An overnight sleep study has confirmed that you have obstructive sleep apnea. Your sleep doctor then tells you that continuous positive airway pressure (CPAP) is the best treatment for you. He or she based this decision on the severity of your problem, your medical history, and your symptoms. You are anxious to see improvements in your sleep, so you're ready to get started.

How will your CPAP treatment process begin? Here is a brief overview of what you can expect:

At the Sleep Center
First you will go to your sleep center or laboratory for a CPAP study. If your sleep apnea is severe, this may take place during your first overnight sleep study. Otherwise, you will need to return for a second all-night sleep study before starting CPAP therapy.

A sleep tech will fit you with a mask and begin treatment with a CPAP machine. As you sleep, the sleep tech will monitor your breathing and make adjustments to the CPAP machine during the night. He or she will find the level of air pressure that keeps your airway open and helps you breathe easily.

After your CPAP study, your sleep doctor will write a prescription and place an order for you to get your own CPAP machine. It may take as little as 48 hours for you to get the equipment you need to begin treatment at home.

The sleep center may use a CPAP machine that seems bulky and heavy. Regulations for sleep centers require them to use models that are often much larger and noisier than the units that are used in the home. Your CPAP model will probably be about the size of a tissue box and will produce only a low level of noise. Let your doctor know if you travel often. He or she can make sure that you get a small, light model that is easily portable.

Ask your doctor if your unit will come with a heated humidifier. Adding warm moisture to the forced air can make CPAP treatment more comfortable for many users. If your unit does not come with one, you can always add a humidifier later if your doctor prescribes it.

You should schedule a follow-up appointment with your sleep doctor to review your treatment progress. Your doctor may need to adjust your air pressure setting at a later time. This will especially be needed if you lose or gain weight.

From the DME Supplier
Many people age 65 and older have health insurance through the federal program called Medicare. Most others have some form of private insurance. Your insurance provider has contracts with suppliers of Durable Medical Equipment (DME). A representative of a DME supplier will deliver your CPAP equipment to your home and help you begin treatment. If your sleep center is located in a hospital, you may even be able to meet with a DME representative on-site after your CPAP study.

When the DME representative brings your CPAP equipment to your home, he or she should give you full instructions on how to use the system. The representative should help you try on and adjust your mask, hook up your machine and give it a test run. Here are some questions you may want to ask the DME representative during this time:

• How do I adjust my mask if it feels too tight or too loose?
• How can I adjust my headgear and tubing so that I am able to sleep in a comfortable position?
• Does my machine have a warning sensor that lets me know if I have air leaks?
• How do I use the pressure ramp setting?
• Does my machine come with a humidifier? If so, how does it work?
• What parts do I need to clean and how do I take them apart for cleaning? How often should they be cleaned, and what should I use to clean them?
• How do I replace my machine's air filter and how often should I change it?
• Does my machine self-adjust if I travel to a location that has a higher or lower altitude than where I live?
• Can I plug my machine in if I am visiting a foreign country?
• Can my sleep doctor download treatment details from my machine?
• Does my machine have any other features that I should know about?
• What phone number should I call to contact you or a customer service representative with questions or concerns?

Stay in close contact with your DME supplier as you begin treatment and get used to CPAP.

On Your Own
The key to using CPAP is to remember that it is not a quick fix for sleep apnea. It involves a long-term commitment to improve your sleep and your health. Your CPAP will only work as long as you put it to work for you. Use your CPAP all night, every night and during every nap.

Be sure to read the instruction manual that comes with your CPAP. Make sure you use your unit properly and clean it regularly.

Remember that your DME supplier is a great resource when you have questions or concerns about your treatment. You should also contact your primary care doctor or your sleep doctor if you experience any ongoing problems with CPAP.

Your insurance provider will probably require that your DME supplier contact you or your doctor after two or three months of treatment. In order for your insurance to cover ongoing CPAP treatment, your insurance provider will want to verify that you are using the treatment regularly.

You will also need to replace some of your CPAP equipment on a regular basis. This will help you ensure that your CPAP therapy remains safe and effective. Check with your insurance provider to find out about your specific coverage for the replacement of CPAP parts. These are some general guidelines that will give you an idea of what your insurance may cover:

• Tubing: 1 per month
• Nasal mask cushions or nasal pillows: 2 per month
• Disposable filters: 2 per month
• Nasal mask or nasal pillow system: 1 every 3 months
• Non-disposable filter: 1 every 6 months
• Headgear: 1 every 6 months
• Chinstrap: 1 every 6 months

To replace your CPAP machine or humidifier, your sleep doctor will need to write a prescription for you to get a new unit.

Ask your sleep doctor if he or she can recommend a support group for people with sleep apnea that meets in your area or on the Internet. Making a connection with other people who are using CPAP can help you maintain a long-term commitment to your treatment.