CPAP Therapy Tips

CPAP Machines: The Ultimate Guide to CPAP Devices and Features

Article Summary

This article provides the information you need to make smart decisions about your CPAP therapy. Learn all about CPAP machines and their most important features, and find out how they can benefit you as you start or continue your treatment.
 

Table of Contents

1. Benefits of Using a CPAP Machine | 2. What is a CPAP Machine? | 3. How to Use a CPAP Machine | 4. CPAP Humidifiers | 5. Top CPAP Machine Features | 6. CPAP Machine Cost | 7. Do I Need a Prescription? | 8. Why APAP Machines are Better | 9. An Overview of BiPAP Machines | 10. An Overview of Travel Machines | 11. References

What is Sleep Apnea?

In order to better understand CPAP machines (also known as PAP machines), we first need to set a good foundation by understanding Obstructive Sleep Apnea, and how it impacts your sleep. What is Sleep Apnea? Sleep Apnea is a condition in which the upper airway becomes blocked repeatedly during sleep. The blockages occur when the muscles of the throat and tongue relax during sleep, causing them to fall limp and block the throat, preventing air from reaching the lungs. Because these blockages occur every time a person falls asleep, the cycle of choking from lack of oxygen and waking up means the person is getting little good sleep during the night. This leads to a near constant tiredness and has many other negative health consequences1.

When you use a CPAP machine at night, you breathe in only highly pressurized air (from the machine) which opens your airway naturally so that you can breathe. This prevents you from waking up in the middle of the night and allows you to get better sleep. CPAP stands for “continuous positive airway pressure”, and is the most common treatment for Sleep Apnea.

Benefits of CPAP Therapy

According to an article found in the Journal of Family Practice2, treating Sleep Apnea has many positive health benefits, including:

  • more energy
  • improved mood
  • longer periods of sleep
  • reduced afternoon tiredness
  • lower blood pressure
  • reduced risk for heart attack and stroke
  • improved overall health

In the next section, we’ll go over CPAP machines in greater detail, along with the differences between CPAP, APAP, and BiPAP machines.

 
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What is a CPAP Machine?

According to an article published in the medical journal Respiratory Care, a CPAP Machine is a device used to treat Sleep Apnea3/sup>. It works by blowing highly pressurized air through the nose or mouth during sleep, connecting to the airway via a CPAP mask. CPAP masks come in a few styles, such as nasal masks, nasal pillow masks, and full face masks. Nasal masks and nasal pillow masks are for people who breathe through the nose (or for mouth breathers that use a chinstrap), and full face masks are for mouth breathers. Wearing the CPAP mask is important- it’s how the CPAP machine is able to do its work. Because the relaxed muscles blocking the airway are limp during sleep, the pressurized air is able to open the airway and deliver air to the lungs.

The earliest CPAP machines (sometimes called “Pressure Machines”), were originally developed using technology typically found in vacuum cleaners. Since then, there have been many advances in the technology. Machines have gotten lighter, quieter, and are overall far more portable than they were even a decade ago. Today’s machines bear little to no resemblance to their vacuum-motor cousins, as many are whisper-quiet and some can fit into the palm of your hand.

Popular CPAP Manufacturers

The most popular CPAP machine manufacturers on the market today are ResMed, Philips Respironics, Fisher & Paykel, Human Design Medical, DeVilbiss, and 3B Medical.

What Does CPAP Stand For? What are the Differences Between CPAP, APAP, and BiPAP?

“CPAP” is an acronym that stands for “Continuous Positive Airway Pressure”, and is a form of Positive Airway Pressure therapy or “PAP” therapy. There are 3 different styles of PAP devices: CPAP, APAP, and BiPAP machines. Each machine style features a slightly different way they blow air4. The pressure needed to open your airway varies from person to person and depends on many factors. CPAP machines are set at one specific pressure setting between 4 and 20, and that pressure is used at all times. If you actually need more or less during the night, the machine is not able to adjust.

APAP, on the other hand, stands for “Automatic Positive Airway Pressure” and CAN adjust the pressure based on a breath-by-breath basis. Like CPAP machines, they operate in the same range of pressures between 4 and 20, but unlike CPAP machines, they can automatically choose the right pressure setting. This allows for much better flexibility than a CPAP machine, and it’s largely why APAP machines are so popular today4.

