Frequently Asked Questions

What is Sleep Apnea?
How do I know if I have Sleep Apnea?
What is a sleep study?
What is the difference between CPAP, CPAP with C-Flex, APAP, and Bi-Level?
Do I need a prescription for a CPAP, APAP or Bi-Level machine?
Do you file insurance and what information do I need to file?
My mouth is dry when I wake up in the morning. How can I eliminate this?
My spouse says that my mouth drops open when I am sleeping. Does this hurt anything?
I am having sinus problems and my CPAP just makes it worse. What can I do?
I am having some nasal dryness and irritation. Is there a solution?
CPAP Benefits
12 Tips for using CPAP
 

What is Sleep Apnea?

Sleep apnea is a common disorder that affect millions of people. Apnea means that you actually stop breathing. A few of the symptoms of sleep apnea include, but aren't limited to: loud snoring, feeling groggy upon awakening, sleepiness during the day, being able to fall asleep quickly during the day, headaches, memory problems, and lack of energy.

There are three types of apnea: Obstructive, Hypopneas, and Central.

Obstructive apnea is when the airway is blocked. The soft tissue in the rear of the throat collapses causing the airway to close. If this happens for 10 seconds it's considered to be an apneic episode. Obstructive Sleep Apnea is the most common form of apnea.

Hypopnea (hypo=below, pnea=breath) is when there is shallow or below normal breathing or a reduction in airflow. We have to include oxygen desaturation and arousal from sleep for an event to be defined as hypopnea.

Central Apnea is when the part of the brain that controls' breathing doesn't start or maintain the breathing process properly. It's the least common form of apnea (except in very premature infants, in whom it's seen fairly commonly because the respiratory center in the brain is immature) and often has a neurological cause. An example of normal central apnea would be the short pause that occurs following a deep a sigh.

Apnea causes your oxygen levels to drop to an abnormal, sometimes dangerous level. With each apnea, the brain receives a signal to arouse the person from sleep in order to resume sleep. This can happen hundreds of times a night. In most cases, the person doesn't even realize this is happening; they just feel tired and have no energy the next day not really understanding why.

If left untreated, sleep apnea can cause high blood pressure, other cardiovascular disease and weight gain.

If you have any of these symptoms, the next step is to see your physician so he or she can evaluate your symptoms to see if a sleep study is needed.

How do I know if I have Sleep Apnea?

The Epworth Sleepiness Scale is used to determine the level of daytime sleepiness. A score of 10 or more is considered sleepy. A score of 18 or more is very sleepy.

Click here to take a test that can help you see if you need help.

What is a sleep study?

A sleep study is done at a local sleep lab in your area. This is performed by a respiratory therapist and requires an overnight stay. The sleep study records your breathing, brain waves, leg movements, chest movement, and oxygen saturation.

The initial sleep study is done to determine if you have sleep apnea. If you are found to have sleep apnea, the physician will require you to have a second sleep study. The second sleep study is done with a trial of CPAP.  When the apneas start occurring they start with a low pressure measured in cmH20. The pressure is increased until an adequate pressure is achieved that eliminates all apneas, hypopneas and oxygen desaturations.

What is the difference between CPAP, CPAP with C-Flex, APAP and Bi-Level?

CPAP is continuous positive airway pressure. It is constant pressure to maintain an open airway. If you have obstructive sleep apnea or hypopneas the most common treatment is CPAP or continuous positive airway pressure. CPAP is a machine that puts out a pressure measured in cmH20. This pressure is determined by the results of your sleep study.

APAP is set with a high and low pressure. It automatically adjusts to your needs but will not allow you to go above or below the set pressure.

Pressure measure in cmH20. Demonstrated with a pressure of 5 and 20 cmH20.


CPAP with C-Flex is the continuous positive airway pressure but with pressure relief. You can actually exhale with a C-Flex. The C-Flex feels more like natural breathing while maintaining the pressure you need to maintain an open airway.

Watch a short video about C-Flex here.

BiPAP or Bi-Level is two levels of pressure. You have a set inspiratory pressure along with a set expiratory pressure. When the inspiratory effort is being made the higher set pressure is delivered. When flow stops, the pressure returns to base set pressure. This positive pressure wave during inspirations unloads the diaphragm decreasing the work of breathing.

