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The 2022 Ultimate Guide to CPAP Therapy

Everything you need to know about CPAP.

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Sleep is essential for our health. It gives your body the needed reset to survive and thrive. As humans, we need sleep. Studies have shown that sleep deprivation can cause many vital cognitive, behavioral, and bodily functions to be impaired.

Studies have found that 35.2% of US adults don’t get the necessary 7 hours per night. Additionally, 3-7% of men and 2-5% of women in the US have sleep apnea, making it one of the most prevalent sleep disorders.

There is hope if you’ve been diagnosed with sleep apnea or suspect you do. Luckily, we live in an age where CPAP therapy has been thoroughly studied, and advances in technology have been made.

CPAP stats: 3-7% of men and 2-5% of women in the US have sleep apnea, making it one of the most prevalent sleep disorders.

This guide offers an in-depth look at CPAP and covers all the essentials, including what CPAP is, how it works, what it treats, choosing a machine, best practices, accessories, etc. It serves as an ultimate guide for CPAP education with all the essential information one might need when learning CPAP.

What is CPAP?

CPAP, which stands for continuous positive airway pressure therapy, is a sleep apnea treatment method. It works by using a specialized machine (CPAP machine) that aids in keeping airways open and prevents them from collapsing when sleeping.

CPAP therapy is comprised of three to four core pieces:

  • A CPAP device
  • A humidifier (if the CPAP machine doesn’t have one built-in)
  • A mask that covers your nose, mouth, or both (there are a few types of mass which we’ll cover later in this guide)
  • And a tube that connects the mask to the CPAP machine
CPAP therapy is comprised of three to four core pieces: A CPAP device, a humidifier, a mask, and a tube

How does a CPAP Machine Work?

A CPAP machine is used at night or anytime you’re sleeping. It features a compressor that produces a continuous pressurized air stream. This air travels through an air filter into a tube and then through the mask into the user's lungs.

As the user sleeps, the CPAP machine’s airstream pushes against any blockages and opens airways to allow an adequate amount of oxygen to reach the lungs.

Because there is nothing to obstruct the lungs' oxygen flow, breathing does not pause. This prevents the user from continuously waking up to keep breathing.

What does CPAP Treat? (What is a CPAP used for?)

The primary use of CPAP therapy is to treat obstructive sleep apnea, which is a condition that causes not enough air to reach your lungs. Those with sleep apnea have difficulty breathing at night, which can cause them to wake up to breathe constantly. CPAP for sleep apnea prevents symptoms by keeping their airways open while sleeping.

CPAP therapy is also used to treat infants with premature lungs. It helps them breathe by blowing air into their nose to help their lungs inflate.

Does CPAP stop snoring?

Yes, CPAP therapy stops snoring by eliminating its cause: closed or partially closed airways. The machine delivers pressurized air to keep the airways open.

Can CPAP help with acid reflux?

Yes, a 2016 study found those who adhered to CPAP therapy experienced an average 62% reduction in symptoms. However, research showed at least four hours per night for 25% of the nights or more was needed.

Can CPAP help with asthma?

Yes, CPAP has been found to reduce nocturnal asthma attacks. Two studies found CPAP to improve airway responsiveness in nine stable asthmatic nonapneoic patients. It's common for those with sleep apnea to have asthma. One study found 58% of those with moderate asthma to have sleep apnea, with that number jumping to 88% for those with severe asthma.

Who needs a CPAP machine?

CPAP therapy is made for those with sleep apnea. If you haven’t seen a doctor yet, but suspect you have sleep apnea, consider these symptoms:

  • You snore loudly
  • You experience instances where you stop breathing during sleep (another person would report this) 
  • You gasp for air while asleep 
  • You wake up with dry mouth 
  • You experience morning headaches 
  • Insomnia 
  • You are excessively sleepy during the daytime (also known as hypersomnia) 
  • Paying attention while waking is challenging
  • Irritability
Sleep apnea symptoms: snoring, instances of stopped breathing at night, gasping for air while asleep, dry mouth, morning headaches, insomnia, excessive sleepiness, inability to pay attention while waking, and irritability

While loud snoring generally indicates a potentially serious issue, not everyone with sleep apnea shows this symptom. Speak to your doctor if you experience any of these symptoms. Explain the challenges you’re having and how they’re affecting your sleep. Your doctor will perform further tests and possibly prescribe you a machine based on your needs and symptoms.

The History of CPAP

If you’re unsure about CPAP therapy, understanding its history can provide comfort. Before CPAP therapy, the most common treatment was surgical intervention in which part of the respiratory system would be removed.

Sometimes, this surgery was not enough. This would then require a permanent tracheostomy for those with severe sleep apnea.

These surgeries were not only highly invasive but could leave patients compromised of life, specifically if a tracheostomy was performed. Sleep apnea treatment wouldn’t become less invasive by the CPAP machine until the 1980s.

To understand how far CPAP therapy has come, consider this timeline:

  • 1928: The electroencephalography (EEG) test is first introduced, enabling researchers to identify the difference in brainwaves during sleep and wakefulness.
  • 1956: The term Pikwician Syndrome (obesity hypoventilation syndrome) was first coined as a condition in which the balance of oxygen and carbon dioxide in the lungs is thrown off. Sleep apnea is a common effect. This starts the study of respiratory and sleep.
  • 1958: REM sleep was first discovered.
  • 1970: William Dement established the first sleep clinic at Stanford University in California.
  • 1970: Eliot Philipson began researching dogs with respiratory issues.
  • 1976: Dr. Collin Sullivan joined Philipson with the project, testing positive airway pressure on dogs. Breeds such as bulldogs, pugs, and boxers are notorious for breathing problems. A vacuum cleaner was used to blow air out of the first rendition of the positive airway pressure machine. 
  • 1978: Christian Guilleminault discovered airway obstructions during sleep.
  • 1980: Dr. Collin Sullivan is approached by a patient with a severe case of sleep apnea looking for an alternative to tracheotomy. After seven hours of positive pressure administered via a reverse-engineered paint compressor and pool tubing, the patient would wake up feeling alert for the first time in years. 
  • 1980s: With this initial discovery, multiple experiments would transpire throughout the 1980s. This research would jumpstart CPAP therapy advances and create a platform for researchers to understand sleep apnea and its various causes further.
  • 1985: Philips Respironics debuted the first suitable CPAP system in the U.S.
  • 1990: Philips Respironics introduced the first self-sealing interface known as “the bubble mask.” This would mark the next level of CPAP therapy comfort.
  • Today: Millions of patients use CPAP therapy at home to alleviate sleep apnea symptoms.

In the beginning, CPAP was significantly loud and uncomfortable. However, as the technology advanced and matured, CPAP therapy has become far more accessible and convenient. Today’s CPAP machines are much quieter and better developed to be less invasive.

CPAP Pros and Cons

As with any treatment, there are pros and cons of CPAP therapy. Below, we highlight the benefits of CPAP machines as well as drawbacks.

ProsCons
- Reduces and treats symptoms of sleep apnea
- Improves length and quality of life
- Better sleep and more daytime energy
- There is a wide variety of machines to choose from
- Lowers the risk of heart attack, stroke, and other cardiovascular events
- Can reduce blood glucose and cholesterol levels
- Can cause discomfort and feelings of claustrophobia
- Can be loud for light sleepers
- Can cause dry mouth Bloating and gas can occur
- Can cause nosebleeds
- Skin irritation and sores can occur from mask contact
- Nasal congestion
- Difficulty falling asleep

Common Side Effects

The nature of CPAP therapy causes a few potential side effects to occur. The side effects of CPAP machines include dry mouth, gas, and rainout. Below, we highlight each CPAP side effect and how to prevent them from occurring.

Common CPAP Side Effects: CPAP Rainout

CPAP Rainout

What is CPAP rainout?

CPAP rainout occurs when water from the machine’s heated humidifier drops in temperature when making its way up through the hose. This causes the moisture to condense into droplets, creating water inside the tubing or mask.

