What is a CPAP Machine?
CPAP stands for “Continuous Positive Airway Pressure” and is a device used to treat Sleep Apnea. ”CPAP therapy” as it’s commonly called, is the process of treating Sleep Apnea by using pressurized air to open up the throat during sleep, allowing air to reach the lungs.
CPAP machines are most commonly used to create the pressurized air used in CPAP therapy, and are sometimes called “pressure machines”, “apnea machines”, and “breathing machines”.
The earliest CPAP 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.
How is CPAP Different from an Oxygen Machine?
CPAPs and Oxygen are completely unrelated devices. An oxygen concentrator is used to treat conditions like COPD and Emphysema, but isn’t usually prescribed for Sleep Apnea. Like CPAP machines, Oxygen Concentrators are available by prescription only, and aren’t available for athletic training or other recreational activities.
A CPAP machine generates no oxygen, and simply pressurizes the outside air, and delivers it through a tube to the airway. If a person needs to use both machines at night, this is possible. A continuous flow oxygen concentrator connects to some masks and supplies the oxygen while the CPAP machine runs, pressurizing the oxygen-rich air and opening the airway. If you think you need both, you should consult your healthcare professional.
What is a CPAP used for?
CPAP machines are primarily used to treat Sleep Apnea, though they’ve also been used at other times to assist with oxygen therapy for patients with severe respiratory conditions. Sleep apnea machines are often used as a way of helping air reach the lungs during sleep, so that the patient can breathe, and blood oxygen levels can increase. This reduces the impact that Sleep Apnea has on a person’s overall health.
It’s important to realize CPAP machines aren’t a “cure” for Sleep Apnea, it only minimizes the symptoms.
Sleep Apnea can develop as a natural part of the aging process, or it can be the result of changes in a person’s body over time.
There are things you can do to help reduce the amount of tissue in the mouth, throat, or airway; like losing weight, or surgery. It’s important to know even these things won’t “cure” Sleep Apnea or guarantee it won’t ever come back. CPAP therapy remains one of the best, least invasive ways to treat Sleep Apnea, and make a difference for so many people1.
How Does a CPAP Machine Work?
Sleep apnea machines work by blowing 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 those that use a chinstrap), and full face masks are for those that breathe through the mouth.
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.
What Are The Different Types of CPAP machines?
“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 air. 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 today.
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.
Benefits of a CPAP Machine: Do they really work?
According to an article found in the Journal of Family Practice, 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
The truth is, CPAPs do work for many people, helping those that succeed at therapy live fuller, more productive lives. When CPAP therapy is working, you’ll feel a great difference in your energy level and how you function.
But like any treatment, as things change in your life, your response to the treatment will change too. That’s why regular communication with your doctor is important, so that he or she can make adjustments as time goes on, so you don’t miss a beat in your care.
If you want to know if your CPAP therapy is working, you’ll need to look at your data. Interpreting the data can be daunting at first, but we’re here to help. We’ve written two resources: How to Better Understand Your CPAP Results and How to Read CPAP Data. Once you understand what the data means, you can evaluate if your therapy is working.
Want to know how long it will take for CPAP to be effective? Consider reading our article: How Long Before CPAP Helps with My Sleep Apnea?
Side Effects, Common Problems, and Solutions for CPAP Machines
For regular CPAP users, there will always be problems that come up. Here’s a quick rundown of these issues, and what to do about them.
Mask Leaks: Masks don’t always fit properly, and sometimes the way CPAP users sleep causes the airtight seal to break, allowing much-needed therapy air to escape. Often times, mask leaks make a lot of noise, and can lead to the person waking up. Mask leaks aren’t just annoying, they can make your therapy less effective, and make your sleep problems worse– not better.
Sometimes all you’d need to do is tighten the mask, and that could fix the problem. If that doesn’t work, it could be the pillow, pressing up against the mask and causing the seal to break. To fix this issue, consider purchasing a CPAP pillow. These specially-designed pillows have spaces cut out to accommodate the mask, so that it doesn’t break the seal and cause a leak.
Water in the Hose: A heated humidifier gently heats the water in the humidifier tank, causing it to evaporate. As it travels down the tube, the air cools, and can no longer hold the moisture.