BiPAP machines, also known as BiLevel machines, is an acronym that stands for “BiLevel Positive Airway Pressure” and operates at pressure settings between 4 and 25. They are unique in that they have two pressure settings, one for inhale and one for exhale. BiPAP machines are typically used to treat Central Sleep Apnea, as they can prompt breathing, and they can be set at a pressure setting higher than 20 if it is required4.

 
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how to use a cpap machine

How to Use a CPAP Machine?

Once you set up the machine for the first time, using a CPAP machine is fairly easy. Setup can seem a little complicated but don’t worry, it’s not as hard as you may think. You’ll need to do the following steps:

  1. Install the Filters
  2. Attach the Hose to the Machine
  3. Connect the Mask to the Hose
  4. If You Have a Humidifier, add Distilled Water to the Water Chamber.

Notice that we didn’t include instructions on how to set the pressure! That’s because the pressure is written on the prescription, and when you order from CPAP.com we set the pressure up for you. Just like you wouldn’t increase dosages of prescribed medication on your own, it’s a bad idea to mess with your CPAP pressure settings by yourself. After your machine is set up, you’re ready to use the machine. Follow these steps:

  1. Position the mask and headgear on your head
  2. Depending on the type of mask you have, you’ll situate the mask so that it covers the nose, mouth, or seals at the base of the nose.
  3. If your headgear has straps, tighten them for the best fit.
  4. Turn on the machine. You will feel a rushing sensation of air, and that’s ok. Try to relax and breathe normally

That’s all there is to it! If you’re stuck or need more help, please check out the following resource on exactly this topic: How to Use Your CPAP Machine.

In the next section, we’ll cover important features that you may want when shopping for your first (or next) CPAP machine.

 
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Understanding the Most Common CPAP Features

When shopping for your first Sleep Apnea machine, it’s helpful to know what features are most important to you before buying. Do you want a travel CPAP machine? Are you more interested in a quiet CPAP machine? These considerations are very important. In order for your treatment to be successful, you need to use your CPAP machine every night. If you get a machine that’s right for you, it’s easier to stick with your treatment and experience the benefits of successful CPAP therapy.

CPAP machine features most people look for:

  • Small Machines Designed for Travel
  • Humidification Options
  • Quiet Machines (Under 30 dB)
  • Ramp-up Feature (gradual increase in pressure while you fall asleep, a comfort feature)
  • Advanced Data Recording / Smartphone App

Let’s talk briefly about each feature and why it’s important to some people.

CPAP Travel Machines

Some CPAP machines can be bulky and heavy and are not optimized for frequent travel. Many are great as home units, but they don’t pack well. A few of the more recent machines are designed for travel. Many have battery power options for extra portability.

Travel machines are small, compact, and lightweight. Some models are small enough to fit into the palm of your hand! But just because a machine has been designated as a travel device, doesn’t mean it isn’t suitable for home use. Many travel CPAP owners use their machine at home and when traveling.

Even though travel machines are portable, none come with a built-in travel battery. Like many other high-end electronics, batteries are accessories that you can get with your new machine, or you can add one at a later time. Your travel machine doesn’t require a battery to work. It can be plugged into the wall socket as usual, but if you want to use it in-flight, you’ll need to get a CPAP battery.

For more information about CPAP batteries, please see the CPAP power solutions resource.

For more information about Travel CPAPs, please see the CPAP travel machines resource.

 
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CPAP Humidification

Humidification is a comfort feature designed to prevent your nose and mouth drying out during CPAP therapy. A humidifier adds moisture to the air you breathe so that as you sleep so that when you sleep, you aren’t left with severe discomfort.

CPAP humidification works by adding moisture back into the air you breathe, through the use of a small reservoir of water that’s attached to the machine. There are two types of humidifiers:

  • Passover (Cold) Humidifier
  • Heated Humidifier

Let’s go over this in a little greater detail:

Passover Humidifier – A passover humidifier (cold humidifier) doesn’t require cold water to work. It’s called a passover humidifier because the therapy air “passes over” the humidifier and picks up moisture from the water along the way. It then travels through the hose to your mask. It’s called a cold humidifier because it doesn’t use heat to create the humidity.

