Frequently Asked Questions About CPAP
What is Sleep Apnea?Sleep Apnea is a breathing disorder. The Greek word “apnea” literally means “without breath.” There are three types of apnea: obstructive, central, and mixed; of the three, obstructive is the most common. Despite the difference in the root cause of each type, in all three, people with untreated sleep apnea stop breathing repeatedly during their sleep, sometimes hundreds of times during the night and often for a minute or longer. What are the symptoms of Obstructive Sleep Apnea (OSA)?The most common symptoms of OSA in adults are loud snoring and excessive daytime sleepiness. Almost all people who have OSA snore, but not all people who snore have OSA. Other signs and symptoms of OSA include: episodes of not breathing; Restless tossing and turning during sleep; nighttime choking spells, sweating, and chest pain; waking with an un-refreshed feeling after sleep, having problems with memory and concentration, feeling irritable and tired, and experiencing personality changes; morning headaches; heartburn or a sour taste in the mouth at night; in obese adults, swelling of the legs; getting up during the night to urinate; daytime naps or sleeping during inappropriate times or activities. People with Sleep Apnea may exhibit onset high blood pressure, unexplained weight gain, depression and other health conditions.What is the most common treatment for Sleep Apnea?The most common treatment for Sleep Apnea is CPAP, or Continuous Positive Airway Pressure (CPAP), therapy. There are several different types of machines for Positive Airway Pressure (PAP). Treatment involves a PAP machine and a mask. What is a CPAP Machine?
CPAP stands for Continuous Positive Airway Pressure. A CPAP machine delivers a constant flow of air into your mask, at a constant pressure determined by your doctor, to open your airway, and deliver air to your lungs. With a CPAP system, you must exhale your air back thru your mask and against the pressure of the CPAP. For most sleep apnea patients, this can be uncomfortable at first, but easily adapted to within a few weeks. However, some patients, especially those at higher pressure settings, still have a hard time adjusting to their machine. For those patients, some of the manufacturers have developed a feature on their machines that slightly lessens the air pressure when the patient exhales. For instance, Respironics calls their expiratory pressure relief feature “C-Flex”. C-Flex drops the machine’s pressure slightly at the beginning of the exhale cycle, which makes the therapy more tolerable for many patients. What is an Auto-Machine or APAP?With an APAP, sometimes referred to as an auto-titrating machine, the machine is set to a “range” of pressures and will move up or down within that range to provide the patient with the right amount of pressure during the night to overcome airway obstructions or apneas. If you are constantly fighting with your CPAP, you can ask your Doctor to write you a prescription for this type of machine. Many people who cannot tolerate CPAP can tolerate the auto titrating machines. APAP machines have the benefit of automatically compensating for your changing CPAP pressure needs. Your pressure needs can vary over time as you gain or lose weight, or as you get older. Your pressures can even vary from night to night, for instance, if you have taken cold medication or consumed alcohol; this can cause the muscle tone in your airways to lessen, and it will take more air pressure to keep them open. What is a BiLevel or BiPAP machine?A BiPAP, or BiLevel has two different pressure settings; one for inhalation (IPAP) and one for exhalation (EPAP). The machine provides the inhalation pressure, and then switches to a lower pressure during exhalation. This differs from CFlex because the exhale pressure is an exact setting, not just a drop in pressure. BiLevel machines are sometimes required by patients who have relatively high pressure settings and find it uncomfortable to exhale against the pressure. Also, some patients have underlying conditions like weak chest wall muscles or COPD that make it difficult or impossible to exhale against higher pressures.What are the benefits of adding humidification to CPAP therapy?Many people who are prescribed a regular CPAP regimen end up suffering from dryness and congestion in their nasal passages and throat, sore throats, and even nose bleeds. This is caused by the drying effect of the pressurized air moving across the mucous membranes. Humidification can help by adding additional moisture to the air that travels into the lungs. The additional moisture can help compensate for dried out nasal and throat tissues, preventing the problems mentioned above. How do I know which machine I need?First you must find out if your doctor prescribed for you a CPAP, CPAP with CFLEX, Auto-Titrating CPAP (Auto-PAP, APAP), Bi-Level (BiPAP), or an auto-titrating Bipap (Bipap Auto). The type of machine your doctor chooses for you is based on the information he received from your Sleep Study. If you are unsure, please ask your doctor why he chose a particular type of machine for you.