How to prevent CPAP rainout:
  • Move your CPAP machine to a lower level than your mask. This will let gravity prevent condensation from flowing to your mask.
  • Wrap your hose with tubing wrap to keep it warm. Specialized tubing wrap can help insulate the air from the lower room temperature. You can also run the tubing below your blanket for added warmth.
  • Increase your bedroom’s temperature. Colder rooms are more likely to cause condensation buildup in tubing. Raising the temperature of the room can help prevent rainout.
  • Adjust the settings on your humidifier. Talk to your provider about adjusting your humidifier settings. Every climate is different, and some may not require a high-temperature setting.
Common CPAP Side Effects: Nasal Congestion

Nasal Congestion

Nasal congestion is one of the most common side effects caused by CPAP therapy. It typically includes feelings of a stuffy or runny nose, burning sensations, or nosebleeds. This side effect is caused by the flow of dry, pressurized air through the sinuses and is more common amongst those with frequent sinus infections.

How to avoid CPAP nasal congestion:
  • Use a nasal saline spray to moisturize nasal passages.
  • Consider using a CPAP humidifier or investing in a machine with one built-in. Added humidity adds moisture to the airflow, which relieves dryness and irritation. For additional comfort, a heated humidifier warms the air for a natural feel.
Common CPAP Side Effects: Dry Mouth

Dry mouth

CPAP dry mouth occurs from the flow of pressurized air. Dry mouth from CPAP typically occurs from using a full face mask but can also happen with nasal pillows or nasal masks from “mouth leak,” which occurs when you sleep with your mouth open and air pressure escapes.

How to avoid dry mouth:
  • Accompany a chinstrap using a nasal pillow or nasal masks.
  • Add a CPAP humidifier.
Common CPAP Side Effects: Sore Throat

Sore Throat

CPAP sore throat is a common side effect that’s easy to fix. It’s caused by a mask air leak, a cold or dry airway, high air pressure, or a sinus infection.

Can CPAP cause voice problems?

Yes, a study has linked CPAP use to vocal changes that involve some degree of mild to moderate hoarseness. Dryness in the throat can cause your vocal levels to fluctuate.

How to avoid a sore throat from CPAP:
  • Check and adjust your mask fit to prevent any leaks.
  • Use a chin strap to keep your mouth closed.
  • Increase your humidity levels.
  • Warm your airflow with heated tubing or a heated humidifier.
  • Talk to your doctor about lowering your air pressure.
  • Replace any old, or broken CPAP supplies.
Common CPAP Side Effects: Jaw Pain

Sore Jaw

If your jaw hurts after using CPAP therapy, you may have a TMJ disorder. Temporomandibular joint (TMJ) disorders affect the jaw joints and surrounding muscles and ligaments. A CPAP mask will condense your face. After continued use, it can cause significant bite changes and push your jaw back. The mask displacing your jaw and air pressure being forced into your airways can result in pain and worsen TMJ symptoms.

How to avoid jaw pain from CPAP:
  • Adjust your mask fit. A too-tight mask can put pressure on your jaw and cause pain.
  • Try jaw exercises. Jaw exercises can help exercise the joints, muscles, and ligaments in the jaw to ease any discomfort. You can try opening your mouth and pushing your lower part forward or pushing your lower mouth from side to side.
  • Use a full face mask. These types of masks can reduce TMJ symptoms and stop them altogether.
  • Seek a doctor for help. TMJ is a condition that should be diagnosed and treated by a medical professional. They'll prescribe a treatment that prevents symptoms.
Common CPAP Side Effects: Red, Dry, or Puffy Eyes

Red, Dry, or Puffy Eyes

Can a CPAP mask cause puffy eyes?

Dry eyes occur when your mask leaks air. The air escaping from the mask blows across your face and drys your eyes while asleep, causing your eyes to be red, puffy, and even itchy. This may go unnoticed as the leakage amount changes as you change sleeping positions during the night. Try the tips below if you're using CPAP and red eyes do occur.

Can CPAP cause blurry vision?

If your CPAP is causing blurred vision, it's a sign that dry air from the machine is reaching your eyes. You may not notice it while awake because it only occurs when the pressure increases while sleeping. This is a common side effect of dry and puffy eyes from your CPAP machine.

How to avoid dry eyes:
  • Ensure your mask fits properly and adjust it while lying in your preferred sleeping position.
  • Ensure your headgear isn’t too loose or tight. A loose mask allows air to escape, and an overly tight one can prevent the cushion from sealing correctly, which can cause CPAP eye problems.
  • If you’re using a mask that requires the cushion to inflate, hold it slightly above your face to assist it in building up CPAP pressure.
  • If, after refitting, leakage continues, a replacement might be mandatory. Cushions should be replaced every two to four weeks. Your mask frame should be replaced every three months and the header every six months.
Common CPAP Side Effects: Difficulty Exhaling

Difficulty Exhaling

Some new CPAP users may find it challenging to exhale against the continuous airflow. This can cause shortness of breath even when there’s enough air being swallowed.

How to avoid difficulty exhaling:
  • Try checking and adjusting your CPAP machine’s exhalation relief settings, also called EPR, A-Flex, C-Flex, or SmartFlex. This is the feature of the machine that reduces airflow pressure during exhalation.
  • Talk to your doctor or specialist about adjusting your CPAP machine's pressure settings. Never attempt to change your pressure settings without a medical professional’s help.
  • Talk to your doctor about switching to an AutoCPAP machine, also called an APAP machine. APAP machines use advanced algorithms to monitor breathing patterns and adjust pressure accordingly.
  • Another option to consider is a BiPAP machine. BiPAP machines feature two pressure settings. The higher pressure setting during inhalation provides support to prevent sleep apnea, while the lower pressure during exhalation offers a more natural feeling breathing pattern.
Common CPAP Side Effects: Allergic Reaction

Allergic Reaction

Can CPAP cause an allergic reaction?

Yes, CPAP can cause an allergic reaction. This will typically occur the same night you wear it. However, the major cause of this is inconsistent cleaning. Another major cause is you may be allergic to the materials of your CPAP mask, padding, liner, or hose.

How to avoid allergic reactions:
  • Let your doctor know of any allergies before CPAP therapy. If you're allergic to any materials, it's vital to let your prescriber know. THey'll recommend the best equipment that won't interfere with allergies.
  • Change your CPAP equipment. Most CPAP masks are made from a safer material, silicon. However, older models tend to be made with latex. If yours is made with latex, it might be best to switch to one without.
  • Clean your equipment daily. Keeping your equipment free from allergens and bacteria is always the best way to prevent infections.
  • Keep the room your CPAP is in clean. The surroundings of your CPAP machine are vital to keeping it clean as well. Because your machine is sucking in the surrounding air, you want it to be as clean as possible.
  • Keep your CPAP machine away from windows or vents. It's best to keep your machine away from any windows so it doesn't suck in any pollen or other outside allergens. It's also a good idea to keep it away from vents that may push bacteria into the machine.
Common CPAP Side Effects: Neck Pain

Neck Pain

When using CPAP, neck muscle pain can occur from the mask's straps pressing down on the area where your head and neck meet. This can be caused by a variety of things including an overly tightened mask, worn equipment, and a mask that uses straps at the base of your skull.

How to avoid CPAP neck pain:
  • Switch to a minimalistic mask. Full face masks typically feature straps that run across the base of your skull. This can cause neck pain from the constant pressure applied in that region. Other mask styles such as nasal pillows use straps that don't affect the neck.
  • Loosen up your mask. A tight mask can be a significant cause of neck pain. Too much pressure on the neck can decrease blood circulation and cause muscles to be sore.
  • Replace your equipment. Old CPAP headgear can cause you to tighten your mask as it loses its effectiveness. If you have to tighten your mask constantly, it might be time for a replacement.
  • Invest in a CPAP pillow. If your sleeping position has been altered because of CPAP, you may need a CPAP pillow. These are specialized pillows made to make sleeping with CPAP more comfortable. They feature indents to fit your neck and prevent any sleeping discomfort.
Common CPAP Side Effects: Bloating, Burping, and Gas

Bloating, Burping, and Gas

Can CPAP cause gas and bloating?

Higher pressure settings on a CPAP machine increase the chances of swallowing air, called ‘aerophagia’ or ‘CPAP belly syndrome.’ This happens when the airflow becomes challenging to breathe against and redirects into your esophagus. This causes symptoms of bloating, burping, passing gas, and stomach pain.

How to prevent this:
  • Talk to your doctor or specialist about adjusting your CPAP machine's pressure settings. Never attempt to change your pressure settings without a medical professional’s help.
Common CPAP Side Effects: Skin Irritation and Acne

Skin Irritation and Acne

A build-up of germs and bacteria can occur as your CPAP mask collects skin oils, dead skin cells, and sweat while you sleep. This can lead to your CPAP masking causing acne, skin irritation, a rash, and sores.

