapy to keep you off your back, and in some cases surgery, but these work best for mild to moderate apnea.
  • CPAP machines take adjustment; many people stop using them within the first few months, so finding the right mask fit and pressure settings matters for long-term success.
  • Your doctor can refer you to a sleep specialist if your primary care doctor suspects apnea, and insurance often covers both the diagnosis and the device.

How a CPAP machine works and why it's the standard treatment

CPAP stands for continuous positive airway pressure. The machine is a small bedside box about the size of a toaster that pulls in room air, filters it, and gently pressurizes it. A hose connects the machine to a mask that covers your nose, mouth, or both. As you breathe in, the pressurized air holds your airway open so it cannot collapse.

CPAP is the gold standard because it works for nearly everyone and the evidence that it prevents heart attacks and strokes is strong. You wear it every night, and most people adjust to it within a few weeks, though the first nights can feel strange. The machine is quiet — quieter than most people expect — and modern masks are smaller and more comfortable than older versions.

The pressure setting is measured in centimeters of water pressure (cm H₂O) and ranges from about 4 to 20 depending on how severe your apnea is. Your sleep study determines the starting pressure, but your doctor may adjust it based on how you feel and whether you're still having breathing events. Using it correctly means wearing it for at least 4 hours a night, though 6 to 8 hours is ideal.

Other treatment options for mild to moderate apnea

If your apnea is mild or you cannot tolerate a CPAP machine, a dental device (also called a mandibular advancement device) may work. It looks like a sports mouthguard and gently moves your lower jaw forward while you sleep, which opens your airway. A dentist trained in sleep medicine fits it to your mouth. It works best for mild apnea and is easier to travel with than a CPAP, but it does not work as well for severe cases.

Positional therapy means training yourself to sleep on your side instead of your back, since gravity makes apnea worse when you lie flat. Some people wear a special shirt with a bump on the back that nudges them if they roll onto their back. This only works if your apnea happens mainly in one position, which your sleep study will show.

Weight loss, if you are overweight, can reduce apnea severity — sometimes dramatically — but it takes months and does not always eliminate it completely. Avoiding alcohol and sedating medications before bed also helps because they relax your throat muscles and make apnea worse. Surgery to remove tissue from your throat or reposition your jaw is an option in rare cases, usually only after other treatments have failed.

What happens during a sleep study

A sleep study is how doctors diagnose apnea and measure how many times per hour your breathing stops. There are two types: an in-lab study where you sleep in a hospital or sleep center with sensors attached to your chest, legs, and face, and a home sleep test where you wear a small portable device at home for one or two nights.

In-lab studies are more thorough and let technicians adjust your CPAP pressure while you sleep, so you leave with both a diagnosis and your pressure setting. Home tests are cheaper, faster, and more convenient, but they only work if your apnea is moderate to severe — mild cases can be missed. Your doctor will recommend which type based on your symptoms and medical history.

The study itself is painless. Sensors measure your breathing, oxygen level, heart rate, and brain waves. You sleep as normally as you can, and the data tells your doctor how many apnea events you had per hour (called the AHI, or apnea-hypopnea index). An AHI of 5 to 15 is mild, 15 to 30 is moderate, and above 30 is severe.

Getting a CPAP machine and insurance coverage

Once your doctor prescribes a CPAP, you get it from a durable medical equipment (DME) supplier — a company that rents or sells medical devices. Your doctor's office usually has a relationship with one or more suppliers and can refer you. The supplier will fit your mask, show you how to use the machine, and set the pressure based on your prescription.

Most insurance plans, including Medicare, cover CPAP machines after a sleep study confirms the diagnosis. Medicare requires that you try the machine for 30 days and use it at least 4 hours per night on at least 21 of those nights before they will pay for it. If you meet that threshold, Medicare covers 80 percent of the cost after your deductible. Private insurance varies, but the process is similar.

If you do not have insurance, a basic CPAP machine costs between $300 and $800 to buy outright, or $30 to $60 per month to rent. Masks cost $50 to $150 each and need replacing every few months. Some sleep centers and nonprofits offer financial information or loaner machines if cost is a barrier.

Why people stop using CPAP and how to stick with it

About half of people who start CPAP stop using it within the first year, usually because of discomfort, claustrophobia from the mask, or dry nose and throat. This is so common that sleep doctors expect it and plan for it. The key is finding the right mask — there are dozens of styles, from small nasal pillows to full-face masks — and giving yourself time to adjust.

Start by wearing the mask during the day while watching TV or reading, so it feels normal before you sleep in it. Use the machine's ramp feature, which starts at low pressure and gradually increases as you fall asleep, making the transition gentler. A humidifier attached to the machine reduces dryness. If you wake up with marks on your face or feel the pressure is too strong, tell your doctor — small adjustments often make a huge difference.

Joining a sleep apnea support group, either online or in person, helps because you hear from others who have solved the same problems. Many people who quit CPAP later restart it after learning tricks from others or after experiencing a health scare that motivates them. Your sleep doctor can also refer you to a respiratory therapist who specializes in helping people adjust to the machine.

When to see a sleep specialist

Your primary care doctor can diagnose and treat straightforward sleep apnea, but a sleep medicine specialist (a doctor with extra training in sleep disorders) is helpful if your case is complex. This includes situations where you have mild apnea but severe daytime sleepiness, when CPAP is not working well, when you have other sleep disorders alongside apnea, or when you are considering surgery.

Sleep specialists work in sleep centers, which are often part of hospitals or large medical practices. Your primary care doctor can refer you, or you can search for one through the American Academy of Sleep Medicine website. Insurance usually covers the visit if your doctor refers you and documents that you have symptoms of sleep apnea.

Frequently Asked Questions

Can sleep apnea go away on its own?

Mild sleep apnea sometimes improves with weight loss or positional changes, but moderate to severe apnea does not go away without treatment. Once your airway is prone to collapse, it stays that way. Treatment controls the condition, but you typically need it long-term.

What if I cannot tolerate a CPAP mask?

Try different mask styles — nasal pillows are smaller and less intrusive than full-face masks. A humidifier and ramp feature help with comfort. If CPAP truly does not work, a dental device or positional therapy may be options, though they work best for mild apnea. Talk to your doctor about alternatives.

Do I need to use CPAP every single night?

Yes, ideally. Apnea happens every night you sleep, so treatment should too. Even one night without it means your oxygen levels drop and your heart works harder. Consistency is what prevents long-term damage.

How long does it take to feel better after starting treatment?

Many people notice improved daytime alertness within a week or two, but full benefits take several weeks as your body catches up on deep sleep. Some people feel worse initially because they are suddenly aware of how tired they actually were.

Will I need a sleep study again if my symptoms change?

If your symptoms get worse, your doctor may order another study to see if your apnea has worsened and your CPAP pressure needs adjustment. If you lose significant weight or your symptoms improve, a repeat study can show whether treatment is still needed at the same level.