Heated Humidifier – A heated humidifier uses a thin metal heating plate to add humidity to the air, creating warm moisture that many people find comfortable. If you find that condensation is forming in the hose creating water droplets, you can use a hose cover (kind of like a coat for your hose), or you can use a heated hose, and that should take care of the problem.

Many CPAP users, including myself, find humidification to be more of an essential feature than an added luxury.

 
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Top CPAP Machine Features

Quiet Machines Under 30 dB

In order for a CPAP machine to improve your sleep, you need to actually be asleep. If you’re a person that cannot sleep with any noise, then a quiet machine is very important. There are several machines that have decibel ratings under 30, which is considered to be almost-whisper quiet. It’s also possible to reduce the noise the machine makes by using a quiet mask with a quiet machine. Since much of the noise has to do with the mask itself, a quiet machine and a quiet mask is very helpful.

There are a couple of good resources for quiet machines and masks:

Consider a Quiet CPAP Machine Under 30 dB
Quiet Masks for Quieter Therapy

Ramp-Up Feature

Ramp-up is a feature some machines have to improve comfort. When using ramp, the machine starts at a lower pressure and gradually increases to the pressure you need for your treatment. This reduces any discomfort that you may feel from having too much pressure all at once. Ramp is a great way to eliminate the feeling and makes it easier to fall asleep. For many people, ramp is just as essential as humidification.

Advanced Data Recording

When you’re using your CPAP equipment frequently, it’s important to know how you’re doing.

Many CPAP machines have advanced data tracking to a micro SD card, and some have a mobile app that connects to the machine via Bluetooth. Data tracking can tell you things like what your AHI (Apnea-Hypopnea Index) was last night, how long you slept, and how many blockages, apneas, and hypopneas you experienced during sleep. For many people, data tracking is an essential tool to have.

Other Helpful Resources:

Everything You Need to Know About Buying a CPAP Machine

In the next section, we’ll go over CPAP machine cost in greater detail, and tell you what you may expect to pay for a new machine.

 
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graphic showing CPAP machines with price tags

CPAP Machine Cost

When you start looking for a CPAP machine you’ll find that the costs vary widely. For most new CPAP customers the initial setup cost is right around $650 – $1,000 when you factor in the cost of a machine and a mask.

There’s a general rule-of-thumb to follow when considering buying a CPAP machine.

  • The average cost for a CPAP machine is right around $500
  • APAP machines usually cost near $800
  • BiPAP machines are the most expensive and start out at around $1,300

Should You Buy a CPAP Machine Online?

Buying online has many distinct advantages over going through your insurance to get a CPAP machine. The biggest advantage you get when you buy online is getting a CPAP machine that is less expensive and has exactly the features you want.

When you go through insurance, they pick out the machine for you, and it’s often more expensive than what you could get on your own. Insurance companies consider travel machines to be “luxuries” and often times won’t pay for one. So if there’s a specific brand of machine that you’re interested in or a specific feature that’s important to you, it may make more sense to buy online – at CPAP.com.

You Can Still File a Claim After Purchasing from CPAP.com

Just because you buy online with CPAP.com, you can still file a claim with your insurance company. CPAP.com provides you with an insurance-compliant invoice so that you can submit it for reimbursement as an out-of-network DME.

You’ll want to check with your insurance company for exactly what their coverage options are for an out-of-network DME before you make a purchase if you’re planning on seeking reimbursement.

Helpful Resources:

Everything You Need to Know About CPAP Machine Cost

In the next section, we’ll cover prescriptions, and discuss why you need them and how to get one.

 
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graphic showing a man wearing a CPAP mask, with question marks floating overhead

Why Can’t I Get a CPAP Machine Without a Prescription?

This is a common frustration among newly diagnosed CPAP patients. Federal and State law requires a doctor’s prescription to be on file before a CPAP machine can be sold to a customer. This is because a CPAP machine is considered a Class II Medical Device, a medical implement requiring a doctor’s care while using. Examples of Class II Medical Devices are CPAP machines, BiPAP machines, APAP machines, and Oxygen Concentrators.

