Introduction

Do you need to buy a new CPAP machine, but you’re unsure about which one to get? Maybe you don’t know the differences between the different machine types, you’re unsure about the features of the top-rated CPAP machine models, or you want help with differently priced CPAP models.

 

There is no need to worry about any of that! Picking a CPAP machine can be a strenuous task requiring many considerations – but that’s exactly why we, at Health Sqyre, have put this E-Book together. We want to help you understand everything about the process of purchasing a machine that’s right for you.

 

It’s likely that not all parts of this ultimate guide is applicable to you, so feel free to skip to those sections that are relevant to you.

 

If you have any questions along the way, or you want additional help/information in a particular area, please feel free to contact us, at https://healthsqyre.zendesk.com/hc/en-us/requests/new – we’d love to get your thoughts or to help you out!

 

We hope you become a master of CPAP machines after reading this guide! Let’s waste no more time, and get straight into it…

Table of Contents:

1. Types of PAP Machines

CPAP vs. APAP vs. BiPAP
Additional Features
Travel Machines

 

2. Your sleep apnea type and AHI

What are OSA, COMPSA, CSA?
Apnea-Hypopnea Index (AHI)

 


3. CPAP Machines: Climatic Factors

Altitude
Dryness
Temperature
Other Considerations

 

4. Buying your CPAP Machine using Cash vs. Insurance

Reimbursement by Insurance
High Deductible vs. Low Deductible Plan
Status of your Insurance Plan
Other Cases
Insurance companies and compliance tracking

6. CPAP, APAP, and BiPAP Comparison

Mechanism
How common is it?
Who should use it?
Disadvantages
Benefits

7. Comparison Chart of Best CPAP Machines

CPAP
APAP
BiPAP
Travel Machines


8. CPAP Machine Features

Power Options
> Batteries
> DC Power Cord/Inverter/Converter
> Solar Power
Warranty
Technology

9. CPAP Machine Buying Considerations

14 Factors to Consider

10. CPAP Machine Data and Compliance

Machine Data
Face-to-face Re-Evaluation
Failure

 

11. Do I need a Humidifier?

What is a Humdifier?
When would I need a Humidifier?
Quick Facts
When would I NOT need a Humidifier?
Extra Tips + Reminders

12. What Kind of Hose should I get?

What is a CPAP Hose/Tubing?
Types of Hoses: Heated vs. Unheated
Should you get a Heated Hose?
Extra Tips + Reminders

 

13. CPAP Machine Manufacturers

14. CPAP Machine Glossary

 

 


 

1. Types of PAP Machines

 

CPAP vs. APAP vs. BiPAP

The 3 types of PAP machines are CPAP, APAP, and BiPAP, and they work by gently blowing pressurized air through the airway to give the minimum amount of pressure to keep the throat open.

CPAP stands for Continuous Positive Airway Pressure and is the most commonly used treatment option for people experiencing obstructive sleep apnea. CPAP machines deliver constant and pressurized air into the airways.

APAP stands for Automatic Positive Airway Pressure. APAP machines are a non-invasive treatment for sleep apnea that deliver pressurized and unobstructed air through a mask during sleep. The APAP has two range settings, low and high. The setting automatically adjusts based on the user’s needs using an algorithm.

BiPAP machines are a non-invasive treatment for sleep apnea that have two pressure settings: one for inhalation and one for exhalation. This method is used in situations where marked difficulty breathing is present.

Additional Features

For the basic function of applying pressure to the airway, there is generally little difference among PAP devices. However, they do vary in shape, size, weight, and additional features.

The two most distinguishing features in PAP devices are ramping and pressure relief.

Ramping: This feature allows the PAP device on startup to gradually increase the pressure over a short period of time until the prescribed pressure is reached. Some users find that this allows them to fall asleep more easily and improves their ability to wear the PAP machine.

Pressure Relief: With pressure relief, at the beginning of exhalation, a small decrease in pressure occurs. The amount of pressure reduction is adjustable. It provides a way to improve user comfort and compliance, without compromising therapy effectiveness.

 

Travel Machines

A travel machine is a portable PAP machine that is smaller, lighter, and conducive to mobility. There are many travel CPAP, APAP, and BiPAP machines available. When traveling, transporting your PAP machine, mask, tubing, and power cords can be a factor to continuing your therapy.

 

 


 

2. Your Sleep Apnea Type and AHI

 

We are going to explore the 3 commons types of sleep apnea and the clinical definitions of each. We will also show you how your apnea hypopnea index (AHI) is calculated.

 

What are OSA, COMPSA, and CSA?

Obstructive Sleep Apnea (OSA) means that something is blocking your air passage while you are sleeping. When this occurs, your brain is signaled to wake up and breath. You might gasp for air or have deep breathing just long enough for the obstruction to pass without ever really waking up. OSA diagnosis ranges from mild to severe. It depends on the number of times in an hour that your breathing stops (apnea) or becomes very shallow (hypopnea). Apnea episodes may occur from 5 to 100 times an hour. More than five apneas per hour is abnormal. More than 30-40 per hour is considered severe sleep apnea.
Central Sleep Apnea (CSA) occurs because your brain doesn’t send proper signals to the muscles that control your breathing. Your breathing is not controlled and has repeated stops and starts during sleep. The condition is often caused by another comorbidity.

Complex Sleep Apnea (COMPSA) is diagnosed when the user is developing either or both central apneas and central hypopneas while using their CPAP.

These diagnoses affect the type of CPAP machine that you buy. The CPAP machine is still one of the best recommended machines for each initial diagnosis.

 

Apnea-Hypopnea Index

Apnea-Hypopnea Index (AHI) is a numerical measure that accounts for the number of pauses in your breathing per hour of sleep. It is what your treating Doctor uses to determine the severity of your diagnosis.

To calculate your AHI, add the total number of apnea events, plus hypopnea events and divide by the total number of minutes of actual sleep time, then multiply by 60 (100 apneas + 60 hypopneas = 160 divided by 240 minutes = .66  x 60 = 40 AHI).

