Home My Experience with CPAP

Caveat

I am neither a doctor nor a medical professional.  What follows is my personal experience.  Since I am an engineer by trade, the following descriptions are somewhat technical.  If you need more or do not like what you see, there are plenty of professional web pages that will love to have you buy their products.  A little knowledge is a terrible thing.  No knowledge is worse.

My experience in life is that taking any expert advice will cost you. You will either not like what you get or you are just too stupid to know that there are always alternatives.  Arm yourself early.

My History

I have always had sleep problems.  When I was a kid; I went to bed at 8 pm and woke up at 4 am.  I would then go out and hang around the train tracks for a few hours before getting ready for school.  No.  Someone else burned the Butler roundhouse before I even knew there was a roundhouse.

I tried sleeping pills, but they have serious side effects.  Even prescription ones.  The anti-depressant, Thorazine, I took in high school ruined my life.  For example, after I insisted on attending as the school representative to a formal dinner, I fell asleep with my face in the mash potatoes.

As I got older, the sleep problem got worse.  I thought maybe I had narcolepsy or it was another permanent side effect from the Thorazine (like my chewing on things, the vision problems, or the dry mouth).  I would fall asleep anywhere, anytime.  I could fall asleep in rush hour traffic.  I could fall asleep mid-sentence -- when it was my sentence.  I had a wonderful friend, Michelle.  She would sit next to me and kick me when I started snoring in a big meeting or when I dozed off in a group meeting.  I do not know if my problem with remembering names is related to this.  I do not think so but she would fill in a name when I stopped and tried to recall one.  She kicked me hard when I forgot my own name.

I finally told my doctor about the sleep problems and he sent me to a sleep disorder doctor.  The title is probably not somnambulist.  In any case, that doctor sent me to have a sleep study.

Sleep Study

The original sleep study was obviously abbreviated by the HMO.  I went to the study office, they wired me with a harness, gave me a box and sent me home to sleep in my own bed.  The result of this, other than many tangled wires, was a prognosis of sleep apnea.  The doctor prescribed a CPAP for me.  At least no narcolepsy.  I was just so fat that when I fell asleep, my throat muscles relax and my fat throat closes on itself.  This causes me to choke (making a distinctive snoring sound).  The lack of oxygen to my brain causes me to wake up, opening my throat again.  This becomes a repetitive process happening dozens of times per hour.

The identification of sleep apnea is relatively new.  This oxygen deprivation causes many problems, including death.  People who died from stroke when they woke up or while they were asleep were said to have had a stroke.  True, but not really indicative of the problem.  The anxiety caused by lack of sleep and ability to concentrate causes high blood pressure amongst other things.  So about 10 years ago, they found sleep apnea as the origin and not a derivative problem causing these heart attacks and strokes.  My father died of strokes.  He had the Sleep Apnea Snore.  His mother died of strokes.  She was seriously overweight.  Maybe it runs in the family.  I do not want to find out.

There are several solutions for sleep apnea:

  1. Ignore the problem, doze off, drive off a cliff or

  2. Surgery.  The insurance companies do not like to pay for this and there are other negative side effects. Or

  3. A CPAP machine.

Constant Pressure Air Pump (CPAP) Description

CPAP? This machine is an electric Constant Pressure Air Pump.  It connects to you with a 1-inch diameter hose and a face mask.  The face mask covers your nose and sometimes more than that. (We shall get there).  Your lungs become inflated balloons.  Instead of a neutral pressure in your lungs, you inflate to a positive pressure and you learn to breath over this pressure.

At first this super-breathing is uncomfortable since when you open your mouth, all the air comes out and you deflate. The experience is negative.  You end up with a negative pressure in your lungs.  You cannot close your mouth because the air is coming out.  After a few times, you learn to not open your mouth.  If you cannot stop this process there is always a chin strap or a face mask that also covers the mouth.  

When the power goes off, you will wake up because you cannot breath.  This is true of the smallest to the largest of masks.  You do not want this to happen.  Some people cannot accept sleeping with a mask, over their mouth or not (We are getting there).

