In 1981 researchers confirmed that continuous positive airway pressure (CPAP) can treat obstructive sleep apnea (OSA). Today CPAP remains the most effective and common treatment for OSA. Although the first CPAP machines were large, heavy and noisy, today's units are small, lightweight and almost silent.

Other methods of treating sleep apnea have been developed over the years, including oral appliances and surgical treatment.

The American Academy of Sleep Medicine (AASM) has conducted expert reviews of all the common sleep apnea treatments. The AASM sets standards and promotes excellence in sleep medicine. Their reviews show that CPAP remains the best and first option for treating OSA.

From these reviews, the AASM issued official guidelines for sleep doctors. These guidelines are called "practice parameters." Based on the best evidence from research, they help doctors make decisions on how to treat their patients.

The following descriptions show the AASM's conclusions about CPAP and other methods of positive airway pressure.

• CPAP is the first treatment option for moderate to severe OSA.
  CPAP should be considered before all other options in these two cases. It remains the standard treatment option for sleep apnea.

• CPAP is also recommended for treating mild OSA.
  CPAP is also a good treatment option if you only have mild sleep apnea.

• CPAP improves self-reported sleepiness in people with OSA.
  A common symptom of sleep apnea is daytime sleepiness. OSA can cause you to briefly wake up hundreds of times in one night. This can make you very tired during the day. CPAP can improve your sleep and help you sleep longer. This helps you feel more refreshed when you wake up.

• CPAP may improve the quality of life of people with OSA.
  Sleeping better with CPAP can affect every area of your life. Feeling well rested can help you feel better about your health and your life.

• CPAP may lower the blood pressure of people who have both OSA and high blood pressure .
  Sleep apnea puts a lot of strain on your heart as you sleep. People with OSA have a greater risk of high blood pressure. Many studies are looking at how CPAP affects blood pressure. Current results show that CPAP lowers blood pressure in some, but not all, people with OSA.

• Using a heated humidifier makes CPAP easier to use.
  The warm moisture from a humidifier makes the air from a CPAP machine easier to breathe. Many CPAP models now have an "integrated" humidifier connected to the unit.

• Sleep doctors should stay in close contact with patients who are using CPAP.
  Your sleep doctor plays an important role in helping you get used to using CPAP. He or she can help you make sure that you are getting the maximum benefit from it. This includes solving any problems with your mask or machine. You should talk to your sleep doctor regularly during your first month of treatment. After that, you should schedule an appointment every year to check on your treatment progress. You should also contact your sleep doctor anytime you have a problem with CPAP.

There are other positive airway pressure therapies for treatment of OSA. However, little evidence exists to support the effectiveness of these therapies as a treatment for OSA. Also, limited data exist to support how first-time users of other positive airway pressure therapies respond to these treatments. The AASM has information about other positive airway therapies in practice parameters posted on its Web site at www.aasmnet.org.