CPAP Machine Buyer′s Guide for 2020
Presumably, you are reading this 2020 Buyer′s Guide about CPAP machines because you are considering purchasing a CPAP machine for yourself or someone you care about. Perhaps you have been recently diagnosed with sleep apnea. Maybe you are pondering acquiring a replacement for your current device or thinking about purchasing a second machine for back-up or travel. This guide has some information for you whatever your current needs.
One thing is sure: anyone shopping for a CPAP machine is looking for value. Every corner of the healthcare industry is full of talk about value these days. Doctors, hospital executives, insurance companies, government agencies, and legislators continuously talk about the need to focus on value in health care delivery in the United States. Value is simply the trade-off between cost and quality, between price and features. You are here because you are pondering spending some of your own money on a healthcare product. You are here because you are committed to the long term health of yourself or someone you love.
Selecting a CPAP or AutoPAP machine is not a one product fits all proposition. All six machines in this guide are winners, but they will not each be a home run for everyone. This guide covers machines ranging from an entry-level, single-mode machine to feature-rich devices that can run 365 nights a year at home and on the road. Use this guide to determine which CPAP machines could bring you the most value and the most significant return on your investment in 2020.
Which Features Do You Have To Check Before You Buy A CPAP?
First, let's review the questions to get answered when evaluating a CPAP machine for your specific sleep therapy needs.
What modes does a machine have?
Fixed level CPAP (also known as manual CPAP) delivers constant pressure throughout use. If the prescription says CPAP of 6, the machine delivers CPAP of 6 throughout the night. AutoCPAP (also called AutoPAP or APAP) machines monitor your breaths for flow obstructions and increase or decrease the level of pressure throughout the night to continually eliminate obstructions. Some machines can only do manual CPAP but all AutoCPAP machines can do AutoPAP and manual CPAP. The prescription from your provider must request AutoCPAP for you to use that mode.
How much does it cost?
When you purchase anything cost is a critical factor in your value assessment. CPAP and AutoPAP machines are available in a wide range of prices. Newer models cost more than older models. Devices that have more features tend to cost more. When evaluating CPAP machines, consider what accessories you need for quality therapy and what accessories are included or require an additional purchase. A humidifier is an example of an accessory to consider carefully. Is humidification essential to you? Is the humidifier included or does it require an extra purchase?
What is the size and weight?
Weight and size may not matter much if you always plan to leave the machine at your bedside. Many people, though, like smaller machines even at home because they blend in with the environment in the bedroom. Other people do not care. If space is limited at your bedside, size can be a concern. If you travel, size and weight can be a consideration. If you take long airplane trips and know you will be sleeping on the plane, size and weight are important attritubtes.
Some devices have built-in power supplies that reduce the number of cords and parts. Many have external power bricks. The weight of the external power supply should be considered as part of the total weight of the machine since it is an essential component.
What about humidification?
One of the most common complaints about CPAP therapy is that it can dry out the mouth and nose. Under normal circumstances, air from the environment is warmed and humidified by the nose before it reaches the lungs. When using a sleep therapy machine, a higher flow of dry air is delivered to the mouth and nose than during normal breathing. The nose often cannot keep up with adequately warming and humidifying the flow by itself. When a humidifier is used, the air flow picks up water vapor before it arrives at the mask.
When using a humidifier, it is generally necessary to fill the water tank with distrilled water each night and clean it each morning. Also, as the warm, moist air travel throughs the CPAP tubing to the mask, it cools and water vapor condensates out. Cooling can cause water to accumulate in the tubing. How much this happens depends on the temperature in the room. Some machines include an option to use a heated circuit. The heated circuit monitors the temperature of the gas flow and adjusts to avoid condensation.
