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Q. What is a CPAP?

A. CPAP is an acronym for Continuous Positive Airway Pressure. It’s a device which blows air from a machine, through a tube, and into a mask which fits over either the nose or the nose and mouth. Its purpose it to provide a pneumatic splint for your airway.

Q. What is a BiPAP?

A.BiPAP is a trademarked acronym of Respironics, Inc., for Bi-level Positive Airway Pressure. The generic name for this device is a bi-level device. Like the CPAP, it’s a device which blows air from a machine, through a tube, and into a mask which fits over either the nose or the nose and mouth. Its purpose it to provide a pneumatic splint for your airway.

Q. What’s the difference between a CPAP and bi-level device?

A. The chief difference between the CPAP and the bi-level devices are that CPAP machines deliver air at a constant pressure, while bi-level machines deliver air at one pressure when a person inhales, then drops the pressures to a pre-determined setting as the person begins to exhale. A bi-level device is generally used for people who have breathing difficulties or compliance problems with a CPAP.

Q. What’s an AutoPAP, and how’s it different from a CPAP or BiPAP?

A. An AutoPAP is similar to a CPAP or Bi-level PAP machine, in general use, but the devices difference is that it will sense a snore or an apnea and automatically increase the pressure to stop the snoring or apnea.

Q. If I had my choice of a CPAP, BiPAP, or AutoPAP, which one would best serve my needs?

A. This is a question best answered by your sleep specialist -- once you've had your titration study. During that study, a sleep technician will fine-tune the pressure(s) you need, seeking the best approach to your individual situation.

Q. What brand of CPAP or BiPAP is best?

A. In the United States, all machines must meet basic guidelines, set forth by the U.S. Food and Drug Administration, as the machines are listed as Class II Medical Devices. Because of that classification, that means they must meet certain standards, but also are available, and the pressures set, only on the order of a physician. Further, this also means that there is no "better" or "best" brand of CPAP or BiPAP -- except the one that you prefer, or that your insurance carrier will cover.

Instead, what you might want to do is ask your sleep specialist for an "open prescription" for the CPAP or BiPAP machine being prescribed, with only your pressure defined, as well as any additional instructions, such as breathing rate, etc. An "open prescription" means the sleep specialist did not specify "BRAND Y CPAP or BiPAP MACHINE/MODEL" -- so you can shop around for the machine you like. Shopping around for CPAP or BiPAP machines may prove inconvenient, but perhaps you will find a machine you feel better about having.

To shop around for an CPAP or BiPAP machine, you'd basically go from home healthcare company to home healthcare company, explaining to them you have an open prescription for an CPAP or BiPAP device and would like to see theselection of machines offered by that particular home healthcare provider.

When you are looking the machines over, forget about the "look" of the machine, although most do look similar. Instead, start up the various machines, listen to them in operation, and place it on two phone books on the floor. Sit in a chair and listen to the machine. This is about the sound you will hear while the machine is in operation.

Once you have a machine in your home, it's ideal the machine be kept low, such as on the bottom shelf of a nightstand or on a small item (such as a phone book) on the floor, especially if you have a humidifier or heated humidifier connected to the CPAP or BiPAP machine.

Q. How long do CPAP or BiPAP devices last?

A. The average reported life is about five years. Some people have had CPAP or BiPAP machines last longer than that, and others have had machines die after about a year of use. Under Medicare guidelines, which many health insurance companies follow for routine guidance and handling of matters such as equipment replacement, machines will be replaced once every five (5) years.

Q. How is sleep apnea treated?

A. Apnea is most commonly treated with a positive pressure device, such as a CPAP, BiPAP, or AutoPAP.

Q. How will using an CPAP or BiPAP affect my life?

A. The most noticeable impact on your life will be that you begin to wake up refreshed. Another impact it will have is that it will help prevent damage from happening, which could be caused by untreated apnea.

Q. How do I set up my CPAP or BiPAP system?

A. The first system you get should be set up by the home healthcare company where your physician ordered the equipment. The company should have sent a qualified respiratory therapist to your home to instruct you on proper use, cleaning, and checked the equipment, ensuring it is set to the proper pressures, as prescribed by your physician.