How to prevent skin problems:
  • It’s vital to regularly wash your CPAP mask with soap and water. Be sure to It’s vital to regularly wash your CPAP mask with soap and water. Be sure to replace your mask cushions every two to four weeks.
  • Try using mask liners and mask gel to fight the build-up of sweat and skin oil.
  • Be sure to wash your face before bed to prevent excessive buildup.
Common CPAP Side Effects: Skin Marks

Skin Marks

It's very common for CPAP straps to leave marks. This happens from the mask sitting on your face overnight and pressing down on your skin. Luckily, there are a few ways of preventing this.

How to avoid skin marks:
  • Adjust your mask size or style. If skin marks are a big deal, try a smaller mask or a type (such as a nasal mask) with less surface area pressing onto your skin.
  • Adjust your mask fit. The tighter the mask, the more marks it'll leave on our skin. Don't let it become too loose, as this will cause leaks.
  • Opt for BPAP. BPAP machines feature two pressure settings that regulate both inhale and exhale. This reduces the overall pressure, so you don't need a tighter fit.
  • Invest in mask padding and liners. Most masks come with padding or strap covers. However, if you notice marks after use, you may want to opt for added padding.
  • Sleep on your back. Sleeping on your side can cause your head to press down on your mask, which can cause marks. Sleeping on your back prevents that pressure and may deter marks from occurring.
Common CPAP Side Effects: Claustrophobia

Claustrophobia

Those new two CPAP therapy may find it challenging to adjust to wearing a CPAP mask and tubing. This is particularly true when using a full face mask. This feeling typically goes away with time and consistent use.

How to avoid CPAP claustrophobia:
  • Gradually introduce yourself to CPAP therapy. Use it for short periods while awake. Once you’ve adjusted to the feeling, try putting it on with the device turned on while laying in bed.
  • Consider switching to the more compact nasal pillow or nasal mask. These have a smaller profile and broader field of vision.
  • If a full face mask is mandatory, try switching to one with a minimal-contact design.
Common CPAP Side Effects: Headaches

Headaches

While not a common side effect, headaches after using CPAP machines occur if the machine’s pressure is too high or sinus blockages are present.

How to avoid CPAP headaches:
  • Loosen your face mask or chin strap.
  • Talk to your doctor about lowering the machine’s pressure.
Common CPAP Side Effects: Dizziness

Dizziness

There have been complaints from new users who experience dizziness after wearing a CPAP mask. While the cause is unknown, it’s believed that it might be caused by the pressure change in the middle ear. However, this symptom is short-lived.

CPAP Alternatives

If you decide CPAP isn’t for you, there are other options for treating sleep apnea. A few alternatives to a CPAP machine include:

CPAP Alternatives: Adjusting Your Sleeping Position

Adjusting your sleeping position

When it comes to sleep apnea, your sleeping position can play a role. Sleeping on your back is notorious for aggravating and causing sleep apnea. A few methods of preventing you from rolling over include placing a tennis ball near your back and using a knee pillow or body pillow to aid with side sleeping.

If you avidly sleep on your back (and don’t want to change), then a wedge pillow might help. These specialized pillows put you in an inclined position which helps reduce snoring and other sleep apnea symptoms.

CPAP Alternatives: Oral Appliances

Oral appliances

Try using oral devices such as an orthodontic retainer or mouthguard. These devices put pressure on your tongue to keep airways open.

CPAP Alternatives: Nutritional and Exercise Therapies

Nutritional and exercise therapies

Obesity is one of the major causes of obstructive sleep apnea. Being obese causes your lungs to put added pressure on them, creating breathing troubles. Losing weight can reduce the condition and even make most symptoms go away.

CPAP Alternatives: Surgery

Surgery

There are a variety of surgical procedures that can be performed to remove or minimize sleep apnea. These procedures are broken down by those directed at the soft palate or other areas of the breathing passages. 

The type of sleep apnea surgery selected will vary based on your condition and the cause of sleep apnea. A few common sleep apnea surgeries include:

  • Soft Palate Procedures: These are the most common types of sleep apnea surgeries. This type of surgery involves removing and repositioning tissue to increase the airway size without hindering normal functions such as breathing, speaking, and swallowing.
  • Hypopharyngeal Procedures: These types of procedures treat blockage that occurs in the lower throat area through a combination of tissue repositioning, tightening, removal, or shrinkage.
  • Jaw Advancement Surgery: This surgery involves moving the jaw forward to make breathing easier.
  • Hypoglossal Nerve Stimulation: This newer method stimulates the nerve that controls tongue movement. It involves placing a system inside the body during surgery. When turned on during sleep, the system stimulates the hypoglossal nerve and moves the tongue forward to allow more space for breathing in the throat.
  • Pillar Procedure: This procedure uses coffee-straw-like pieces inserted into the roof of the mouth. This stiffens this area to reduce airway collapse.

How to Choose a CPAP Machine

CPAP machines can be complex and daunting if you’re new to sleep apnea treatment. In this section, we break down the key areas to focus on when selecting the right machine.

CPAP Machine Type: APAP vs. CPAP vs. BiPAP

The type of CPAP machine you choose is arguably one of the most critical decisions. There are three types of PAP machines:

  • APAP (automatic positive airway pressure)
  • CPAP (continuous positive airway pressure)
  • BPAP (bi-level positive airway pressure)

The difference between these machines lies in the pressure they emit. Below we compare BPAP vs CPAP vs APAP.

CPAP

CPAP machines provide a fixed air pressure determined by a doctor’s prescription. This is the minimum air pressure level required to keep airways open. These machines are typically the first type of machine prescribed as they treat milder cases.

Who should use CPAP:
  • You’re a healthy individual with no lung or respiratory disease history.
  • You’ve been diagnosed with mild to moderate OSA.
  • You’re breathing patterns don’t change much throughout the night.

APAP

APAP machines are the most common PAP machines used by sleep apnea patients. The air pressure delivered is auto-adjusting to meet the sleep positions of the user. If the user rolls on their back and puts more pressure on their airway, the machine senses the change in breathing and increases airflow.

Who should use APAP:
  • You have varying levels of apnea events dictated by your sleep phase (i.e., they increase during REM sleep and decrease during others).
  • You toss and turn while asleep.
  • You’re a side sleeper.
  • Your breathing fluctuates depending on the season (i.e., allergy and flu season)

BPAP

Whereas CPAP and APAP machines use a single air pressure, BPAP machines use two. One pressure setting is used during inhalation and another during exhalation. The purpose of this is to offer a more natural breathing experience.

Some BPAP machines include spontaneously time mechanical breaths, known as ventilation. These come in handy if the user experiences a sleep apnea event and stops breathing. In this case, the machine will administer a mechanical breath after a programmed period. These types of PAP machines have been proven to be helpful for those with severe respiratory illnesses from COVID-19.

Who should use BPAP:
  • You struggle to exhale against higher air pressure.
  • You have any health condition that affects your exhale breathing, such as CSA (Central Sleep Apnea), Chronic Obstructive Pulmonary Disease (COPD), Overlap Syndrome, and Obesity Hypoventilation.

Below, we highlight the key differences between APAP, CPAP, and BiPAP.

CPAP (continuous positive airway pressure) APAP (automatic positive airway pressure) BPAP (bi-level positive airway pressure)
Air Pressure LevelFixed (single)Automatic (single)Two Levels (inhale & exhale)
Sleep Apnea SeverityMild to ModerateMild to ModerateMild to Severe
Benefits- Most cost-effective
- Great for those with milder conditions
- Automatically adjusts to breathing patterns
- Great for seasonal allergies
- Adjusts if you’re sick
- Great for varying sleeping positions
- Can be used as a CPAP
- Great for those with difficulty exhaling or more intense conditions

Where to get a CPAP machine (Where can I Buy a CPAP Machine?)

While requiring a prescription, CPAP machines can be purchased online, in-store, or through your doctor. If ordering a CPAP machine online, you will be required to upload your prescription or send your doctor’s contact information.

Is it illegal to sell a CPAP machine?

It should be noted that it is unlawful to sell CPAP machines without a prescription. Therefore, it’s best to avoid any place that is doing so.

How to get a CPAP prescription (How do I Purchase a CPAP machine?)

To obtain a CPAP machine legally, you must first get a prescription through your healthcare provider. This section breaks down the steps towards getting one.

