Tips on Purchasing Your First CPAP Device

By Admin
  You’ve been diagnosed with sleep apnea and now need to choose a PAP therapy device, a mask, and whatever accessories you may need to make the treatment more comfortable and effective. Where should you begin? We’ll tell you. You should always begin by seeking help from a medical professional or a specialist in the field. If you are making your purchase online, a knowledgeable DME (durable medical equipment) provider can help you find the best machine for your needs, including mask fittings and preferences. If you are making a purchase on the SistemmaCPAP.com website, we are always available by phone, via chat, or through email at support@sistemmacpap.com. If we are not immediately available, please leave a message and we will respond within 24 hours. To make things simple, most retailers provide starter kits that include a machine, a mask, and cleaning products or other accessories. But if you’d like to create your own setup, here are a few things to consider before making your purchase.  
The Research
When starting PAP therapy for the first time, make sure to do your research. Look up the manufacturers, the retailers, the device ratings, and any other information about sleep apnea and PAP therapy that can help you make a decision. Some things, such as the preference for full-face masks among patients who move or reposition themselves during the night, are helpful to consider when making a first purchase. But you will only learn such information by reading, or if you prefer, watching videos. These days there is an overwhelming amount of information available, so keep your reading focused on the most relevant subjects for a beginning patient. Once you learn the basics, you’ll be on your way to becoming a pro.
The Cost
PAP therapy devices are advanced durable healthcare equipment, and therefore not cheap, but getting a copay from an insurance company or making your purchase from an online retailer can greatly reduce the financial burden. But if pricing is a problem for you, consider a used and refurbished system. By law, used therapy devices must be thoroughly cleaned and sanitized using the most advanced cleaning systems available before sale, and contamination is rare. In fact, it is likely easier to contaminate your own device than become sick from a legitimate sale of a used one. The price range for a new CPAP machine is about $400 to $800, with APAP going up a little further to between $600 and $1,000. A BiPAP device can cost anywhere between $1,000 to $2,000 on the standard market. By comparison, a used device will be at least 30 to 50 percent less from most retailers and DME providers. Before you make your purchase, take all of this into consideration and decide what is best for you. A PAP therapy system is more than a simple purchase of a product. It is an investment in your health and wellbeing, likely to be by your side for years to come.
The Machines
PAP therapy devices come in three main types. There are other types, as described below, but the majority of initial purchases will be for the following:
  • CPAP machines, which use the original mode of continuous positive airway pressure. This is the standard machine type with a single pressure setting.
 
  • APAP machines, which use automated positive airway pressure, providing different pressure settings that change according to patient needs.
 