Humidifiers always add weight but may or may not add bulk to the machine. Some humidifiers are integrated into the machine shell and do not add to the size of the device. Some CPAP machines have also been validated for use with waterless humidification systems. These waterless systems use heat moisture exchangers, which are sometimes called artificial noses. HMEs collect water vapor from exhaled air. The stored water vapor is picked up by inspiratory air flow traveling up the circuit to the mask. HMEs add a bit of weight to the circuit. If the air is quite dry, HMEs may not pick up enough water vapor to be effective. HMEs also must be replaced at regular intervals once removed from the package.
What quality of comfort features matter to you?
The current generation of CPAP machines all contain some features designed to make therapy more comfortable. In 2020, you can expect your CPAP machine to include a pressure ramp option. The basic ramp feature initiates therapy each night at a low pressure and gradually increases it over a set period. The pressure ramp lets you acclimate to CPAP while you are settling into bed.
All the machines in this guide include a basic pressure ramp, but there is some differentiation between devices with some having more complex, ramp configuration choices. Some machines, for example, may keep the pressure steady at a very low pressure indefinitely until they detect the first flow obstruction. Others initiate the ramp-up period automatically when they detect the first breath from the user.
You should expect any auto-PAP machine purchased in 2020 to have an expiratory pressure release feature. During CPAP therapy, the pressure holds the airway open so that when you breathe in air moves into your lungs without any obstructions. During exhalation, that pressure is still there. Some users find it uncomfortable to breathe out against the pressure, especially if they are new to sleep therapy or if the required pressure on inspiration is high. Expiratory pressure release detects exhalation and drops the pressure slightly to make exhaling feel more natural.
Each of the auto PAP machines in this guide has an expiratory pressure release option, and each name this feature something different. Some of the devices also have enhanced variations in the algorithms that do more than drop the pressure during exhalation. Fixed level CPAP therapy does not require software that monitors the user breath to breath so expiratory pressure release may not always be included on machines that only provide fixed level CPAP.
Will it be quiet enough?
CPAP machines pull in air from the room using a motor. All of them generate white noise. The air travels at a high velocity through the tubing to the mask, creating a bit of a mini air tunnel that could add additional noise. Many people enjoy white noise at night and are entirely unbothered; for others, it can be a significant source of concern.
Machines that have a noise level rated at < 30 dBA are quiet enough for most people. If the acoustics in your bedroom amplify sound or you or your partner are particularly bothered by noise during sleep, look for machines that have a dBA rating 25-28. Smaller units, especially those designed for portability, need 1.7 to pack lots of power into tiny motors; as a result, they tend to be louder than full size machines.
What are your travel plans?
Do you travel a lot? Do you need to sleep on airplanes for long overseas trips? If you do travel, will you always have access to a power supply during sleep? Do you need an external battery source? How vital is humidification to you during travel? These are all questions to ask yourself as you determine how to ensure you get your sleep therapy on the road. If you need to sleep on airplanes, verify that the machine has been FAA approved for in-air use. If you are traveling overseas, check that it can adjust for voltage and be used with a power adaptor for another country.
Does your medical insurance cover CPAP machine purchase?
Most incurance companies cover home use CPAPs and require compliance report to make sure you need this device and are using it everyday. Some company only cover CPAP rentals.
If the insurance covers CPAP machine purchase, you may shop for one from your local DME (Durable Medical Equipment) stores, who usually can bill your insurance directly. Or you can shop online like our dealers Respshop.com. We do not bill insurances directly but our invoices are accepted by most insurance companies. Online dealers will accept email/fax prescriptions, or they can call your physicians directly for the prescription record, plus the machine settings. Typically you can save 50% or more by shopping online. Either you shop locally or online, you are still responsible for deductbles, co-pay or co-insurance. Since local store prices are much higher, often time you may find you need to pay more copay/duductable/co-insurance than the machine price online.
If your insurance company only covers CPAP rental, usually you get a used machine and pay monthly fees up to 13 months. After that the machine become your property (double check your plan for details). We advise you re-check the effectiveness of the CPAP theray after one month use. If you find the machine is helpful and you plan (or your doctor wants you) long term use, it would save you more if you buy a brand new machine from Respshop.com.