Q. What are some things I should know before hooking a humidifier (passover or heated) into my CPAP or BiPAP system?

A. .

Q. I’ve been on CPAP or BiPAP for two days now. How long does it take before I begin to feel better?

A. Good question! Two days isn't really enough time for 99% of the people who ever try CPAP or BiPAP. In fact, it could take a few months before you actually begin feeling any noticeable difference. Why? Well, your sleep deprivation didn't occur all at once, nor did your massive sleep debt suddenly accumulate in a few days. Once you get used to using the equipment for the entire time you sleep -- every time you sleep -- you will begin sleeping better. From there things should only get better.

Q. What can I do about air leaking out of my mouth?

A. Well, there are a number of things you can try. The first one that doctors and home healthcare companies like to suggest is making use of a chin strap. It's basically an elastic strap which tucks under your chin and over the top of your head. These straps typically sell for anywhere between $18 and $30 -- or more in the United States. Many people have reported success in improvising chin straps using a variety of materials, including a portion of an Ace bandage or other similar material.
   If that doesn't solve the problem for you, as it isn't the end-all, cure-all for most people, you might want to check with your healthcare provider about adding humidification to the CPAP or BiPAP. The most effective type of humidification is heated. The heated humidification is achieved through a small device that attaches in the air circuit of the CPAP or BiPAP system. Some health insurance carriers like to harass people about covering the cost, usually about $600 for a heated humidifier, as opposed to about $300 for a "passover" or non-heated humidifier.
   If you present to your healthcare provider with a variety of symptoms known to be caused by lack of humidification, including bloody noses following all-night use of the CPAP or BiPAP without humidification; dry mouth and nasal passages (it isn't hard to know where the nasal passages are in your head when lack of humidification is the problem -- you can feel the entire path!); and a host of other problems, you have a good case to argue to the health insurance carrier. If you need additional ammunition to help fight the health insurance carrier, you can use a Letter of Medical Necessity for a Heated Humidifier provided by Awake In Philly Community Education Group. The letter is in PDF format, and is located at:

Q. How long does it take to get used to CPAP or BiPAP?

A. That depends on the person. Some people take to CPAP or BiPAP like a duck takes to water, others have a hard time adjusting and require several months. When I first started out on the BiPAP, it took me about three months to use the machine the entire time I slept -- each and every time I slept (including naps!). During that time, I destroyed about nine (yes, count them 9) nasal masks. How did I destroy them? Basically, I tore them off my face, in my sleep, and tossed them across the room, sending them sailing into the wall. It seems the hard plastic shells never liked that sudden stop.

Q. Do I ever have to have another sleep study? If so, how frequently should a new sleep study be performed?

A. Yes, more than one study will need to be performed over the course of time.

It’s suggested that under ideal circumstances, should you gain or lose 30 pounds or more, a follow-up sleep study be performed to ensure your CPAP or BiPAP pressure is correct. It’s also suggested you have a follow-up sleep study at least once year two years, as well. Other indicators that a new sleep study may be in order would be snoring while using the CPAP or BiPAP or daytime sleepiness returns.

Q. How long will I need to continue using the CPAP or BiPAP?

A. That's a good question, and not one that can be answered with 100% honesty by anyone, including your physician. Why? Because for some people -- understand that this means a very small minority -- apnea is strictly weight-related. For most people, however, apnea is the result of aging; the result of a malformed airway; the result of a crowded airway; or a host of other variables. For the majority of the people who are diagnosed with apnea, CPAP or BiPAP is basically something they will use for life, at least until a cure for apnea is discovered.

Q. How often must I use the CPAP or BiPAP?

A. Every time you sleep -- for the entire time you sleep.

Q. The noise from my CPAP or BiPAP keeps me awake. What can I do to muffle the sound?

A. If the CPAP or BiPAP is making more noise than a 1968 VW Beetle with no exhaust, it's time to call for help. If it is a matter of getting used to the sound of the CPAP or BiPAP motor running, try turning on the radio; turning on a fan; or adding a white-noise generator in the room.