1. Visit your doctor

The first step is to visit your doctor and explain your symptoms, letting them know what you’re experiencing. This will give them a better idea of which treatment options to offer. The first thing your doctor will want to know is if you’re getting enough oxygen when sleeping. This is determined through an overnight sleep apnea test.

2. Take a Sleep Apnea Test

Once you’ve visited your doctor, they will recommend a sleep apnea test. There are two types of tests:

  • At-home pulse oximetry test: An overnight pulse oximetry test determines your blood oxygen levels when asleep. They send you home with the device to wear overnight. The device is usually worn over your index finger or is a band placed on your chest or forehead. A sleep clinician then receives your test, reviews the results, and contacts your doctor.
  • Lab sleep study: Also called polysomnography, this sleep apnea test takes place overnight in a sleep lab. You’re connected to a variety of machines that monitor for apneas. This study offers a more detailed insight into how often and how long you’re breathing stops.

Home tests are typically more affordable than lab tests. However, lab tests offer greater insight into your condition. One study has found home tests to be just as efficient at detecting moderate to severe cases. On the other hand, lab studies can detect other sleep disorders and abnormalities.

3. Get Your CPAP Machine

Once you have your prescription, the next step is to choose your machine. You can either get one from a local CPAP store or shop online. Both will require you to give them your prescription.

After choosing your machine, your dealer will send it to a nurse to set your pressure settings based on your prescription. This step is vital as your machine needs to be set by a professional for health safety precautions.

Renting vs. Buying

When it comes to deciding to rent or buy, a key factor is CPAP insurance coverage. Most insurance companies pay on a 10-month rental basis where you own the device after the said period.

Does insurance cover CPAP machines?

Your insurance will decide on the rental rates based on the purchase price. For example, if the CPAP machine is $800, the rental price will be $80/month for ten months. The CPAP supplies such as masks, tubing, and cushions are typically purchased outright.

It’s important to be wary of potential compliance requirements. These are a set of standards in place by your insurance provider requiring proof you are using the equipment for them to continue payment.

If, after the 10-month rental period, you do not meet their requirements, they will require you to pay cash for your equipment or return it.

It’s not required you use insurance to pay for your CPAP machine or supplies. Sometimes it’s beneficial not to. Here are a few cases where it makes sense not to rent through insurance but pay out of pocket instead:

  • You don’t have health insurance
  • Your deductable is high
  • You don’t want to deal with the complexities of health insurance
  • You don’t like your provider that’s contracted with your insurance
  • You’d like to order online or through a specific vendor
  • You’re ordering a second machine (most providers won’t pay for more than one machine every five years)
How to Choose a CPAP Machine: Humidification

Humidification

Humidifiers are a key component of CPAP. Humidifiers improve the comfort experience by reducing symptoms of dryness and congestion. It also helps you avoid dry mouth & nose, running nose, chapped lips, sinus-type headaches, and nose bleeds.

The first thing to consider with CPAP humidification is if your device supports humidification. Because some units don’t, this is vital to look at.

Another area to continue, if you want humidification, is where to choose a machine that has it built-in or not. Machines with built-in humidification take up less space as they don’t require additional equipment. However, those that use a separate humidifier can provide more output because of their larger size.

How to Choose a CPAP Machine: Noise Levels

Noise Levels

You’ll want a quiet machine that won’t do the opposite of what it’s designed to do, help you sleep. The magic number to consider is 30 dB. This is the noise level considered to be a whisper. A machine over 30 dB (even by just a few decibels) can be a noisy machine.

How to Choose a CPAP Machine: User Experience

User Experience (screen/menu)

When selecting a device, you want one that works and is easy to use and navigate. When going through your selection process, be sure to look up reviews and tutorials of the machine to indicate if it’s easy to use.

How to Choose a CPAP Machine: Size

Size

The size of your CPAP machine is vital for a few reasons:

  • If you travel often, you’ll want a device that’s easily portable and won’t take up a ton of room.
  • Your machine needs to fit in your living space. If tight on space, this is even more important.

Another option to consider is a travel CPAP machine. These are designed to be compact and lightweight for on-the-go use.

Before purchasing a machine, measure the area where it’ll be sitting. This will give you an idea of your space constrictions.

How to Choose a CPAP Machine: Compatibility

Compatibility

Having a device compatible with other CPAP equipment brands can be of great convenience, especially if you’re worried about the price or want more flexibility when choosing accessories and equipment.

How to Choose a CPAP Machine: Accessories Included

Accessories included

What added value does the CPAP machine offer? Some brands offer additional accessories such as masks, tubing, filters, etc. These can save you money while making it easier to get the needed equipment.

How to Choose a CPAP Machine: Warranty

Warranty

Because you’ll most likely be using your machine every night, having a solid warranty is essential. Look at the machine’s warranty and note how long it lasts and what is and isn’t covered. This will help prevent surprises should your machine break in the long run.

How to Choose a CPAP Machine: Added Technology

Added technology

Most of today’s CPAP machines come equipped with added technology such as smartphone apps, WiFi connectivity, LCD displays, and more. If you’re looking for a better experience, these added features might be worth considering.

How to Choose a CPAP Machine: Recent Recalls and Brand Reputation

Recent recalls (brand reputation)

When it comes to a CPAP machine, you’ll want a dependable one, not at risk of getting recalled. You must check for any CPAP machine recalls on a potential device you’re considering or the brand to ensure you don’t select one that might be a health risk.

How to Choose a CPAP Machine: Costs

Costs

When considering a device, it’s essential to look at the CPAP machine's price and all the equipment required to use the machine. This includes but is not limited to:

  • Tubing
  • Mask
  • Pillows
  • Storage equipment (travel bag)
  • Filters
  • Humidifiers
  • Cleaning equipment
  • Earplugs
  • Cushions and seals

If you require more than just the standard equipment, these costs can add up. Consider everything you need to avoid any “costly” mistakes.

How much does a CPAP Machine Cost?

The cost of a CPAP machine ranges from as low as $250 to $1,000 or more. The price of a CPAP machine will vary based on the type, brand, added features, and more. The CPAP machine's cost with insurance will also fluctuate based on your insurance type and what's included in your plan.

CPAP Accessories

When it comes to not just effectiveness but comfort, the right CPAP equipment can make all the difference. This section breaks down the various CPAP accessories available, including what they do, benefits, selection tips, and more.

CPAP Accessories: Masks

CPAP Masks

Your CPAP machine mask is a pivotal piece to successful CPAP therapy. The right mask will offer a comfortable experience, allow you to sleep in your preferred position, deliver adequate airflow, and prevent air leaks. When it comes to style, there are four different CPAP mask options:

CPAP Accessories: Full Face CPAP Mask

Full Face CPAP Mask

Full CPAP face masks are the most common and traditional style of CPAP masks. These masks cover both the mouth and nose to provide air supply to both regions.

Pros:

  • Provides pressure to both the nose and mouth

Cons:

  • Tend to be larger and can cause you to feel claustrophobic.
  • Can obstruct your field of vision.

If you tend to breathe through your mouth at night, then a CPAP full face mask is ideal. CPAP masks that aren't full face do not cover the mouth which can hinder treatment.

CPAP Accessories: CPAP Nasal Pillow Mask

CPAP Nasal Pillow Mask

Nasal pillow masks (also called CPAP pillow masks) offer a minimal mask option by providing air through the nostrils. Their straps avoid the chin, which is excellent for those with facial hair.

Pros:

  • Minimal to prevent feeling claustrophobic
  • Don’t imbed on your field of vision
  • Great for those who wear glasses
  • Great if you have facial hair

Cons:

  • Do not work correctly if you start breathing through your mouth at night
  • Can be easily removed if you move in your sleep heavily

If you're worried about the bulkiness of a full face mask, then a nasal pillow CPAP mask is a good choice.

CPAP Accessories: Nasal Mask

Nasal Mask

CPAP nasal masks are a hybrid of the standard full face mask and nasal pillow mask. They deliver air through the nostrils through a broader coverage than the nasal pillow. Their straps cover below and above the ears for a more secure fit.

Pros:

  • Secure fit makes it ideal if you move a lot in your sleep
  • Suitable for high-pressure settings

Cons:

  • Can impede your field of vision
  • Straps can irritate facial hair

When comparing a CPAP mask nasal vs a full face mask, the nasal mask offers a tuned down version with the same strap support to prevent the mask from dislodging while asleep.

