Concierge sleep medicine · London
CPAP for obstructive sleep apnoea, done properly.
A consultant sleep physician sets the plan. A specialist physiologist fits the mask and titrates the pressure. And someone stays involved through the first thirty nights — where most people quit.
Why patients choose us
- 01
A sleep physician, not a mask fitter
A consultant sleep physician sets the plan. A specialist physiologist fits the mask and titrates the pressure.
- 02
The right device, chosen for you
Fixed CPAP, auto-titrating APAP or BiPAP — the answer depends on your sleep study, your breathing and your comorbidities.
- 03
Adherence support, not just a delivery
A CPAP that lives in the cupboard fixes nothing. We stay involved through the first hard weeks — where most people quit.
Indicative pricing
What private CPAP therapy costs in London.
Indicative ranges across our partner clinics. Send the details and we quote firm figures across two or three device and titration options.
In short
A home sleep study, a physician review and a fitted CPAP typically lands around £1,500–£2,800 all-in.
| Item | Indicative range | Typical duration | Turnaround |
|---|---|---|---|
| Sleep physician consultation | £250–£450 | 45 min | Same visit |
| Home sleep study (WatchPAT / Nox T3) | £350–£650 | 1 night | 5–7 days |
| In-lab polysomnography (PSG) | £1,200–£2,200 | 1 night | 7–10 days |
| CPAP titration (in-lab) | £1,000–£1,800 | 1 night | 7 days |
| APAP auto-titration trial (at home) | £400–£800 | 1–2 weeks | Report at end |
| Fixed CPAP or APAP device (purchase) | £650–£1,400 | — | Delivered in a week |
| BiPAP device (purchase) | £1,600–£3,200 | — | Delivered in a week |
| Mask, tubing and humidifier chamber | £90–£220 | — | Same visit |
| 30-day adherence review | £150–£300 | 30 min | Report same week |
Prices vary by device brand, mask family, whether titration is in-lab or at-home APAP, and whether you buy or rent. We come back with a firm quote within one working day.
The problem
The right diagnosis, the right device, the right first month.
A third of people prescribed CPAP quietly stop using it in the first year. Almost always because the fitting was rushed, the mask was wrong, or nobody looked at the device data before habits set.
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Not sure you actually have OSA?
A proper sleep study — home or in-lab — reviewed by a sleep physician. We do not prescribe CPAP without the numbers.
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CPAP feels intolerable?
Almost always mask, pressure, humidification or claustrophobia — all fixable if picked up in the first thirty nights.
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Want it done properly?
A named consultant, a physiologist for fitting, and a structured adherence review with your actual device data.
The journey
From sleep study to steady adherence — what happens, in order.
One team from diagnosis through titration, mask fitting and the thirty-day review that matters most.
Phase 1 · Before your device
Diagnosis and physician review
Phase 2 · Titration and fitting
Pressure and mask, set right
Phase 3 · After
Adherence review, on-going care
- 01
Before
A sleep study first
A home sleep test or in-lab polysomnography confirms OSA, quantifies severity (AHI), and rules out central events before we prescribe CPAP.
- 02
Before
Consultant sleep physician review
A named sleep physician reads the study, considers your comorbidities, and decides whether fixed CPAP, APAP or BiPAP fits.
- 03
Before
Device and mask selection
We match device and mask family to your anatomy and breathing pattern — nasal, nasal pillows or full face.
- 04
Titration & fitting
CPAP titration
Either an in-lab titration study or an at-home APAP trial that finds your 90th centile pressure over one to two weeks.
- 05
Titration & fitting
Mask fitting and set-up
A physiologist fits the mask, sets humidification and ramp, and coaches the first night — the single strongest predictor of long-term use.
- 06
After
Follow-up and adherence review
A 30-day review reads the device data — usage hours, residual AHI, leak, central events — and troubleshoots before habits set.
- 07
After
Ongoing care
Annual review, consumables plan, and a low bar to come back for mask changes, pressure re-titration or a device swap.
Typical end-to-end: 3–4 weeks from sleep study to fitted CPAP. First adherence review: day 30.
When it helps
When CPAP is the right treatment.
The situations we see most, plus the one red flag that means an urgent assessment rather than a routine referral.
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Moderate–severe OSA (AHI ≥ 15)
The gold-standard treatment where a sleep study confirms moderate or severe obstructive sleep apnoea.
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Mild OSA with daytime sleepiness
Symptomatic mild OSA — sleepiness, cognitive fog or cardiovascular risk — where CPAP is worth trialling.
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OSA with cardiovascular disease
Uncontrolled hypertension, atrial fibrillation, heart failure or coronary disease with OSA raise the case for CPAP.
