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Sleep medicine · London

CPAP titration & fitting clinic - London.

Private CPAP titration and mask fitting for obstructive sleep apnoea - a named sleep physiologist, a choice of ResMed, Philips or Löwenstein machines, and free mask exchange within 30 days.

A stethoscope on a clinical desk

What CPAP is

Continuous positive airway pressure - the gold-standard for moderate to severe OSA.

A quiet bedside machine, a soft mask, and pressurised room air that splints the upper airway open through the night. It is not oxygen and it is not a drug - it is a mechanical answer to a mechanical problem.

CPAP delivers a gentle, continuous stream of pressurised room air through a mask worn during sleep. The pressure acts as a pneumatic splint, holding the tongue, soft palate and pharyngeal walls open so that obstructive events (apnoeas and hypopnoeas) do not occur. Used every night at the right pressure, it abolishes snoring, restores oxygen saturation, and returns sleep architecture close to normal within a fortnight.

Indicative pricing

What CPAP titration and fitting costs in London.

Indicative ranges across UK sleep units.

In short

Titration + fitting + machine, all-inclusive: £850–£2,400, or from £45/month on rental.

Package Indicative range
Initial consultation and mask fitting only £220–£380
APAP auto-titration (2–4 weeks) with machine and mask £850–£1,600
Premium package (ResMed AirSense 11 + heated humidifier + premium mask) £1,400–£2,400
In-lab attended titration polysomnography £1,600–£2,400
Monthly rental (machine, mask, humidifier) £45–£95/month
Annual consumables replacement (mask, tubing, filters) £280–£450

Prices vary by unit, by machine brand, by mask model, and by whether a heated humidifier is included. Insurer packages differ again.

The problem

The right pressure, the right mask, the right first month.

CPAP fails when the mask leaks, the pressure is wrong, or nobody answers the phone in week one. All three are worth checking before you buy.

  • Is the pressure right?

    APAP for most, in-lab titration for complex cases - and a review of the data at four weeks before a fixed pressure is set.

  • Is the mask right?

    Two or three mask styles trialled at fitting. Free mask exchange within 30 days if it does not suit at home.

  • Is there support in week one?

    A named physiologist reachable by secure message for leaks, dry mouth, aerophagia and congestion - the moment when most patients give up.

When it helps

When CPAP is the right step - and when BiPAP or ASV fits better.

The clinical situations most often seen, plus the ones where CPAP is set aside for BiPAP, ASV or an implantable option.

  • Moderate to severe OSA on sleep study

    AHI over 15 events per hour, or over 5 with symptoms - CPAP is the gold-standard first-line treatment.

  • Excessive daytime sleepiness (Epworth over 10)

    Persistent sleepiness, morning headaches and cognitive fog that a partner or a sleep study links to apnoea.

  • Witnessed apnoeas and loud snoring

    A partner describes pauses in breathing, choking or gasping arousals - a common trigger for referral.

  • Cardiovascular comorbidity

    Resistant hypertension, atrial fibrillation, heart failure or a recent stroke where OSA control lowers cardiovascular risk.

  • MAD or positional therapy has failed

    A mandibular advancement device or positional therapy has not controlled the AHI - CPAP is the next step.

  • Pre-operative optimisation

    CPAP set up before elective surgery in known OSA to reduce peri-operative respiratory risk.

  • Overlap syndrome (OSA plus COPD)

    BiPAP rather than CPAP is often the right choice - assessed at the fitting and titration appointment.

  • Red flag: sleepiness at the wheel

    Falling asleep while driving is a DVLA-notifiable safety issue - urgent titration and compliance data are needed.

Titration & machines

Two titration routes, three main machines, one honest recommendation.

Attended in-lab titration for complex cases, APAP auto-titration for most. Choice of ResMed, Philips or Löwenstein - not a single-brand contract.

  • APAP auto-titration at home

    A ResMed AirSense 11 AutoSet or equivalent adjusts pressure night by night over 2 to 4 weeks. The modern first-line for most uncomplicated OSA.

  • In-lab attended titration

    A polysomnography night with a sleep physiologist adjusting pressure in real time. The most precise route for complex cases, central events, or overlap syndrome.

  • Empirical fixed pressure

    A fixed pressure chosen from height, neck size and AHI, without titration. Rarely used now - kept for travel back-up or where APAP is not tolerated.

  • CPAP vs BiPAP

    BiPAP delivers two pressures (inspiratory and expiratory) for higher pressure needs, COPD overlap, obesity hypoventilation or central apnoea. Decided at fitting.

  • ResMed AirSense 11 AutoSet

    The most common UK machine in 2026. Built-in cellular reporting, quiet motor, MyAir smartphone app for nightly compliance and leak data.

  • Philips DreamStation 2

    Post-recall clean stock now widely available. DreamMapper app, heated tube option, small footprint suitable for bedside tables.

  • Löwenstein prisma20A

    A quieter German alternative, gaining UK availability. Auto-titration, integrated humidifier, well-liked for light sleepers and light-sleeping partners.

  • Heated humidifier and tubing

    A heated humidifier reduces nasal congestion, dry mouth and rainout. Often standard on some packages and available as an add-on on others.

Mask types

The mask is two-thirds of the therapy.

Masks come in three families, chosen based on your breathing pattern, facial anatomy and any claustrophobia. Two or three masks trialled at fitting.

  • Nasal pillow (AirFit P30i, Swift FX)

    Two soft silicone pillows in the nostrils. Minimal facial contact, best for the claustrophobic and for beards. Best for lower pressures.