CPAP Accessories: Hybrid Oral Mask

Hybrid Oral Mask (CPAP Hybrid Mask)

A hybrid oral mask could be considered the opposite of a nasal pillow. It delivers air to the mouth and not the nose, making it ideal if you sleep with your mouth open. Its design covers the lower part of your mouth, making it a great option if you wear glasses or prefer a full field of vision.

Pros:

  • Doesn’t impede your field of vision
  • Great if you sleep with your mouth open

Cons:

  • Can irritate facial hair
  • Can create a feeling of claustrophobia
CPAP Accessories: Tubing

Tubing

Selecting the proper tubing can make a massive difference in comfort and quality of treatment. You’ll want tubing that provides ample pressure, enough length to move, and works with your CPAP machine. Another thing to consider is heated tubing, which will cover below.

Tubing Length

The CPAP hose’s length will be the maximum distance your mask can be from the machine. The standard CPAP tube size is six feet; however, there is tubing available in 10 feet.

Things to consider:

  • Where will your device be sitting? You’ll need tubing that can stretch without pulling on the machine. However, you also don’t want too much tubing, which can cause discomfort. If cold/dry air affects you negatively, you’ll want a shorter tube or one that’s heated.
  • Do you shift sleep positions often throughout the night? The tubing will need to be long enough to move accordingly.

Tubing Diameter

This refers to the tube's inner width. This is important as the tubing diameter affects the pressure being emitted from the machine. The standard diameter is 19mm; however, slim or thin tubing is available with a 15mm diameter.

There’s also the less common 22mm diameter tubing used by older CPAP machines. These work better for older machines as they are less capable of estimating and controlling air pressure.

It’s important to note if you end up switching tubing diameter, let your provider know. They may need to adjust the pressure settings on your machine.

Tubing Connectors

Tubing connectors consist of the two pieces that connect the hose to the machine and the mask to the tubing. All hoses feature a 22mm connection cuff that fits all CPAP masks. The connection port on most CPAP machines is made to fit standard 19mm tubing. You may want to take this into consideration when choosing your tubing diameter.

Newer CPAP machines also fit the thinner 15mm tubing. It’s best to check your machine’s user guide to see what sizes of tubing fit.

Heated Tubing

If you find yourself struggling with dryness in your mouth, nose, or eyes, your problem might be not getting enough humidity. Turning up your humidification on your machine can resolve this issue. However, it also can cause a CPAP rainout.

A great method of preventing CPAP rainout and dryness is investing in heated tubing. Heated tubing improves the efficiency of the humidification by maintaining a warm air temperature as it passes through the hose. Heated tubing is great if you sleep in a cold temperature which makes rainout more likely.

Adding heat to the tubing makes it more prone to bacteria and mold growth. Because of this, it’s even more vital to clean the tubing every day.

CPAP Hose Cover

A con to CPAP heated hoses is they still have the feel of standard tubing. A great way to combat this is by using a hose cover over your tubing. Hose covers for CPAP machines are made of soft cloth to make them comfortable to touch. This prevents you from waking up in the middle of the night because you touched your hose.

CPAP Accessories: Pillows

Pillows

Because a major cause of sleep apnea is suppressed airways, your sleeping position matters. Pillows can help promote a healthy sleep posture, relieve any pain, and counter the discomfort associated with CPAP. Below, we highlight a few pillows that offer comfort and support for CPAP users.

Wedge Pillow

If you can only fall asleep on your back, a wedge pillow is a must-have. Sleeping on your back causes your airway to constrict, making sleep apnea worse. For this reason, sleeping on your back is the worst position.

A wedge pillow elevates your upper body, which prevents airways from being constricted. They’re also great for spine alignment, blood circulation, and neck, shoulder, and back pain relief.

CPAP Memory Foam Pillow

CPAP pillows are specially made pillows with curves and indents designed to accommodate CPAP masks. These types of pillows typically feature a larger indent made to fix the neck region and relieve pressure from the mask.

They use memory foam for better support and positioning. Standard pillows tend to cause your head to sink, making using the mask uncomfortable and stiff.

Knee Pillow

Sleeping on your side is one of the best sleep positions for sleep apnea. If you struggle to stay in this position, a knee pillow can help. These pillows support your knees to help keep you in a side sleeping position. They’re also an excellent source of back, hip, leg, and foot pain.

CPAP Accessories: Humidifiers

Humidifiers

As mentioned earlier, humidity levels are important to prevent dry air from entering your airway. This helps prevent them from becoming dry and causing dry mouth/throat, cracked lips, nosebleeds, chest pain, and nasal infections. While most CPAP machines today feature a humidifier, there are a few without.

Regardless of whether the CPAP machine you’re interested in has a humidifier or not, you’ll want to consider the following:

Heated vs. Passover

Heated CPAP humidifiers feature a heating plate that warms the water. This prevents CPAP rainout from occurring and can provide a soothing experience. Passover modifiers have no heating component.

Heated humidifiers are preferred for those prone to dryness during therapy or in a cooler environment. However, passover humidification is ideal for users who prefer a lower pressure setting on their humidifier or in a warmer and more humid environment.

Built-In or Separate

Another component to decide upon is if you want a built-in or separate humidifier. Both of which have pros and cons.

Built-In HumidifierStand Alone Humidifier
Takes up less space
Easier to travel with
Sometimes will turn the machine off if water level depletes
Price is included in with the machine


Typically produce less humidity than external humidifiers
If a part of it breaks, the whole unit must be sent for repairs
Can be compatible for multiple types of machines
Larger in size for more output
Entire CPAP machine doesn’t have to be sent in if it breaks


Take up more space
Have additional pieces requiring cleaning
Require an additional power source
CPAP Accessories: Filters

CPAP Machine Filters

CPAP filters are vital to CPAP success and safety as they protect you against bacteria and particles such as:

  • Dust
  • Mold 
  • Smoke 
  • Pollen 
  • Pet hair 
  • And other allergens

They work by filtering the air being inhaled by your CPAP machine. There are three types of CPAP filters:

  • Disposable filters: These are made from thin paper or paper-like material with a finely woven electrostatically charged material. This allows them to attract very thin particles.
  • Non-disposable (also called internal) filters: These are made from absorbent foam and are usually located near the back of the machine. These filters, sometimes called pollen filters, aid in removing larger particles such as pollen, pet hair, and dander.
  • Disposable in-line bacteria filters: These feature an ultra-fine construction to target bacteria and viruses. They work simultaneously with disposable and non-disposable filters. These attach to the CPAP air outlet to purify the air before reaching your mask. Disposable in-line bacteria filters are great for those vulnerable to allergies and sinus infections.

Some machines feature a dual-filtration system which means they use both disposable and non-disposable. With this design, the disposable filter acts as a backup to the non-disposable by filtering out finer particles it may have missed.

Keeping the air traveling to your airway from your CPAP machine is vital to safety and CPAP success. The following factors can make changing or replacing filters more frequently needed:

  • Having pets
  • Being around tobacco smoke 
  • Using a wood-burning fireplace

When it comes to your filter cleaning and replacement schedule, the following chart offers best practices.

Filter TypeClean EveryReplace Every
Non-Disposable (Internal)Two WeeksTwo Weeks
DisposableWeek, TwiceTwo Weeks
Disposable Inline BacteriaWeek, Twice30 days

Every machine is different, making their filter requirement vary as well. When selecting any filter, it’s vital to check your machine’s requirements to ensure you choose one designed to fit with your machine.

CPAP Accessories: Sanitizers and Cleaners

CPAP Sanitizers and Cleaners

If using soap and water aren’t enough, consider specialized CPAP cleaners or sanitizers. These CPAP accessories can help speed up the cleaning process and ensure you efficiently clean your machine and its accessories. Below, we highlight a few common types of cleaners and sanitizers:

  • CPAP tubing UV sanitizer: These devices utilize ultra-violet light to sanitize and prevent the growth of biofilm inside the hose. They’re specially shaped to fit the tubing and don’t use harmful Ozone, which can irritate the lungs.
  • CPAP UV Cleaner & Sanitizer: These offer a convenient way of cleaning other CPAP accessories such as masks, humidifier chambers, and filters. They feature a drawer to place items in.
  • CPAP Wipes: CPAP wipes are made specifically for equipment to be non-irritating and lightly scented or not scented at all. They can be convenient when traveling as they do not need to use any distilled water and can be used anywhere.

