A User Guide to CPAP Machine Selection

CPAP machines are prescribed for people with sleep disorders and other types of breathing disorders. Obstructive sleep apnea (OSA) is the most common type of sleep disorder for which a CPAP device may be prescribed. When people with OSA sleep, soft tissues in the airway relax and get in the way of air movement in and out of the lungs. Central apnea is another sleep disorder in which there is a disruption in signals between the brain or the heart that causes pauses in breathing during sleep.

People who have sleep disorders often complain of daytime sleepiness or wake up with headaches. Some people also notice that they wake up at night choking or gasping. Partners of people with sleep disorders may notice excessive snoring or even interruptions in breathing. Sleep disorders that are not treated can have serious short-term and long-term consequences. Daytime sleepiness can interfere with your ability to enjoy life and snoring can interfere with your partner’s sleep. Daytime sleepiness also increases the risk of accidents on the job or while driving. Over time, sleep disorders can contribute to high blood pressure, damage the heart, and lead to strokes as well contribute to type 2 diabetes.

Sleep disorders must be diagnosed by a physician. The physician will order a sleep study. The physician may use an at home test kit or may send you to a sleep center for overnight evaluation. Once diagnosed, a CPAP machine with a face mask is often the first prescribed intervention to treat sleep apnea.

CPAP stands for continuous positive airway pressure. CPAP therapy works by generating a flow of air that creates pressure in your upper airway (nose and mouth). The pressure holds the airway open so that your breath freely moves in and out of your lungs while you sleep. Selecting the right equipment for CPAP therapy can be a little confusing or overwhelming at first as there are different types of devices available. The best choice for you will depend both on your physician’s prescription and your needs.

Types of machines

Manual CPAP: A manual CPAP machine adjusts flow to maintain a constant level of pressure chosen by your physician. The machine makes sure that the desired pressure stays steady throughout your sleep.

AutoPAP or AutoCPAP: AutoPAP stands for automatic positive airway pressure. The autoPAP machine “automates” the pressure setting to match your need in the moment. These machines move the level of pressure up and down as needed by looking for obstructions or pauses in breathing. When breathing is less obstructed, it ramps down the pressure. When breathing is more obstructed, it ramps up the pressure. AutoPAP machines work a bit like cruise control in a car! As we move in our sleep, for example, the degree of obstruction in the airway changes and the autoPAP machines adjusts in real time with those changes.

If you have used a manual CPAP machine in the past and had trouble getting comfortable, ask your physician if autoPAP is an option for you. The autoPAP machines start out with less force when you are settling into bed and drifting off to sleep, making them easier to adjust to for many people.

Bi-level Machines (BiPAP, VPAP): Bi-level machines provide varied levels of pressure while you breathe in and out. These machines provide more pressure and flow during inspiration and a lower level of pressure and flow during exhalation. These devices push air in when you breathe in. Companies that manufacture bi-level machines use different proprietary terms to describe them, such as BiPAP (bilevel positive airway pressure) and VPAP (variable positive airway pressure). Sometimes people who need a high level of pressure to overcome their obstructive sleep apnea find it difficult to breath against the machine flow. This is because the CPAP or AutoPAP machines generate higher pressures by pushing out higher flows of air. Bi-level machines can make these people much more comfortable.

Bi-level may also be ordered for patients with certain types of lung diseases to help them take in deeper breaths during sleep. People with central apnea also benefit from a bi-level machine since it can be set to push a breath into the lungs at regular intervals. Bi-level machines are the most tuned in to the user, so they are also the most expensive.

Are you worried that CPAP machines will get in the way of living your life or enjoying sleep? Let us help you! Selecting the machine and mask that fits your needs best is the ticket to better sleep at night and happier, healthier days.

Helpful hint: If you tried manual CPAP in the past and just could not get comfortable, the newer autoPAP machines may really change your mind! Unless your physician prescribes strictly manual CPAP, give autoPAP machines a good look.

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