Positive Airway Pressure

Understanding Different PAP Treatment Options

CPAP: (Continuous Positive Airway Pressure)

A CPAP device delivers air pressure through a nasal mask that is worn while sleeping. For many patients, CPAP therapy dramatically improves their daytime functioning as well as their overall health. The pressure setting of the device is typically determined with a diagnostic titration sleep study. SleepQuest is unique in providing every patient with an advanced featured Auto PAP that can be set up as either a fixed CPAP device or provide additional comfort as an Auto PAP device.

Auto PAP

Continuous positive airway pressure (CPAP) was the most common device for treatment of sleep apnea up until the last several years, but now an Auto PAP has become more common as it provides superior care. Not all companies who supply these types of devices start the patient with an Auto, many start the patient with a standard CPAP device.  The Auto PAP responds to the individual's needs throughout the night by providing a range of pressures that support the airway in order to keep it open. The device supplies only the required pressure necessary to keep the airway open thus patients sleep at lower pressures for roughly 80% of the night. While in non-REM sleep the device remains at lower pressures and only increases pressures to a higher level when a patient is in REM sleep and OSA is at its worst. In order to keep their airway open, the device will increase pressures just enough to keep the airway open and prevent the patient from awakening. APAP adjusts automatically to the changing needs throughout the night for each patient.


As the name implies, these devices provide two levels of pressures; a higher pressure during inhalation, and a lower pressure during exhalation. This form of pressure support assists patients who have difficulty adjusting to a single pressure CPAP or Auto device. It is also very helpful for patients who are obese and suffer from shallow or inadequate air in the lungs.

Bi-level Auto

A Bi-level Auto provides a higher inspiratory pressure and a lower expiratory pressure, automatically adjusting to the changing needs of the patient throughout the night. Patients who have had difficulty tolerating a fixed CPAP or Auto pressures may find this device more comfortable.

Bi-Level with Back-Up Rate

In addition to providing a separate higher inspiratory pressure and a lower expiratory pressure, this non-invasive ventilation device also provides a back-up rate that "kicks in" a breath if a patient stops breathing. This device is commonly used for patients with severe respiratory conditions such as restrictive airway disease or neuromuscular conditions such as ALS ("Lou Gehrig's Disease").

Adaptive Servo Ventilation

This is a sophisticated device for cases when the CPAP, Auto or Bi-level treatment itself brings on additional Central Sleep Apnea events. This dual condition is called Complex Sleep Apnea. It also works well in rare cases if the patient without therapy suffers over 50% of the night from Central Sleep Apnea. Adaptive Servo Ventilators monitor each breath and adapt to prevent Central Sleep Apnea events from occurring.

About SleepQuest

"From my very first visit at SleepQuest, they offered friendly, prompt and professional service."Julie P.
"I traveled from Gilroy to Redwood City because of your knowledgeable staff."Geoff D.
"Before, I met with a Sleep Care Specialist, I had felt so awful for so long. Now, I feel like a new person with renewed energy and hope. I can’t thank SleepQuest enough for all their help."Christie V.
"I choose SleepQuest because their Sleep Care Specialists are always friendly, patience, and helpful."Jin T.

Expert Guide to Sleep Apnea 

This guide to understanding Obstructive Sleep Apnea (OSA) was written by SleepQuest’s Chief Scientific Officer; William C. Dement, M.D., Ph.D.


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