When choosing a sanitizer, try to avoid devices that use Ozone. This chemical has been found to be harmful with use over time. UV CPAP sanitizing machines are proven to be safer and equally as effective.

CPAP Accessories: Earplugs

Earplugs

If you, or anyone you share a bed with, are a light sleeper, then earplugs might be a necessity. While most machines are whisper quiet, they can disturb anyone who needs silence to get a good night’s rest. Using earplugs with CPAP can help drown out any noises.

CPAP Accessories: Chin Straps

Chin Straps

Sleeping with your mouth open can hinder CPAP therapy. If you sleep with your mouth open, a chin strap for CPAP can help keep it shut. These specialized headgear wraps around your chin to prevent your mouth from opening. They also help prevent snoring. CPAP chinstraps typically have a chin cup for added comfort and are adjustable.

CPAP Mask Frames

Most masks feature a frame system that makes up the core of the mask. The frame of the mask keeps the cushion in place and attaches it to the straps. Most frames are made of hard plastic; however, there are options made from softer materials such as flexible silicone.

CPAP Accessories: Mask Cushions

CPAP Mask Cushions

The cushion of the mask is the piece that comes in contact with your skin. Its primary responsibility is to create an airtight seal around your mouth and nose. This is vital to keeping the pressure of the mask at the desired setting. There are a few styles of cushions that vary based on the mask type (full, nasal, and nasal pillow). 

The materials making up the CPAP cushion liner are usually soft materials such as silicone, gel, foam, or memory foam. The right cushion will be dependent on your breathing pattern, preferred sleep position, and the set pressure of your machine.

CPAP Accessories: Headgear

CPAP Headgear

CPAP headgear is the stretchy straps that keep the mask in place and a tight seal. They’re usually made of soft and elastic material to conform to your head shape. There are more comfortable options available that feature cushioning or wider straps.

CPAP Batteries

An optional accessory is a CPAP travel battery. These are a great feature if you frequently travel and run into the issue of not having a power source. Most CPAP batteries are made of lithium-ion which is lightweight, charges quickly, and lasts for at least one night of CPAP.

CPAP Machine Use: Tips & Best Practices

When you’re new to CPAP therapy, it can be overwhelming at first. Entering the world of CPAP can be a life-changing experience, given it’s something you’ll be using every night. For this reason, it’s best to know the ins and outs of using CPAP and a few tips to make your experience easier. This section highlights best practices to help avoid any CPAP issues.

CPAP Tips: Sleeping Position

Sleeping Positions

When it comes to sleep apnea, your sleeping position matters. Below, we break each position down and how it pertains to CPAP and sleep apnea.

CPAP sleeping positions: On your back

On Your Back - Worst for Sleep Apnea

Sleeping on your back is the worst position for sleep apnea. This position puts pressure on your airway, which can aggravate symptoms. If sleeping on your back is non-negotiable, try sleeping with a wedge pillow. These pillows elevate your back and minimize pressure on your airway. They’re also great for spinal alignment and blood circulation.

CPAP sleeping positions: On your stomach

On Your Stomach - Worst for Your Back & Spine

Sleeping on your stomach is ideal for sleep apnea and the worst for your back. While you’re less likely to snore as this position opens airways, you also can put a strain on your back muscles and spine. If stomach sleeping with CPAP is mandatory for you, try adding a pillow below your stomach. This adds much-needed support for your back and spine.

CPAP sleeping positions: On your side

On Your Side - Best for Sleep Apnea

Side sleeping is the best position for sleep apnea as it reduces snoring. This position can help improve blood circulation, reduce acid reflux, and reduce back or neck pain. The only downside of sleeping on your side with CPAP is it can cause wrinkles from placing your face and mask on a pillow.

CPAP masks are designed to allow users to sleep in almost any position. Most are adaptable to sleepers who frequently change positions while asleep. A suitable mask and pillow can make a significant difference when it comes to sleep position.

CPAP Tips: Water for CPAP

Water for CPAP

As mentioned earlier, CPAP water for humidification is a core piece of comfortable treatment. For example, if you forget to put water in your CPAP, it will cause dry air to be pushed to your airways which can cause a dry and itchy throat.

This brings up another question, what kind of water for CPAP? The answer is always distilled water, and for two reasons:

  • It prolongs the life of your machine. Other water types do not remove minerals like calcium, magnesium, and iron, making water “hard.” If present in the humidifier’s water, a build-up of mineral deposits (called scale) can potentially damage the machine.
  • Distilled water is safer. While tap water might be more convenient, it contains minerals and possible organisms that you don’t want to risk inhaling.

How often do I need to change the water in CPAP?

To prevent the build-up and contamination of allergens, bacteria, and mold, changing your CPAP machine's water before every use is vital. The warm and moist environment of your humidifier's reservoir is the ideal climate for the growth of these harmful contaminants.

Can I use purified water in my CPAP?

It's best to avoid any type of water other than distilled. While purified water may be safe from contaminants, it may contain minerals that make it "hard." These can build up and damage the machine.

How much water does a CPAP machine use?

The chamber in a CPAP humidifier typically holds 11 to 17 ounces of water. The amount it uses while you sleep depends entirely on the humidity levels of your room and its settings.

CPAP Tips: How to Stop CPAP Rainout

CPAP Rainout

CPAP rainout is a common phenomenon when using a CPAP machine. This occurs when water vapor from the humidifier cools down and returns to its liquid state, causing water in your CPAP mask or hose. You might wake up to your CPAP mask dripping water on your face.

How to Stop CPAP Rainout (How to Stop Water in Your CPAP Mask and Hose)

A cooler room temperature causes it. However, you can keep moisture out of your CPAP mask and hose with these tips:

  • Position your CPAP machine at a lower altitude than your sleeping position. This will let gravity force any water buildup down the hose and back into the humidifier.
  • Keep your room temperature higher. If a warmer room temperature doesn’t bother you, doing so will keep vapor from the humidifier from becoming liquid.
  • Use a CPAP tubing wrap for insulation. This will keep the tubing warm and aid in preventing water from forming. It also doubles in purpose as it keeps the uncomfortable (and often cold) tubing from touching you while asleep.
  • Place your tubing under your blankets. This is an excellent alternative to CPAP tubing wrap. Your body heat gets trapped under the blanket, which can help keep your tubing warm to prevent rainout.
  • Adjust your humidifier. If you live in an already humid climate, chances are you don’t need a high humidifier setting. Talk to your provider about modifying your humidifier settings. Keep in mind the humidifier is designed to warm the air to about 80° F.
  • Adjust your humidifier seasonally. Your CPAP humidifier setting in the summer may need to be lowered as your environment's humidity levels increase. Just be sure to increase your levels during dryer seasons.
Follow our best CPAP positioning practices: Places at a level below your bed, away from windows, on a flat surface, secured to the surface if needed, and a minimum of 6

Positioning a CPAP Machine

Your CPAP positioning is essential for the best treatment and comfort. The machine is designed to filter air into your lungs; therefore, you want it to be unobstructed. However, you also want it to be in a position that prevents rainout and gives your tubing slack for any possible shifts in sleeping position. Use the following tips when setting up your CPAP machine.

Does my CPAP machine need to be lower than my bed?

The best position for your CPAP machine is on a stand lower than your bed’s height. This minimizes the noise you hear from the machine and prevents condensation from building up in the hose. It also prevents the device from being pulled and falling.

Don’t place it on the floor

While yes, placing it on the floor is best for rainout prevention; it will increase the accumulation of dust and debris. It also puts the machine at risk of interference by any pets present. You may want to invest in a CPAP nightstand designed to place your device at an ideal height.

Place it at a minimum of 6” away from any walls or items

Try to put your machine at least 6” away from the wall and other things. You want the device to have plenty of room to circulate air without being blocked or having to filter excessive amounts of dust.

Don’t place it in front of a window

It’s also essential to keep your machine away from windows. While it’s tempting to draw in fresh air from outside, your machine can also suck in pollen and other allergens that can make symptoms worse.

Make sure your tubing has plenty of slack

The last thing you need is to be woken up because you shifted sleep positions and pulled your CPAP machine onto the floor. When setting up your CPAP oasis, test the positioning by moving around in bed with your mask on. This will give you an idea if you need more or less slack. You might also find you need a longer hose.