So what now?  I ignored the CPAP request -- for a year.  Then I went back and started over.  This time the sleep test is at Home Sleep on Bascom in San Jose.  They have offices outfitted as bedrooms.  This is an interesting anachronism.  I mean a fully furnished bedroom is not expected on the other side of a business hallway door.  It worked better than a harness at home.  You sleep for 4 hours with a wire harness connected to a brick.  The brick is a radio transmitter relaying your neurological signals to a nearby computer..  Then they set you up with a CPAP and you sleep another 4 hours.  During this second period, they vary the air pressure until you sleep most comfortably.  Then you get a prescription indicating you need a CPAP machine and at what air pressure.  The pressure value is multiple centimeters of mercury like a barometer.  Usually 10 to 14.

It turns out that not only does Home Sleep perform the test; they are also the insurance company designated supplier of the devices.  They supply me with a Respironics Solo. Obviously the cheapest possible model since this is an HMO.

My world gets immediately better.  I mean I can stay awake all day with no naps.  No falling asleep in meetings.  Michelle still has to kick me for names.  I use a waterbed so I do not have to worry about twisting the air hose.  The CPAP is noisy but I sleep sound enough to not hear it.

Inferior Engineering -- History

I also discover that there are multiple brands of these CPAP machines.  Medical industry engineering and quality is far behind the curve.  Most electronic commercial devices have not used separate component assemblies in ten years.  I built things like this while in college 40 years ago.  The Solo electronics is composed of individual components soldered to a circuit board.  Worse than this is they have no concept of consumer-level requirements.  A telephone built like this might last a few days of household use.  Here is the problem.  Components have aluminum wires about 1/16th inch in diameter or smaller.  Soldering these to a circuit board using tin or lead solder (or silver) still makes the component, which is multiple times heavier than the wire, a serious lever to the board.  The board in the Solo CPAP is also inverted so that the components are actually hanging from their own wires.  Can you imagine a worse electrical environment?  I can.  The air pump is basically a 60-cycle motor attached to a diaphragm.  By design this is a vibrating machine.  So now you have electronic components hanging by wires from their soft-metal mounts undergoing constant vibration.  Do you know why they banned aluminum wiring in homes?  Aluminum breaks down under stress or vibration.  Aluminum will crack and ultimately break in the best of environments.  You could not invent a worse design for the Respironics Solo.

2009:  Product engineering has improved greatly.  I guess progress and sales volume do wonders for reliability.  My Respironics RemStar is still running after 8 years.

2011: I now have a Respironics CFlex.  The electronics appear to be state of the art -- including pretty displays and programmable air pressure curves.

Cost

Do know how much they charge for one of these machines?  Between $400 and $2,000 depending on the profit motive of the supplier!  The original design was so deficient that if the device lasted a year, it was probably sitting next to a hospital bed attached to an invalid.

So I get this CPAP and use it and am happy.  Until one day it stops working, I open it up, and I see the part that fell off the board.  A choke (copper wire coil) weighing about 1/4 pound has broken its aluminum lead wire.  I take it back to Home Sleep to get it fixed.  It works for another year before it seriously dies.  Home Sleep orders me a new one.  The Respironics Solo:  a better model -- and I am warned to never take it apart.  They have had too many other engineers complain about product quality.

Doctor

A doctor needs to prescribe a CPAP and the designated pressure.  Make sure you get the prescription paper from the doctor.  For some reason the doctor does not want to release this.  Sort of like eyeglasses from doctors on insurance plans.  The motive is obvious: if they do not give you the prescription, you must obtain glasses from them.  I do not understand the motive of the sleep doctor for keeping the prescription.

Prescription

I have said it above but I need to repeat it.  The sleep study will provide a prescription indicating the air pressure setting you are to use.  This is a piece of paper like you get for pills.   Do not lose this piece of paper.  Like eyeglasses, the doctor with the piece of paper my not want to give it to you because he also wants to guarantee you buy you CPAP from him. It is the law: you get to have the piece of paper!  You might ask before the study if they are going to make this difficult.

Here is the deal.  i had a study done 8 years ago.  The doctor sent the prescription to the insurance company and not to me.  The insurance company sent it to their preferred supplier and I got a CPAP with that setting.  I never saw the paper.  It is now 8 years later.  Like eyeglasses, this prescription expires in two years.  I cannot buy a new CPAP if I need one.  I cannot even buy a new mask without a prescription.  8 years ago, I needed neither.  I just told the CPAP monger what pressure I needed, they turned their back, pushed some buttons and sent me home.  Now. No paper no CPAP.