Pressure measure in cmH20. Demonstrated with a pressure of 15/10 cmH20.

Do I need a prescription for a CPAP, APAP or Bi-Level machine?

Yes, a prescription is required by the FDA. The physician determined your desired pressure setting during the sleep study which eliminated the apneas. You can fax your prescription to: (770) 573-1053 or e-mail it to: Missy@mscpap.org.

Do you file insurance and what information do I need to file?

No, we are able to provide discount prices on the CPAP/BiPAP machines and supplies because we do not file insurance. Here is a list of HPCS Codes so that you can file with your insurance company:

HPCS Code Description
A7034 Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap
A7032 Replacement cushion for nasal application device, each
A7033 Replacement pillows for nasal application device, pair
A7035 Headgear used with positive airway pressure device
A7036 Chinstrap used with positive airway pressure device
A7037 Tubing used with positive airway pressure device
A7038 Filter, disposable, used with positive airway pressure device
A7039 Filter, non disposable, used with positive airway pressure device
A7045 Exhalation port with or without swivel for CPAP
A7046 Replacement water chamber for humidifier, each
E0561 Humidifier, non-heated, used with positive airway pressure device
E0562 Humidifier, heated, used with positive airway pressure device
A9999 Miscellaneous supply or accessory, not otherwise specified

My mouth is dry when I wake up in the morning. How can I eliminate this?

The first step is to consider adding a humidifier to your CPAP/BiPAP machine. You can add heated humidity or cool depending on your preference. The newer CPAP/BiPAP machines have humidification systems that integrate with their machines. If you have an older system the Velocity II with heater will go with any CPAP/BiPAP machine you will need an 18 inch hose found under accessories to connect them.

If you already have humidification and are still having a dry mouth when you wake another cause could be you are dropping your mouth open. You may want to consider a chin strap, which keeps your mouth closed. The other option is a full-face mask which covers your mouth and nose.

My spouse says that my mouth drops open when I am sleeping. Does this hurt anything?

Yes. It means that you are not getting the full pressure you need. You may want to consider a chin strap or a full-face mask. 

I am having sinus problems and my CPAP just makes it worse. What can I do?

There are several solutions you should consider:

  1. Add heated humidity to your CPAP machine.
  2. Make sure you use distilled water or boil your water, don't use tap water in your chamber.
  3. If you have heated humidity, it is very important to clean your tubing, humidifier chamber, filter, mask, and headgear. Mold and bacteria can easily build up.
    1. Clean the mask with Citrus II mask cleaner, Citrus II mask cleaner wipes.  or with soap and water (not Dawn dish soap, it is too abrasive) rinse and allow to air dry. This should be done weekly.
    2. Clean the headgear and permanent (or non-disposable) filter with soap and water (not Dawn dish soap, it is too abrasive) rinse and allow to air dry. This should be done weekly.
    3. Soak the tubing and humidifier chamber in 1 part vinegar, 3 parts water for 30 minutes, rinse well, and allow to air dry. This should be done weekly.
    4. Fine filters or disposable filters should be changed every two weeks to monthly. Most of these are white so if they start to turn gray it is time to change them out.
  4. Use nasal strips (can be obtained at your local grocery or drug store).
  5. Nasal irrigation: there are numerous types available by searching online.

I am having some nasal dryness and irritation. Is there a solution?

 

  1. Add heated humidity to your CPAP or BiPAP machine.
  2. RoEzIt®, a non-petroleum based lubricant can be used for nasal dryness and skin irritation associated with Oxygen and CPAP therapy.

CPAP benefits

(brought to you by www.sleepeducation.com)
 
Continuous positive airway pressure, or CPAP, is the most common and effective treatment for obstructive sleep apnea (OSA). The steady flow of air from a CPAP machine keeps your airway open and restores normal oxygen levels as you sleep. This helps you maintain a steady, healthy level of breathing through the night.
 
For many people, the positive results of using CPAP are quick and dramatic. Their initial night of using CPAP may feel like the first good night of sleep they have had in years. Others may not notice improvements right away. It may take time for them to adjust to this new way of sleeping.
 
