CPAP: a splint made of air
CPAP stands for continuous positive airway pressure. A quiet bedside blower pushes room air through a tube and mask at a steady, gentle pressure all night. That cushion of pressure props the floppy pharynx open from the inside — a *pneumatic splint* — so the upper airway collapse behind obstructive sleep apnea simply cannot happen. The apneas vanish, oxygen steadies, and the arousals stop.
When two pressures beat one
BiPAP delivers two pressures: a higher one as you breathe in and a lower one as you breathe out. That extra push on inhalation actively helps move air, which is why it suits people who need help *ventilating*, not just splinting — for instance obesity hypoventilation syndrome, where the daytime carbon dioxide is high. BiPAP is one form of non-invasive ventilation, and specialized versions are also used for some kinds of central sleep apnea.
The simple rule of thumb: CPAP holds the airway open; BiPAP also helps push air. For straightforward obstructive sleep apnea, plain CPAP is usually the first and best tool. BiPAP is reserved for those who cannot tolerate CPAP or who need genuine ventilatory support.
Other tools and everyday levers
Not everyone needs or tolerates a machine. A mandibular advancement device — a custom dental appliance worn at night — eases the lower jaw forward, pulling the tongue base with it and widening the throat. It works best for snoring and mild-to-moderate obstructive sleep apnea, and many people find it easier to live with than a mask.
- Weight management. Even modest weight loss can lower the AHI and is central in obesity hypoventilation syndrome.
- Side sleeping. For some, lying off the back keeps the tongue from falling against the throat.
- Avoiding alcohol and sedatives near bedtime, since they relax the airway muscles even further.