Germs, In General

I am redundant here but it is necessary.  Germs are microscopic brainless beings attempting to alter your body chemistry.  There are good germs and bad germs.  Here we are only concerned with the bad germs.  If a bad germ is successful, it breeds more of the same and you become ill.  You body is a miraculous entity.  Your liver has a spreadsheet of all the germs which it has encountered.  When it encounters a germ already on the sheet or similar to ones on the sheet, it tells your body to prepare for the worst and to start producing antibodies to kill the invaders.  Little armies enter your blood stream seeking these germs and destroying them.  When the germs are all gone, the armies dissolve and you go back to normal again.  This is so automatic that you rarely know that it has happened unless the germ-killing armies fight to a draw or lose.  Amazing.  Now the germ's perspective.

Germs like nice, warm, cozy, homes.  They go dormant if too cold and die if too hot.  Your body is just the right temperature for most germs.  Refrigerators will not kill germs.  Freezers will not kill germs.  Hot water or cooking at temperatures exceeding 150 degrees will kill most germs.  Alcohol, chlorine, and other chemicals kill germs.  Anything that claims to be "anti-bacterial" will kill some germs.  Antibiotic medicine kills germs -- selectively.    This takes care of the warm.  Cozy?  Nice?

Germs need a home.  Flat surfaces make breeding difficult.  Germs like moisture.  They like nice, warm, moisture with embedded food.  And they are not picky about the food. Why are we talking about germs?

Your CPAP hose and face mask make ideal warm and cozy homes for germs.  As soon as you take off the mask and turn off the machine, all of the germs accumulating from your breathing into the devices start to grow new families.  When you return the next evening, place the mask on your face, and turn on the CPAP, you instantly inhale all of these new families of germs.  Yuch.  It gets worse.


Your nose has little hairs and mucous filters to retard germs entering your throat and lungs.  These are great for normal, every day breathing in normal fresh air.  But your CPAP is not normal.  It forces air directly down your nose and throat into your lungs.  Your lungs are a paradise for germs.  Lots of nice little pockets for safe homes.  Lots of nice warm moisture.  A bio-chem lab could not produce a better paradise for germs than your lungs.

When you have a CPAP your body is always in overdrive to kill new bacterial.  This is where you need to do your job as your body needs all of the help it can get!  Back to the old narrative.

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Nose Health

Nose Health is critical, believe me.  Remember: you are rebreathing the air that is passing through the nose piece.  You want this air to be super-clean.  The germs you left last night really love to grow their germ families in your old  nose juice.  Tonight you will get more sick.  In fact, this is insidious (look it up).  I spent over a month with a cold before I figured out I got better during the day and worse at night.  Keep the nose piece clean or you will have a perpetual cold.

The hose?  When I am sick, I rinse the hose with soapy water every night otherwise I rinse it very irregularly.  I know.  I should wash it daily as well.

Hygiene

Fabric Parts

The cloth parts of the head piece should be washed daily.  In fact, wash the entire thing.  Why?  Your scalp will itch. The perspiration from your head breeds lots of nasty things that you then place in your hair every night.  Keep the headgear clean.

Use regular laundry detergent.  If you use bleach (real chloro), make sure you rinse it well.  I always add a small amount of bleach to every laundry load, more for whites.  Any bleach left in the head piece cloth will make your scalp itch and maybe change your hair color.  In fact, any soap residue will cause you to itch.

Many head pieces no longer have any cloth.  Look for these.

Airway Parts

For the plastic parts and the hose, dish soap, shampoo, or hand soap works just fine.  I prefer the dish soap.  I use Joy brand.  Joy will clean the algae off of concrete so I am sure it will clean the algae off of my CPAP hose.  Antibacterial soap is good.  Anything that kills germs is good.  Sometimes I use mouthwash (Not Listerine!) and rinse well, super well.

I hear that there are two products that you use with care.  The first is Windex because it supposedly fills holes in semi-porous plastic (like PC Screens).  The second is is Dawn brand soap.  Dawn supposedly coats what you are cleaning with a light film.  I do not know if Dawn is unique in this or if it is even true but I have heard it so often that I avoid Dawn.  The optometrist told me to never use Dawn on my sunglasses but any other brand was good.  He was wrong.  I used Joy and it took the color coat off the sunglasses.  Talk about cheap sunglasses (Sam's Club $30).

Warning.  The airway parts (hose, nosepiece, etc.) send air from the CPAP directly into your nose and lungs.  The slightest bit of cleaning product residue will hit the inside of your nose like a bombshell.  The last thing you need when you are ready to go to sleep is to have to get back out of bed and rewash (and dry) your air hose.  Never use alcohol or anything strong.