Diagnosis Results:
None/Minimal: AHI < 5 per hour
Mild: AHI ≥ 5, but < 15 per hour
Moderate: AHI ≥ 15, but < 30 per hour
Severe: AHI ≥ 30 per hour

Successful CPAP therapy is determined by your compliance reporting and continued visits with your sleep treating Doctor. Your CPAP machine uses web based software or an SD data card to record this information.  Users who can see their mask leakage rates may be encouraged to try a new mask that works better. And, being able to see the cpap compliance numbers (AHI) can influence the user to make changes for the better.

If you want to know if you have sleep apnea, you can take our quiz, Find Out If You Have Sleep Apnea Quiz.

 

 


 

3. CPAP Machines: Climatic Factors

 

Your CPAP Machine’s functionality or settings can be altered depending on where you live. There are various factors you need to consider, such as altitude, dryness, and temperature.

After reading this section, you will know everything you need to make an informed decision before buying a CPAP machine.

 

Altitude

According to the NCBI (National Center for Biotechnology Information):

“Altitude significantly alters delivered pressure according to predictions made by the fan laws, unless a unit has pressure-compensating features. Clinicians should consider this factor when CPAP is prescribed for patients who live or travel to places located at significantly higher or lower elevations than the titration site.”

So long story short, a change in altitude is correlated with changes in CPAP machine pressure levels. At higher altitudes, the air is thinner (i.e. there are less air molecules) so there is a drop in the air pressure. That means that if you use your CPAP at a higher altitude, the pressure exerted by the machine will be lower than your prescribed pressure, even if you set it at your prescribed pressure level.

This is important information particularly for CPAP users who go camping often or live at higher altitudes. Fortunately, most of the latest, best CPAP machines on the market are equipped with a function called ‘auto-altitude adjustment’, where the machine automatically detects changes in altitude and adjusts the therapy pressure accordingly.

However, if you are using an older model machine, you may have to manually change the pressure levels at higher altitudes – talk to your physician to get advice on exactly how much you should be adjusting your machine’s pressure level. There are calculations that have to be made before manual adjustment.

 

Dryness

During dry seasons, the dry air that is forced into your nasal cavities or throat may feel uncomfortable. In fact, around 40% of CPAP users suffer from dry mouth, a condition that can cause other side effects like headaches, bad breath, sneezing, swelling, infections, nosebleeds, and more.

In order to counter these potentially negative effects, you should make sure to attach a humidifier to your machine – this will ‘humidify’ the air and make a more comfortable therapy experience. Humidification is recommended even if you don’t live in a dry area – check out this blog to read more about humidifiers.

On the other hand, if you’re in a humid environment, you may not even need to use a humidifier.

You will also notice that the water in the water chamber of your CPAP machine will deplete faster during dry seasons.

 

Temperature

In cold conditions, the air you breathe will be extra uncomfortable – unless you enjoy breathing cold air. For that reason, we would recommend getting a heated humidifier instead of passover humidifiers.

Passover humidifiers simply add moisture to the air flowing through your CPAP machine, essentially making the air you breathe more damp. On the other hand, a heated humidifier warms up the air you breathe in (you can even heat up the water chamber prior to starting your therapy), making it generally more comfortable for the user.

Also, in cold conditions, the air you breathe inside your mask will be warmer than the air outside, increasing the chances of rainout – when moisture condenses inside the mask and wets your face.

In hot weather, you may perspire, making the mask more prone to slipping off your face and causing air leakages. In this case, you may want to try using a mask liner, or use a nasal pillow mask that has minimal contact with your face.

 

Other Considerations

If you are using air conditioning during hot weather, the air in the room may dry out more easily – hence, the advice from the ‘dryness’ section would apply.

Watch out for allergy season – if you get congestion from allergies from seasonal factors like pollen, you may want to make sure you use a full face mask or a chin strap.

You should have a better idea of how these various factors may affect your CPAP machine and therapy experience. We would advise that you talk to your doctor more carefully, to ensure you make the right decisions based on exactly where you live.

 

 


 

4. Buying a CPAP Machine using Cash vs. Insurance

 

When should you pay in cash and when should you use insurance when buying a CPAP machine?

In this section, we will be covering factors you should consider when deciding how to pay!

Note: It’s typically cheaper to purchase CPAP equipment in cash because cash prices are usually but not always cheaper than insurance prices.

What should you do?

You should sign up with Health Sqyre for free and provide your insurance information to find out exactly what the deal is…

 

Reimbursement by Insurance

If the CPAP supply is not reimbursable by your insurance company then you will be paying cash (out-of-pocket) for it anyway, so it’s in your best interest to find the cheapest cash price.  If it is reimbursable by your insurance, then using insurance is a good option to save money. If not, paying in cash is your only option.

Most CPAP machines are covered by health insurance companies. Most third party payers follow the Medicare reimbursement schedule, which typically covers a machine every 5 years. Check out our blog post on CPAP HCPCS Codes to see the list/schedule of the CPAP HCPCS Codes.

 

High Deductible vs. Low Deductible Plan

Do you have a high deductible plan or a low deductible plan? If you have a high deductible plan, it’s typically better to pay in cash, provided that you have not met or you are not close to meeting your deductible. This is because as noted above, cash prices are usually cheaper than insurance prices, so it’s typically cheaper to purchase CPAP equipment in cash – but this is not always the case. On the other hand, it’s usually better to use your insurance if you have a low deductible plan unless you are not even close to meeting your deductible.

Many Americans now have higher deductibles to meet before they can use their health insurance benefits. Higher deductible typically means lower monthly premiums and that some benefits are covered before you meet your deductible. However, almost all plans require you to meet your entire individual or family deductible before CPAP equipment are covered.

 

Status of your Insurance Plan

What is the status of your plan? Are you close to meeting your deductible? Have you met your deductible? If you have met your deductible, then take advantage of your insurance to get the cheapest price. If your deductible has not been met, pay out-of-pocket (in cash).
Health Sqyre provides you with a real-time health insurance dashboard that shows your deductible, co-insurance rate, and out-of-pocket maximum information. Sign up free today to see!

