Short List of My Best PAP Equipment
For people with sleep apnea and for their healthcare professionals, peer coaching article #11, updated 23 November 2011
Good equipment and good information on how to use it are essential for success at life-saving CPAP therapy. Medical and equipment needs, opinions, and preferences differ. These are my opinions and what works for me. Other people will have their own best list. Many successful CPAP users use a data-capable machine.
1. The right type of PAP (Positive Airway Pressure) machine with data capability for my individual needs, plugged into a surge protector. The machine must have a display of AHI and mask leaks, or data capability, that is, optional software to measure AHI (Apnea Hypopnea Index of events per hour), AHI related to pressure, leak rate, etc. The machine must be prescribed by a doctor and should be agreed upon by both doctor and patient. I have APAP (auto adjusting CPAP pressure) with exhalation relief, which can also be used in the straight CPAP mode, so you get two machines in one; more options, if you select a machine with various exhalation relief options. The auto-adjusting feature is very important because a) the initial sleep lab pressure titration may be wrong, b) pressure needs vary during the night, c) pressure needs may change over time with weight loss or gain, and another sleep lab study is expensive. In the six years I’ve successfully been on CPAP, I’ve never needed straight CPAP (only one pressure). But I’ve used APAP every night, and adjusted the pressure range upward several times because of weight gain, without the need for another costly sleep study.
Those with certain medical needs requiring straight CPAP or with limited income may want a less expensive straight CPAP machine, if it costs them less than an APAP. The Medicare billing code is the same for CPAP and APAP, so with insurance, the patient’s cost for straight CPAP is not necessarily less than the cost of the superior APAP machine which also functions as a CPAP. Some people require BiPAP machines with different pressures for inhalation and exhalation, or an auto-adjusting BiPAP.
2. Machine software (not covered by insurance and usually bought online) so my doctor and I can monitor and adjust my therapy and I can succeed. I found this essential when I started APAP, since my physician was not very knowledgeable about the details of CPAP therapy and the Respiratory Therapist at the Durable Medical Equipment provider was also not helpful, referring me to my physician. I was on my own in discovering effective therapy, aided by software reports. I had a fully data capable APAP machine with software showing apneas, hypopneas, non-responsive apneas/hypopneas (flow limitation) at various pressure settings, average pressure, minutes at various pressures, vibratory snore, and average and large leaks. Now that APAP has worked well for me for a few years, I find that a machine with a display of AHI is adequate, rather than using software.
3. A heated humidifier, machine-specific for comfort (a key success factor), healthier airways, avoidance of nosebleeds and dry mouth, and use of a full face mask.
4. A heated hose, if it comes with the machine, or an Australian SleepZone heated hose to eliminate rainout (condensation in hose) and a spare standard hose, plus a hard plastic hose connector. http://www.sleepzone.com.au/
I also use a fleece Snuggle Hose cover over the cover that comes with the heated hose, from cpap dot com.
5. At least two of the three main types of masks and headgear: nasal mask, nasal pillows, full face mask. Consideration of nasal prongs and other types. Finding the right mask and adjusting to it is the most difficult part of CPAP therapy for most people. Try out a mask before purchase through a daytime, professional mask fitting at a sleep lab, lying down under pressure on sides and back while leaks are measured. Have a spare back-up mask and headgear. Mask preference is very individual.
6. A bed pillow such as the PAPillow that works with the mask. It's used on top of a memory foam bed wedge for silent acid reflux. http://www.papillow.com/ Pillow preference is very individual.
I have the smaller, lower mini PAPillow, shaped like a triangular boomerang.
7. A power supply (machine-specific or stand-alone or a deep cycle battery) in case of power outage, and a DC connector.
I have an integrated rechargeable battery pack for my backup machine (see below), a machine-specific DC connector for each of my two machines, and an AGM battery.
8. If income allows and if the primary machine is heavy, a small, light CPAP machine with integrated heated humidifier and rechargeable battery pack for travel, camping, and naps on the sofa, and as a temporary spare in case the primary machine breaks. An old PAP machine may also serve as a spare. http://www.cpaptalk.com/viewtopic/t31649/If-your-XPAP-breaks-at-10pm-tonight-do-you-have-a-backup.html
1. The right type of PAP (Positive Airway Pressure) machine with data capability for my individual needs, plugged into a surge protector. The machine must have a display of AHI and mask leaks, or data capability, that is, optional software to measure AHI (Apnea Hypopnea Index of events per hour), AHI related to pressure, leak rate, etc. The machine must be prescribed by a doctor and should be agreed upon by both doctor and patient. I have APAP (auto adjusting CPAP pressure) with exhalation relief, which can also be used in the straight CPAP mode, so you get two machines in one; more options, if you select a machine with various exhalation relief options. The auto-adjusting feature is very important because a) the initial sleep lab pressure titration may be wrong, b) pressure needs vary during the night, c) pressure needs may change over time with weight loss or gain, and another sleep lab study is expensive. In the six years I’ve successfully been on CPAP, I’ve never needed straight CPAP (only one pressure). But I’ve used APAP every night, and adjusted the pressure range upward several times because of weight gain, without the need for another costly sleep study.
Those with certain medical needs requiring straight CPAP or with limited income may want a less expensive straight CPAP machine, if it costs them less than an APAP. The Medicare billing code is the same for CPAP and APAP, so with insurance, the patient’s cost for straight CPAP is not necessarily less than the cost of the superior APAP machine which also functions as a CPAP. Some people require BiPAP machines with different pressures for inhalation and exhalation, or an auto-adjusting BiPAP.
