Auto Cpap

Frequently Asked Questions

1. QUESTION:
   What is the difference between a BIPAP machine and an auto-adjusting CPAP machine?
   I had a sleep titration study about a year ago, but the cpap machine prescribed didn't work well for me. Now I'm told I might need either a BIPAP or an auto-titrating CPAP. The sleep titration study showed that I needed a pressure of 18.

   But what is the difference between these two machines? Which might be best for me?
   P.S. Give the time that's passed, I'm told I might need another sleep titration study

   • ANSWER:
     CPAP stands for continuous positive airway pressure. If you notice, the amount of pressure that the machine provides remains the same while you breathe in and out. You can, however, change the pressure level. Auto-titrating CPAP machines do this automatically based on your breathing pattern.

     BIPAP stands for bilevel positive airway pressure. Unlike CPAP, the machine provides two different levels of pressure depending on whether you are breathing in or out. The given pressure is higher when you inhale and lower when you exhale.

     90% of patients with sleep apnea improve with CPAP. A small minority require BIPAP. The "best" treatment is the one that works for you. If your symptoms are not controlled with either mode, you may require surgery.

2. QUESTION:
   Do you know if there is a reputable place where I can purchase a pre-owned auto CPAP machine?
   I just got my prescription. The sleep specialists I'm seeing only sell brand-new equipment, and all models and brands are same price, which I find difficult to understand because for most electronic equipment, there are different brands and prices.

   • ANSWER:
     Get your script and send it in to cpap.com. They have many different models and prices

3. QUESTION:
   auto cpap question?
   i have been testing a auto cpap, 2days. i woke up i asssume because i stopped breathing, my month wide open with a ton of air pressure. i have a full face mask. i have this auto machine because they are trying to figure out what pressure i need. i have had a cpap machine for 2 years and i feel it is not working good enough?? anybody else gone thru this??

   • ANSWER:
     A good durable medical equipment supplier has a labs and professionals who are licensed and trained to do this and obtain the right fit and pressure. If you are working with them already it is important that you document episodes like what you described in detail and call for an appointment to make an adjustment.

4. QUESTION:
   REMstar/auto cpap machine reliability.?
   My wifes REMstar/auto with humidifier, bought about two years ago, has broken down three times so far. The manufacturers claim that it had water in it. They fixed it under warranty the first two times but now I have to pay for any repairs. Has anyone else had problems with this brand of machine?

   • ANSWER:

5. QUESTION:
   Cost of CPAP machines in different countries?
   I use a Respironics CPAP Auto M machine to help me to breathe when I am sleeping, and I am researching the cost of the machine in different countries. If you are a user, could you please let me know the price you paid.
   This is serious research.

   • ANSWER:
     check cpap.com and billmyinsurance.com and understand that your insurance has a huuuuge markup. also for more info on sleep apnea go to cpaptalk.com

6. QUESTION:
   Hi, sleep apnea. cpap machines. Has anyone experienced fluid build up in lungs using humidifier??
   Using a full face mask with a resmed "spirit" auto cpap with humidifier (built-in). I find that I am sleeping on my left side. I stopped using the machine about 12 months ago. I have very recently became extremely short of breath. X-ray has shown that I have a build-up of fluid,with partial lung collapse and consolidation. Fluid was extimated at approx 2 litres (2/3 of lung capacity.) two attempts to drain the lung via needle in my back resulted in 800ml. then 170ml. I was then referred to a specialist who will use an exploratory instrument to look into my lungs then attempt to drain the remaining liquid. This is to happen next thursday, 4thy October, 07. The first attempts were done "blind" The next will be done with ultrasound assistance. Done one day stay overnight for observation. Has anyone had or heard of the build up of fluid, possible from the humidifier, in conjunction with cpap machines. Doctors are totally non committal at this point.Iam a fairly big fellow, 106Kg. 70 year

   • ANSWER:
     Ok, you stopped using your home CPAP unit 12 month ago, and yet, you think that the humidifer somehow caused your fluid build up??????

