CPAP Essentials Glossary (15 terms you should know)

CPAP Language…

When you get diagnosed with a sleep apnea condition or have a suspicion that you might have it, you enter the world of sleep apnea and CPAP medical and sales terminology that you probably never heard of. Even if you are not new to CPAP, if you are using the therapy for months (even years) you can always get into the situation of being confused and not understanding "what they are saying".

We have compiled a list of 15 CPAP terms (and, importantly, their variations) that you should know and know their meaning. So let’s jump right into it…here are the 15 CPAP related terms for you:

1. Sleep Apnea. Start from the begging, if you are not new to this condition you can probably skip this one, rest of you here’s what sleep apnea actually is… Sleep apnea (or apnoea) is a sleep disorder (somnipathy) in which pauses in breathing or periods of shallow breathing during sleep occur more often than normal (defined by the National Heart, Lung and Blood Institute). Simply said, it is a severe type of snoring in which there is a longer pause in the process of breathing, more precisely, inhaling the air. If untreated, the sleep apnea condition can be destructive to your health, life quality, and in extreme cases even lethal.

2. Hypopnea. This is a term closely related to apnea. Hypopnea is a condition in which upper airways are partially closed/blocked and thus limit the air intake, which further makes the breathing shallow (for 10+ seconds breathing is 30-50% less than normal breathing).

3. OSA, CSA, Complex SA. There are 3 types of sleep apnea: Obstructive sleep apnea (OSA), Central Sleep Apnea (CSA), and Complex Sleep Apnea.

OSA is the most common type of sleep apnea (84% of all sleep apnea diagnoses); it occurs when throat muscles relax and physically block the airways, which further causes the blocking of the airflow.

CSA is the least common type of sleep apnea (0.4%); it is a neural issue and occurs when the brain fails to send signals to the muscles that control breathing, which causes the breathing process to stop.

Complex Sleep Apnea takes 15% of diagnosed sleep apnea conditions. It is a combination of the previous 2 types of sleep apnea; Complex sleep apnea is also known as treatment-emergent central sleep apnea (TESCA).

4. CPAP, APAP, BiPAP, and CPAP Machine. 

Continuous Positive Airways Pressure (CPAP) is a term that is used to describe the most common and effective obstructive sleep apnea therapy. CPAP is a technology used in sleep apnea treatment. It is providing constant air pressure to the user's mouth through a tube and face mask.

Automatic Positive Airways Pressure (APAP) is a technology created out of CPAP, but advanced in the way air pressure is delivered to the users' airways; instead of continuous air pressure, the APAP machine is automatically adjusting the pressure to be higher or lower according to the current breathing rhythm and depth, and it is doing so with smart algorithms technology.

Bilevel Positive Airway Pressure (BiPAP) is another upgraded version of CPAP machine/therapy; BiPAP has 2 air pressure phases: low and high air pressure. One pressure level for inhalation (IPAP), and the other, a lower pressure, for exhalation (EPAP). This helps make the whole breathing process a bit easier for some people who find the constant same level of air pressure uncomfortable. 

CPAP (APAP, BiPAP) machine is a device used for CPAP therapy.

5. Pressure. You can guess this one from the direct meaning of the word itself, just put it in the context of CPAP therapy. Pressure is the unit of measure used for PAP machines; it is a measure of air pressure force needed to keep the airway open during therapy. The pressure unite is measured in centimeters of water pressure (cm H20), and it usually ranges from 4 cm H2O to 20+ cm H20. Pressure is exclusively prescribed by a sleep clinician and should not be adjusted without first consulting with them.

6. Ramp, Ramp Time. The ramp is a setting on your PAP device that is used to start at a lower pressure and increase to the minimum prescribed pressure over a period of time (it is a feature used to make CPAP therapy more comfortable). Ramp Time can be set depending on the device you are using, to Off, or 5 to 45 minutes, or in some advanced models to Auto (using smart algorithms technology Auto will slowly ramp up the pressure once it detects the need for it).

7. Leak. The leak is a term used to describe a measure of air leak which happens most often because of a face mask not being adjusted correctly or moved so it's not sitting on your face properly or in some cases tubing, or connector issues. The acceptable leak is up to 24l of air per minute, everything over that should be considered as a malfunction and should be fixed.

8. Humidifier. The humidifier is part of the PAP device that is used to add moisture to the pressurized air, using water vapor. Some more advanced humidifiers are heated and use warm water. This process is used to reduce nasal congestion, and prevent dry nose and mouth.

9. Rainout. This is a term used to describe condensation that collects within the CPAP tubing and mask. It happens when the warm, humidified air from the CPAP machine hits the colder room temperature air and cools down. What happens then is a simple physics, now cooler air cannot hold as much moisture as the initially warm air, which further causes the water in the humidified air to form water droplets. Rainout can be prevented using heated tubing.

