CPAP: Not a Cure, With Risks and Costs You Need to Know
For many, CPAP (continuous positive airway pressure) machines are the default treatment for obstructive sleep apnoea (OSA). They keep the airway open by delivering pressurized air through a mask. However, it’s important to understand that CPAP is a management tool—not a cure—and it comes with its own set of challenges, risks, and financial obligations.
CPAP Doesn’t Cure Sleep Apnoea—it Manages It
CPAP provides immediate mechanical support to keep airways open, but it does not address root causes such as dysfunctional breathing patterns, low CO₂ tolerance, or muscle tone issues in the airway. That’s why, despite correct usage, many people continue to experience symptoms, especially during REM sleep or upon early morning mask removal.
Potential Risks and Side Effects of CPAP
CPAP therapy is widely used, and while many benefit, others face uncomfortable or even dangerous side effects:
- Skin irritation, nasal congestion, dry mouth, and dry eyes—all common, and often mitigated with humidifiers or mask adjustment
- Aerophagia (swallowing air), which causes bloating, belching, and abdominal discomfort—experienced by about 16% of users
- Claustrophobia and discomfort, especially for new users, leading to poor adherence
- Leaks and pressure issues that interfere with sleep quality and effectiveness
- Device failure or ineffectiveness—a faulty CPAP setup may offer no improvement, and continued untreated apnoea can have serious health consequences
Safety Concerns: The Philips Recall
A significant global safety concern involved Philips CPAP machines, which were recalled after internal sound-dampening foam degraded and released harmful particles. Over 5 million devices were affected, linked to 561 reported deaths, and eventually led to a US$1.1 billion settlement.
This highlights that CPAP devices are not infallible, and manufacturing defects or design flaws can introduce severe health risks.
Financial Considerations: CPAP Costs in Australia
Upfront Purchase Price
- Typical CPAP machines in Australia range between AUD 700 to AUD 2,500+, depending on features like auto-adjusting pressure, humidifiers, and travel portability
- Some sources place average costs around AUD 500–3,000, while others estimate about AUD 1,271 as an average
Annual Maintenance Costs
- Masks, filters, tubes, and cushions need regular replacement:
– Masks: every ~3 months
– Headgear: ~6 months
– Tubing: ~3–6 months
– Filters: every 2 months - Ongoing supply costs average AUD 100–300 per year
- Another estimate places maintenance and cleaning costs at AUD 220–1,600 annually
So realistically, CPAP therapy in Australia can easily cost around AUD 1,000–4,500 in the first year, and around AUD 200–1,600 annually thereafter.
The Bigger Picture
- CPAP manages symptoms, but doesn’t address breathing dysfunctions that may underlie OSA.
- Adherence can be low, often because of discomfort, mask fit issues, or unresolved side effects.
- Safety isn’t guaranteed, as the Philips recall tragically showed.
- Costs add up, making CPAP a long-term financial commitment, not just a one-off purchase.
Why Breathing Retraining Offers a Different Path
Breathing retraining (like the Buteyko Method) works on improving nasal breathing, CO₂ tolerance, and breathing smoothness. This can:
- Support airway stability naturally—potentially reducing the severity or frequency of OSA episodes.
- Build resilience to internal breathing triggers, without relying on mechanical pressure.
- Be a cost-effective, sustainable, and empowering alternative or adjunct to CPAP.
Final Thoughts
CPAP may be a valid therapy for conditions, such as motor-neuron disease, where respiratory function is compromised. But in no way it is a cure for sleep apnoea. CPAP will manage the symptoms, but the cause of obstructive sleep apnoea will still be present, creating a lifetime dependency on an expensive apparatus, which also involves annual maintenance costs. Awareness of CPAP machines’ risks, limitations, and costs is essential. For long-term changes that target the root of sleep apnoea, exploring breathing retraining, reducing inflammation in the body, achieving an optimal body weight will offer a safer, natural and sustainable path forward.