     NO WAY!

     What you are discribing is fluid between the lung and the thorasic cavity. There are some very serious causes that create this fluid buildup...and I am gonna let the Doctor be the bearer of that news, once he knows...He will find out cause they are gonna take samples of that fluid to the lab and look it over.

     Now, about your CPAP...USE IT!

     It has a tendancy to reduce work of breathing, especially in situations like the one you discribed. And you will sleep better, feel more rested, and wont have that sleepy state come over you during the middle of the day....

     And as for "fluid build up using the humidifer", I suspect what you are worried about is "rain out"...that is, where the air coming into the machine is warmed and humidifed at a temperature slightly warmer than body temperature, and it comes out to a COLD hose, and the air cools, loosing some moisture...A good example is dew on the grass in the morning...

     Don't worry...all the humidity does is sooth a dry throat, caused by the volume of air and pressure to the lungs....So relax...use the CPAP...get better rest....feel better...

7. QUESTION:
   What is the best cpap machine on the market?
   I think it comes down to the Respironics System One REMstar auto and the REsMed S9 elite.

   Cost is not an issue here. Any input will be greatly appreciated, I'm new to all this and feel overwhelmed. Yet sleep apnea is creating a huge burden on my life.

   Again, thanks to anyone that can lead me in the right direction.
   I meant to write the S9 autoset, not elite.

   • ANSWER:
     I think the Respironics machine probably has the edge. It is an autotitrating machine which gives a gentle lead in at the beginning and ramps up the pressure to meet your need during the night. Respironics also has a great reputation and great customer service. Good luck!

8. QUESTION:
   HI I just started using cpap machine I am finding it nearly impossible to get sleep with the mask on?
   I find it difficult to exhale with the air being blown in, I have been trying an auto machine which reduces the pressure for exhalation, is this what they call Bipap? I am seriously thinking of stopping its use, any advice?

   • ANSWER:
     Go back to whoever prescribed the CPAP and have the settings checked.
     It might be that BiPAP is a better choice for you.
     Did you lose or gain any weight recently? that might make a huge difference.
     How about your sleep position? Does it help to sleep propped up?
     Don't stop before you try other settings and maybe other alternatives!

9. QUESTION:
   Is it legal for a medical supplier or DME to give a patient a used CPAP or AutoCPAP without their consent?
   I received a Auto CPAP from a supplier to check it out and see if it would do better then the CPAP i've already got. I started checking out the menu and there was over 400 hours already logged on the machine. Talking to another medical supplier i found out it might be against the law to give a patient a used machine without prior patient consent. Is this true? Do you think i can pitch a fit and get this medical supplier to get me a new AutoCPAP instead of keeping this used one?
   By the way the CPAP i do have i had to buy because i didnt have insurance at the time.
   The rep told me he would bring me a new AutoCPAP for me to try. I guess he thought "new" meant new to me instead of new in box. And as far as I can tell my insurance has not been billed yet because i havent received an EOB yet.

   • ANSWER:
     If you are renting it , naturally it would be used as it is a rental unit.. If it was sold as new YES that is a problem.

     I would be very direct to the supplier it you did buy it new as their action was totally inappropriate.

10. QUESTION:
    Which is better Respironics REMstar Auto or ResMed S9 Autoset or ResMed S9 Elite?
    Hi, My doctor has recommended me to use a CPAP machine.

    My insurance company will cover 50% of the cost if I purchase from the local DME who price all the above machines the same. Can you please suggest which one of these is the best machine, less noisy and more comfortable.

    Thanks for your help.

    • ANSWER:

11. QUESTION:
    ResMed S9 AutoSet vs. Respironics REMstar Auto (PLEASE help)?
    I have moderate obstructive sleep disordered breathing with UARS and don't know which machine would be better for me: the ResMed S9 AutoSet or the Respironics REMstar Auto.