Place your machine on a flat surface

Inclines force your CPAP machine to work harder. It also puts your humidifier at risk of spills and can cause it to misread water levels. Keep your machine on a flat surface to best work its magic. You can check for an inclined by seeing if the water in the humidifier is flat or sloped.

Plan for any potential fall risks

Do you have dogs with tails of mass destruction? Or perhaps cats that love to play king kong during the night?

Make sure you plan for any potential fall risks. The last thing you need is your machine falling to the floor and water from the humidifier sending your machine to an early grave.

A great solution is earthquake putty to keep it secure to a surface. You can also enclose your machine in a drawer or cabinet if you have the resources. Just make sure it has adequate room to breathe. Some people even make their own custom CPAP machine table.

Use Only a Heavy-Duty Extension Cord or a Surge Protector - "Can you plug a CPAP machine into an extension cord?"

If your wall outlet is too far for your machine's cord to reach, you can use an extension cord. However, it's vital to employ a heavy-duty extension cord or a surge protector to prevent damage. We recommend a surge protector to prevent the device from breaking should a storm cause power surges.

It's also vital to plug your device into an outlet that isn't being used by other major appliances. You do not want to overload the socket as this can damage your machine.

CPAP Tips: What can you put in a CPAP? Distilled water only. Don't use essential oils, vaseline, vicks, or purified water

What can you put in a CPAP?

While it’s tempting to place essential oils, vapor rub, or CBD oil in your CPAP’s humidifier, filter, or mask, don’t do it. Your machine is made to pump oxygen into your airway. And adding any foreign substance can send it deep into your lungs and cause health issues.

The only thing you should put in your CPAP is distilled water. Because it’s filtering the water and into the hose, any other substances can cause it to work harder and potentially cause damage to the machine.

Can I use essential oils in a CPAP?

If you'd like to add aromatherapy to your CPAP machine, consider placing a diffuser next to your machine if you’re dead set on adding essential oils to your CPAP routine. The machine will draw air from the room and give you the benefits of the oil without any potential damage or health risks. The same thing can be done for vapor rub.

Can I use vaseline with my CPAP mask? Can I put Vicks in my CPAP?

While placing Vaseline or Vicks around your nose or on your mask may be tempting, don't do it. The water vapor from the CPAP will carry it into your lungs which can be bad for your health. Additionally, placing it on your mask can damage the mask and cause air leaks.

Common CPAP mistakes and problems

Using your CPAP machine is vital to relieving sleep apnea symptoms and better sleep. Improper use can further hinder your symptoms and even worsen them. To ensure you get the most out of your CPAP therapy, consider these most common CPAP problems and how to remedy them:

Wrong CPAP Mask Size or Style

There is no one-size-fits-all solution for your mask. Everyone’s face/head is not the same size/shape. This makes having the proper mask vital to avoid any CPAP mask problems. An improper size/style can cause air to leak and create discomfort.

How to avoid this issue:

  • Try multiple types of masks. There are quite a few options available, including a full face mask, nasal pillow, and nasal mask. It’s important to keep trying out various styles and sizes of masks to find the ideal one for your comfort. Nasal pillows are more minimal and fit under your nose. They’re great if you feel claustrophobic with a traditional full-face mask. On the other hand, Nasal pillows are great if you wear glasses or read with your mask on as they don’t block your vision.
  • Perfect your size choice. Consider selecting a mask size like choosing shoes; not every brand’s size is the same as the others. Some run high while others run low. However, once you’ve identified a range of sizes that work, this process becomes easier. CPAP masks are also typically adjustable, so play around with that.
  • Work with your doctor to learn best practices. Be sure to ask your doctor or provider to train you on how to adjust and fit your mask properly. A correctly fit mask shouldn’t be uncomfortable or cause any pain.
  • Use the machine’s fitting test (if applicable). Some CPAP machines have a feature that tests your masks fit, letting you know if any air escapes when in use. This feature can help you adjust the fitting and positioning of your mask to prevent air from escaping.
What is an acceptable leak rate with CPAP masks?

Leak is the amount of air escaping your mask. An acceptable leak rate is 24 liters per minute or less. Anything less enables you to benefit from CPAP therapy. Anything above 24 liters/minute indicates there is something wrong with your mask such as incorrect fitting or worn materials.

Improper Hygiene

CPAP hygiene is vital to your health and CPAP comfort. By nature, CPAP machines are a magnet for bacteria, allergies, and infections. Their wet nature makes them a high risk, making proper cleaning vital. They’re also pumping oxygen into your airways, making it even more important to practice cleanliness.

How to avoid poor hygiene:

  • Clean your equipment every day. While this is tedious, it can prevent bacteria and other substances from growing and infiltrating your body. It can also keep pungent smells from forming in your mask. Make it a habit to clean your CPAP equipment every day for 5-10 minutes.
  • Use specialized CPAP cleaners and sanitizers. Specialized cleaners and sanitizers for your CPAP can make the cleaning process much easier. They come in many forms, including mask cleaning machines, hose sanitizers, and the more affordable wipes.
  • Make sure you sanitize all of your equipment. Be thorough with your hygiene practices. This means cleaning all your equipment, including your machine, humidifier, humidifier chamber, mask, cushions, and hose. Doing so will significantly lower the chances of infection.
  • Keep your sleeping area clean. Your machine uses the air in your room to pump oxygen into your airways. An unclean living area means unclean air, a recipe for infection. Be sure to regularly clean your bedroom to ensure the air is clean and there’s nothing harmful your machine might inhale into your body. It might even help to purchase an air purifier as a safety net.
  • Change your CPAP's water every day. Using the same water as prior can put you at risk of any mold in the CPAP reservoir. Water that's been sitting in the humidifier can form mold and attract a variety of harmful contaminants. Changing it every day prevents this from entering your body.

Using Old or Expired Equipment

While CPAP equipment such as masks and tubing can last for quite some time, it’s best for your safety to replace it regularly. Failure to do so can put you at health risk and reduce the effectiveness of your therapy.

Best practices for equipment lifetime:

  • CPAP mask: Every three to four months
  • Mask cushion and pillows: One to two times per month
  • Headgear: Every six months
  • Chinstrap: Every six months
  • Filter: Varies depending on the type; check the user manual of your machine
  • Humidifier water chamber: Every six months
  • Tubing: Every three months
  • Machine: Check with the user manual as this varies by brand and model. Insurance typically will cover a replacement every five years.

Failing to Consult a Doctor

The internet is full of a lot of insight and helpful advice. However, nothing beats the personalized care and experience of a medical professional. Going the easy route of the internet may cause you to miss out on a more in-depth treatment, potentially worsening your symptoms or causing inadequate CPAP treatment.

Best communication practices for your doctor:

  • Come to each appointment prepared. It’s always best to arrive at each appointment with your questions or concerns written down. This ensures you cover everything and don’t forget to bring up certain topics.
  • Don’t be afraid to get personal. Healthcare, by nature, is very personal. You might be embarrassed to bring up certain things. However, it’s important to face these fears as your health quality depends on it. Just remember that your doctor is there to help without judgment.
  • Start with an appointment and keep going. A quick google search shows there are other non-CPAP machines claiming to do the same thing without a prescription, it’s best to avoid this. Starting your CPAP journey with a professional lowers any potential health risks. Because you go through sleep tests, your doctor is able to make a clear and precise recommendation based on your specific needs and symptoms. Cutting a healthcare provider out opens you up to even more health problems.

Poor Machine Positioning

It’s common for new users to place their machine at too high or low of a level, around cluttered space, near a window, on an incline, and too close or too far from their bed. These scenarios can leave them uncomfortable, with worse symptoms, and even with a broken machine.

Follow our best CPAP positioning practices:

  • Placed at a level below your bed (but not on the floor)
  • Away from windows
  • On a flat surface
  • A minimum of 6” from any objects
  • Secured to the surface if needed

CPAP Care and Maintenance

Not to sound redundant, but sleep is so important to your health. And having sleep apnea can really mess with your sleep which then depletes your quality of life. Because you’re highly dependent on a CPAP machine to maintain good health, keeping up with care and maintenance is of utmost importance. This section breaks down tips and best practices for properly using your CPAP equipment and keeping it in proper shape.

Read Your Equipment’s User Manuals

No brand nor model is precisely the same. All require different methods of care and maintenance. This makes it essential to read through the included manuals. They’ll provide a thorough run-through of what’s needed to keep your equipment clean and in good working order.