Health Sqyre also provides you with the cheapest cash (out-of-pocket) price and insurance price for your plan, so you can compare them side-by-side.

It makes sense to use your insurance to buy CPAP equipment if you’re close to meeting your deductible.  It also depends on the price of the product that you’re buying.  If the product costs less than the amount remaining on your deductible, such as a CPAP mask, then you will probably get the best price paying in cash (out-of-pocket). However, if the product costs more than the amount remaining on your deductible, such as a CPAP machine, then you will save more money by using your insurance. If you’re not close to meeting your deductible, then it’ll be cheapest to pay in cash.

 

Other Cases

If you don’t have health insurance and paying in cash is therefore your only option, but you are experiencing some financial hardship in paying for your CPAP equipment, there is an organization called The Reggie White Foundation that offers low-cost CPAP and supplies. For a CPAP, there is a $25 program fee and proof of financial hardship. For CPAP supplies, there is a $10 program fee and proof of financial hardship. See the Reggie White Foundation CPAP Therapy User Application.

Medicaid is a state and federal program that provides health coverage if you have very low income. It does cover CPAP equipment, but you will need authorization. The amount of coverage varies by state, and supplies are covered separately. Deductibles and co-payments may apply depending on whether or not you have a secondary insurance.

Even if you have insurance, you may want to pay in cash for your CPAP and supplies. Some people may find it easier to pay in cash to avoid dealing with insurance talk, such as EOB, co-insurance, etc. Your insurance company might only authorize specific providers for your CPAP equipment, and you might happen to not be satisfied with the selection (product options, customer service, location, etc.). Then, you can also choose whichever vendor you would like to buy from by paying out-of-pocket.

 

Insurance Companies and Compliance Tracking

Health insurance companies usually cover a CPAP machine with proof from a sleep study. A lot of insurance companies pay for these on a rental basis (term of 2-12 months) than paying it full outright. The patient owns the device after the last rental payment is made.

Less than half of patients prescribed CPAP therapy are actually getting the therapy for more than four hours each night. Insurance companies don’t want to pay for the machine that patients don’t use. Therefore, most insurance companies require that you prove you are compliant in therapy and are tracking data (statistics including hours of use, sleeping time, AHI, and leak rate) for compliance, and sleep apnea patients need to show compliance before purchasing the device or getting resupplies.

The most common ways of obtaining this compliance data is through a smart card, attachable modem, or a wireless-enabled CPAP device. A smart card is the data/memory card inside the device that stores your usage data. It can be removed to be manually sent to your physician or equipment provider for data report. An attachable modem can be bought separately. It uses cellular service to regularly send data. A wireless-enabled CPAP device is common among new models. These wireless-enabled modems use wi-fi, Bluetooth, or cellular service to automatically transfer data. The data is transferred to your equipment provider that is billing your insurance to acquire payment for the equipment, and the insurance company also receives the report.

Most insurance compliance guidelines require that you get CPAP therapy for a minimum of 4 hours per day for at least 22 days out of a consecutive 30 day period within the past 3 months to show compliance. However, the requirements may vary depending on your insurance plan. Many insurance companies, including Medicare, require proof of CPAP compliance to continue paying for the rental or purchase of the equipment. Insurance companies are also requiring yearly proof for authorization of replacement supply payments. Replacement supplies (additional masks, cushions, tubing, filters, etc.) are sent by the equipment provider every 3 months.

Most health insurance companies will require compliance for a machine. If you use your insurance to buy a CPAP machine, you will need to provide documentation, such as prescription, doctor’s notes, and a valid sleep study. Cash, however, only requires a prescription.

This can all sound like a pain in the butt. But worry no more. Health Sqyre conveniently provides a list of specific documentation requirements to make your experience simple and seamless.

These are the factors you should consider when deciding whether to pay out-of-pocket (cash) or use insurance. Choose wisely and save money! If you have any further questions, feel free to chat us or shoot us an email!

 

 

 


 

5. Cheap vs. Expensive CPAP Machine

 

How much should I spend on my CPAP Machine?

Making the proper cpap machine selection is crucial for successful therapy. There are several manufacturers developing machines that range from low to high cost. Since the cost of the machine will be a factor most consider, let’s discuss the difference between low cost and high cost machines.

 

Do I buy the cheapest CPAP machine?

If the CPAP machine has all the features that you are going to need for successful therapy, this could be the right choice for you. But, if price is your sole determining factor, you will need to review why the price is so low.

Used/second hand machines are the least expensive way to buy a cheap CPAP machine. If you are just looking to have a backup or use it for travel, this might not be a bad idea. But, CPAP machines are designed to last around 5 years and you might be buying a machine with not much life left on it. You will also not likely have any type of warranty or customer support from the manufacturer.

Discontinued machines are heavily discounted or advertised in the clearance section to eliminate the manufacturer’s or supplier’s inventory. Buying this machine is a great way for the CPAP user to save money on a new machine. However, many of the most modern CPAP machines will have removal pieces and these pieces are the most common components of the machine that need to be replaced. The water chamber and hose may need replacement just as often. You will need to ensure the discontinued machine will have these replacement pieces available to you during the 5 year reasonable useful lifetime (RUL) period.

 

So, do I buy the more expensive CPAP machine?

Resmed and Philips Respironics are the two leading CPAP manufacturers in today’s market. Their reputations are anchored by offering high quality machines and accessories, but not at a discounted price. One of the reasons why you would purchase from one of them is their CPAP machines have a lot to do with the technology built into them. They are both industry leaders in healthcare informatics, with software solutions that enable patients and medical professionals to wirelessly monitor sleep data.

Resmed’s Airsense 10 AutoSet uses an algorithm that works to automatically adjust to each user’s therapy pressure as their needs change – hourly, nightly and from season to season – to deliver the patient’s ideal, lowest therapy pressure.It is one of the most clinically published in the field of sleep-disordered breathing.

In addition, these highly rated CPAP manufacturers have 2-3 year product  warranties and excellent customer support. CPAP machine features have a price and you need to decide which ones you need for successful CPAP therapy. You can take our quiz, Find the Right CPAP Machine, to help in your selection.

