If you use a CPAP machine (typically for sleep apnea) which one do you use?

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raccoon city
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If you use a CPAP machine (typically for sleep apnea) which one do you use?

I use a CPAP machine to help me sleep.

I had to pay for it with my own money because I don't have sleep apnea anymore and my insurance wouldn't cover it.

I bought a Fisher & Paykel ICON Auto in June of 2014 for $510.

icon_auto

It works well for me, and it was one of the cheaper full sized CPAP machines with a humidifier when I got it.

If you use a CPAP machine, which one do you use?

I'm just curious how many other BLF members have one, and what they have.

I'd also like to know if you like your CPAP machine or not.

Edited by: raccoon city on 01/23/2021 - 03:52
raccoon city
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By the way, my old CPAP machine was a Philips Respironics REMstar Plus, with the optional humidifier.

remstar_plus2

My insurance covered that one back around the year 2001 or 2002.

It worked great for many years, but eventually died, and that's when I got the ICON Auto.

Sorry for the crappy photo.

It was the best I could find on Google Images as the machine is a very old model.

justanotherguy
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Phillips system one
its a kinda old.

I’m curious, where do you buy supplies, mask, nasal pillows or what not?

flydiver
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I’m a Respiratory Therapist. I was on the first wave of putting CPAP out in the field. RT’s in hospitals didn’t know how to use them. Many physicians were pretty uneducated about OSA. The public was almost completely uninformed.
Insurances often would not pay for them. They were considered ‘experimental’.

Early CPAP were pretty large compared to what they would become. They made a fair amount of loud white noise. Some people actually located them in an adjacent room and put a hole in the wall to run tubing. Those units would handle longer tubing OK. New ones will not deal with much additional length.

Most masks were PVC (polyvinyl chloride), like the disposable masks for O2. Face oils hardened them and for some people they’d petrify in a month, often leading to some unfortunate pressure sores, usually on the bridge of the nose. Fitting was often not very good as there were only 3 mask sizes. There were some silicone nasal pillows. Some people like them, others hated them.

The new systems and masks are vastly better.

Some of the stories I heard from people with OSA ran the range from sad to hilarious. Most wives were very enthusiastic to get their snoring husbands quieted down and hopefully feeling better. The men rarely even acknowledged they had a problem.

Quote from one of the leading OSA researchers at an RT seminar:
“Men don’t have sleep apnea, they only have denial. What they don’t deny is how much their wives bitch about their snoring,”

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leestrong
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flydiver wrote:
I’m a Respiratory Therapist.

Wow, we do have all kinds of experts here Big Smile
I have a question: Will chronic use of CPAP or BIPAP result in dependence, e.g. forgetting how to breath autonomously and independently during sleep?
flydiver
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leestrong wrote:
flydiver wrote:
I’m a Respiratory Therapist.
Wow, we do have all kinds of experts here Big Smile I have a question: Will chronic use of CPAP or BIPAP result in dependence, e.g. forgetting how to breath autonomously and independently during sleep?

Nope, breathing is pretty much hardwired.
One of the issues with some, not all, OSA people is that they may be ‘respiratory slugs’. The inherent breathing drive is somewhat lower, and their tolerance for CO2 may be higher. My own family has this tendency. Father used CPAP. My wife comments on my lack of breathing sometimes.

If anything the CPAP may (significantly) improve overall health with improved sleep. There are a host of health issues associated with OSA, not the least of which is dying in a vehicle accident when falling asleep at the wheel. Met a mailman that had wrecked 2 trucks that way, and a jeweler that needed to be driven 3 miles to work.

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cohoer
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After 5 years using an S9 ResMed I got a newer A10; both worked well for me/wife(she stopped kicking me in the back to restart my breathing). I use an Alien hatchling face mask. I tried several nose pillow variants. All made my lips do whoopie cushion imitations. No problems re:forgetting to breathe w/o the mask.

raccoon city
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justanotherguy wrote:

I'm curious, where do you buy supplies, mask, nasal pillows or what not?

For me, either at cpap.com, directhomemedical.com, or usually on eBay.

I think most places require a prescription, but on eBay you can get some CPAP supplies without one.

raccoon city
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flydiver wrote:

Quote from one of the leading OSA researchers at an RT seminar: "Men don't have sleep apnea, they only have denial. What they don't deny is how much their wives bitch about their snoring,"

I was in college when I developed sleep apnea.

My roommate claimed that I snored extremely loudly, and I'm sure he was right.

For a while, we took turns sleeping in our bedroom, while the other person slept in the living room.