The moisture falls out, often winding up in the tube. This can lead to uncomfortable splashes during the night. The solution, in most cases, is to make sure the warm air stays warm. This can be done with a heated hose, or a hose cover. Both products help keep the air warm as it travels to the airway, and this, in turn, prevents the splashes.
Dry Mouth: Sometimes dry mouth can be caused by mouth breathing, or from not using a CPAP humidifier. If you’re naturally a mouth breather, dry mouth can easily be fixed by using a humidifier, as the humidifier adds moisture to your dry therapy air. It can also prevent nasal dryness if you breathe through the nose.
For more solutions to common CPAP problems, check out the following article: Easy Remedies to the 19 Most Common CPAP Problems
Strategies for Getting Used to CPAP Therapy
Getting used to CPAP therapy can be very difficult and stressful. You may find the CPAP mask to be uncomfortable and constricting, and you may have to change sleeping positions. After a few weeks, you may be ready to give up. Here are some steps to help you adjust and make it feel a lot more comfortable as you begin CPAP therapy:
- Practice makes perfect! Practice wearing the CPAP mask around the house, even when not connected to the machine. This will help you get used to therapy and is a desensitization technique many people practice when starting CPAP therapy
- Get used to the pressure and sound! Try turning on the machine and breathing normally. You’ll notice that even though the pressure has increased, you’re still breathing. Try listening to the sound of your machine for a little while even when you’re awake to get used to the noise. This will help make therapy seem more natural.
- Fight back against claustrophobia! If you feel claustrophobic about your CPAP therapy, try locating the vent holes in the mask. Then try breathing with the mask on, with the machine not running. This will help you realize you can’t suffocate while wearing the mask.
How much do CPAP Machines 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 without insurance 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
Purchasing a CPAP without insurance will cost you a lot less in the long run than buying directly from your insurance company’s CPAP supplier, which will often charge a higher rate than what the device would cost if you simply paid cash.
Best CPAP Brands
Most CPAP suppliers like CPAP.com carry a wide selection of devices at different price points. There are only about 3 major CPAP device manufacturers on the market today. Those manufacturers are:
- Philips Respironics
- Fisher & Paykel
We’ll go over these manufacturers a little more in greater detail below. All of these top machine manufacturers also have a wide selection of masks.
ResMed: In the CPAP industry, ResMed is considered to be one of the leading sleep apnea machine manufacturers and has the highest prices. ResMed manufactures the AirMini, AirSense 10, and the AirFit P10, along with many other products
Philips Respironics: Philips Respironics is another leading CPAP machine manufacturer, and is considered a close #2 in terms of quality, and has moderate to high prices for their machines. Philips Respironics manufactures the DreamStation and the DreamStation Go, as well as the DreamWear series of masks, along with many other products.
Fisher & Paykel: Fisher & Paykel sells the Icon series of machines as well as the SleepStyle. Based out of New Zealand, Fisher & Paykel is known for their quality, and occupy the #3 spot in the CPAP market. They also manufacture the Simplus Full Face mask.
Human Design Medical: Human Design Medical (or HDM) is a manufacturer of CPAP machines like the Z1, and has been in the game for years. The Z1 is currently their flagship product, and it’s a really popular travel device because of low costs and portability.
Somnetics: Makers of the Transcend line of CPAP and Auto CPAP machines, Somnetics is a US company, based in Minnesota. The Transcend is an innovative portable CPAP machine, that provides hours of therapy in a very small package.
The rest of the CPAP machine and mask market is occupied by several other manufacturers, including 3B Medical, DeVilbiss, and a few others. 3B Medical is known more for the Lumin CPAP Sanitizer than any of its other products. DeVilbiss manufactures the IntelliPAP series of devices.
Where Can I Buy a CPAP Machine?
There are two ways most people get their CPAP machine:
- Through an Insurance Provider
- By Buying Online
Since insurance covers most Sleep Apnea machines and treatments, why would anyone pay cash for a machine and buy online? The easiest answer to this complicated question is simple. Most of the time insurance companies won’t pay for CPAP machines if you haven’t met your deductible, meaning you’ll be renting it to begin with AND often times paying much more than what the machine costs.
Buying online is a lot less expensive, and if you’re going to have to pay out of pocket anyway, most people would prefer to pay less and get a better machine than what the insurance company is willing to provide.