  • Nasal mask (AirFit N30, N20)

    Covers the nose only. The workhorse - well-tolerated, good seal across a wide pressure range, and a good first choice for most patients.

  • Full-face mask (AirFit F20, F30)

    Covers nose and mouth - the answer for mouth-breathers, chronic nasal blockage, or higher pressures where a nasal mask leaks.

  • Hybrid interface

    Nasal pillows plus a mouth cushion - a low-profile alternative to full-face for mouth-breathers who dislike a bulky mask.

  • For facial hair or a narrow bridge

    Pillow interfaces and F30 style masks with a lower seal line clear beards and avoid the nasal bridge - two of the commonest fitting problems.

  • For claustrophobia

    Start with a nasal pillow, add short awake-wearing practice sessions, and defer any mask that touches the forehead - most patients settle within two weeks.

Safety and first-month support

What to expect in the first four weeks - honestly.

CPAP is very safe. The things worth planning are the mask leak in week one, the dry mouth in week two, and the compliance data at week four.

  • Mask leak and skin marks

    The commonest problem in week one. Fitting adjustment, a different mask style or a skin liner solves most cases without changing pressure.

  • Dry mouth and nasal congestion

    A heated humidifier and heated tubing settle this in most patients. A chin strap helps mouth-breathers on nasal masks.

  • Aerophagia (swallowed air)

    Bloating and belching from air swallowed at higher pressures - often improved by lowering EPR, changing position, or switching to BiPAP.

  • Claustrophobia and mask anxiety

    A nasal pillow interface is often the answer. Desensitisation - wearing the mask awake for short periods - helps most patients settle within two weeks.

  • Compliance data matters

    Insurers, the DVLA and the sleep team all look at usage - typically over 4 hours per night on 70% of nights. Reaching it is worth aiming for.

  • Central apnoea on CPAP

    A small number of patients develop treatment-emergent central apnoea on CPAP. Picked up on the machine data - a switch to ASV or BiPAP may be needed.

  • Cleaning and consumables

    Weekly mask and tubing wash, filter change monthly, mask cushion every 3 months, tubing yearly. A schedule often comes with the machine.

  • Travel and airlines

    CPAP counts as medical equipment on all UK airlines and does not count against hand luggage. A travel letter and universal power adapter are supplied.

  • Red flags after starting

    New chest pain, worsening breathlessness, or waking gasping despite CPAP - call the sleep unit the same day.

Reading your CPAP notes

Your CPAP report in four parts. Read the last one first.

Whichever machine you were fitted with, the report the sleep physiologist sends you keeps to the same shape.

A London sleep physiologist reviewing CPAP compliance data

A quiet reminder

Sleep-medicine language is precise and can read coldly - ask for a plain-English explanation.

If anything in the report is unclear, ask your clinician to explain it in plain English.

  1. 01 Header

    Machine, mask and prescribed pressure

    Which machine you were fitted with, mask model and size, prescribed pressure range (APAP) or fixed pressure (CPAP), and EPR setting.

  2. 02 Technique

    Titration route and humidifier setup

    Attended in-lab titration or APAP at home, ramp settings, humidifier temperature, tubing type, and any comfort features enabled.

  3. 03 Findings

    Compliance and residual AHI

    Nightly usage hours, days used over 4 hours, residual AHI on machine data, leak percentiles, and central versus obstructive split.

  4. 04 Impression

    Fixed pressure, follow-up and consumables

    Read this first: whether a fixed pressure is being set, when the next review is, mask exchange window, and consumables schedule.

Recognised by major UK insurers

BupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealix

Cover for CPAP varies by insurer - most fund the sleep study and consultation, and many fund the machine.

Frequently asked

Common questions about CPAP.

Quick answers on titration length, masks, travel, insurance, cleaning, and APAP versus fixed pressure.

  • How long does CPAP titration take?

    For most patients APAP auto-titration runs at home for 2 to 4 weeks - the machine adjusts pressure night by night and the data is reviewed at the end. An in-lab attended titration is a single overnight polysomnography with a physiologist adjusting pressure in real time, reserved for complex cases, central apnoea or overlap syndrome.

  • Can I change my mask if it does not suit?

    Yes. The commonest change is from nasal mask to nasal pillow, or from nasal to full-face for mouth-breathers.

  • Can I travel with a CPAP machine?

    Yes. UK airlines treat CPAP as medical equipment - it does not count against your hand-luggage allowance. Modern machines run on universal 100 to 240V power and most have a battery pack option for camping or long-haul flights. A travel letter is supplied with the machine.

  • Will my insurance cover CPAP?

    Cover varies. Most major UK insurers (Bupa, AXA, Vitality, Aviva, WPA) fund the sleep study and consultation, and some fund the machine outright, while others reimburse a fixed contribution.

  • How do I clean my CPAP?

    Wash the mask cushion daily with mild soap and warm water. Wash the tubing and humidifier chamber weekly. Change the machine air filter monthly. Replace the mask cushion every 3 months and the full tubing yearly. Ask for a written schedule, and use app reminders for consumables if your machine has them.

  • What is the difference between APAP and fixed CPAP?

    APAP (auto-titrating) adjusts pressure night by night between a set minimum and maximum, responding to your breathing. Fixed CPAP delivers one pressure all night. Most patients start on APAP for titration and either stay on APAP long-term or have a fixed pressure set from the data once it has settled.

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