Have Your Healthcare Provider Check Your Machine Routinely

This is especially important if your machine’s warranty is about to expire. They can do a thorough run-through of your machine to ensure it’s working and even issue a return if they notice any issues.

Clean Your Equipment Daily

Daily cleaning is vital to your health and safety. Make sure you clean and disinfect all parts of your CPAP therapy including the machine, mask, cushion, tubing, humidifier, and any other parts involved. It might even help to develop a cleaning checklist to ensure everything is covered.

Use the Proper Cleaning Products and Equipment

What you use to clean with matters. Avoid using harsh soaps, chlorine bleach, antibacterial, and alcohol-based solutions. Any aromatic or scented oils should be avoided. A great tip is to use one part vinegar and three parts water solution after cleaning to reduce soap residue and disinfect.

If you’re looking for a more efficient and safe method of CPAP hygiene, you can invest in specialized equipment and cleaner solely made for CPAP. This includes:

  • CPAP Wipes
  • CPAP UV Sanitizer 
  • CPAP Tubing UV Sanitizer

Replace Your Equipment Regularly

Daily use of your CPAP equipment makes regular replacement important. Your equipment will wear as you use it, forming holes in tubing, mask cushions, and more. To keep your CPAP therapy effective, replace it regularly.

Filter Care

Most CPAP machines feature filters (sometimes two) that filter the air being pushed through the tube. Routinely replacing your filters can significantly extend the life of your machine. These are relatively inexpensive and easy to replace.

Nondisposable filters typically need weekly hand cleaning using a mild dishwashing soap mix combined with a clear water rinse and air dry. How often disposable filters need replacement will vary depending on the brand and model but typically last up to one year.

Disposable filters, on the other hand, typically need replacing every month or two (or when visibly discolored and dirty).

Mask Care

Masks are made up of a few different components:

  • An outer frame
  • An inside soft cushion 
  • And the headgear

The mask’s cushion is the most fragile and vulnerable part because it lies against your face. To maximize the lifespan of your mask:

  • Remove make-up before use
  • Place your mask on skin that’s free from oils and moisturizers 
  • Clean the cushion with a mild pure soap mix and air dry daily 
  • Be gentle with the cushion to avoid tears 
  • Clean the mask frame and headgear weekly

How to Tell if CPAP is Working

Any CPAP newbie wonders if the therapy is actually working. And because it requires some time to adapt, you might feel discouraged or eager for results. In the morning, after using your machine through the night, ask yourself:

  • Do I feel refreshed?
  • Am I able to get up easier than before? 
  • Am I less irritable and free from a headache?

If you answer yes to any of these questions, then the CPAP is working. However, it’s important to note that CPAP therapy can take some time to adjust to. You might not see results right away as you start acclimating yourself to sleeping with CPAP. It's important to stick through with CPAP in order to reap the benefits.

Signs your CPAP therapy isn’t working

  • The machine doesn’t turn on at all. Most machines can be turned on by the push of a button (some turn on by breathing into the mask). If your machine doesn’t turn off or provides no airflow, then it’s best to take it to your provider to determine if it needs to be repaired or replaced.
  • Your humidifier’s water level never goes down or rarely needs to be filled. If that’s the case, then your water chamber may not be heating adequately. The water in your humidifier should need to be refilled every two to three days (we recommend refilling it daily).
  • The air is uncomfortably cool. For comfort purposes, the humidifier needs to push heated water out. If this isn’t the case, then your humidifier might be having issues.
  • Water condenses inside heated tubing. If you’re using heated tubing but the water is condensing inside it, your humidity setting might be too high or the tubing is incorrectly connected or not working.
  • Your machine is louder than advertised. Most CPAP machines are designed to be quiet. If you notice your machine is louder than advertised, it might have something wrong with it.
  • You're still snoring or showing Apnea. Snoring should never occur when using CPAP. If you’re still snoring or showing symptoms, then your pressure settings might need to be increased.
  • Your symptoms worsen. Some CPAP users start seeing benefits in a few days or weeks. If you start to feel worse or your symptoms start showing again, it’s best to see your doctor so they can make adjustments. Sometimes, symptoms reappear after a while due to weight gain, alcohol use before bedtime, and aging.
  • Your CPAP machine is older. Unfortunately, CPAP machines don’t last forever. And as they age, you might notice their quality of treatment start to diminish. They might start making louder noises, not produce as much pressure, or become harder to use. These are all signs you need to replace your machine.

The easiest way to know if your treatment is working is to continuously meet with your healthcare provider. They’ll be able to keep an eye on your therapy and point out any abnormalities or issues. This is especially true if your symptoms go away after initial use and then return.

Using CPAP While Sick

A common question is “can you use CPAP while sick?”

Understandably, there’s concern that CPAP will make things worse if you are congested or have a sore throat.

If you’re sick with an illness that limits breathing, it can make CPAP machines work not as effective and more challenging to use. If you’re congested, it can be harder to breathe with the machine, especially if you use a nasal mask.

Additionally, it can contaminate the mask. Some studies indicate a risk of secondary infection if microorganisms are allowed to breed and multiply on a contaminated mask.

Another aspect to consider is coughing spells. The flow of air from the machine can cause coughing spells if you have a sore throat, making things even more uncomfortable.

COVID and CPAP: Is it Safe to Use CPAP with COVID?

In short, yes it's safe to use your CPAP if you have COVID. And it's important you continue to use your machine until speaking to your doctor. Because the air is being transported through a closed environment (the hose), you don't have to worry about your therapy increasing the chances of COVID spreading to a partner.

Tips for using CPAP While Sick

If you’ve been using CPAP for a while and end up sick, it can be nerve-racking. Use these tips to ease your worry:

  • Don’t be afraid to take a break from CPAP. A general rule is that it’s okay to take a break from using CPAP if you have a cold or stuffy nose. You can actually benefit from it. If you’re experiencing ear pressure/pain, nosebleeds, a sore throat, coughing, shortness of breath, or nausea/vomiting then it can be a good idea to take a break.
  • Use saline spray or rinse. Saline spray is an inexpensive and effective method of moistening the lining of the nose. It can also help to rinse the nasal sinuses with a neti pot.
  • Use nasal decongestants. If your illness is allergy-related, prescription medications such as nasal steroid sprays can help relieve chronic congestion.
  • Take cold and flu medications. Try using medications such as Benadryl which target cold and flu symptoms. Additionally, medications like Mucinex can thin the mucus to clear it out. If the issue is coughing, cough suppressants such as cough syrup or throat lozenges can help.
  • Use a heated humidifier and tubing. If a head cold or nasal congestion is the issue, the CPAP’s humidifier can minimize irritation and inflammation in the airway. Research has shown that heated humidifiers can reduce the risk and duration of infections. Heated tubing can also reduce the risk of condensation and bacterial colonization.
  • Switch to a full face mask. If your illness causes a stuffy nose, it can be nearly impossible to use a nasal mask. For this reason, try switching to a full face mask that allows you to breathe through your mouth instead. As symptoms lower, you can then switch back to the nasal mask.
  • Switch your sleeping position. To improve your breathing quality, try sleeping on your side or stomach. It might help to raise your head as well. You can use a wedge pillow or stack several pillows up. If you decide against using a CPAP while sick, this can provide additional relief.
  • Modify your pressure or switch to APAP. When nose obstruction occurs, adding pressure to your CPAP can help open airways. It might also help to switch to APAP which uses a variety of pressures. Consider talking to your doctor to see which options work best.
  • Be extra thorough with your cleaning. While hygiene is vital to CPAP, it’s especially true when sick. Make sure you’re diligent with cleaning your CPAP mask, tubing, and humidifier tank as these are the most at risk of infection.

About the Author

Brandon Landgraf is the Digital Marketing Manager for Carex Health Brands. He finds passion and fulfillment in creating content that enhances, improves, and enlivens others' quality of life. All of his written work is formulated to not only offer essential advice and tips but back it with proven studies and experts. His mission is to connect with readers and provide steps to make their lives better.

You can connect with him on LinkedIn here.

About Carex Health Brands

Carex is your one-stop shop for home medical equipment and for products that assist caregivers with providing the best possible support and care for their loved ones. Carex Health Brands has been the branded leader in in-home, self-care medical products for over 35 years. Our goal is to improve the lives of our customers by bring them quality products that bring dignity back to their lives. With our three nationally distributed brands, Carex Health Brands serves national, regional and independent food, drug and mass retailers along with wholesalers, distributors and medical dealers.