2. Machine software (not covered by insurance and usually bought online) so my doctor and I can monitor and adjust my therapy and I can succeed. I found this essential when I started APAP, since my physician was not very knowledgeable about the details of CPAP therapy and the Respiratory Therapist at the Durable Medical Equipment provider was also not helpful, referring me to my physician. I was on my own in discovering effective therapy, aided by software reports. I had a fully data capable APAP machine with software showing apneas, hypopneas, non-responsive apneas/hypopneas (flow limitation) at various pressure settings, average pressure, minutes at various pressures, vibratory snore, and average and large leaks. Now that APAP has worked well for me for a few years, I find that a machine with a display of AHI is adequate, rather than using software.
3. A heated humidifier, machine-specific for comfort (a key success factor), healthier airways, avoidance of nosebleeds and dry mouth, and use of a full face mask.
4. A heated hose, if it comes with the machine, or an Australian SleepZone heated hose to eliminate rainout (condensation in hose) and a spare standard hose, plus a hard plastic hose connector. http://www.sleepzone.com.au/
I also use a fleece Snuggle Hose cover over the cover that comes with the heated hose, from cpap dot com.
5. At least two of the three main types of masks and headgear: nasal mask, nasal pillows, full face mask. Consideration of nasal prongs and other types. Finding the right mask and adjusting to it is the most difficult part of CPAP therapy for most people. Try out a mask before purchase through a daytime, professional mask fitting at a sleep lab, lying down under pressure on sides and back while leaks are measured. Have a spare back-up mask and headgear. Mask preference is very individual.
6. A bed pillow such as the PAPillow that works with the mask. It's used on top of a memory foam bed wedge for silent acid reflux. http://www.papillow.com/ Pillow preference is very individual.
I have the smaller, lower mini PAPillow, shaped like a triangular boomerang.
7. A power supply (machine-specific or stand-alone or a deep cycle battery) in case of power outage, and a DC connector.
I have an integrated rechargeable battery pack for my backup machine (see below), a machine-specific DC connector for each of my two machines, and an AGM battery.
8. If income allows and if the primary machine is heavy, a small, light CPAP machine with integrated heated humidifier and rechargeable battery pack for travel, camping, and naps on the sofa, and as a temporary spare in case the primary machine breaks. An old PAP machine may also serve as a spare. http://www.cpaptalk.com/viewtopic/t31649/If-your-XPAP-breaks-at-10pm-tonight-do-you-have-a-backup.html
Medicare will pay for a replacement machine every five years and many insurance companies follow Medicare guidelines. Since technology advances so rapidly, you may want a new machine every five years, keeping your previous machine as a backup.
9. For those who need it: An overnight recording pulse oximeter to measure blood oxygen saturation levels. Perhaps your physician can issue one for you to use at home for a one-night test. If you buy one, be sure to get not just an ordinary pulse ox, but one that can record oxygen levels all night and generate a report. It may cost up to $500, bought online. It’s useful if you require supplemental oxygen at night or your oxygen saturation rate is dangerously low without CPAP. I don’t have a pulse ox but borrow one occasionally to check on my treatment. It’s very handy to loan to relatives and friends who may have undetected sleep apnea, to raise their awareness and encourage them to see a physician.
Good places to research products: http://cpap.com and manufacturer web sites
Places to get PAP equipment through insurance:
- A local Durable Medical Equipment/Home Medical Equipment company that takes your private health insurance, if their service is good and what you pay out-of-pocket is reasonable, compared to online DME pricing
- Online DME, check with your insurance to see if you will be reimbursed
9. For those who need it: An overnight recording pulse oximeter to measure blood oxygen saturation levels. Perhaps your physician can issue one for you to use at home for a one-night test. If you buy one, be sure to get not just an ordinary pulse ox, but one that can record oxygen levels all night and generate a report. It may cost up to $500, bought online. It’s useful if you require supplemental oxygen at night or your oxygen saturation rate is dangerously low without CPAP. I don’t have a pulse ox but borrow one occasionally to check on my treatment. It’s very handy to loan to relatives and friends who may have undetected sleep apnea, to raise their awareness and encourage them to see a physician.
Good places to research products: http://cpap.com and manufacturer web sites
Places to get PAP equipment through insurance:
- A local Durable Medical Equipment/Home Medical Equipment company that takes your private health insurance, if their service is good and what you pay out-of-pocket is reasonable, compared to online DME pricing
- Online DME, check with your insurance to see if you will be reimbursed
Places to get PAP equipment at your own expense:
http://cpap.com and other online CPAP retailers
Online sites for used equipment: Beware of used machines with a permanent tobacco or campfire smoke smell or pet or other odors, and used masks that have not been thoroughly disinfected, if the previous owner had a staph infection.
Humor by Mike Moran: Mar 07, 2006 CPAP for Fun and Profit (Things been way to serious lately)
Sources: Based on personal experience with obstructive sleep apnea and gleaned from the collective wisdom of cpaptalk.com contributors.
Want more? See the peer coaching articles at http://smart-sleep-apnea.blogspot.com , http://www.cpap.com FAQ Learning Center, or search http://www.cpaptalk.com or post a message there.
Not written by healthcare professionals. The information and opinions offered are not intended or recommended as a substitute for professional medical advice.
© Mile High Sleeper, August 2006 - 2011. All rights reserved. You may make copies of this message and distribute in any media for free educational purposes, as long as you credit the author and include this copyright notice and the web address smart-sleep-apnea dot blogspot dot com
Labels: APAP, backup machine, BiPAP machine, building a CPAP support team, CPAP humidifiers, CPAP masks, CPAP software, heated hose, smart display
posted by Mile High Sleeper Gal | 10:04 AM
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