Filters

Each CPAP has its own filter things.  My Respironics has a gray sponge (with a plastic cover cap -- not the new CPAP).   I leave the cover cap off and have an extra sponge ready.  Removing the plastic cap increases the CPAP noise slightly but it makes the filter more accessible.  Here in the desert, I get  unbelievable amounts of dust in this filter very rapidly.

The Respironics also has a paper filter that the CPAP supplier insisted upon using.  I find the directions indicate using this paper filter only for high allergy and other particulate situations.  These things are not reusable and are expensive.  I gave them up as soon as I read the directions.  I think my desert dust qualifies as particulates but I am used to breathing this dust and a little more in my CPAP does not bother me.  It might bother you and you might want to keep spending the money on these little filters.  Maybe your insurance pays for these.

Remember that your CPAP breathes all of the air that you breath.  If you want your CPAP to last a long time giving you nice clean air to breath, keep the filters clean.  I have several filters to permit the clean one to dry.

Smoke

I am very sensitive to cigarette smoke.  Even though I claim my nose is burnt out, my nose still senses smoke rapidly.  Cigarette smoke will clog your CPAP and its filters almost instantly.  If you are smart enough to have a CPAP,  you are smart enough to not smoke and hopefully you pass this requirement along to any house mates.  I might be overly sensitive but if someone walks past my RV during the night and they are smoking, I choke.  Since nobody should be walking past my RV at night, this makes a reliable although unwelcome burglar alarm.

Antihistamines

Sooner or later you will catch a cold or some other malady that will clog your nose.  This is a disaster for you. For several reasons.  First off, your CPAP will not give you air.  I recommend antihistamines for this.  I use Actifed (hard to get) or Drixoral (not made any more).

Sleep Position

For all people, sleeping on your back with no pillow is the most healthy.   This keeps our back straight and your neck properly aligned with your head.  I could not do this to save my life.  Well, I did once to save my face but it was hard and I cheated: I used a pillow.  Next best is on your back with a pillow.

WIth a CPAP, sleeping on your front is difficult but you can do it if you let your head hang off the top of the pillow.

Sleeping on your side is not healthy in any case but with a CPAP you might find yourself getting tangled in the hose.

I sleep on my front with two pillows and the CPAP hose fitting between them.

When I had my waterbed, positioning was easy but with a mattress, you have to figure out what is most comfortable for you.  But I would try on your back with or without a pillow before you try anything else.

Masks, Etc.

Here it gets complicated.  I suggest you go to a good web site (e.g. CPAP-Supply) and see the choices.  Lots of brands and remember: it is your life your are trying to save.  The agents at Apria or wherever have more choices than they tell you about so when you go to their office, go prepared.  Me: I talked with Mike at CPAP-Supply and he gave me all sorts of help.  I have used the unit he recommended for the last 8 years.

I used what was called the "Breeze" except I removed the metal frame and only use the nosepiece with an elastic band around the back of my head.  My latest works like my modified Breeze and is called the Swift FX.  I wonder who makes up these names.

By the way, my descriptions and terms below do not necessarily match the manufacturer's terms.

Nose Mask

For whatever reason, the hospitals love these.  When I was in the hospital they put one of these on me (I sent for my own unit.  Saved on the hospital bill and saved my sanity).  When I got my first CPAP, they included one of these.  What is wrong with these, you ask?

They need to seal around your nose.  This means that they come in sizes to match your face and nose.  They must fit your nose but not invade your eye area and not go down to your mouth or push up on your nostrils.  If you find one that does all of this, then you have this hose hanging down the front of you acting as a crow bar on the mask.  Worse off, the slightest air leak will drive you nuts -- finding a nose mask that fits perfectly is impossible..  This week it fits, next week it does not. You have heard of the Chinese water torture of a constant drip on your head?  Try to sleep with a tiny, constant breeze on your eyelids.

The mask is visible and although it does not cover your eyes, it obstructs your vision.  Nasty.

You also have a cotton web headpiece that goes over your head and holds the mask in place.  This may consist of a couple pieces of interconnected canvas to a thin cotton cap with straps.  Yuch.  Remember to wash it every morning or your head will itch all the next day.