What is the difference between a cool passover humidifier and a heated humidifier?Humidifiers function through the process of water evaporation as air is drawn across a pool of water. A cool passover humidifier tries to use the surface area of the water to maximize humidification. Therefore, these units are usually wide and flat, and are usually stand-alone units. Heated humidifiers increase the evaporation rate by heating the body of water. The evaporative process is enhanced due to the higher temperature of the water. Since the surface area of the water is not as important, heated humidifiers can usually be much more compact than passover humidifiers. I am getting excessive water condensing in my mask and breathing tube. Is there any way to stop this from happening?“Rainout” is the term that is commonly applied to this condition, and it is usually caused by moisture condensing from the warm, moist air moving through the relatively cool breathing tube. Some possible solutions to this problem would be to make sure that the humidifier is not positioned at a level above the patient. Also, sometimes this can be alleviated by simply routing the breathing tube under the covers to keep it warm. If this is not an option, there are hose wraps made of fleece-like material that can be wrapped around the breathing tube to insulate it. Sometimes, simply turning the humidifier setting down slightly will cure this, or raising the temperature of the room a little bit. What is a nasal mask?A nasal masks seals around the entire nose and is held in place with straps, or headgear. ** Please Note — if your mouth comes open at night-you may need to use a chin strap (a strap that goes underneath your chin and fastens on top of your head-this helps to keep your mouth closed) or a Full Face Mask (a full face mask covers your nose and mouth) What is a full face mask?A full face mask seals around both the nose and mouth and is held in place with straps, or headgear. Full face masks are used for ‘mouth breathers’. For some people the mouth tends to drop open unknowingly during sleep. This allows the treatment pressure (what your machine pressure is) blowing through the nose through a nasal mask to escape through your mouth, which means your airways are not held open by your prescription pressure any longer. The full face mask allows you to continue to receive your therapeutic pressure because your nose and mouth are covered and you are not losing your pressure. Sometimes nasal blockages like a common cold or those who have nasal congestion due to illness or allergies might also need a full face for consistent treatment. Many people will use a nasal mask during most of the year and will switch to their full face mask when they can’t breathe through their nose.What are Nasal Pillows or Nasal Cushions?Nasal pillows sit right at the entrance to your nose-or, your nostrils. They don’t go in far, they form a gentle cushiony seal and are held in by a formed headgear. The cushion does not fit over the tip of the nose or rest on the bridge. A nasal cushion normally seals over both nostrils and is similar to the nasal pillows. Does every mask work with every machine?Yes-every mask works with every machine. In other words, if you have a Respironics machine and want a Fisher/Paykel mask-they are all compatible-no matter what combination. However, always read the manual that comes with your machine and mask for up to date information on compatibility issues with auto-titrating machines. Does every mask fit on my tubing?Yes, every mask is made with a universal fit to your tubing. Occasionally, we hear that people are having trouble getting their new mask on their old tubing-it is almost ALWAYSbecause a piece of your old mask is stuck on the end of your tubing by mistake. How often will insurance pay for new supplies for my CPAP?Medicare and most insurance will pay for new supplies as follows:Nasal and Full Face Masks 1 every 3 monthsHeadgear 1 every 6 monthsTubing 1 every 3 monthsNasal Pillows 2 every 1 monthFull Face Liner 1 every 1 monthWhite Disposable Filter 2 every 1 monthGrey Non Disposable Filter 1 every 6 months Do I have to take my machine with me when I travel?The answer is almost always yes. Check with your doctor to determine if traveling without your CPAP is safe. Can I use my machine if I travel out of the country?Yes. Some machines are made to handle 100 to 240 volts. Those that do not have this dual capability will need a converter. Keep in mind that you will require an adaptor which will allow you to use a US power cord in an overseas outlet. Can I use my CPAP while camping?
