Frequently Asked Questions

CPAP/BIPAP Questions

A: Most people continue to sleep using their CPAP devices for the duration of their lives, even though their pressure setting may need to be adjusted downward due to improvements in the severity of their sleep apnea. However, some no longer need treatment because they lose weight; experience changes in their muscle tone; undergo oral surgery;  or have their airway structures “trimmed” down by a physician.

A: BiPAP machine (also referred to as BiLevel or VPAP) delivers two separate and distinct pressures. A higher pressure is need for inhalation, while a lower pressure is needed for exhalation. The machine alternates between the two pressures which are set per the doctor’s order or prescription. A prescription for a CPAP machine may not be used to purchase a BiPAP machine.

A: Bipap (Bi-Level Positive Air Pressure) machine has multiple uses such as:

  • Regulating a preferable amount of air pressure for breathing
  • A suitable treatment method for sleep apnea
  • Integrated with an optional breathing timing feature

A: A Bipap machine furnishes a regulated supply of air pressure directly to the throat of a patient suffering from obstructive sleep apnea. Unlike its CPAP counterpart, a Bipap machine monitors the breathing sequence in a patient and optimizes its air pressure flow as per their requirements.

A: CPAP – Continuous Positive Airway Pressure – Single fixed pressure for a continuous pressure flow.

APAP – Auto-Titrating Positive Airway Pressure – This device is set within a range of pressure (usually 4-20 cm H2O) and monitors changes in breathing then automatically adjusts pressure to compensate for the pauses in breath.

BiPAP – Bi-Level  Positive Airway Pressure – Two fixed pressures, one for inhalation, one for exhalation

A: When CPAP therapy is working, a CPAP user may notice the following:

  • Greatly Improved Energy
  • Lower Fatigue
  • Lower Blood Pressure
  • Less Brain Fog
  • Decreased Need for Caffeine
  • Reduced Drowsiness While Driving or Bored

It won’t be hard to figure out if CPAP therapy is working. There will be many very noticeable differences in a person’s mood and energy levels if CPAP is working. Here are some signs CPAP is not working:

  • Continued Snoring, Even When Using the CPAP Machine
  • Feelings of Being Tired During the Day
  • Blood Pressure Remains High
  • Falling Asleep While Driving or Bored
  • Continued High AHI Levels

The truest way to tell if CPAP therapy is working is by tracking the AHI reading within the CPAP machine’s data. If nightly AHI readings are higher than 5, it’s a sign therapy isn’t working. An AHI reading below 5 is considered normal. If CPAP therapy isn’t working, it’s not always a sign therapy should be discontinued. Most of the time, a doctor or medical professional can make changes to therapy such as increasing therapy pressure or recommending a change like positional therapy to help bring down a high AHI. Many times, adjustments to CPAP therapy can fix the problem, and help get back on track.

A: Using a CPAP machine treats OSA, it is not a cure. It is very important to remember that this is therapy and therapy is continuous. CPAP therapy is still today, the most recommended and the most effective treatment for obstructive sleep apnea.

A: CPAP stands for “continuous positive airway pressure,” and it is considered to be the most recommended and effective treatment for obstructive sleep apnea (OSA). A CPAP machine provides air at a constant prescribed pressure through a tube and CPAP mask, which patients suffering from OSA to maintain uninterrupted breathing while sleeping by holding open their airways.

The pressure of the air is determined during your sleep study and your doctor will prescribe you a CPAP machine at that pressure. CPAP therapy is traditionally provided through a nasal mask that seals around the nose. However, more innovative and comfortable options are available and advances in the delivery of CPAP therapy are continually occurring. For instance, CPAPs with FLEX or EPS technology will offer you exhalation relief. APAP, BiPAP and Bi-Level machines offer various levels of pressure throughout the night and exhalation relief.

A: All new machines these days are extremely quiet compared to older model machines. Patients will hear the noise from the air venting out of their CPAP masks before they will ever notice the noise from their CPAP machine. This is why it is recommended that when you shop for a new machine, look for other features like size, comfort features or the option of an integrated humidifier.