By working to normalize your breathing, CPAP helps protect you from the severe health risks that are related to OSA. These risks include the following:
 
Heart Disease
Many of the risks involved with OSA are related to how your heart functions. A person with an extreme case of sleep apnea can stop breathing hundreds of times in one night. The pauses in breathing cause drastic changes in your oxygen levels. This puts an enormous strain on your heart and can lead to an increase in your heart rate.
 
Research shows that people with OSA have a higher rate of death due to heart disease. The link is strongest between OSA and high blood pressure. Studies also show that CPAP may reduce these high blood pressure levels in people with sleep apnea. The use of CPAP over an extended period of time may help protect you from heart problems and reduce your chance of dying from them. These problems include the following:
  • Congestive heart failure
  • Coronary artery disease
  • Irregular heartbeat

Stroke

Recent research has also shown that sleep apnea greatly increases your risk of stroke. A stroke is a sudden loss of brain function. It occurs when there is a blockage or rupture of one of the blood vessels leading to the brain. Stroke is one of the leading causes of death and long-term disability in the U.S.

Studies show that people with OSA are two to four times more likely to have a stroke than people who do not have sleep apnea. The consistent use of CPAP can reduce this risk of stroke for a person with OSA.
 
Diabetes
OSA is also related to glucose intolerance and insulin resistance. These are factors in type 2 diabetes, the most common form of diabetes. Treatment with CPAP can improve insulin sensitivity in people with type 2 diabetes and OSA.
 
Motor Vehicle Accidents
Having sleep apnea can make you up to 15 times more likely to be involved in a deadly motor vehicle accident. The daytime sleepiness caused by OSA can make it hard for you to stay awake while driving. Treating sleep apnea with CPAP reduces your risk of being in an accident.
 
In addition to reducing the health risks related to sleep apnea, CPAP provides other benefits that contribute to your overall health and well-being. It helps you in the following areas:
 
Alertness
CPAP can reduce the sleepiness and daytime fatigue that are common symptoms of sleep apnea. By preventing pauses in breathing as you sleep, CPAP restores a normal sleep pattern and increases your total sleep time. This helps you to wake up in the morning feeling more refreshed.
 
Concentration
Using CPAP may enable you to think, concentrate and make decisions better during the day. This can reduce your chance of injury at work and improve your productivity.
 
Emotional stability
People who use CPAP often show reduced levels of depression and higher ratings of their quality of life.
 
Medical expenses
Sleep apnea causes you to visit the doctor more often and have higher annual medical expenses than a person without OSA. These annual expenses decrease when you use CPAP to treat sleep apnea.
 
Snoring
By keeping your airway open as you sleep, CPAP can also reduce the sound of snoring. You may not notice this because many people are unaware of their snoring levels. But your bed partner will benefit greatly from the quieter sleeping environment.
The key is to continue using CPAP all night, every night and during every nap. You put your health at risk if you only use CPAP part of the time. Partial use also keeps your body from getting fully adjusted to the breathing assistance.

Get the maximum benefit from your CPAP by making a long-term commitment to improve your sleep and your health. Talk to your CPAP supplier if you need help with your CPAP treatment. Contact your sleep doctor if you experience any ongoing problems.

 

12 Tips for Using CPAP

 (brought to you by www.sleepeducation.com)

  1. Begin using your CPAP for short periods of time during the day while you watch TV or read.
  2. Use the "ramp" setting on your unit so the air pressure increases slowly to the proper level.
  3. Use CPAP every night and for every nap. Using it less often reduces the health benefits and makes it harder for your body to get used to it.
  4. Newer CPAP models are virtually silent; however, if you find the sound of your CPAP machine to be bothersome, place the unit under your bed to dampen the sound.
  5. Make small adjustments to your mask, tubing, straps and headgear until you get the right fit.
  6. Use a saline nasal spray to ease mild nasal congestion.
  7. Take a nasal decongestant to relieve more severe nasal or sinus congestion.
  8. Use a heated humidifier that fits your CPAP model to enhance your breathing comfort.
  9. Try a system that uses nasal pillows if traditional masks give you problems.
  10. Clean your mask, tubing and headgear once a week.
  11. Regularly check and replace the filters for your CPAP unit and humidifier.
  12. Work closely with your sleep doctor and your CPAP supplier to make sure that you have the machine, mask and air pressure setting that works best for you.
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