If you are going to a camping ground where normal mains power is available you should always use your CPAP. If you are concerned about the environment being much colder than your bedroom, you should discuss this with your sleep clinic or supplier before leaving. Some simple remedies such as running CPAP tubes under the bedclothes may be sufficient to warm the inspired air. Alternatively, you may need to consider hire or purchase of a heated humidifier. Can I use my CPAP with a battery?Using CPAP with a battery requires some planning and you need to consult your CPAP supplier well before leaving on your holiday. Some newer CPAP machines are able to operate directly from a battery in which case you will only need the adaptor from car to CPAPmachine. Other machines will operate if a suitable inverter is used. An inverter is a device that takes input from a battery (12V DC), and makes it into a similar voltage to normal mains power (240V AC). You should be aware that different inverters may vary in their characteristics and some may be more suitable than others for use with your CPAP machine. Use of an inverter that is unsuitable for your machine may shorten the life of the CPAP machine by placing greater stress on the motor. It is very important that you consult the supplier of yourCPAP for information about which inverters are recommended. How long will my CPAP run on a battery?This is very dependent on the type of CPAP machine and the pressure delivered. Older CPAPmachines tend to use more power and when the pressure delivered is higher, more power is used. In general a well charged car battery will operate a modern CPAP machine (through an inverter) for at least 8 hours. However, it is important that if you are dependent on that battery to start you car in the morning, you check this out before finding yourself stuck with a flat battery. If you can afford to buy a second battery, a deep cycle marine or recreational vehicle battery would be a good investment. An auto electrician could arrange for this to be charged from your car’s alternator while travelling. In this way you will not be dependent on your CPAP battery to start the car. A battery charger may also be a good investment for those times when you can use mains power to recharge the battery. Can I use my CPAP on a ship or plane?Yes, but because of increased security measures at airports, it may be easier to travel if you have a copy of your prescription for your CPAP machine with you. It also is suggested that you call your airline ahead of time and ask if there is a special screening procedure required to carry on or check your CPAP device. See the CPAP travel page for more information on airline guidlines. Cruise ships and long distance airplanes are equipped with power outlets that are suitable for use with most CPAP machines. You must consult with the airline or shipping line concerned to find out the voltage that is available to you and then confirm with your clinic or supplier that the pump will operate at this voltage. The airline will generally require completion of a medical certificate by your doctor and may only approve the use of specific units during flight. As these arrangements with airlines can take some time it is best to commence these well before the date of departure.
CPAP stands for Continuous Positive Airway Pressure. A CPAP machine delivers a constant flow of air into your mask, at a constant pressure determined by your doctor, to open your airway, and deliver air to your lungs. With a CPAP system, you must exhale your air back thru your mask and against the pressure of the CPAP. For most sleep apnea patients, this can be uncomfortable at first, but easily adapted to within a few weeks. However, some patients, especially those at higher pressure settings, still have a hard time adjusting to their machine. For those patients, some of the manufacturers have developed a feature on their machines that slightly lessens the air pressure when the patient exhales. For instance, Respironics calls their expiratory pressure relief feature “C-Flex”. C-Flex drops the machine’s pressure slightly at the beginning of the exhale cycle, which makes the therapy more tolerable for many patients. What is an Auto-Machine or APAP?With an APAP, sometimes referred to as an auto-titrating machine, the machine is set to a “range” of pressures and will move up or down within that range to provide the patient with the right amount of pressure during the night to overcome airway obstructions or apneas. If you are constantly fighting with your CPAP, you can ask your Doctor to write you a prescription for this type of machine. Many people who cannot tolerate CPAP can tolerate the auto titrating machines. APAP machines have the benefit of automatically compensating for your changing CPAP pressure needs. Your pressure needs can vary over time as you gain or lose weight, or