CPAP and Humidification Questions

A: Most CPAP and Bi-level (BiPAP) machines today are designed to operate on both AC and DC battery currents. In the United States, the AC current from wall outlets is 110 volts and most batteries produce 12 volts of DC current. Overseas, the AC current is usually 220 or 240 volts.

A: All of the masks are standardized so that any mask will connect with any machine. There are however a few masks that are not recommended for use with Auto CPAP machines. The ComfortLite by Respironics is not recommended with Auto CPAP’s because of the way the machine senses when you are having an apnea occur. Also, it has been said that with pressures over 12 cm of H2O, nasal pillow style masks may become uncomfortable for the user because of the high pressure being applied directly inside the nostrils.

A: If you are purchasing a CPAP Machine, a CPAP Humidifier, or a CPAP Mask, we need a copy of a prescription written by your doctor. A sleep study report does not qualify as a prescription. A prescription is NOT required if you are purchasing any other products.

A: The only care you are required to do for machines is to clean or change the filters at the air intake of the machine to keep the internal parts from accumulating dust. Here are some more tips on caring for your machine:

  • Keep the area around your machine clean and be sure to remove all dust. This will ensure that  you continue to receive optimum air quality.
  • Keep the air intake of the machine unblocked. Curtains, bedding, and papers can easily block the air intake and reduce the airflow to your machine.
  • With most machines, it is easy to spill water from the humidifier into the machine and cause damage. Therefore, if you have a humidifier, avoid picking up your machine when the humidifier is attached. Instead, empty the water from the chamber every morning.
  • We highly recommend that you take your machine into Feeling Great’s CPAP clinic every six months to have it re-calibrated and cleaned by one of our certified CPAP clinicians.

A: Below are some tips for “easy traveling” with your CPAP device.

If you are flying:

  • Don’t check your CPAP machine, because it can easily get broken. Rather, take it with you on the plane; it will not be counted as one of your “carry-on” bags. It is also a good idea to put a copy of your prescription in your CPAP bag, so it’s always handy if you need it.
  • Call your airline ahead of time to find out if they have any instructions or special procedures for bringing your CPAP machine on the plane with you, and for getting through security.
  • Most airlines do not allow passengers to use their CPAP devices during flights. If you need to make special arrangements, call your airline ahead of time.

If you are driving or camping:

  • If your machine has the ability to run off of 12V (check your owners manual) then you will be able to run your machine off of either a battery, or plug it into the cigarette lighter adapter in your car / RV if you purchase the proper cables.
  • We sell battery adapter cables for those who wish to bring their CPAP camping in the wilderness. You’ll find these in our online store.
  • A 12V deep cycle marine battery or a motorcycle battery are recommended for the longest life between charges. The life span of the battery depends on its rating and what your pressure setting is on your machine.

A: Your machine will come with a six-foot hose, power cord, at least one filter, and manuals. Most manufacturers include a carrying case which is designed specifically for their equipment. Your machine will not come with a delivery system or mask. CPAP masks must be purchased separately. You’ll find more details and specifics on all of our CPAP / BiPAP equipment in the “Shopping” section of this website, under the “CPAP Machines” sub tab.

A: You should always use distilled water in your humidifier to prevent the buildup of mineral deposits on your water chamber. This will significantly prolong the life of you humidifier.

Mask and Supply Questions

A: If you are purchasing the same mask that you already have, then somewhere on your existing mask there will be a size indication, usually a single letter (M for medium, etc.). If you are feeling adventurous and purchasing a new style mask, then the best option is to call us and request a sizing gauge for the mask you are interested in. We have sizing gauges for many of the masks that we sell that we can send you at no cost. The other option would be to come see us if you are in the area and we can fit you, or if you are not in our area, then visit a local homecare dealer and see if they will be able to size you for a mask.