    Here is the data from my polysomnography:

    - AHI = 4 events per hour
    - Supine AHI = 3
    - REM AHI = 6.6
    - Obstructive apneas = 0
    - Central apneas = 0
    - Mixed apneas = 0
    - Apnea Index = 0
    - Central apnea index = 0
    - Mixed apnea index = 0
    - RDI = 26.5 events per hour
    - Total respiratory arousals = 165
    - Respiratory arousal index = 28.4
    - Total RERAs = 131
    - Rera = 22.6 per hour
    - Arousal index = 49.9
    - Arousals = 290
    - Average duration of apnea/hypopnea events = 33.8 seconds
    - Longest hypopnea = 54.9 seconds
    - Less than 1% of sleep was spent in oxygen saturations less than 90%

    Diagnosis: "Moderately severe obstructive sleep disordered breathing with evidence of upper airway resistance syndrome (UARS) in a patient with snoring. There was exacerbation noted during REM stage sleep."

    I just did my CPAP titration study and don't have the results yet. But the technician told me that the highest pressure used was 10.

    Here is the issue: I was set on getting the ResMed S9 AutoSet because it seems to be in a league of its own with all the different features and the design. Unfortunately, it doesn't detect RERA's, and the Respironics REMstar Auto does.

    Given my profile, which would be more important, the design and features of the ResMed S9 AutoSet or the ability to detect RERA's with the Respironics REMstar Auto?

    I'm concerned that since I have UARs with RERAs, if I get the S9 AutoSet and start having events, it wont be able to detect them and I will have no idea what's going on in terms of duration and frequency when I look at the data reports.

    Here is what the ResMed S9 AutoSet detects and reports:

    - AHI
    - Pressure
    - Leak
    - Central Apnea Index (CAI)

    Here is what the Respironics REMstar Auto detects and reports:

    - AHI
    - FL (flow limitation)
    - RERA
    - snore
    - leak
    - CA (clear airway apnea)
    - OA (obstructed airway apnea)
    - HY (hypopnea)
    - PB (periodic breathing)

    I am totally new to all of this and have no idea if I'm over thinking this issue. However, if anybody can provide some insight as to which machine would be best for me I would greatly appreciate it. UARS has destroyed my life and I would really like to get it under control.

    Thank you in advance for your advice.

    • ANSWER:
      My honest opinions coming from someone who's been in the clinical department of a DME company for years...

      Why get an auto!? You just did a titration study which detects what your optimal pressure setting is. The doctor is not going to now order an auto adjusting machine.

      The UARS that you refer to are also hypopneas and MILLIONS of people have them, including my husband, and a standard CPAP treats them well. A hypopnea is a 50% or greater reduction in flow with vary amounts of oxygen desaturations. If the tech from the titration study feels 10cm is effective, it will treat your apnea.

      Based on the data you gave, your AHI is 0. That means that you had NO obstructive or central apneas or hypopneas is more than 4% drop in oxygen. Because your RDI (respiratory disturbance index) is elevated, that tells me that you have hypopneas with less than 4% drop in oxygen. You also indicated that you spend a minute amount of time below an acceptable oxygen level, if at all.

      If your insurance covers CPAP (as it might not because your AHI is 0 and some insurances don't recognize RDI), a standard CPAP is what you'll get from any DME company. My favorite (as well as the other clinicians in my entire company) are the ResMed machines. The Elite II is a great machine as well as the new S9. They will record compliance, leak, AHI... You honestly wont need all that other junk. The ResMed machines are user friendly and great for travel.

      An AHI of 4 indicates that you technically wouldn't have sleep apnea if the hypopneas with less than 3% desats weren't counted. So if you don't want to do CPAP, don't stress about it. Have another sleep study in 5-6 years or with weight gain...

      As for the simple answer... Res Med Elite II... If you are private paying for a machine, don't waste your money buying a machine with features you don't need (the auto adjusting mode) because you already paid someone to watch you and determine that stuff...

      Does that help? Make sense??? Contact me if it doesn't.

