CPAP Equipment

CPAP equipment consists of blower devices, mask, gear to hold the mask on, and a tube to connect the blower to the mask.

• The Mask: A nasal CPAP system will deliver air into your airway through specially designed nasal CPAP masks or pillows. The mask fit is critical for proper treatment. Friends and family may be helpful in adjusting to the CPAP equipment and mask. The mask does not breathe for you; the flow of air creates enough pressure when you inhale to keep your airway open. There are several ways to get air into the nose and upper airway: A mask that covers only the nose, nasal pillows that fit into the nostrils and on occasion a full face mask that covers the nose and the mouth. For most, the nose mask is the most comfortable. Sizes vary from large to petite and from wide to narrow. A Nasal pillow system is more comfortable for some but may cause problems at higher pressures because the air blows directly into the nose. Nasal pillows also come in different sizes and must be turned correctly to fit the shape of the nostril. A number of different styles of masks area available, making proper fit likely.
   
• CPAP System: Speak with your doctor and your equipment supply company about which machine is best for your needs. When deciding which CPAP equipment to use, think about what features you prefer. There are many choices. Options include the ability to convert to foreign currents (automatically or with additional equipment), the capability to adjust for different altitudes (automatically or manually), an attached heated humidifier, ramping (which allows for a gradual increase in pressure), DC (direct current) operations via a car or boat battery, and bright colors. Bi-level devices with two different pressures--one for inhalation and a lower pressure for exhalation--are also available. In addition, the Food and Drug Administration (FDA) has approved some auto-adjusting (auto cpap machines) devices for the market; these machines are designed to sense varying pressure needs as you sleep and to change the pressure automatically as needed. The latest type of machine to receive FDA approval is equivalent to a CPAP system with continuous or constant pressure for inhalation, but it has flexible lower exhalation levels (Cflex). The exhalation pressure is determined partly by the machine, which responds to the user's exhalation patterns, and partly by the user, who selects one of three settings.
  
  A more sophisticated CPAP system with higher costs is not always automatically covered by insurance but may be covered with a specific physician prescription and documented failure to respond to standard CPAP treatment.
  
  High end machines will monitor how often you use CPAP devices and can also record if you had any apneas while using the machine (this can indicate a need to adjust the pressure). Your doctor may want to download this data periodically to verify the adequacy of your CPAP treatment, and the compliance monitor can also be an important feature if you need an objective verification that you are obtaining sufficient amounts of sound sleep. For the data to be downloaded, you may have to take the CPAP system in to the sleep center or home care company. If the data are imbedded in a small, thin card, you may be able to take or to mail the card to the sleep center or home care company. You may be able to send the data via a telephone modem (supplied with the machine) that does not require Internet access.
   
• Pressure of CPAP Devices: A pressure between 5.0 and 20.0 centimeters of water pressure (cwp) is usually effective. This is the amount of pressure necessary to hold up a column of water of that height. The higher the pressure, the more noticeable it is. However, patients at higher pressures also are able to use CPAP over the long run. Some machines gradually increase the pressure over several minutes at the beginning of the night; this feature is called a ramp. The ramp allows time to go to sleep before reaching the maximum CPAP equipment pressure.

When using a CPAP system, air will blow out of the mouth when it is open. This makes talking difficult when using CPAP equipment. Some patients feel that it is difficult to breathe when using NCPAP. This sensation will diminish if one breathes calmly and deliberately. Watching TV and holding the mask up to the nose without strapping it on will help adjust to its use. Normally, a patient's mouth stays closed during sleep. However, in some cases, a chin strap may help hold the mouth closed.