A: The best way to clean your mask is to use a product that we sell called Citrus II CPAP Concentrated Cleanser. This cleaner disinfects your mask without breaking down your mask cushion. Otherwise you can use a MILD soap that is NOT anti-bacterial. This is because the anti-bacterial soap will break down you mask cushion significantly faster. Tubing can be cleaned using a mild vinegar water solution (1 part vinegar, 3 parts water) and swishing is back and forth through your tubing. You can also use the CPAP Tube Cleaning Brush that we sell to assist you in the cleaning process. Water chambers can also be cleaned with the vinegar water solution.

A: Using the right mask is essential to the success of your treatment. You will need a mask this is comfortable and fits properly. It should form a good seal on your face so that air doesn’t leak (this would be uncomfortable and make your therapy less effective). A nasal mask which covers the nose is the most common. However, some people breathe through their mouth when they sleep. In this case, a full face mask that covers both the nose and mouth is the best option. Another option would be a nasal mask and chinstrap. This will prevent the jaw from opening during sleep and still provide for effective therapy.

A: Unfortunately, our faces are designed differently, and no mask will seal 100% of the time, because air will look to escape via every nook and cranny. However, you’ll want to get the best fitting mask and adjust your headgear properly to have the best seal. Also, before using your equipment make sure your face is clean and free from moisturizers, make up, or creams.

A: There are many methods available. Most manufacturers of CPAP masks include cleaning instructions in the packaging. Alternatively, we recommend that our patients use a solution containing one part white (distilled) vinegar and two parts water. Simple soak your masks for 15-20 minutes and then dry it on paper towels. This is a great  – and inexpensive – way to disinfect your mask!

A: Use the following as guidelines, because they adhere to most insurance carriers’ requirements.

  • Once a Month – Face cushion/nasal seal cushion, nasal pillows, device filters.
  • Every 3 Months – Mask (excludes headgear) and tubing.
  • Every 6 Months – Headgear, chin strap, humidifier water chamber.

Extra supplies are available for self-pay purchases.

A: For filters, if you are using the white, disposable filters, you should change them whenever you start to see them get fairly dirty. Remember, this is the air you are breathing at night! If you have the foam, reusable filters, then you should rinse them out and let them air dry at least once every other week. Medicare guidelines suggest that you replace your tubing every 30 days. This may be a little too often so we recommend replacing your tubing once every three months. This is because dirt and bacteria can build up in your tubing and that can cause you to become ill. Water chambers should be replaced at least once every 6 months.

A: After cleaning your tubes and hoses in warm water (don’t use soap in the water or you may be blowing bubbles out of your tube!) and rinsing them thoroughly, you can dry them by leaving them alone for a while or using one or more of the techniques listed below.  It’s a good idea to have two hoses so you can rotate them as necessary.

  • Spin the tube gently. The centrifugal force pulls the water to the outside of the tube.
  • Tie a fishing weight to a nylon string, paper or cloth towel, or other fabric and pull it through the tubing.
  • Set a hair dryer on low and blow it through the connector hose (you can even duct-tape it to the end if you’d like to leave it there for a while)
  • Place the hose in a freezer for a couple of hours. The droplets will freeze and fall off the hose surface when you flex it from the outside.

A: If you are purchasing the same mask that you already have, then somewhere on your existing mask there will be a size indication, usually a single letter (M for medium, etc.). If you are feeling adventurous and purchasing a new style mask, then the best option is to call us and request a sizing gauge for the mask you are interested in. We have sizing gauges for many of the masks that we sell that we can send you at no cost. The other option would be to come see us if you are in the area and we can fit you, or if you are not in our area, then visit a local homecare dealer and see if they will be able to size you for a mask.

A: Air leaks from the mouth whenever the mouth is opened during CPAP therapy. This occurs for many reasons, but a very common one is due to nasal irritation from the CPAP airflow.