That's right: we had to sleep in different rooms because my snoring was so loud.  :O

flydiver
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Separate sleeping quarters for couple is very common. I’d hear stories of guys that went on fishing/hunting/camping trips with their buddies and they were not happy at all with the poor OSA guy.

I diagnosed a guy on a diving trip. I could hear him snoring 2 rooms away.

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leestrong
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flydiver wrote:

Nope, breathing is pretty much hardwired.

Thank you for the explanation, and alarming stories Facepalm
I gained ~30 pounds in the past couple years, and started getting complaints about horribly loud snoring. My airway gets obstructed unless I sleep on the side and with mouth closed. I can still get a good night of sleep with the right posture, so I am not sure if I need a CPAP machine.
flydiver
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FWIW, weight is an additional problem. The ‘pressure setting’ on the CPAP is often a function of how much extra weight you are carrying.
Often men think they will lose weight, then not need the CPAP.
It’s hard to lose weight. I have never, ever seen someone with untreated OSA lose weight. The energy, and discipline simply aren’t available.
I have seen men treated with CPAP lose weight, sometimes without even trying hard. They simply feel so much better they start being active again and burn off the extra. Weight loss is never a guarantee though.

BTW, it’s not the snoring, it’s the ‘stop snoring/no breathing’ that’s the problem. The apnea is where everything goes wrong.
Back sleeping does increase the probably of obstruction. I’ve known people to sew a tennis ball into PJ tops or an undershirt.

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JaronRH
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I have a ResMed AirSense 10 that I’ve been using for almost 2 years now. I was averaging 23 events a hour so I definitely needed it! It has definitely made a difference for me!

cohoer
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What pressure is your machine set at. Mine hasn’t changed since I first got it at 10psi. A guy I know says his is at 20, seems a lot to me, I would expect sealing issues.

23 is a lot of events, I think. After my nasal RotoRooter (polyps, deviated septum), afib procedure and metropolol meds, I seem to rarely exceed 5-7, mostly less.

JaronRH
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I’m at 12psi. Thankfully, it’s dropped me down to just over 1 event a hour now!

flydiver
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cohoer wrote:
What pressure is your machine set at. Mine hasn’t changed since I first got it at 10psi. A guy I know says his is at 20, seems a lot to me, I would expect sealing issues.

A way to envision it is to think of your upper airway as one of those long skinny balloons. Now, put a book on it. To keep the airway open you have to blow up the balloon enough to raise the book adequately. Heavier book requires more pressure.
The book “weight” correlates reasonably well with the neck size and overall weight. OSA people often have short stout necks and are carrying extra weight.

No, it’s not ‘exact’, and the analogy doesn’t fit everyone, but it’s about 75% in the ballpark. You could do a quick and dirty sleep study with a measurement of the neck, and a scale. You could get a starting pressure from there. Then you tweak the pressure based on real world results. In real life we often had to do that even with a sleep study. The study is an odd enough circumstance that it can adversely affect sleep, thus the setting was off.
Some newer CPAP units can measure airflow and adjust pressure if there is no breathing for a predetermined period of time.

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Not as dark now
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I also have a ResMed AirSense 10 with nasal pillows that I’ve just started using. I was averaging 68 events a hour but now it’s less than 2. I have to sleep on my side… If I sleep on my back I get air escaping through my mouth that wakes me up.

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I use two. ResMed AirSense 10 for home:

And ResMed AirMini for travel and camping:

Both work great. The AirMini was pretty loud so I added a muffler and it’s super quiet now. It’s so convenient for travel.

flydiver
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That ResMed AirMini is amazingly small! I’ve seen them decrease in size but never figured that level would be possible.

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flydiver wrote:
That ResMed AirMini is amazingly small! I’ve seen them decrease in size but never figured that level would be possible.

It is incredibly small and works well too! I can put it in my back pocket!
Essexman
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I was diagnosed with OSA a few years back and put on a CPAP. Since then I’ve lost 16kg (35lb) and i’m much fitter than I was. Last year I had a sleep test after not using the CPAP for two weeks. Good news is I no longer require the CPAP, bad news is I can’t sleep well without using it, and I’m left feeling tired without it.

When I asked the best way to stop using the CPAP my consultant said I was the first he’s come across asking that, he suggested just going cold turkey. I’m waiting for another sleep test, but with covid the NHS here in the UK has cancelled most non essential treatments.