12. QUESTION:
    How to adjust Remstar Auto pressures?
    Hi
    I have a long time standing with issues regarding allergies and they have once again gone haywire. When this happens, I can not breathe through the nasal pillows sytem - yes I've told the Sleep doc but he told me that the machine should still work if I gave it time. Well I have tried time and time again (over a period of 19+ months) and found that when there's trouble to use a mask that allows me to breathe through my mouth. In doing so, we have found that the lower pressures used on the pillows doesnt quite cut it with the larger mask. It was suggested I try adjusting the pressure just two or three units. I have tried playing with my machine but it doesnt seem to want to allow me to make this change - even temporarily. Have you made changes? If so, please tell me how to do so. My doc's located over 50 miles away and two of the office docs are on vacation.

    What I need is directions (STEP BY STEP) on how to change the CPAP Pressure - for when I am using the larger mask.

    • ANSWER:
      Ahhh, I actually know the answer to this one, as I had just asked a similar question elsewhere.

      The good folks at ________ tell me that you can reset pressures by:

      1 - unplug your machine
      2 - press the arrow keys simutaneously as you plug the machine back in
      3 - keep holding til you hear a double beep

      Now what I found was that I had to select through the "clinicians menu" til I found the area that set a new Max for pressure.

      I have been told that once you play adjust your own pressures, your RT may not be legally allowed to work on your machine in the future. (but I really dont know)

13. QUESTION:
    out of breath and so so tired?
    I have recently been diagnosed with both obstructive and central sleep apnoea and have been using the auto nitrate cpap machine. My wife still wakes me 2 or 3 times a night to say "your not breathing" but i also get really bad chest pain (not heart related) more ribs and sternum pain.
    Over the past few months i have also noticed on odd occasions throughout the day that i am not breathing and when i realise its almost like a panic attack and i am gasping for air. this is really strange as i've never heard of anybody not aware that they are not breathing whilst awake.

    • ANSWER:
      We help many OSA and some CSA patients with their ongoing therapy so what you describe is something that to a degree we have heard before.

      Unfortunately, you have mixed sleep apnoea and especially the central part of it makes it complex. An Auto-CPAP machine, which automatically titrates as you describe, works great for obstructive sleep apnoea. If you only had OSA, your wife wouldn't be observing any worrisome breathing lapses any more. Some people new on CPAP get that chest pain which is usually put down to the fact your lungs are simply not used to these mass volumes of air. The lung is pretty much a muscle and connected to various bits inside your chest so once it starts expanding through CPAP to what it used to, it takes a while to become as elastic again as can be. Most CPAP patients (commonly knows as hoseheads) find this discomfort settles after a couple of weeks. It's like if you start running regularly, you first have some muscle aches to get through but once those muscles are used to the new levels of exercise, they won't complain much any more.

      But indeed, keep your clinic in the loop about these side-effects so they can log them and stay up to date.

      Now the complex part. Central Sleep Apnoea, as you probably know, is a matter of the brain failing to communicate with the lungs. It's simply forgetting to tell your body to breathe. That indeed can be scary.

      CPAP isn't generally the preferred treatment for central sleep apnoea. Most end up on BiLevel treatment, sometimes with a backup timer. A CPAP machine doesn't breathe for you. It simply gives pressurised air to remove any obstructions. But during a central apnoea event, there is no obstruction so the CPAP simply pumps in air. It doesn't help you breathing fully into the lungs and certainly doesn't help you breathe out. And breathing out is as important as breathing in.

      So with BiLevel therapy, you get two distinct pressures. IPAP and EPAP. That's an i for inhalation pressure and an e for exhalation. Or inspiration and expiration. In and out are different to help you breathe better. Some BiLevel (or BiPAP) devices then have a timer. These are often referred to as BiLevel ST. The T stands for timer. These become actual ventilators, as in, breathing machines. So they monitor your breathing and when you stop breathing of your own accord (central), it will start breathing for you.

      Now I'm not saying this is what you need, just making you aware of it. You may want to ask your sleep consultant whether a BiLevel machine may be appropriate for your case.