The correlation between the lack of humidification and mouth leaks is a topic being heavily researched. Studies are now being conducted on the hypothesis that a large amount of mouth leakage is caused by the following cycle:

• CPAP therapy is used with ineffective or no humidification.
• The nasal membranes are unable to adequately condition the increased airflow and after a few minutes the airway and nasal passages become dry.
• To remedy the dryness and obtain moisture, the body uses the mouth to breathe.
• CPAP air follows the path of least resistance and leaks out of the open mouth.
• The air leaking through the mouth causes more dryness.
• Patient wakes up feeling tired with significant dryness in mouth and dry, swollen nasal passages.

The answer to this cycle is humidification. If the mouth continues to open during sleep, a chinstrap may be needed to hold the jaw up so that the mouth can close. If mouth breathing continues, a full face mask that covers the nose and mouth is indicated.

Oxygen Concentrator and cylinder Questions

A: It is mandatory to clear your oxygen concentrators once or twice a week.

A: Oxygen concentrators filter the 21% oxygen contained in the ambient air. It furnishes this pure and non-nitrogenous oxygen to patients suffering from breathing problems. To attempt this task, the oxygen concentrator moves the purified oxygenated air into the beds via a compressor.
Furthermore, it evenly distributes this pure oxygen through the hoses inserted into the nostrils.

• Secure oxygen cylinders in your vehicle so they do not roll or bump against other cylinders or objects.
• Crack a window in the vehicle to increase ventilation.
• Keep cylinders out of direct sunlight.
• Do not store cylinders in the trunk of a vehicle.
• If you will be traveling outside of our service area for an extended amount of time, please call us. We will help you coordinate appropriate oxygen services while you travel.

A: No, there are underlying differences between an oxygen concentrator and a ventilator. Some of the key differences between these two medical instruments are as follows:
• The primary purpose of a ventilator is to aid in the respiratory process. However, an oxygen concentrator does not help in respiration but only facilitates pure and filtered oxygen to patients who have hypoxia.
• A ventilator is an invasive medical device while an oxygen concentrator is noninvasive in nature and usage.

A: The other methods of providing long term domiciliary oxygen are cylinders delivered to the patient’s home (the most widely used method) and liquid oxygen in a domestic tank replenished twice weekly in some countries. The capacity of the oxygen cylinder can range from 40- 3445 liters capacity and cost between Rs. 2,625- 12,215. The cylinder can provide oxygen at 1 LPM for 11.3 hrs (e.g.680 litres capacity cylinder) or 4 LPM for 2.8 hrs. Thus the overall running costs turn out to be much higher than the oxygen concentrator. The use of a liquid oxygen system has been investigated in the United States. The apparatus consists of a portable “walker” and a reservoir which contains a supply for three to four days. Regular deliveries are required as for cylinders and this contributes appreciably to the cost.

A: Yes, oxygen concentrators are extremely beneficial during the Covid-19 pandemic crisis. It helps people suffering from breathing ailments by oxygenating their lungs.

A: An Oxygen Concentrator aids in the appropriate delivery of pure oxygen from the atmosphere directly to the nasal cannula of a patient suffering from breathing distress. This medical device filters breathable oxygen from the nitrogen-rich ambient air and oxygenates individuals who have problems in inhaling and exhaling fresh air.

A: It is mandatory to clear your oxygen concentrators once or twice a week.

A: Oxygen concentrators filter the 21% oxygen contained in the ambient air. It furnishes this pure and non-nitrogenous oxygen to patients suffering from breathing problems. To attempt this task, the oxygen concentrator moves the purified oxygenated air into the beds via a compressor.
Furthermore, it evenly distributes this pure oxygen through the hoses inserted into the nostrils.

1 Remove the regulator by loosening the T-handle.

2 Slide the pegs out of the holes on the valve post and remove the regulator.

3 Remove the tab from the valve post on the new cylinder

4 Make certain there is a washer on the large post on the regulator.

5 Attach the regulator to the cylinder by slipping the regulator over the valve post of the cylinder.

6 Align the pegs located on the inside of the regulator yolk with the holes in the valve post.

7 Slide the regulator forward so the pegs go into the holes

8 Turn the T-handle on the regulator until it is tight. If the handle is not tight enough or if the washer is not in place, the cylinder will leak when the valve is opened