So question for @flydriver – any idea on procedure to come off CPAP long term?

flydiver
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No, I don’t.
OSA needs a ‘definition’ to be recognized as a disease condition. Everyone has an occasional bit of apnea during the night. It becomes defined as OSA when the number, duration, degree of O2 desaturation, and sleep state disruption cross lines that were determined somehow.
So…..what if someone is just this side of that line, or that side of the line? I’ve seen people, and their physicians have to deal with that dilemma. Throw insurance payments into that mix and it gets even messier.

In the UK, the CPAP was no longer supported/paid for if you did not ‘pass the OSA requirement’?
Do you own it yourself? If you do, and it works for you, I see no reason to not simply keep using it. It’s certainly not going to hurt you.

Usually people really don’t want to deal with CPAP. Even people that are seriously symptomatic often refuse to deal with it, finding the CPAP experience somehow worse than the OSA condition. One of the patients our company was trying to treat was a physician. His OSA was so bad it was seriously interfering with the work in his group practice. Of course, his colleagues insisted he be treated, of he would be asked to leave. There were legal and professional issues. So, we’d bring the equipment out. He’d return it a couple weeks later. Then get censored by his group who could tell he had ceased using it, and we’d bring it back. I remember at least 3 rounds of that. I don’t know how it ultimately turned out.

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Essexman
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flydiver wrote:
No, I don’t.
OSA needs a ‘definition’ to be recognized as a disease condition. Everyone has an occasional bit of apnea during the night. It becomes defined as OSA when the number, duration, degree of O2 desaturation, and sleep state disruption cross lines that were determined somehow.
So…..what if someone is just this side of that line, or that side of the line? I’ve seen people, and their physicians have to deal with that dilemma. Throw insurance payments into that mix and it gets even messier.

In the UK, the CPAP was no longer supported/paid for if you did not ‘pass the OSA requirement’?
Do you own it yourself? If you do, and it works for you, I see no reason to not simply keep using it. It’s certainly not going to hurt you.

Usually people really don’t want to deal with CPAP. Even people that are seriously symptomatic often refuse to deal with it, finding the CPAP experience somehow worse than the OSA condition. One of the patients our company was trying to treat was a physician. His OSA was so bad it was seriously interfering with the work in his group practice. Of course, his colleagues insisted he be treated, of he would be asked to leave. There were legal and professional issues. So, we’d bring the equipment out. He’d return it a couple weeks later. Then get censored by his group who could tell he had ceased using it, and we’d bring it back. I remember at least 3 rounds of that. I don’t know how it ultimately turned out.

Thanks for your reply.

Here in the UK the NHS has just that, they set a limit of episodes per hour averaged over one night sleep test. If you are below that limit you don’t get treatment.

No I don’t own the CPAP, after my test results last year I was asked to return the CPAP to the NHS. I wrote to the consultant explaining and had a follow up telephone call with her, she concluded the same as you, continue using CPAP, but at the same time try to come off it.

From the research I’ve done, It would appear the pressure level can be adjusted to less and less over time to a point I should be able to come off it. This makes more sense to me compared to just going cold turkey. I’ll just have to wait for my next appointment and sleep test, see where it goes.

It took me many weeks to fully get used to using the CPAP, and more weeks to feel the benefit of using it. Again from my research, those that take longer to get used to using it seem to then struggle to stop using it!

On a lighter note, one of the nurses told me a great story – Her nurse friend hooked up with a young man in a pub one evening and had a one night stand with him. She spent the whole night awake as he slept, he was suffering with sleep apnea, snoring and stopping breathing for minutes at a time. She had breakfast with him and explained about his condition and told him to make an appointment as soon as possible. Long term she saved his life. Apparently she was the first lady to stay and have breakfast with him, others had just left in the night, now he knows why!

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I started using CPAP around September last year after completing a sleep study. A local supplier offers 30 day trial rentals which comes off the purchase price if then bought. The trial was a mind-opener. Massive energy and mind clarity boosts. Needed less sleep. Unfortunately it was a full nasal mask and it got more and more claustrophobic over time. Then I bought a machine and tried gel nasal pillow. It was great but started to hurt one nostril. Switched to the nasal pillow and it’s been just right. I don’t think I’m getting as good results as I did with the full nasal mask but the trade-off for no claustrophobia is worth it for now. I may try again in the future.

I bought one of these APAP machines. It’s very quiet, I don’t even hear it unless I take the mask off. (These are Australian prices. I’m sure other countries could get them far cheaper.) Has a humidifier, plenty of adjustable parameters, and I discovered I can get into the prescription settings (which I haven’t fiddled with). Using it, my events have dropped to below the average of people without apnea. Great results!

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I bought a weighted blanket, and it looks like it’s helping now.