Positive Airway Pressure Therapy (PAP)

The most common form of therapy for Sleep Disordered Breathing (SDB) is Positive Airway Pressure, or PAP, therapy. This consists of wearing a nasal or facial mask during sleep which is attached by a long flexible hose to a PAP machine. The PAP machine delivers pressurized, heated and humidified room air through the mask to your upper airway.

PAP therapy was first used in the 1980s. Since then it has been evidenced by countless testimonials and research articles to often dramatically improve the daytime function and quality of life for patients suffering from Sleep Disordered Breathing or Sleep Apnea.

More About Snoring and Sleep Apnea >> 

The Importance of Treatment Initiation

The most critical step with PAP therapy is the initiation and level of support you will get from the Sleep Center.

Proper treatment pressure, immediate availability of a comfortable system, and good education often mean the difference between success and failure.

Successful treatment can be life changing for you and your bed partner. It may also prevent the progression of many chronic diseases that have been linked to Sleep Disordered Breathing.

More About Links to Chronic Diseases >> 

Ensuring Long Term Success

The Fusion Sleep Center provides an integrated PAP therapy initiation and management program.  After training and educating patients, we follow through with our therapy adherence program providing the long-term support needed.

PAP Therapy is initiated immediately after concluding a PAP titration study, and the patient is provided with all required equipment on-site*. Afterwards patients have access to our clinical support team as needed to help ensure a successful therapeutic outcome and increased quality of life.

What is a Titration Sleep Study?

Unlike pharmaceuticals that have fairly standard prescription dosages, PAP therapy requires a patient-specific titration. Airway obstructions vary from one individual to the next, and the optimal treatment pressure is different for each individual. It may also vary throughout a person's life. Re-titrations may be necessary if a patient gains or loses weight or after having select surgical procedures.

The adjustment of a patient's PAP machine is usually done in the Sleep Center during an overnight sleep study. This study is called a titration study, whereby the pressure and other settings of the device are being adjusted to best fit the patient's airway.

The sleep technologist will adjust the PAP levels in response to breathing events, such as hypopneas and apneas. The goal is to find the lowest pressure that will prevent events during all stages of sleep. The study takes the entire night since the pressure need may depend on the stages of sleep and body position.

Types of PAP Machines

A PAP machine is basically a very advanced miniature airflow generator, capable of pressurizing filtered room air to the set level prescribed for each patient.

The basic PAP machine, called CPAP (Continuous Positive Airway Pressure) provides constant pressure at all times.

Bi-Level PAP machines (Bi-PAP) are prescribed by physicians in select cases. Those devices will vary the pressure based on the patient's breathing. They slightly reduce the pressure during each exhalation cycle thereby alleviating the effort needed to exhale against the mask pressure.

Most PAP machines fit conveniently on a nightstand next to the bed. Recent developments in PAP technology have resulted in much more compact units that have become very silent, easy to travel with, and will universally plug into any electrical outlet.

At Fusion Sleep we work with carefully selected types of PAP machines from select manufacturers, providing the best quality and highest level of technology to patients.

Comfortable Mask Systems

The mask system is the most critical part of the PAP system. Selecting the right mask to fit the patient's facial structure can be the key to the success of the PAP treatment.

Two basic kinds of mask systems exist. Nasal mask systems are used for the majority of PAP users. These masks cover only the nose to provide the pressure support. A full face masks is only used for patients who breathe through their mouths and do not tolerate nasal masks.

At Fusion Sleep we work with a variety of masks from several manufacturers to ensure optimal mask fit and patient comfort.

Heated Humidification

Most PAP machines will be used together with a heated humidifier. The humidifier plugs onto the device and is used to increase the humidity in the pressurized air.

Using heated humidification can have a dramatic effect on comfort. Humidifiers relieve nasal irritation and dryness that can result from constant air flow, especially at higher treatment pressures.

PAP Therapy Side Effects and Their Treatments

• Some patients experience nasal dryness, irritation, or congestion as a result of PAP therapy. Heated humidification will solve almost all cases of nasal irritation.
• A few patients experience pressure sores from the mask, especially masks that require tight headgear. Pressure sores have become far less common as mask technology has progressed.

* Patients have the freedom to choose their equipment provider and are not required to accept those services from Fusion Sleep. The Center will coordinate referrals to another Durable Medical Equipment (DME) provider as requested by the patient.  Depending on the patient's healthcare insurance carrier, Fusion Sleep may not be able to provide equipment and supplies on-site, in which case the Center will help coordinate referrals to a participating network DME provider.