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OSA with treatment-resistant hypertension
Blood pressure that will not settle on three or more drugs — OSA is a common, missed contributor.
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Hypoventilation syndromes
Obesity hypoventilation, neuromuscular disease and some heart failure phenotypes need BiPAP rather than CPAP.
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Failed mandibular advancement device
When an oral appliance has been tried and the AHI or symptoms have not improved enough, CPAP is the next step.
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Perioperative OSA optimisation
Newly diagnosed OSA before major surgery — CPAP started ahead of time reduces post-operative respiratory events.
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Red flag: sleepiness while driving
Falling asleep at the wheel is a DVLA-reportable emergency — same-week assessment, not a routine referral.
Device and mask options
One CPAP does not fit all. Nor does one mask.
What each option on the table actually involves — and which fits which patient. Alternatives to CPAP are covered in the FAQs.
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Fixed-pressure CPAP
A single prescribed pressure delivered all night. The classic option — quiet, reliable, and the reference standard in trials.
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APAP (auto-titrating CPAP)
The device adjusts pressure breath by breath to the minimum that keeps the airway open. Often chosen for positional or REM-dependent OSA.
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BiPAP (bi-level PAP)
Different inspiratory and expiratory pressures. Used for obesity hypoventilation, neuromuscular disease, heart failure or CPAP-intolerant patients.
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Nasal mask
Covers the nose only. Comfortable, well tolerated, and the first choice for most nasal breathers.
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Nasal pillows
Small silicone pillows that seal at the nostrils. Minimal facial contact — good for claustrophobia and glasses-wearers who read in bed.
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Full face mask
Covers nose and mouth. Needed if you mouth-breathe or have persistent leak with nasal masks.
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Heated humidification
A warmed water chamber that reduces dry mouth, dry nose and cold-air discomfort — often the difference between quitting and continuing.
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Ramp and expiratory pressure relief
Comfort settings that ease you into pressure at sleep onset and reduce the sense of pressure when exhaling.
Our vetted London network
A small panel of sleep physicians, we picked them.
Consultant sleep physicians and specialist physiologists across central, north, west and south London. Introductions are made privately, once we understand your case.
Selection criteria
How we choose every sleep physician in our network.
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Consultant sleep physicians, not general respiratory physicians as a default
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Specialist sleep physiologists for titration and mask fitting
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CPAP, APAP and BiPAP devices — the full range, not one brand
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Structured adherence review at 30 days with device data, not a one-off delivery
Safety and red flags
What can go wrong on CPAP — honestly.
CPAP is a very safe therapy. The things worth watching for are the reasons people quit, the physiological red flags, and the treatments that make CPAP inappropriate.
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Persistent daytime sleepiness on CPAP
Not everyone with OSA is sleepy because of OSA. Persistent sleepiness on treated CPAP needs a rethink — comorbid narcolepsy, depression or insufficient sleep.
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Treatment-emergent central apnoeas
A small proportion develop central apnoeas once CPAP is started. If they persist beyond a few weeks, a device change (ASV) may be needed.
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Aerophagia and reflux
Swallowing air on CPAP causes bloating and can worsen GORD. Lower pressures, positional changes and reflux treatment usually settle it.
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Aspiration risk with reduced consciousness
CPAP in someone acutely obtunded is dangerous — the airway is not protected. It is a chronic therapy, not an acute rescue.
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Pre-existing pneumothorax
Positive-pressure ventilation with an untreated pneumothorax is contraindicated. Chest imaging is checked if there is any concern.
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Epistaxis and nasal congestion
Dry mucosa, unheated air and mask pressure can trigger nosebleeds. Humidification and a nasal steroid usually fix it.
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Mask-induced pressure ulcers
A mask that leaves marks on the bridge of the nose is a mask that is fitted wrong. Refit early — do not tolerate skin breakdown.
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Claustrophobia leading to abandonment
One of the commonest reasons people quit. Nasal pillows, gradual desensitisation and a shorter ramp usually rescue the trial.
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Cardiac failure and CPAP
CPAP can help heart failure with OSA but can worsen central sleep apnoea in heart failure. A physician-led titration matters.
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Poor adherence < 4 hours/night
Below four hours a night on 70% of nights, the health gains fall away. Adherence is the therapy — troubleshoot early.
Reading your CPAP report
Your CPAP report in four parts. Read the last one first.
Whether your titration was in-lab or at-home APAP, the report the sleep physician sends you keeps to the same shape.
A quiet reminder
Sleep-medicine language is precise and can read coldly — we translate it for you.
If you would like us to talk you through the numbers before your review, just ask.
- 01 Header
Diagnosis and severity
The OSA diagnosis with the AHI from your sleep study, severity band, and the indication for CPAP.