They have gotten these masks very complicated.  You can get ones with a gel seal to prevent the leaks.  They cost more.  The other price you pay is that they weigh more than the bare plastic mask.  Good luck.

Mouth Open:  Full Face Mask or Chin Strap

I do not need these so my comments are gratuitous.
The chin strap is a novel idea.  Maybe it works.  If I had this problem, I would hate a chin strap.
To me Full Face Masks are just as bad as the nose mask.  But you need one of these if you cannot keep your mouth closed.  WIth any CPAP device, loss of power will wake you up quickly: there is not air to breath any more.  Your reaction is to pull the mask off and gasp.  WIth the full face mask, just opening your mouth will not make power loss better.

Nose Nipples

The most popular one of these (I have a couple) is/was a stainless steel band that goes from the back of your head to your forehead.  At the back of your head is a plastic triangular pad to hold the band comfortably in place.  There is another plastic piece on top to hold the air tube in place.  There is a third piece in the front.  This last is composed of a slide and a triangular tubular piece with two little nipples curved upwards.  These nipples fit into your nostrils.  Different color nipples for different size nostrils.  I love this unit for lots of reasons.

The hose connects on the top and fits into the slider in the front connecting to the nostril piece.  Nothing in front hanging down.  You really do not see the tube or the nose piece: you can read your book or watch TV.  I do not understand the physics but when you put the headpiece on, the nipples fit close to your nostrils: you can breath around them.  When the power goes on, they snug up to your nostrils and flex to make a tight fit.  No eye air.  No leaks.  Nothing.  Great.

Now if you have a head shape not conducive to this thing just fitting over the top, it comes with side straps connecting the back pad to the plastic in front.  These can fit loosely to not bother you but just enough to center the band on your head.  OK?  All of the problems of the mask are gone.  I have one problem.  I keep breaking the plastic slider piece in front.  I think this is an engineering problem on their side but I have found a work-around.  I remove the stainless steel band keeping only the rear plastic  pad, the side bands, and the actual hose end/nose plug piece in the front.  A piece of Velcro on the nose plug and another on the side bands which I glue together and I have an unbreakable working headpiece.  Nothing in front.  Nothing over the top. I can see to read or whatever.  I must be a little careful that I do not pull the hose in a strange direction but otherwise, this works fine for me.

Nose Plugs

If you have just read my Nose Nipples descriptions, you are prepared for the ultimate devices.    Nothing on or over your head.  Nothing on your nose or mouth. Just an air hose with two very flexible tubes terminating each with a little plug (as above) that fits into your nostril.  These look cute on the web page but I have not had the need to try one yet.  If I need a new unit I shall try one of these.

My Requirements

CPAP?  I really need it to sleep.  I need the 12V.  I need the portability.  I need to put it in my backpack when I travel on the city bus.  It is just going to cost me more than because these guys do not have the quality concept of the marketplace.  It sort of scares me to think that someday I may be in the hospital and my life may depend upon inferior engineering.

Humidifier

Humidity is a problem.  The air forced through your windpipe causes dehydration.  This can be mild or severe.  You can get used to it or not.  I needed a humidifier at first.  These are either passive (air sucked across a water surface) or active with water vaporized into the air stream.  Needless to say, if you need a humidifier, the passive one is not the way to go.  The passive humidifier is a tray that you fill with water.  If you can keep from spilling the water, you are better than me.  I jumped up one night causing the water back into the CPAP.  It died -- permanently.  If the water had dumped the other direction, I would have had a good nose full.  Or a bad nose ful.

I live in the desert where the humidifier is necessary, at least for a while.

Initially you may need to put Vaseline in your nostrils.  If this does not help, see the medical supply company and have your insurance authorize an active humidifier.  Some CPAP's (like my CFlex) now come with a built-in/add-on humidifier.  Me: I think my nose just got burned out from the dry air.  My smeller is not so good but  I use the CPAP with no extra humidity at the sea shore.  I need the humidifier in  Las Vegas or I get nosebleeds.

If you use the humidifier, use vapor distilled water!  If your house water leaves mineral rings on your houseware, just think of what the minerals will do to your lungs.

Again, nose health is an issue.  The moisture from the humidifier travels the length of the hose to your nose piece.  This is an additional 6 feet of cozy germ homes.  If you use a humidifier, clean your hose every morning.

12 Volts DC Versus 110 Volts AC

Your household runs on 110v AC current.  Almost all electric appliances operate on this voltage.   Your CPAP expects 110V AC.