 

 


 

6. CPAP, APAP, and BiPAP Comparison

 

This CPAP machine type comparison explains some of the most important information and differences you need to know about CPAP (continuous positive airway pressure), APAP (auto-adjusting/autoset positive airway pressure), and BiPAP (bi-level positive airway pressure) machines.

Which positive airway pressure machine your doctor prescribes depends on what kind of sleep apnea you have (obstructive sleep apnea or central sleep apnea) and what health conditions or habits that may influence your sleep or breathing you have. Some users change the type of device they use after using one type of machine for a while and then realizing that it’s uncomfortable or not suitable for them

 

Mechanism

CPAP:
A CPAP machine uses a motor that pressurizes the air that enters the device. It delivers that air through a tubing connected to a CPAP mask at a continuous stream of constant pressure, which keeps your upper air passages open during sleep.

APAP:
APAPs work the same way that CPAPs do, except that the air is dispersed at a range of pressures instead of a single, continuous pressure. The device keeps fluctuating the pressure level and adjusting to the minimum pressure necessary to prevent airways from collapsing.

BiPAP:
BiPAPs have two ‘levels’ of pressure – one pressure at inhalation, and a lower pressure at exhalation.

 

How Common is it?

CPAP:
Most commonly used PAP device

APAP:
Very commonly used PAP device

BiPAP:
Least commonly used PAP device

 

Who should use it?

CPAP:
Patients with OSA (obstructive sleep apnea) use CPAP machines. People with less severe cases of OSA tend to use CPAPs.

APAP:
Patients with OSA (obstructive sleep apnea) use CPAP machines. People who have allergies/congestion, experience apneas only during REM sleep, change sleep positions often during the night, enjoy drinking alcohol before sleep, or use sedative medication may benefit from the auto-adjusting feature.

BiPAP:
People who struggle to exhale at a continuous pressure level (usually people with severe OSA/high pressure settings), suffer from CSA (central sleep apnea)/COPD (chronic obstructive pulmonary disorder)/CHF (congestive heart failure)/neuromuscular disease/hypoxemia/aerophagia may benefit from using the Bi-level feature.

 

Disadvantages

CPAP:
Some users find the continuous flow of air pressure upon each exhalation uncomfortable.

APAP:
Some users find the continuous flow of air pressure upon each exhalation uncomfortable. The APAP is also more expensive than CPAP, and many APAP users complain about the practice of Bricking.

BiPAP:
The BiPAP machine is very expensive. For that reason, most insurance providers will ask the patient to “prove” that they tried using a CPAP machine and weren’t able to tolerate it, to make sure the patient really needs it.

 

Benefits

CPAP:
CPAP machines are the cheapest out of the three types mentioned. Also, many of the newer CPAP machines are able to sense the user’s breathing at a breath-by-breath case, decreasing the machine pressure up to 3 cm H2O at every out-breath. ResMed calls it “EPR (expiratory pressure relief), Respironics calls this feature ‘CFLEX/AFLEX/BiFLEX’, and Fisher & Paykel calls it “SensAwake”.

APAP:
Because an APAP can adjust its own pressure, patients can skip the sleep lab and, instead, take a home sleep test. Then, an APAP can be used for a month or two, after which your healthcare provider can evaluate the usage data to help you determine your optimal pressure level.

BiPAP:
It’s an effective solution for people with high therapy pressure levels who find the continuous pressure uncomfortable, or people with certain health disorders.

 

 


 

7. Comparison Chart of Best CPAP Machines

 

We’ve put together four comparison charts (for CPAP, APAP, Bi-PAP, and Travel Machines) which outline the main differences between some of the most popular PAP machines on the market.
For a more detailed comparison, check out our best CPAP machines of 2017 page!

CPAP (Continuous Positive Airway Pressure) Machines

Machine Name

DreamStation CPAP

AirSense 10 CPAP

AirStart 10 CPAP

Price (the price is a range if it depends on add-ons)

$449 – $796

$758 – $808

$279.00

Our Ratings

9.3 – 10

8.4 / 10

7.7 / 10

Sound Level

25.8 db

26.6 db

26.6 db

Machine Weight

1.56 lbs

2.75 lbs

2.75 lbs

Size (including all parts, like the humidifier)

11.7″ x 7.6″ x 3.3″

10.04″x4.75″x5.91″

10.04″x4.75″x5.91″

Built-in Humidifier

No

Yes

Yes

Pressure adjustment at exhalation

C-Flex

EPR

EPR

Ramp

Yes

Yes

Yes

Leak Compensation

Yes

Yes

Yes

Maximum operating altitude

7500 feet

8500 feet

7500 feet

Integrated battery

No

No

No

Advanced Software/Data

Yes

No

No

Optional software

DreamMapper

ResScan

N/A

Auto Altitude Adjustment

Yes

Yes

Yes

Automatic on/off

Yes

Yes

No

Features

LCD Display, Autotrial, SmartRamp, Bluetooth Connectivity

AirView, LCD Display, Autoramp, Light sensor, and SmartStart

AirView, LCD Display

APAP (Auto-adjusting Positive Airway Pressure) Machines

Machine Name

DreamStation Auto CPAP

AirSense 10 Autoset

Icon Auto CPAP

Price (the price is a range if it depends on add-ons)

$449 – $866

$756 – $883

$445.00

Our Ratings

9.3 – 10

9.1 / 10

7.0 / 10

Sound Level

25.8 db

26.6 db

29 db

Machine Weight

1.56 lbs

2.75 lbs

4.8 lbs

Size (including all parts, like the humidifier)