      You may also want to consider the facilities at your current clinic. There happens to be a massive difference in quality and capacity between clinics. As your case is much more complex than "simple" OSA, you will want to be at the best equipped sleep clinics like John Radcliffe, Leicester General, Royal Brompton or St Thomas for example. If you are out "in the sticks" you probably have a lesser equipped and lesser experienced/educated clinic.

      So keep talking with your current clinic and make them aware of your symptoms and side effects. Keep a log as relying on your memory isn't a good idea with sleep apnoea. You might find patterns when you log dates and times, as well as how well you slept etc.

      Hope that helps and please consider joining the CPAP UK Forums linked below. There are over a thousand CPAP users there who can share tips.

14. QUESTION:
    Paying for an apartment?
    It has become a little too crowded at my house. I'm 31 and I live with my two brothers, nephew, and my brother's fiance`. Although its comforting to have family around especially when I get sick (I'm a diabetic w/sleep apnea on a cpap). It has become annoying to come home after work to noise(loud talking, tv, company). When I have company (male) there is an issue with my brothers. After dealing with people all day at my job, I just want to come home to peace and quiet I was thinking of taking an online class and apply for a student loan and also use my tax returns to pay for my rent. Possibly up to six months. But I am also wondering if this is wise. I spend about 0.00 a month on insulin and supplies. Then I have auto ins, groceries(healthy food is not cheap), phone, cable, internet(combined), and a cell phone. I don't have kids, my car is paid for, and I pay 0 a month in rent to my mother since this is her home. I am also looking for another job, possibly out of state. I hate the cold here in Michigan. I just want insight as to what to do? I even thought of just NOT being home so much. Travel, work out, etc just not be home. Any suggestions?????

    • ANSWER:
      You need to figure out your income and expenses. Create a budget. Even if you can pay for it for six months, what will you do after that? What are average rental prices, and how much can you earn?

      I think student loans are meant for studying, not for housing.

      You can look into getting a room at someone's house or moving in with roommates, but a lot of them have the same problems as what you're describing. If you want quiet, find someone elderly who has a house with a room to rent.

15. QUESTION:
    Wise? You my student loan and income tax to pay for my apartment?
    It has become a little too crowded at my house. I'm 31 and I live with my two brothers, nephew, and my brother's fiance`. Although its comforting to have family around especially when I get sick (I'm a diabetic w/sleep apnea on a cpap). It has become annoying to come home after work to noise(loud talking, tv, company). When I have company (male) there is an issue with my brothers. After dealing with people all day at my job, I just want to come home to peace and quiet I was thinking of taking an online class and apply for a student loan and also use my tax returns to pay for my rent. Possibly up to six months. But I am also wondering if this is wise. I spend about 0.00 a month on insulin and supplies. Then I have auto ins, groceries(healthy food is not cheap), phone, cable, internet(combined), and a cell phone. I don't have kids, my car is paid for, and I pay 0 a month in rent to my mother since this is her home. I am also looking for another job, possibly out of state. I hate the cold here in Michigan. I just want insight as to what to do? I even thought of just NOT being home so much. Travel, work out, etc just not be home. Any suggestions?????

    • ANSWER:
      If you're taking an online course, you're not going to be able to receive a student loan in any amount that will be sufficient for paying rent as well as the materials you need for your class. When loans are assessed they keep in mind what your education will cost including tuition, room, board, books, etc. They do look at what school you are attending and what kind of program you're participating in. Unless you find a pretty liberal lender (which is a difficult thing to do these days) your loan will be enough to cover materials and tuition only, as you will not be housed on a campus, paying room and board.
      I don't know what you recieve in tax returns, but unless it's a pretty large amount, I have a feeling they won't be enough to cover your rent, either. You could potentially apply for a personal line of credit, but the interest rate is usually pretty high. Your best bet may be to wait and see if you can land a higher paying job and evaluate whether or not you can afford rent plus your other monthly expenses given your new salary. A monthly budget does wonders.