  • BiPAP (or BiLevel) machines, which use alternating pressure settings. A higher setting is for inhalation and a lower setting is for exhalation. These machines are for those patients who have difficulty exhaling against pressure.
There is also BiPAP S/T and ASV (adapto-servo ventilation) machines, which both use response mechanisms to adjust to patient breathing changes in the night. S/T is short for Spontaneous Timed mode, which responds to the patient when the minimum number of breaths per minute has not been met. ASV, on the other hand, will respond on a breath-by-breath basis with variations in pressure. While ASV is highly effective, it is also a more advanced and complex form of PAP therapy that most beginning patients will not need to consider unless they have a central, mixed, or complex sleep apnea diagnosis. Each type of PAP therapy machine has its own advantages, and patients tend to start with standard CPAP or APAP, and proceed to other forms if there are problems. Once you understand how the machines work and what you may prefer in the longer term, then you can make a more informed purchase.
The Prescriptions
Some patients will get a prescription from a medical professional that specifies which kind of machine you should get. In these cases, you may have less options, but your medical provider should help by prescribing a specific type. The prescription may also specify what pressure setting is needed to treat your specific condition. Getting a prescription is not always a simple process, as the machines are becoming more specialized, and it is likely that you will need to undergo a sleep study if you haven’t already. Once your insurance provider is certain that you need a PAP therapy system, they will either reimburse your purchase, or have you pick up the equipment on lease or loan. Often, the complete ownership of the PAP equipment will depend on your compliance rates, which are often sent to the company remotely. Keep in mind that your usage times will be recorded as soon as you begin therapy. While some older models use SD cards exclusively, most will use Wifi connections to upload your sleep data remotely.
The Masks
PAP therapy masks come in different sizes and designs, but all connect to the CPAP machine via the CPAP tubing. The most important considerations when choosing a CPAP mask are the different types available, and the different sizes of each type. Make sure to tell your provider or retail source what preferences you think you may have after doing the research. Full-Face Masks Full-face masks cover the nose and mouth and much of the cheeks as it is strapped to the back of the head. These masks are preferred by mouth breathers and those who move around a lot during the night. full-face masks are also good if you have sinus problems, allergies, or may not find a nasal mask comfortable. Some patients find full-face masks to be somewhat overbearing, or they may become clausterphobic during therapy, so prefer a more lightweight nasal or nasal pillow mask. Also, due to the larger surface area, there is a higher chance of air leakage from full-face models, and some activities such as watching TV may be limited while wearing them. Nasal Masks Nasal masks fit over the nose and cover area just above the lips to the bridge of the nose. These masks are preferred by many who find the larger full-face options too heavy. Nasal masks come in many different styles and are described by users as having a natural airflow that doesn’t affect the mouth. In most cases, nasal masks will not obstruct movement or become jarred when changing positions, but if that does become a problem, a full-face alternative should be considered, as they are more sturdy. One should also have good nasal breathing capabilities to use this type of mask. Nasal Pillow Masks Nasal pillow masks are a lighter, softer version of the nasal mask. These are great for patients with skin sensitivities or problems feeling claustrophobic even when using a standard nasal mask. Nasal pillow masks minimize surface area contact, so hardly touch the patient at all. While they may be less sturdy than other models, they are made of durable materials that resist physical pressure and bend rather than break. Nasal pillows are extremely soft to the touch, and may be a good choice if you have reservations about wearing a mask to bed.
The Features
PAP therapy features are very important to the treatment experience, and many of them are comfort features which allow for more relaxed and natural therapy experiences. Using these features will make a big difference to the beginner, so make sure to follow instructions upon first setup, and make any necessary adjustments as you go along. Learning to use your CPAP device is going to be an ongoing process, but the more you learn and prepare yourself, the better that process will be. Humidification Not all PAP therapy devices come with a humidification system built in, but most will include the option. This is a comfort feature that provides warmth and moisture to the air you breathe, and for some patients it is an absolute necessity. Humidification prevents dry mouth and nasals, and greatly reduces the chance for infections, bleeding nose, headaches, and other symptoms of prolonged dry air in the mouth and upper airway. Ramp For those just beginning PAP therapy, it usually takes some time to get used to the pressure when trying to go to sleep. The Ramp feature is a great solution for this, as it reduces pressure upon starup, gradually increasing to the set pressure according to whatever timing interval you choose to start with. Setting the Ramp to around 30 or 40 minutes allows plenty of time to relax as you drift off to sleep. Since the Ramp feature increases the pressure gradually, you are likely to be asleep by the time it reaches your prescribed pressure setting. Therapy Data As mentioned, a PAP therapy device will collect sleep data during each session. This can include start and stop times, sleep cycles, snoring, AHI (apnea-hypopnea index), number of awakenings (for any reason), heartrate, leakage, breathing patterns or changes, and other recorded information related to your sleep experiences. You can access this data yourself to see how your sleep habits change between sessions, and your doctor or healthcare provider can use the information to track therapy progress over time. The data collected can be different from one machine to the next, and the method of collection can range from memory or SD-card storage to direct Wifi uploads or Bluetooth applications. Some devices will require an application download, but there is usually no extra cost associated with this feature. Remote Monitoring Modern machines may also include remote monitoring capabilities that allow your doctor or a sleep technician to make direct changes to your PAP therapy unit as a result of the sleep data readings. This way, doctors can track your progress and make changes without having to wait for an appointment at the clinic. These capabilities are highly efficient and convenient, but you may want to know whether the feature is left on by default, or whether you will need to access the proper settings to enable outside access. Security measures such as pin numbers or passwords will keep this access limited to those you have allowed access to.
Other Considerations
Some other things you may want to consider are noise levels (if you are a light sleeper), size and portability, the look and feel of the device, and personal preferences. Most machines are fairly quiet, but you may want to ensure that the sound level is at 30 decibels or lower. Below 30 dbs is about the sound of a whisper or wind in the trees. Above 40 dbs is more like the vibration of a cooler or refrigerator. For size preferences, consider whether you travel a lot, or if you often sleep in more than one place. If you need a device that packs away easily, there are plenty of small and portable versions on the market, including the ResMed AirMini and Philips Dreamstation Go models. The look and feel of the models can be explored through online images or in retail outlets, but the general idea is to look for something that fits with your personal style and environment. Also, some of the various features may fit your preferences as well. For example, some models include expiratory pressure relief (EPR), which mimics the BiPAP experience of lower pressure during exhalation. Other features such as leak compensation, alarm and alert settings, and mode options may be selling points as well. But the fist and last source of information should always be your doctor, provider, or retail specialist who can answer any questions and help to guide you in your final decision.  
Sources
Alaska Sleep Clinic - https://www.alaskasleep.com/blog/cpap-machines-manufacturers-features-considerations American Association of Sleep Technologists - https://www.aastweb.org/blog/what-is-pap-therapy Journal of Clinical Sleep Medicine - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4773618/ Sleepapnea.org - https://www.sleepapnea.org/treat/cpap-therapy/ Verywellhealth - https://www.verywellhealth.com/what-is-cpap-3015254