11.7″ x 7.6″ x 3.3″

10.04″x4.75″x5.91″

6.3″ x 6.7″ x 8.7″

Built-in Humidifier

No

Yes

Yes

Pressure adjustment at exhalation

A-Flex

Autoset with Easy Breathe

SensAwake

Ramp

Yes

Yes

Yes

Leak Compensation

Yes

Yes

Yes

Maximum operating altitude

7500 feet

8500 feet

9000 feet

Integrated battery

No

No

No

Advanced Software/Data

Yes

Yes

Yes

Optional software

DreamMapper

ResScan

InfoSmart

Auto Altitude Adjustment

Yes

Yes

Yes

Automatic on/off

Yes

Yes

No

Features

LCD Display, SmartRamp, Bluetooth Connectivity

AirView, LCD Display, Autoramp, Light sensor, and SmartStart

Alarm Clock and Alarm Tunes, Smart Dial

BiPAP (Bi-level positive airway pressure) Machines

Machine Name

DreamStation BiPAP

AirCurve 10S

DeVilbiss IntelliPAP Auto Bilevel

Price (the price is a range if it depends on add-ons)

$1,639.00

$1,726.00

$1,145.00

Our Ratings

N/A

N/A

N/A

Sound Level

25.8 db

26.6 db

26 db

Machine Weight

1.56 lbs

2.75 lbs

2.75 lbs

Size (including all parts, like the humidifier)

11.7″ x 7.6″ x 3.3″

10.04″x4.75″x5.91″

6.5″ x 8.4″ x 6.4″

Built-in Humidifier

No

Yes

No

Pressure adjustment at exhalation

Bi-Flex

EPR with Easy Breathe

SmartFlex

Ramp

Yes

Yes

Yes

Leak Compensation

Yes

Yes

Yes

Maximum operating altitude

7500 feet

8500 feet

8500 feet

Integrated battery

No

No

No

Advanced Software/Data

Yes

Yes

Yes

Optional software

DreamMapper

ResScan

SmartLink

Auto Altitude Adjustment

Yes

Yes

Yes

Automatic on/off

Yes

Yes

Yes

Features

LCD Display, Auto-adjusting technology, Bluetooth

LCD Display, TiControl

LCD Display, Auto-adjusting technology, Flow rounding technology

Travel Machines

Machine Name

DreamStation Go

AirMini

Z1 Auto  

Transcend miniCPAP

Price (the price is a range if it depends on add-ons)

$799.00

$880.00

$479.00

$499.00

Our Ratings

9 / 10

8.8 / 10

8.4 / 10

7.8 / 10

Sound Level

30 db

30 db

26 db

26.6 db

Machine Weight

1.86 lbs

0.66 lbs

0.625 lbs

0.9 lbs

Size (including all parts, like the humidifier)

5.94” x 5.94” x 2.31″

5.4” x 3.3” x 2.1”

6.48″ x 3.3″ x 2.02″

6.1″ x 3.5″ x 2.8″

Built-in Humidifier

No

No

No

No

Pressure adjustment at exhalation

C-Flex, C-Flex+, A-Flex

Autoset with EPR

ZBreathe

EZEX

Ramp

Yes

Yes

Yes

Yes

Leak Compensation

Yes

No

Yes

Yes

Maximum operating altitude

7500 feet

8500 feet

8000 feet

8000 feet

Integrated battery

Optional: DreamStation Overnight Battery (~13 hours run time with CPAP mode, pressure 10 cm H2O, 12mm tubing, 37LPM of leak, 73.4 F room at an elevation of 1650 ft). Weight: 1.53 lbs.

No

Optional: Z1 PowerShell (~8 hours run time at pressure 14 cm H2O). Weight: 0.53 lbs

Optional: P8 Multi-Night Battery Pack (~14 hours run time at 14 cm H2O). Weight: 1.5 lbs

Advanced Software/Data

Yes

Yes

No

Yes

Optional software

Yes

No

Yes

Yes

Auto Altitude Adjustment

Yes

Yes

Yes

Yes

Automatic on/off

No

Yes

No

No

Features

Micro-flexible tubing, Bluetooth, LCD touchscreen display, optional overnight battery, APAP version available

HumidX Waterless Humidification, Bluetooth, Auto-adjusting technology

Bluetooth, Auto-adjusting technology, Optional Powershell

Auto-adjusting technology, Optional overnight battery

 

 

 


 

8. CPAP Machine features

 

In this section, we’ll explain CPAP machine features you need to know, from power options for home/travel machines, an overview of CPAP machine warranty policies, to the technological features of the latest CPAP machines on the market. You’ll be a master of CPAP machine features in no time!

Power Options

Standard CPAP Machines do not usually come with an integrated battery. This means that if you plan on taking your CPAP machine somewhere without a power source, you will need to find a way to power up your home or travel CPAP. Here are your options:

a) Batteries

Most CPAP machines can accept battery kits. ResMed and Philips Respironics have developed their own battery kits, specifically for their machines, while battery specialty stores have manufactured universal battery kits to work with all types of CPAP machines.

The charge is good for one night, maybe two. But if you are planning to stay away for longer, a deep-cycle marine battery can be used and will provide power for up to three days, maybe more (depending on usage). You can re-charge the battery various ways but the most common is from using the DC outlet or an inverter.

b) DC Power Cord/Inverter/Converter

If your CPAP machine has a DC outlet, you can use a DC power cord and connect it to a cigarette lighter plug. A DC adapter cable with converter clips can be used with a deep cycle marine battery to offer direct power. If you do not have the DC outlet, you will need an inverter to convert your DC power to AC power.

Adapters have become necessary for traveling with a CPAP when power is derived from a battery. Some DC converters are even strong enough to power both the machine and the humidifier. However, the use of humidifier can drain the battery life by 50%. The DreamStation Go does not even offer a humidifier option.

c) Solar Power

Solar power is the newest option to recharge your battery kit. The Transcend Travel CPAP machine has a solar power option for those going off grid or do not expect to rely on an available power source.

The catch? You must have at least six hours of sun. But, this truly portable and sleek-designed charger is ideal for camping trips.

SunPower has also manufactured a solar panel that allows you to charge their Freedom Travel Battery Pack and is compatible with many popular CPAP machines.

 

Travel CPAP machines, on the other hand (like the DreamStation Go, Z1 Auto, and Transcend), have optional integrated batteries that the manufacturers made, available for purchase. The ResMed AirMini does not have a separate integrated battery. An integrated battery is designed specifically for the CPAP machine and does not require additional cables, inverters, and/or adapters. It simply attaches to your CPAP machine, using the same cord the CPAP machine uses for power. Once it is charged, it is ready for portable use.