Q. I have high blood pressure. Will it improve now that I am using CPAP or BiPAP?

A. It could. This is something that will have to be closely monitored by your treating healthcare providers.

Q. Will I lose weight now that I’m using CPAP or BiPAP?

A. It's possible.

Q. I just started on CPAP or BiPAP therapy, but it’s irritating my nose.

A. .

Q. My sleep’s being disrupted by the cold air from the CPAP or BiPAP machine. What can I do?

A. .

Q. Should I use the CPAP or BiPAP if I have a cold?

A. .

Q. I often have a stuffy nose and breathe through my mouth frequently. Any suggestions?

A. .

Q. If I am hospitalized, should I take my CPAP or BiPAP machine with me?

A. Absolutely! Also be sure you know your prescribed pressure. It wouldn't hurt for you to have a MedicAlert ID necklace or bracelet, as well as carry a note in your wallet, notifying emergency medical personnel that you have apnea, the type of machine you use (CPAP, BiPAP, AutoPAP), as well as your prescribed pressure.

Q. When will the CPAP or BiPAP device cure my apnea?

A. Never, is the quick and simple answer. Now, for the detailed answer. ...

(Also see surgery)

Q. I wake up in the middle of the night and find I have removed my mask. Is this common, and what can I do to stop it?

A. .

Q. I was diagnosed with obstructive sleep apnea, and since beginning CPAP or BiPAP treatment, I suffer severe bloating. My primary care physician ordered a few medications and suggested an anti-gas tablet, which is sold over-the-counter. Nothing has helped. The MD said there was nothing else to try and I needed to give up the machine. Since my energy level and muscle pains have improved using my CPAP or BiPAP, I am not willing to give up that easily. Can you recommend anything else to try? Different face mask? Different MD?

A. The bloating could be caused by swallowing air, which isn't uncommon in people, especially initially. It could take several months to learn how to "not" swallow the air, getting it into the stomach.

Your doctor sounds like a real winner in some regards, but in others, sounds like one I would fire -- without delay! Telling someone to give up the CPAP or BiPAP, without further study is like telling a cancer patient to forget about pain killers. Okay, so it isn't quiet that extreme, but I'm sure you get my point.

My best recommendation would be to find a sleep specialist who is board-certified in sleep medicine. If you can find one at one of the larger research universities, that would be even better for you, I feel. You can find a listing of board-certified sleep specialists at:

Interesting Apnea Statistics

Interesting Apnea Statistics

~~ Apnea in United States ~~

As of October 18, 2009 at 8:55 a.m.(ET) (-0500), the U.S. population
was 307,725,269. Sleep researchers estimate approximately seven percent
of the population suffers from obstructive sleep apnea. Using that
estimate, there are potentially 21,443,850 apneics in the U.S.

~~ Apnea around the world ~~

As of October 18, 2009 at 8:55 a.m.(ET) (-0500), the world population
was 6,791,269,358. Sleep researchers estimate approximately seven percent
of the population suffers from obstructive sleep apnea. Using that
estimate, there are potentially 475,388,855 apneics in the world.

   Awake In Philly is a community education group for individuals who have been diagnosed with at least one of the recognized sleep disorders, as well as anyone else impacted by those with sleep disorders. The information contained in this site is intended to provide support, guidance, and encouragement to others contending with the many challenges of sleep disorders. The goals of Awake In Philly are to support, educate, and inform those who feel the impact of sleep disorders, as well as the general public, and is not intended to replace medical advice, nor is any information to be misinterpreted as an attempt to diagnose, treat, cure, or prevent any disease.

   If you have questions about any of the medical conditions mentioned on this website, especially if you suspect that you (or someone you know) has sleep apnea, please contact a qualified medical professional immediately. Medical advice should only come from qualified, licensed, and trained healthcare professionals.

Citation: David F. Jackson. “index.shtml”, located at . Awake In Philly Community Education Group. Last Modified on Sunday, 03-Jun-2007 11:25:13 EDT. (Page last visited: Saturday, 03-Dec-2016 14:37:45 EST).

This site is © 2000-2006 by Dave Jackson (Scoop0901). All rights reserved. Unauthorized duplication, storage, or reproduction in any form is strictly prohibited. To inquire about permissions, contact us via our contact form.
The Sleep-e Times -- the official publication of Awake In Philly -- covering sleep disorders for the non-researcher