as you get older. Your pressures can even vary from night to night, for instance, if you have taken cold medication or consumed alcohol; this can cause the muscle tone in your airways to lessen, and it will take more air pressure to keep them open. What is a BiLevel or BiPAP machine?A BiPAP, or BiLevel has two different pressure settings; one for inhalation (IPAP) and one for exhalation (EPAP). The machine provides the inhalation pressure, and then switches to a lower pressure during exhalation. This differs from CFlex because the exhale pressure is an exact setting, not just a drop in pressure. BiLevel machines are sometimes required by patients who have relatively high pressure settings and find it uncomfortable to exhale against the pressure. Also, some patients have underlying conditions like weak chest wall muscles or COPD that make it difficult or impossible to exhale against higher pressures.What are the benefits of adding humidification to CPAP therapy?Many people who are prescribed a regular CPAP regimen end up suffering from dryness and congestion in their nasal passages and throat, sore throats, and even nose bleeds. This is caused by the drying effect of the pressurized air moving across the mucous membranes. Humidification can help by adding additional moisture to the air that travels into the lungs. The additional moisture can help compensate for dried out nasal and throat tissues, preventing the problems mentioned above. How do I know which machine I need?First you must find out if your doctor prescribed for you a CPAP, CPAP with CFLEX, Auto-Titrating CPAP (Auto-PAP, APAP), Bi-Level (BiPAP), or an auto-titrating Bipap (Bipap Auto). The type of machine your doctor chooses for you is based on the information he received from your Sleep Study. If you are unsure, please ask your doctor why he chose a particular type of machine for you.
What is the difference between a cool passover humidifier and a heated humidifier?Humidifiers function through the process of water evaporation as air is drawn across a pool of water. A cool passover humidifier tries to use the surface area of the water to maximize humidification. Therefore, these units are usually wide and flat, and are usually stand-alone units. Heated humidifiers increase the evaporation rate by heating the body of water. The evaporative process is enhanced due to the higher temperature of the water. Since the surface area of the water is not as important, heated humidifiers can usually be much more compact than passover humidifiers. I am getting excessive water condensing in my mask and breathing tube. Is there any way to stop this from happening?“Rainout” is the term that is commonly applied to this condition, and it is usually caused by moisture condensing from the warm, moist air moving through the relatively cool breathing tube. Some possible solutions to this problem would be to make sure that the humidifier is not positioned at a level above the patient. Also, sometimes this can be alleviated by simply routing the breathing tube under the covers to keep it warm. If this is not an option, there are hose wraps made of fleece-like material that can be wrapped around the breathing tube to insulate it. Sometimes, simply turning the humidifier setting down slightly will cure this, or raising the temperature of the room a little bit. What is a nasal mask?A nasal masks seals around the entire nose and is held in place with straps, or headgear. ** Please Note — if your mouth comes open at night-you may need to use a chin strap (a strap that goes underneath your chin and fastens on top of your head-this helps to keep your mouth closed) or a Full Face Mask (a full face mask covers your nose and mouth) What is a full face mask?A full face mask seals around both the nose and mouth and is held in place with straps, or headgear. Full face masks are used for ‘mouth breathers’. For some people the mouth tends to drop open unknowingly during sleep. This allows the treatment pressure (what your machine pressure is) blowing through the nose through a nasal mask to escape through your mouth, which means your airways are not held open by your prescription pressure any longer. The full face mask allows you to continue to receive your therapeutic pressure because your nose and mouth are covered and you are not losing your pressure. Sometimes nasal blockages like a common cold or those who have nasal congestion due to illness or allergies might also need a full face for consistent treatment. Many people will use a nasal mask during most of the year and will switch to their full face mask when they can’t breathe through their nose.What are Nasal Pillows or Nasal Cushions?Nasal pillows sit right at the entrance to your nose-or, your nostrils. They don’t go in far, they form a gentle cushiony seal and are held in by a formed headgear. The cushion does not fit over the tip of the