 

Warranty

The warranty duration is only one of the __ factors you should be considering for a CPAP’s warranty policies, before purchasing a machine. The majority of CPAP machines have a 2-year warranty (Eg: ResMed and Respironics), and some (Eg: DeVilbiss CPAP machines) have a 3-year warranty. The majority of CPAP humidifiers have a 1-year warranty, and some have a 2-year warranty.

A very important factor to consider is how convenient and quick the warranty service is. Manufacturers like Philips Respironics, ResMed and DeVilbiss have very convenient warranty services – you can trade your defective machine for a brand new one, and there is almost no idle time wasted between returning the faulty machine and receiving a new one.

On the other hand, some of the other manufacturers take longer to replace your machine, and they often repair the machine and send you a refurbished version, instead of a brand new model.

You should thoroughly check the manufacturer’s warranty policies before purchasing a CPAP machine.

 

Technology

There are a couple of ‘technological features’ that are common in many CPAP machines:

– Auto-adjusting pressure
All APAPs have this feature – the CPAP machine detects your sleeping behavior on a breath-by-breath basis, checking for flow limitations, apneas hypopneas, etc, and adjusting the pressure level accordingly. The exact capabilities depends on the manufacturer. Respironics calls this the auto-adjusting pressure, Resmed calls this feature the AutoSet Algorithm, and F&P calls this the Auto Algorithm.

– Pressure relief at exhalation
Many of the latest CPAP machines are able to decrease the pressure level by up to 3 cm H2O at every out-breath, mimicking a more natural breathing pattern. This softens the transition between inhalation and exhalation, adding a layer of comfort to the CPAP user’s therapy. Respironics calls this A-flex/B-flex/C-flex, ResMed calls this EPR (Expiratory Pressure Relief), and F&P calls this SensAwake (though, the function of SensAwake slightly differs).

– Auto Start/Stop
Many of the top CPAP machines are able to detect when the user puts on their mask and starts breathing, and turn on the therapy accordingly. Likewise, once the user takes off their mask at the end of their therapy, the machine turns off automatically. This avoids the need to manually switch the machine on and off before and after each therapy session.

– Mask fit check
Many machines can tell you whether your mask is fitting snugly or not, usually with a green/red light. This way, if the machine detects that your mask isn’t fitting properly, you can readjust your mask before starting your therapy, to avoid any leakages.

– Leak compensation
Leak compensation is when the CPAP machine compensates the pressure level when leakages occur – i.e. when there is a leak, the pressure level is increased automatically. This ensures that you are able to continue your therapy at the optimal pressure level, even when some leaks occur. Most CPAP machines have this feature.

– Heated hose
Some CPAP machines (Eg: The Airsense 10, DreamStation, or Icon) have optional (or integrated) heated hoses. If the hose is heated, it keeps the humidification warm, making it more pleasant to breathe in the air during therapy. It’s basically an add-on comfort feature.

– Data tracking
All CPAP machines either have advanced data tracking, with which you can check all kinds of data like events per hour, leak rate, AHI, periodic breathing, etc., or basic compliance data, which shows basic information like usage hours. If you want to improve your therapy success and track your progress, we would recommend getting a machine with advanced data tracking.

– Ramp feature
Ramp is when, at the beginning of your CPAP therapy, the machine starts at a lower-than-prescribed pressure level and then gradually ‘ramps’ up the pressure over time. This is a comfort feature intended to make it easier to fall asleep, as users may find high pressure levels uncomfortable and distracting when trying to fall asleep. Most machines are equipped with this feature.

– Bluetooth
Many of the CPAP machines on the market have bluetooth capabilities, allowing the user to connect to an app (Eg: DreamMapper for Respironics) to track their data.

 

 

 

 


 

9. CPAP Machine Buying Considerations

 

CPAP therapy can treat your sleep apnea, but it can other be bothersome in some ways. This section is to help you avoid common complaints about CPAP machines from users and to help you consider important factors when choosing a CPAP machine. Check out the mask version of the Things to Consider/Most Common Complaints blog post.

 

a) Design

Some CPAP machines look bulky and some newer models look sleek. Although design is not be as important as functionality, it may still be something you want to consider. You would rather have a pretty looking CPAP machine by your bedside than a bulky-looking one, right?

 

b) Features

This is one of the more important things you should consider when looking for a CPAP machine. Features provide options that cater to the user’s needs and can make your therapy more convenient and comfortable. Here are some of the features you should consider:

Auto Algorithm – Is it an auto CPAP? Auto CPAPs automatically adjust the airway pressure.

Pressure relief – makes it easier for the user to exhale by reducing the pressure

Ramp – gradually increases the pressure to what is prescribed, making it more comfortable for the user to breathe

Humidifier – does it have an integrated humidifier or do you need to buy it separately? Is it heated? Heated humidifiers help minimize rainout.

Portability – is it light and small enough to be travel-friendly? This is an important factor if you travel frequently. It’s much more convenient to have a CPAP for home and another for travel purposes.

Mask On/Off Alert – Some users are active sleepers, moving around quite a lot during sleep. This feature will alert the user if the mask comes off or loses the seal.

Leak Compensation – Compensates leaking mask by increasing the airflow to make sure that the user is still getting the prescribed pressure

Screen – Is the screen LCD and in color? This feature is not too important of a feature to have, but having an advanced screen can make it easier to navigate the menu and customize your settings.

Data Recording – An important feature to track and report usage. Some CPAP machines record basic data, such as how long you were asleep for, whereas other advanced CPAP machines track AHI, changes in pressure, leak rates, etc. There are also various ways for the data to be stored (smart card, attachable modem, wireless-enabled), and certain data trackers have wireless data transfers, allowing your physician or provider to automatically get updates and remotely be able to make adjustments to the machine settings for therapy purposes.

