When Looking for a New CPAP or BIPAP

Here are some things to keep in mind
when making choices

Most medical equipment manufacturers make CPAP or BIPAP machines with durable medical companies in mind. The durable medical companies may want CPAP / BIPAP machines with certain abilities to meet the needs of doctors who order the CPAP or BIPAP machines for their patients with Sleep apnea. This is why many of the machines come with extra features such as memory for recording sessions and compliance meters. They allow the doctor to monitor the patient with apnea.  These extra features may or may not be important to you when ordering the equipment and may only add to the total cost of the CPAP or BIPAP machine.

Sometimes there are certain extra features that you absolutely must have on your CPAP or BIPAP.  For those who travel often, light weight machines that adjust for altitude and run off 110 or 220 electrical currents may be important.  For those traveling in four-wheel vehicles, buying CPAP or BIPAP products with the capability of operating using DC adaptors, or inverters which convert DC to AC would be important.

Ordering spare parts such as fuses, humidifier chambers, hoses and masks are also important things to consider when initially purchasing your CPAP or BiPAP.  Having spare parts around the house may come in handy if the unthinkable occurs and one of them breaks in the middle of the night!  And, certainly, once you have found yourself the CPAP mask that you have come to love, don’t leave yourself without a spare.  If it breaks in the middle of the night it could take days before a new CPAP mask could be shipped to you!

Once you start using your CPAP / BIPAP machine, I know you’re going to love it!  Before you know it, trying to sleep without a CPAP / BIPAP will be unthinkable. 

CPAP (Continuous Positive Airway Pressure) is a compressor used in the treatment of obstructive Sleep Apnea. It gives you single set pressures through a nasal mask worn over the nose and or mouth.

A physician’s prescription is needed to purchase this equipment.  

Bi-level (BI = two pressures or BIPAP and VPAP)  is an air compressor that gives you two pressures. It works the same as a CPAP but allows the user to exhale at a lower pressure.  A BIPAP is generally for people who cannot adjust to the constant pressure of a CPAP. 

A physician’s prescription is needed to purchase this equipment.  

APAP (Auto PAP/Auto Titrate—A Smart Machine!) determines the correct pressure needed to open up your airway.  At any given time, it is sampling a number of different indicators to adjust itself up or down in pressure.  This will reduce the average pressure delivered throughout the night.  By keeping the pressure as low as possible, the CPAP user is more comfortable and is more likely to keep using their CPAP.  Sleep studies give you a read-out on what pressure needs you have for one night but APAP will be able to adjust for any possible pressure you might need on any given night.  APAP will adjust to any new possible changes you may have in your life such as a gain or loss of weight or simply the accumulation of time as you grow older.  You or your insurance may not want to pay for a new sleep study every time these changes occur.  With APAP you do not have to worry. APAP will always adjust itself to most any situation.

A physician’s prescription is needed to purchase this equipment.  

Cflex or Softx machines offer a more comfortable way to deliver CPAP therapy by taking the work out of exhalation.  The CPAP machine tracks and reacts to every breath throughout the night.  It allows for the user to get a drop in pressure for a split second during the exhalation process.  This makes for a more natural comfortable Night’s Sleep.

A physician’s prescription is needed to purchase this equipment.  

Bi-Flex combines the BIPAP and the Flex of the Cflex technology.  It softens the Airflow in both the inhalation and the exhalation making breathing more natural. This BIPAP machine is truly the “Cadillac” of BIPAP machines in regard to comfort.  If you have ever been uncomfortable on higher pressures, this is the way to go.  You will really come to love your Bi-flex!. 

A physician’s prescription is needed to purchase this equipment.  

Nasal CPAP Masks comes in a variety of shapes and sizes. It’s the standard way of delivering positive pressure.  It’s the best choice for those who don’t mind the feeling of something covering their face and nose and are comfortable breathing through their nose.  This CPAP nasal mask has the least amount of problems when compared to the other interfaces. 