10. Tubing, Heated Tubing. Hoses that are used to deliver pressurized air from the PAP machine to your face mask are usually called tubing. More advanced tubes can be heated, to prevent “rainout” and make breathing pressurized air less uncomfortable.

11. CPAP Mask, Headgear. A CPAP mask is used to deliver pressurized air from the CPAP machine, via tubing, to your airways. There are several types of CPAP face masks:

Full face mask. Self-explanatory, full face mask covers full or most of the face. It covers both the mouth and nose at the same time. This is the most common CPAP mask as it fits all types of "breathers".

Nasal mask. Unlike the full face mask, this mask is significantly smaller and covers only the nose. Choice number one for “nose breathers”, this mask allows them much more mobility during sleep. Since it is more comfortable, recently it is gaining popularity with all types of breathers as it is used in combination with the chin strap which keeps the mouth closed during sleep.

Nasal pillow mask. The smallest of the 3 types, the nasal pillow mask is an upgraded solution to the nasal mask. This mask does not cover any part of the face, but instead, it sits right under the nose and uses silicone pads that fit just inside the nostrils.

Total face mask – covers the full face from chin to forehead, covering the whole face. These masks might be prescribed in the case of patients with facial irregularities when a proper mask seal cannot be obtained.

Oral masks – opposite to nasal masks, oral masks cover only the mouth. These are usually used when users have deviated septum or any similar issue with nose breathing, and for some reason cannot tolerate the full face mask, or simply find this mask as the better alternative due to its minimalistic design.

Hybrid masks – as suggested by its name, a hybrid mask is the combination (hybrid) of two mask types (most often combining the full face mask and nasal pillow mask, or even oral and nasal pillow mask).

Headgear. This is the part of the face mask, the elastic straps that hold the mask onto your head.

12. CPAP Ozone Disinfector. This device has multiple different names (mostly depending on the manufacturer), so you can hear someone saying cpap ozone sanitizer, CPAP ozone cleaner, and even a combination of all the terms, CPAP Cleaner Ozone Sterilizer Disinfector Sanitizer… But they are all used for the same device that is used to clean and sanitize your CPAP equipment, using ozone as a sanitizing agent. CPAP ozone sanitizers are highly efficient (sanitize over 99.9% of germs, mold, bacteria, and even viruses) and simple to use, just put your CPAP equipment in sanitizing bag and push the button to start the process. For the best cleaning and sanitizing results, we recommend using PrimeClean® CPAP Cleaner.

13. CPAP Mask Strap Covers, Chin Strap. Mask strap covers are used to reduce the distress caused by CPAP Straps. CPAP Strap Covers are a small addition/accessory that is designed to be wrapped around the straps of the CPAP masks and since they are made of soft, natural materials, they will reduce the pressure marks, rash, or any discomfort CPAP straps might cause. 

14. Letter of Medical Necessity (LMN). LMN is a certificate issued by a physician that states that the prescribed item(s) is/are medically indicated, and necessary with reference to the standards of medical practice and treatment of a patient's condition. LMN is a document that you want to have during traveling, at an airport or customs…and it is also used if you need to indicate that your medical condition is eligible for your health insurance cover.

15. ResMed, Phillips Respironics, Somnetics, Fisher & Paykel, DeVilbiss, Apex Medical… These are all CPAP device big brand manufacturers' names. 

The history of ResMed is linked to the beginnings of CPAP therapy… Baxter International was the first company that licensed Dr. Sullivan’s CPAP patent and developed a commercial CPAP machine, released in 1988. After that, the company ResCare acquired Baxter International, and in 1995. changed the name to ResMed. With its wide variety of products and PAP machines, it is easily the most influential company in the sleep apnea therapy industry.

Phillips Respironics is part of the huge Phillips family. Focused on sleep apnea therapy, it is offering high quality and familiar brand name. As their main competitor, they also offer a wide variety of products for different needs and occasions.

Even though there are quite a few companies by now that produce PAP machines, it is very few that can be named next to ResMed and Phillips Respironics…but there are a few good manufacturers worth mentioning: Somnetics, Fisher & Paykel, DeVilbiss, Apex Medical…

The Final Word

CPAP terminology can sound confusing. Especially if you are new to CPAP therapy. But it is not something you should be worrying about. We find that the above-mentioned 15 terms and their variations are most often used, and knowing them should be enough to understand most of the texts or chats related to the CPAP world.

If you feel that we missed some term that is very often in use, or misinterpreted some, please feel free to contact us and point to it, we will be glad to improve ourselves through your suggestion.