 

c) Performance

This is another important thing you should consider; does it work well? Does it perform as well as it claims to? The lack of machine performance can be attributed to two things – if you are using it correctly and maximizing its capabilities or that the machine is not the right one for you (it may not be a good machine with certain features that you need)

 

d) Power

How is the battery life? This relates to the portability feature in that if you are a frequent traveler/camper, you should look into machines with overnight batteries (for when you are off the grid) or long-lasting charge. Also, does it have an option to use a portable battery? Does it come with multiple plug-in adapters, such as a DC power supply?

 

e) Sound Level

This is the most common complaint among users. Although most CPAP machines on the market have a sound level of less than or around 30dbA, which is about the sound of a whisper, this is an important factor to consider, especially if you are a sensitive sleeper.

Every Health Sqyre product review has Design, Features, Performance, Power, and Sound Level ratings, which will help you get a sense of what the machines you’re considering is like.

 

Keep the above factors in mind when choosing the right CPAP machine for yourself. Your comfort in experience and responsibility in mind come first, so that you can stay compliant in your therapy and avoid the potential life-threatening dangers of untreated sleep apnea.

 

 


 

10. CPAP Data and Compliance

 

There are two requirements for compliance: machine data and face-to-face re-evaluation. If you are going to use your insurance to purchase your CPAP machine, you need to understand what compliance is.

 

Machine Data

The Centers for Medicare & Medicaid Services (CMS) has set the industry standard for CPAP data compliance at using the machine for four or more hours per night for 70% of the nights in a consecutive 30-day period. These values are monitored during the use of the CPAP via built-in smart cards, communication by modem, or a Web-based system to check both the hours the CPAP machine has been running and the amount of time the CPAP mask was actually in use.

Compliance tends to be less in those who do not understand the risks of apnea. Side effects such as nasal dryness, claustrophobia, pressure, and skin allergies to the CPAP mask materials contribute to the problems CPAP users have with compliance. Most of these issues can be resolved when the user’s CPAP team provides support and educates the user early in the compliance period.

Leading CPAP manufacturer, ResMed, developed AirView where you can access nightly therapy data, troubleshoot remotely (using the remote assist feature) and change the device settings remotely. The software also gives access to the user’s entire CPAP team to review the data since there is often a discrepancy in run time versus applied time when the CPAP user removes the mask but leaves the CPAP unit running. This can be resolved early to guarantee better results.

 

Face-to-face Re-Evaluations

For many insurance carriers, simply showing that you use the machine every night from your machine’s data is not enough. You must also visit your doctor no sooner than the 31st and no later than the 90th day of receiving your CPAP machine. The face-to-face clinical re-evaluation by your treating physician must document improvement of your OSA symptoms and objective data related to adherence to PAP therapy.

 

Failure

Removing the CPAP mask early in the night is the major cause for early CPAP non-compliance. It is important to have your CPAP team educate you on the advantages and disadvantages of treatment prior to treatment and all throughout your trial.

CPAP users who fail the initial 12-week trial are usually eligible to try again. In order to retrial, most insurance carriers require a new face-to-face clinical reevaluation by the treating physician to determine the etiology of the failure to respond to PAP therapy; and the user must do a repeat sleep test in a facility-based setting (no home sleep test).

Although there can be challenges to using PAP therapy, many users overcome these challenges by working closely with their CPAP team.

 

 


 

11. Do I need a Humidifier?

 

One of the most common questions new CPAP users ask is “Do I need a humidifier?”
Humidifiers aren’t just another accessory to your device; they serve an important purpose for some users, which we will explore in this section.

 

What is a Humidifier?

CPAP humidifiers are an optional chamber component of CPAP machines that hold distilled water. For heated humidifiers, there is a hot plate below the chamber that heats the water and turns it into humidity and is delivered to the airway. Most of CPAP machines on the market today have a heated humidifier that is integrated into the machine or is easily attached/detached.  There are settings that you can control, such as the temperature of the heated tubing.

Dryness is one of the most common side effects of CPAP therapy that leaves a lot of patients with congestion or sore throat. A lot of patients find CPAP therapy more comfortable with humidifiers because the humidified air relieves dryness and reduces irritation in the sinus. If you sleep with your mouth open, you may experience dry mouth and throat due to air escaping through the open mouth. An alternative solution to open mouth sleepers is a full-face mask or a chinstrap.

 

When would I need a Humidifier?

– If you are over the age of 60

– If you are on 2 or more prescription medications

– If you have chronic mucosal disease, sneezing, or postnasal drip

– If you had your uvula removed

– If you prefer to sleep in a cold room

– If CPAP makes you/your…
> mouth dry
> sneeze
> nasal passage burn
> disrupts your sleep from any of above symptoms
> nose runny
> nose stuffy
> wake up with mucous in your mouth and throast

This list of symptoms can all be resolved with proper use of a heated CPAP humidifier! Moisture, especially when heated, well soften up the nasal passage, allowing for comfort.

Quick Facts

– Patients over 60  years of age are 5x more likely to need heated humidification
– CPAP users taking 2 or more medications are 6x more likely to need heated humidification
– CPAP users with chronic mucosal disease are 4x more likely to need heated humidification
– Patients who sleep in a cold room are most likely to going to experience condensation – CPAP takes the air in the bedroom and delivers it into your nostrils and mouth (if wearing a full face mask). If the air in your room is too cold or dry for your sinuses, it is likely going to cause irritation.

 

When would I NOT need a Humidifier?

– If you are traveling, you may want to leave the humidifier at home.
– If you are in a humid environment, extra humidity may not be necessary.
– If you are a long term CPAP user, you may feel it just unnecessary and may be completely fine without it.

 

Extra Tips + Reminders for the Humidifier

An alternative to the humidifier is saline rinses or sprays.

Certain seasons/weathers may require the use of extra humidity through the airway, and in others, without it may be fine, so you don’t have to use humidifiers year round.

Lower the heat setting if you find your humidifier out of water before waking up. The higher the pressure of your device and the humidifier temperature, the more water is used.

With heated humidifiers, you may need a heated tubing as well to prevent condensation in the tubing. “Rainout” can happen when that condensation builds up in the tube, causing loud noise, and can sometimes even splash your face.

Check out the blog post on tubing to find the right one for you. If it “rains out” due to high heat settings, turn the heat down a bit. Another way to avoid excess condensation is to use a CPAP tubing cover to insulate the hose. Don’t overfill the water chamber because it may boil and spill over water.