nose or rest on the bridge. A nasal cushion normally seals over both nostrils and is similar to the nasal pillows. Does every mask work with every machine?Yes-every mask works with every machine. In other words, if you have a Respironics machine and want a Fisher/Paykel mask-they are all compatible-no matter what combination. However, always read the manual that comes with your machine and mask for up to date information on compatibility issues with auto-titrating machines. Does every mask fit on my tubing?Yes, every mask is made with a universal fit to your tubing. Occasionally, we hear that people are having trouble getting their new mask on their old tubing-it is almost ALWAYSbecause a piece of your old mask is stuck on the end of your tubing by mistake. How often will insurance pay for new supplies for my CPAP?Medicare and most insurance will pay for new supplies as follows:Nasal and Full Face Masks 1 every 3 monthsHeadgear 1 every 6 monthsTubing 1 every 3 monthsNasal Pillows 2 every 1 monthFull Face Liner 1 every 1 monthWhite Disposable Filter 2 every 1 monthGrey Non Disposable Filter 1 every 6 months Do I have to take my machine with me when I travel?The answer is almost always yes. Check with your doctor to determine if traveling without your CPAP is safe. Can I use my machine if I travel out of the country?Yes. Some machines are made to handle 100 to 240 volts. Those that do not have this dual capability will need a converter. Keep in mind that you will require an adaptor which will allow you to use a US power cord in an overseas outlet. Can I use my CPAP while camping?
If you are going to a camping ground where normal mains power is available you should always use your CPAP. If you are concerned about the environment being much colder than your bedroom, you should discuss this with your sleep clinic or supplier before leaving. Some simple remedies such as running CPAP tubes under the bedclothes may be sufficient to warm the inspired air. Alternatively, you may need to consider hire or purchase of a heated humidifier. Can I use my CPAP with a battery?Using CPAP with a battery requires some planning and you need to consult your CPAP supplier well before leaving on your holiday. Some newer CPAP machines are able to operate directly from a battery in which case you will only need the adaptor from car to CPAPmachine. Other machines will operate if a suitable inverter is used. An inverter is a device that takes input from a battery (12V DC), and makes it into a similar voltage to normal mains power (240V AC). You should be aware that different inverters may vary in their characteristics and some may be more suitable than others for use with your CPAP machine. Use of an inverter that is unsuitable for your machine may shorten the life of the CPAP machine by placing greater stress on the motor. It is very important that you consult the supplier of yourCPAP for information about which inverters are recommended. How long will my CPAP run on a battery?This is very dependent on the type of CPAP machine and the pressure delivered. Older CPAPmachines tend to use more power and when the pressure delivered is higher, more power is used. In general a well charged car battery will operate a modern CPAP machine (through an inverter) for at least 8 hours. However, it is important that if you are dependent on that battery to start you car in the morning, you check this out before finding yourself stuck with a flat battery. If you can afford to buy a second battery, a deep cycle marine or recreational vehicle battery would be a good investment. An auto electrician could arrange for this to be charged from your car’s alternator while travelling. In this way you will not be dependent on your CPAP battery to start the car. A battery charger may also be a good investment for those times when you can use mains power to recharge the battery. Can I use my CPAP on a ship or plane?Yes, but because of increased security measures at airports, it may be easier to travel if you have a copy of your prescription for your CPAP machine with you. It also is suggested that you call your airline ahead of time and ask if there is a special screening procedure required to carry on or check your CPAP device. See the CPAP travel page for more information on airline guidlines. Cruise ships and long distance airplanes are equipped with power outlets that are suitable for use with most CPAP machines. You must consult with the airline or shipping line concerned to find out the voltage that is available to you and then confirm with your clinic or supplier that the pump will operate at this voltage. The airline will generally require completion of a medical certificate by your doctor and may only approve the use of specific units during flight. As these arrangements with airlines can take some time it is best to commence these well before the date of departure.