Insurance companies also keep track of your nightly therapy usage, and if they don’t feel like you’re using the machine often enough, they’ll ask for you to give it back. When you buy a machine online, the online seller doesn’t track or look at your sleep data. It’s usually only shared with your physician. The online seller also won’t repossess the machine either once you’ve bought it. It’s yours; no matter how much (or little) you use it.
Insurance companies also have little incentive to give you the best machine for the price you pay, and oftentimes will not give you a quality machine. When you forgo insurance and pay cash, you’ll not only get a lower price, you’ll likely get a better machine.
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, as well as CPAP masks.
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.
CPAP Humidifiers: Overview and Benefits
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.
CPAP Accessories: Notable Examples
CPAP accessories are products intended to improve comfort while using your PAP device, and include some of the following items:
- Aromatherapy for CPAP Machines
- Hose Covers to Reduce Hose Condensation
- Bed Comfort Items
- Mask Liners for Reducing Irritation and Red Marks
- Sleep Tracking Devices
- Hose Lifts to Reduce Tangles
Aromatherapy for CPAP Machines: While it’s not safe to add ordinary scented oils to the water in the humidifier tank, the aromatherapy options for CPAP machines are engineered in a way that you can safely use certain scents in therapy. Scented oils calm and relax many people, so it’s only natural that a person would want to use it during sleep.
Hose Covers: If you use a heated humidifier and don’t have a heated hose, you could be opening yourself up for water splashes in the CPAP tube. As the air condenses and cools on its way from the machine to the mask, it often can’t hold all of the moisture, and it comes out of the air as drops of water.
Hose covers are an inexpensive way of keeping the air from losing its warmth as it travels through the hose, and helping reduce the condensation that forms inside the hose.
Mask Liners: Mask liners are cloth covers for the cushion of a CPAP mask. They’re intended to absorb human oils, make the mask feel less medical, and increase comfort while making a better seal. For anyone who struggles with a good seal or general mask discomfort, a mask liner may help.
CPAP accessories are all optional purchases, but some people consider them essential! Let’s face it. If your CPAP therapy is making you uncomfortable, you’re less likely to stick with it.
What is the best CPAP machine in 2019?
When it comes to the best CPAP machine in 2019, there’s lots of quality machines to choose from. In fact, there’s never been a better time to get a new CPAP machine! The best devices are loaded with quality features, that make it more comfortable than ever to use a sleep apnea machine.
Features like ramp and exhalation relief soften the pressure, making it easy to fall asleep and exhale. In fact many of the best machines are also APAP machines, which are sophisticated enough to tell when your breathing changes and you need more or less pressure. The machine knows what’s best and automatically adjusts.
Among APAP machines, these machines are some of the best on the market heading into 2019:
- ResMed AirSense 10 Auto Set
- ResMed AirMini Auto Set
- Philips Respironics DreamStation Auto
- Philips Respironics DreamStation Go Auto
- Fisher & Paykel SleepStyle Auto
Which one is the best? Well, that really depends. Certain aspects of CPAP therapy may bother you more than other things, so you’ll want to pay attention to things like noise, travel features, comfort features, and the like. Some machines are better than others in certain categories. For example, the AirSense 10 and the DreamStation Auto are both quieter than the AirMini, so if the noise from your machine bothers you, you’d want to go with either of those two machines. But if portability is more important than anything, you’d want an AirMini. It just depends on you and your preferences.
How to Clean Your CPAP
Cleaning your CPAP machine is easier than you might think. Sleep apnea machines themselves require only a little cleaning, and most of the cleaning required is actually for the mask, not the machine itself. Here’s a few ideas to help keep your CPAP machine in tip-top-shape.
Cleaning the Outer Case: You can wipe the outer case down with a damp cloth and that should be all that’s needed. The outer case doesn’t need to be cleaned with soap and water, and the only real thing you’ll need to worry about with the outer case is dust. A quick wipe down would be enough.
Cleaning the Humidifier: The humidifier is easily the dirtiest part of a CPAP machine, and if you use tap water instead of distilled water, you’re making the task unnecessarily difficult. Tap water leaves behind a residue of minerals and impurities inside the tank, that looks like a hard, chalky substance. It’s really difficult to remove, and requires a lot of scrubbing.