- 02 Technique
Device, mode and pressure
Whether fixed CPAP, APAP or BiPAP was prescribed, the pressure or pressure range, humidification and ramp settings.
- 03 Findings
Adherence and residual AHI
Nightly usage hours, the percentage of nights above four hours, residual AHI on treatment, leak and any central events.
- 04 Impression
Plan, review and troubleshooting
Read this first: what to change, when to come back, and what would trigger a device or mask swap.
Recognised by major UK insurers
Cover for CPAP therapy varies — most insurers fund diagnosis and titration; device purchase is often self-pay. We confirm cover before booking.
Frequently asked
Everything we get asked about CPAP.
Quick answers on devices, masks, adherence, alternatives, and when to seek urgent help.
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What is CPAP and how does it work?
CPAP — continuous positive airway pressure — delivers a steady stream of pressurised air through a mask that acts as a pneumatic splint, holding the upper airway open through the night so it cannot collapse and cause apnoeas.
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Fixed CPAP, APAP or BiPAP — which one do I need?
Fixed CPAP delivers one prescribed pressure. APAP auto-titrates within a range and suits positional or REM-dependent OSA. BiPAP uses different inspiratory and expiratory pressures and is reserved for hypoventilation, neuromuscular disease, heart failure or CPAP intolerance.
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How is the pressure titrated?
Either in an overnight in-lab titration study with a technician adjusting pressure, or at home with an APAP device over one to two weeks — the 90th-centile pressure it settles at becomes your prescription.
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Which mask should I choose?
Most people start with a nasal mask. Nasal pillows suit claustrophobia and readers-in-bed. A full face mask is needed for mouth-breathers or persistent leak. A specialist fitting matters more than the brand.
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What counts as good CPAP adherence?
The reference target is more than four hours a night on at least 70% of nights. Below that, the cardiovascular and cognitive gains fall away and the diagnosis needs revisiting.
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Why do people give up on CPAP?
The commonest reasons are mask leaks, dry mouth, aerophagia, nasal congestion and claustrophobia — all fixable if caught in the first month. That is why the 30-day review matters more than the delivery.
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What are the alternatives to CPAP?
A mandibular advancement device (oral appliance) for mild–moderate OSA, positional therapy for supine-dependent OSA, ENT surgery (UPPP, MMA, tonsillectomy) in selected cases, hypoglossal nerve stimulator (Inspire) for CPAP-intolerant moderate–severe OSA, and weight loss including bariatric surgery.
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Is CPAP for life?
For most people with structural OSA, yes. Significant weight loss, treatment of nasal obstruction, or a surgical option can sometimes reduce or remove the need — this is reassessed with a repeat sleep study.
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Can I fly and travel with CPAP?
Yes. Devices are approved medical equipment, do not count as hand luggage on most airlines, and come with travel documentation and universal power. A travel-sized unit is worth considering for frequent flyers.
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When should I seek urgent help?
Falling asleep while driving, sudden new chest pain or breathlessness on CPAP, and any sign of aspiration or acute confusion are urgent — stop and seek same-day medical care.
Related tests
Looking for something else?
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Polysomnography (PSG)
The gold-standard in-lab sleep study.
Learn more -
At-home sleep study
Convenient home OSA screening.
Learn more -
Nox T3 sleep test
Portable respiratory sleep testing at home.
Learn more -
All tests & procedures
Every test and procedure we arrange.
Learn more -
Hypertension
Related condition guide.
Learn more -
Type 2 Diabetes
Related condition guide.
Learn more -
Blood Tests
Related diagnostic test.
Learn more -
Health Assessments Select
Related diagnostic test.
Learn more
In practice, in London
Booking continuous positive airway pressure privately in London — what actually happens
For continuous positive airway pressure, the private London route is mostly about consultant fit and hospital choice rather than raw waiting time. The wait for continuous positive airway pressure on the NHS depends heavily on where you live and how urgently the referral is graded. Central and West London private clinics can normally book within a week, with imaging or a procedure slot to follow shortly after. It’s worth being honest about the reason for going private: usually it’s time, not a fundamentally different test.
Once you’re in the private system for continuous positive airway pressure, the pace picks up noticeably. Consultant slots run to time, imaging is usually available in the same building or a short walk away, and the report comes back typed and detailed. It’s the coordination that tends to feel different — one person on the other end of the phone, not a switchboard. For continuous positive airway pressure in particular, we bias towards consultants who do this every week rather than every month.
We’re careful about what a private pathway for continuous positive airway pressure can and can’t promise. It can compress a wait, put you in front of a subspecialist quickly, and get a proper report in your hands within a week. It can’t rewrite what the imaging or the bloods say. Setting that expectation up front tends to make the whole experience less stressful.