Full Face CPAP Masks cover both the nose and the mouth. It works very well for mouth breathers and people who have tried Nasal CPAP masks on higher pressure who blow through their lips when they fall asleep.  Minor adjustments may be made to allow the surface area to remain sealed all night.

Nasal Pillows  (Nasal Aire and Breeze) are great for people who can’t stand a mask on their face. They offer the strong advantage of having very few leaks. They are also the easiest to fit correctly and get on and off your head.  .  I highly recommend buying the fisher paykel or other brand of heated humidifier in conjunction with this purchase to offset higher pressures and nasal dryness from air passing up your nose. 

Cool Humidification allows air to pick up moisture by running over the surface of the water.  Non-heated humidifiers rely on surface area, time and flow to determine humidity output at a set temperature.  A standard Passover device with no baffles, flow redirection and or limited surface area can produce the lowest humidity output.  Advanced Passover systems such as the OASIS humidifier by Respironics utilizes a combination of large surface area, flow redirection and a baffle system to produce a much higher humidity output. 

A physician’s prescription is needed to purchase this equipment.  

Heated Humidification also allows air to pick up moisture.  Humidity levels are usually raised by heating water.  The higher you raise the temperature, the more moisture air can hold; however, if you raise the temperature too high you may get watery-rain-out in the tubing.  Rain-out is water that collects in the CPAP tubing when using a heated humidifier.  It happens when the warm humidified air which can hold more water than cool air, travels through the cooler air around your CPAP hose.  As the air in the hose cools, the water that the cool air can't hold "rains out" in the tube.  It can be troublesome because the water eventually makes its way out of the CPAP tubing; it will make a gurgling sound and may even get on your face or nose. Purchasing and using Insulation Sleeves for the CPAP tubing will prevent this. It will keep the air from cooling off in your CPAP tube.

A physician’s prescription is needed to purchase this equipment.  

A CPAP users feeling of well being and health is directly related to how often they use their CPAP.  Some problems that may encumber patient’s compliance may include nasal irritation and dryness.  Supplemental humidity is an important management tool to combat this unintended side-affect.

Humidifiers vary in design and style from manufacturer to manufacturer.  Some of these manufacturers have started to make integrated humidifiers that will only work with their machine.  Becoming aware of this is important to your selection.  You don’t want to buy a humidifier that doesn’t work on your machine!

Heat and cool humidifiers both do the job of producing molecular humidity. This fact supports the idea that home CPAP humidifiers, even in the face of poor cleaning technique, are an unlikely source to spread infection. Pathogens colonizing in the chamber would not be carried upstream in the gas because the water vapor particles are too small to carry a virus or bacteria.  Water-rains-out, however, does spread pathogens along the tubing to you.  We strongly advise you to follow the manufacturer’s recommendations for cleaning your equipment.

Chin Straps helps keep your mouth closed during deep sleep.  During the stage of deep sleep, people lose muscle tone temporarily and often a result of this is that their mouth may come open.  A chin strap will not keep high CPAP pressures from blowing through and forcing your mouth open.  Air will just push pass through your lips instead.  It also will not stop you from voluntarily opening your mouth. 

Relative contraindications of CPAP include individuals with bullous lung disease, history of a Pneumothorax, and recurrent sinus or ear infections. There are no absolute contraindications.

CPAP should be temporarily discontinued and a Doctor consulted if pressure changes associated with CPAP aggravates a sinus condition, middle ear infection or severe inner ear discomfort.  Conjunctivitis from air leaking into your eyes and skin abrasions on the bridge of your nose associated with CPAP may all be due to a poorly fitted CPAP Mask.

INSURANCE NOTES:

Many insurance companies will not pay for a BIPAP, APAP,  or BIFLEX unless you have already failed a minimum of at least a one to three month trial on CPAP.  Check with your physician, and or health insurer for the specific details of your health insurance policy.