Or, you could use vinegar, and make the chalky film easier to get rid of. Remember that your humidifier tank is one of the dirtiest places on your CPAP machine. Warm water is a great breeding ground for germs and other pathogens, and if you don’t take the time to clean your tank, you could be breathing in germs all night long.
Cleaning the Mask: It’s important to mention that cleaning CPAP equipment is more about cleaning the mask than anything else, as that’s where most of the germs reside. It’s important to clean your mask daily, and do a deeper clean once a week. For more about cleaning: please see our article about the topic: Everything You Need to Know About CPAP Cleaning
Looking for a Cleaning Machine?
These days, cleaning machines are popular. Why? What’s the big fuss about? Cleaning machines are designed to clean a CPAP machine and accessories better and more effectively than soap and water, and they can do it in around 5 minutes. CPAP.com sells the Lumin, a CPAP cleaning machine that disinfects with powerful UV light in around 5 minutes.
It’s important to note that no cleaning machine on the market works like a dishwasher to actually scrub and clean CPAP items. CPAP cleaners just disinfect. To remove deposits, you’ll need to use soap and water or CPAP wipes to remove those.
How to Use a CPAP Machine
Using a CPAP Machine is simple. Follow these easy steps and you’ll be on your way:
- Fill your humidifier chamber with distilled water and place in the machine, if using a humidifier. You’ll always want to do this step first. You’ll also want to make sure you only use distilled water. Using tap water can leave a chalky film at the bottom of your humidifier and it’s harder to clean.
- Decide if you’re going to use the ramp feature or not. If you plan on using the ramp feature, make sure it’s set up. You usually have to specify what the starting pressure will be.
- Slide the mask into place, starting with the headgear. For most masks you would slide the headgear over the back of the head, and then position the cushions and the frame.
- Clip or attach the headgear to the frame as necessary.
- Turn on the machine.
Alternatives to CPAP Therapy
Looking for a CPAP alternative? There are quite a few different options available today, but not all of them will work for everyone. Here’s a rundown of some of the most popular treatments.
- Oral Appliances: Many of these devices are designed to hold the tongue in place to keep it from sliding backwards in the mouth during sleep, preventing opening up the airway so that air can reach the lungs. For people with very mild Sleep Apnea, an oral appliance may be an effective treatment. Oral appliances work by keeping the tongue from sliding backwards, but if your problem is a narrow airway, or that there’s too much soft tissue in the throat, an oral appliance may do you no good.
- Surgery: In rare cases, your doctor may prescribe surgery to remove excess tissues or improve the geometry of the airway, making it easier to breathe. Surgery is looked at as a last resort, and is usually not the first treatment a doctor will recommend.
- Changing Sleep Positions: Sleeping on your back is the worst position for a person suffering with Sleep Apnea. Shifting positions can actually improve airflow during sleep, and in some very mild cases, it can significantly reduce the number of breathing events during the night. The most helpful change in positions is actually to sleep on your side. Side sleeping allows gravity to work in your favor, helping the soft tissues of the mouth and throat to open naturally, meaning your machine doesn’t have to work as hard– or in some cases even at all.
- Provent: Provent is sometimes prescribed to help in cases of mild Sleep Apnea. It helps redirect your own breath in a way that can open the airway without using a CPAP machine. Provent is only available by prescription, and is only for very mild cases of Sleep Apnea. CPAP.com sells Provent.
CPAP therapy is the easiest and most cost-effective way to treat Sleep Apnea, and is the choice millions choose when treating Sleep Apnea. Some people find alternative therapies to be more tolerable than CPAP therapy, but the results may not be the same. Some alternative therapies are also only effective in mild cases of Sleep Apnea, where more severe conditions require CPAP therapy.
Choosing a CPAP machine can be tough, and there’s a lot to consider. We hope you found this guide to be useful and that it answered some of your questions. We encourage you to sign up for our newsletter, so you’ll never miss a sale or a deal. You’ll also get updated with the latest content from CPAP.com. Don’t miss out!
And if you ever want to reach us, with a comment, question, or help with your therapy; you can give us a call at 1-800-356-5221.
1. 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.
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.