Keep in mind that when you do have a humidifier, you must clean it regularly and properly to prevent the risk of infection with mold build-up in such moist area. You must also fill it up every night with fresh water for sanitary reasons.

As always, remember to fill the humidifier with distilled/purified water. This is not only for the longevity of your water chamber, but also because whatever water you put in there is what is going to turn into the air you breathe into your lungs. Therefore, never use harsh chemicals, bleach, antibacterial or scented soaps to wash the humidifier. You can use mild soap and warm water to properly clean it. Make sure to let it air dry after washing.

Stay compliant in your CPAP therapy by making your experience as comfortable as possible!

 

 

 


 

12. What kind of Hose should I get?

 

WHAT IS A CPAP HOSE/TUBING?

A CPAP hose, also referred to as the tubing, is what delivers airflow that is used to connect…
A. Machine to mask (4, 6, 8, or 10 ft.)
B. Humidifier to mask (4, 6, 8, or 10 ft.)
C. Machine to humidifier (18 or 24 in.)

Pro Tip: Light hoses, such as the Heated Tube for DreamStation CPAP Machines or the ClimateLineAir Heated Tube for AirSense 10 & AirCurve 10 Machines (both weigh 0.03 lb), tend to be more flexible and doesn’t tug on the mask as much.

The internal diameter of the hose (15mm or 19mm) affects the amount of prescribed air pressure. The 15mm slim hoses are compatible with only a select range of machines.

 

Types of Hoses: Heated vs. Unheated

Unheated: Also known as standard or performance tubing and has a smooth inside.
Heated: Contains copper coils that conduct heat.

 

Pros
Cons
Unheated
May be used with different types of machines. A hose with rubber ends won’t make a lot of noise.
Does not help reduce rainout.
Heated
Rainout, which is condensation formed in the hose, can be minimized with the use of heated tube. Can also alleviate dryness, congestion, sore throat, etc. caused from CPAP therapy.
Most of heated hoses are tailored to certain machines.

 

Should you get a Heated Hose?

Well, if you experience dryness, congestion, and sore throat from CPAP therapy, then heated hoses, along with humidifiers, can be helpful. If you have a heated humidifier but no heated tubing, then the effect is minimized because the standard tubing will often be colder than the air that passes through it, causing the air to be less warm. The difference in temperature of the unheated tubing and the heated air is what causes excess condensation, which leads to rainout. Rainout is uncomfortable for the user because it’ll wet the bed and splash water onto the user’s face…

Extra Tips + Reminders

– A tube wrap/cover improves the effect of a heated tubing because of insulation!

– A tube management clip helps secure the hose in place and keeps the mask sealed.

– Make sure to regularly clean hoses too. Use warm water and mild soap to clean the hose, then let it completely air dry. If properly cared for, hoses can last up to a year; however, if it ever gets damaged, replace it immediately.

 

 


 

13. CPAP Machine Manufacturers

 

Below is a list of CPAP/APAP manufacturers and whether they design machines for travel.

 

MANUFACTURER

CPAP

APAP

TRAVEL

3B Medical

AEIOMed

Apex Medical

CareFusion

Curative Medical

DeVilbiss

Fisher & Paykel

Human Design Medical

Philips Respironics

ResMed

Somnetics

 

Sound, humidity, portability, and technology are today’s top features when determining the best CPAP machine to buy. If sound level is an important feature, you need to look at each machine since some are quieter than others. Humidification is not always offered, especially on the travel CPAP machines. The function of portability has increased in demand that most manufacturers have developed entire lines of travel CPAP machines and travel accessories. Technology has designed remote monitoring so your technician can make adjustments to your machine, monitor your progress, or alert you when you need new equipment or supplies.

ResMed’s AirSense 10 is the top selling CPAP machine in today’s market, featuring a quiet sound level at 24 dBA, HumidAir integrated heated humidifier that is built into the CPAP machine, weighs only 1.8 lbs without the humidifier (when traveling), and has a built-in cellular technology so you get unprecedented access to therapy data.

 

 

 


 

14. CPAP Machine Glossary

 

APAP – APAP stands for Automatic Positive Airway Pressure. APAP machines are a non-invasive treatment for sleep apnea that deliver pressurized and unobstructed air through a mask during sleep. The APAP has two range settings, low and high. The setting automatically adjusts based on the user’s needs using an algorithm.

ASV – ASV stands for adaptive servo-ventilation. ASV machines provide support during regular breathing, not just during sleep. Using algorithms, it intervenes when the user’s breathing has significant reductions or pauses.

BIPAP – Bipap machines are a non-invasive treatment for sleep apnea that have two pressure settings: one for inhalation and one for exhalation. This allows for the users to have more lungs moving in and out of the lungs.

BIPAP ST – ST stands for spontaneous time and is a feature of the BIPAP that is activated when the user does not meet the minimum number of breaths per minute by triggering the user to take another breath.

BIPAP w/out Back Up vs. BIPAP w/ Back Up – A BiPAP (also referred to as a BiLevel or VPAP) delivers two set pressures, a higher pressure for inhalation and a lower pressure for exhalation. BiPAP and BiPAP ST machines are similar, as they are both designed to provide the same airway pressure. The difference between a BiPAP and a BiPAP ST is the Spontaneous Timed feature. The ST responds to the user when the minimum number of breaths per minute has not been met. This machine ensures all breaths occur by triggering the user to take another breath within the minute.

BPM – Breath per minute

CPAP – CPAP stands for Continuous Positive Airway Pressure and are the most commonly used treatment options for people experiencing obstructive sleep apnea. CPAP machines deliver constant and pressurized air into the airways.

DATA –  The recording of in-depth information such as: apnea events, hypopnea events, changes in pressure, leak rates, information on snoring, and more.

EPAP – EPAP stands for expiratory positive airway pressure. It is pressure created during exhalation that stabilizes the upper airway, reducing snoring.

HOSE – The hose delivers the pressurized air from the machine to the mask. It can be heated or unheated.

 

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