For more information on this topic, please see this resource from the FDA about device classification and regulation.

How to Get a CPAP Prescription

While your family doctor can write a prescription for a CPAP machine, it’s a better idea to see a sleep specialist and do a sleep study. Technology has advanced so much recently that a sleep study can now be done 100% at home, with no need to spend the night at a sleep lab. The sleep study can find your AHI and from that information, the sleep specialist can prescribe the best pressure to treat sleep apnea.

When you buy your machine from CPAP.com, we will set the pressure based on your doctor’s orders. Once CPAP.com has your prescription on file, you don’t have to submit it again. We’ll store it for you so that when you’re ready for your next purchase you can buy quickly and easily.

Helpful Resources:

Why Can’t I Get a CPAP Machine Without a Prescription?

In the next section, we’ll go over the reason APAP machines are generally better and more widely used than CPAP machines.

 
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graphic showing boxing gloves representative of a showdown between CPAP machines and APAP machines

The Simple Reason APAP Machines are Better Than CPAP Machines

For many users, APAP machines are the clear choice over CPAP machines. Here’s a list of things to consider when choosing between a CPAP or an APAP machine:

  • Most APAP machines can also be set to a straight CPAP mode, allowing you to discover which titration therapy works best for you.
  • Some patients don’t have the same breathing patterns throughout the night due to a variety of reasons like sleeping positions and sleep stages (REM and non-REM sleep). APAP machines automatically adjust to different pressure settings between your low range and high range settings.
  • If you suffer from a cold or allergies, your airways become congested and breathing is more difficult. In these cases, a range in air pressure may be needed to reduce apnea events.
  • Changes in your health such as weight loss/gain can require different settings, and an APAP will automatically make those adjustments. A CPAP machine requires you to recalibrate your pressure settings, and that means waiting for a doctor’s appointment.

APAP machines are often selected for their flexibility, ease of use, and their many advantages over CPAP machines. For more information on why you may want an APAP machine over a CPAP machine, please see the following resource:

The Simple Reason APAP Machines are Better Than CPAP Machines

In the next section, we’ll help you figure out if you need a BiPAP machine and if one would be right for you.

 
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bipap aircurve 10

How to Know if You Really Need a BiPAP Machine

Not everyone needs a BiPAP machine. In fact, most people who have been diagnosed with Sleep Apnea may find that a CPAP machine or an APAP machine more than adequately meet their therapy needs5. So when and why would a person need a BiPAP machine? A person may need a BiPAP machine if they require a higher pressure setting than 20. BiPAP ST machines can also induce breathing if stopped, a feature that’s not available with a CPAP machine or APAP machine, and is helpful in treating Central Sleep Apnea.

Studies have found that switching to a BiPAP machine doesn’t necessarily improve compliance among PAP therapy users, but there are instances when BiPAP makes sense5.

BiPAP machines can be very helpful at improving comfort. They are smart enough to know when a person is breathing in, and automatically increase the pressure. It’s also smart enough to know when a person is exhaling and reduces the pressure so that it’s more comfortable to breathe.

For more information, on why you may want a BiPAP machine, see the following resource: How to Know if You Really Need a BiPAP Machine

Top Questions People Have About BiPAP Machines

Here are some of the most common questions customers have about BiPAP machines:

What’s the difference between BiPAP and BiPAP ST?

This is a question that a lot of people who are new to BiPAP machines have. A BiPAP ST machine has the ability to prompt breathing during the night. It tracks the number of breaths the user takes per minute and notes when the minimum amount has not yet been met. If that’s the case, the machine will increase the breath count by prompting the user to take a breath. A regular BiPAP machine does not have the ability to do this6.

I have a CPAP prescription. Can I get a BiPAP machine?

A prescription for a CPAP machine alone cannot be used for a BiPAP machine. In order to get a BiPAP machine, the prescription needs to specify that you are to have a BiPAP machine.

