This is a level of use of therapy that is considered necessary to achieve benefit. Your insurance company will require that you show this minimal level of use to justify covering the costs of therapy. Bear in mind that the level of therapy usage required for one patient to feel better will differ from others, even though insurance companies usually use a single threshold.

Both insurance carriers and sleep specialists can review CPAP usage by way of built-in monitoring technology in order to see if you are using therapy as needed. This is the same technology that allows your sleep specialist to see other important information about your therapy, such as whether there is ongoing sleep apnea and how well your mask is fitting.

There is either a data card inside the machine that measures usage, which can be uploaded at the sleep clinic for review, or a wireless service that streams the same data live, and made directly accessible to your doctors.

In some instances, if a patient is not achieving their usage target, the insurer may refuse to reimburse that patient for the machine or supplies and may even ask for the machine to be returned. This is often referred to as a "use it or lose it" mentality among insurance payers. This kind of system exists because CPAP is a device rather than a medication. For example, if a patient is prescribed a medication for high blood pressure but they don’t take it as prescribed, the doctor simply won’t issue a refill and there is no need for the ‘use it or lose it’ approach.

Most people don’t like to be told what they have to do and some will resist that kind of demand. A positive mindset is encouraged, remembering that the more you use PAP, the larger are the possible benefits.