Let’s face it. It can be downright difficult to select your first Sleep Apnea machine. There are so many features and options to evaluate and choose from, but once you make sense of it all, you’ll be well on your way to getting better sleep.

For answers to more questions about BiPAP machines, please see this resource: Top Questions People Have About BiPAP Machines.

 
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graphic showing the Airmini overtop of a travel map

Detailed Information on CPAP Travel Machines

Originally, CPAP machines were large, bulky, and heavy devices to carry around. Traveling with a CPAP machine was difficult or impossible, and when plans called for being out-of-town, many people just chose not to bring it.

Fast forward to today. Travel machines dominate the marketplace, and many of the best machines are lightweight and ultra-portable. Today’s best machines are all small enough to travel easily, and some can even fit in the palm of your hand.

Many of our travel machine customers are frequent travelers who depend on these portable machines as part of their day-to-day routine. In fact, newer models such as the Resmed AirMini and the Philips Respironics DreamStation Go are among our top sellers.

It’s worth mentioning that for the most part, insurance companies view travel CPAP machines as “luxuries” and do not accommodate special requests for travel machines for newly diagnosed CPAP users.

For many customers, a travel machine is an essential purchase, and there’s no better time than now to shop for one!

 
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Comparing the Best CPAP Machines

Have you ever wanted to see top-rated CPAP machines compared head-to-head? Want to know about costs, warranties, weight, and portability, whether a machine offers the ramp feature, and which ones offer data tracking? Check out the article below, to get head-to-head comparisons among the best selling machines, and see which one is right for you.

Comparing the Best CPAP Machines

Conclusion

Hopefully, by now, you are armed with the tools you need to successfully treat Sleep Apnea!

Sleep Apnea has significant impacts on your overall health. By now you should realize that you have the best tools and options for living a life with a sleep disorder like Sleep Apnea. If you stick with your treatment, it’s possible to reduce the impacts of this condition and enjoy better sleep, more energy, lower blood pressure, and improved health.

No matter where your Sleep Apnea journey takes you next, you can now be sure you can meet whatever challenges confidently with the tools that can help you succeed.

References:

1. Amedee, Ronald G., MD, et al. Obstructive Sleep Apnea: A Growing Problem. Published in The Ochsner Journal, Fall 2009. Accessed on August 15, 2018.

2. Tipton, John W. What Are the Benefits of Treating Sleep Apnea? Published in the Journal of Family Practice, December 2001. Accessed August 14, 2018.

3. Andreea Antonescu-Turcu, MD and Sairam Parthasarathy, MD. “CPAP and Bi-level PAP Therapy: New and Established Roles”. Published in the medical journal Respiratory Care, June 22, 2011. Accessed on August 14, 2018.

4. Kushida, Clete, M.D., Ph.D., RPSGT, et. al. Clinical Guidelines for the Manual Titration of Positive Airway Pressure in Patients with Obstructive Sleep Apnea. Published in the Journal of Clinical Sleep Medicine, February 2008. Accessed on August 14, 2018.

5. Hiensch, Robert; Nandedkar, Desh S; and Feinsilver, Steven H. Optimizing CPAP Treatment for Obstructive Sleep Apnea. Published in the medical journal “Sleep Related Breathing Disorders” on April 23, 2016. Accessed August 15, 2018.

6. Highcock, M.P., Shneerson, J.M., Smith, I.E. Functional Differences in Bi-Level Pressure Preset Ventilators. Published in the European Respiratory Journal, 2001. Accessed August 15, 2018.

 
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David Repasky has been using CPAP treatment since 2017 and has first-hand experience with what it’s like to live with Sleep Apnea. He brings the patient’s perspective to the CPAP.com blog and has received formal training in CPAP machines, masks, and equipment.

2 comments

    i have been using an APAP machine with humidifier for 5 years and my AHI has been around 1.3 with pressure of 14cmwc on a yearly average. Do I need to continue with it and more to the point, how often should I undergo a sleep study
    What is the AHI for ‘normal’ individuals?

      If your AHI is less than 5, you’re doing great! My nightly AHI is between 4 and 1.5, depending on how I sleep. In my experience I haven’t found I’ve ever gotten an AHI of 0.

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