RV power is 12v DC.  The RV converter converts 110V to 12v.  This is useful for charging batteries and powering car things inside your house.  An inverter converts 12v to 110V.  An inverter permits you to run household appliances in the car or RV.

If you live in a house, the CPAP operate on 110v AC.  If you live in an RV or sleep in your car, you need the CPAP to run on 12v DC.  The Respironics Solo claims to run on 12v DC.  There is a little plug at the back of the Respironics unit that accepts 12v.  If you need to run on a battery and if you are in doubt, look for the 12v plug.  No plug, no purchase.

Other brands claim to be “12v compatible” which means they will accept an inverter.  This is so useless that you should not buy one of these out of general principle: and never if you live in an RV.

Why is real 12v a problem?  An RV runs off car batteries.  If you go camping, you have a special battery for your CPAP.  You can use your car battery but you might run it dry.  I live in an RV.  I need the 12v or an inverter. The new inverters are pretty efficient, about 90-95%.  This may be acceptable but if you do this frequently, the 5-10% difference means the difference between waking up at 3 am or at 7 am.  I am not in a good mood if a dead battery wakes me up at 3 am.

My Respironics would not work with 12v.  It would work from 13.2v.  I can presume, knowing the general nature of the low-class engineering in these things, that Respironics does not test from a true battery but instead uses the less expensive battery synthesizer (13-18v).  A real battery would need charging on a regular basis and I presume this would be inconvenient to a quality test in a cheap environment.

CFlex:

My latest Respironics has gone the way of many electronic devices: it works off DC voltage and comes with a converter on the line cord.  This means that what I said above about voltage loss does not apply: the unit is designed for 12v DC.  The reason many electronic devices have gone to the converter-in-the-line-cord approach is for safety reason (i.e. Underwriters Laboratory approval).

220v

If you live in a 220v neighborhood, replace my 110v references with 220v.  My Respironics Solo will run on either 110v or 220v and only needs a plug adapter for use in Europe.  But this is NOT true for all CPAP machines!  Plugging in a 110v-only CPAP into an adapter and plugging the adapter into 220v will get you smoke and a frantic search in a foreign place for a new CPAP.

12v Cigarette Lighter Plug

Respironics charges $40-$90 dollars for one of their cords connecting your 12v cigarette lighter plug to the CPAP unit.  I understand that the Respironics cord is 'shielded' explaining charging 15 times as much as it is worth.  Go to a Wal-Mart, Radio Shack, or a car parts store and buy a cord for a radar detector.  The cord is just something to convert the cigarette lighter plug to the mini-jack required by the CPAP.  Respironics has caught onto people doing this and have designed the plastic around the jack of new models such that some of the store-bought plugs do not fit.   You can also buy the more expensive voltage converters that have multiple voltage settings and multiple plugs.  Multiple plugs are OK because not all radar detectors have the same plug.  The different voltage settings however are a drawback: this puts the current through a converter.  The converter I tried seemed to randomly drop voltage causing the CPAP to need re-plugging.  If you use a lower voltage or reverse the polarity, you may burn out your CPAP.  Also, watch the wire gauge of the product you buy.  A radar detector can use very thin wire.  The CPAP needs a little heavier wire than this or the voltage drop in the thin wire will cause problems.  And, of course, some CPAP machines do not accept 12v in the first place so for you there is no problem. 

My recommendation: Buy the inverter and do not mess with 12v to the CPAP itself.

Uninteruptible Power Supply (UPS)

Now you are running with the big dogs.  You can  buy an Uninteruptible Power Supply (UPS) at Costco for about $100.  I have several: one for my TV/DVD, one for my computers, and one for my CPAP.  Why? If the power to the CPAP goes out for any reason, you will not sleep.  Once you are used to a CPAP, sleeping without one becomes impossible or at least you wake up with a sore throat.  The UPS is a battery/inverter in disguise.  As long as the UPS is happy with the house electricity, it passes that along to your devices as found.  But if the UPS gets unhappy with the house power, the UPS switches to its own battery.  When the house power is restored, the UPS recharges the battery and gives you house power at the same time.  Obviously the higher price UPS gives you a bigger battery that lasts longer before you have nothing at all.

I like a UPS because it includes a surge protector and makes sure that a brownout does not burn up my equipment.  $100 is cheap insurance for a long life of your CPAP and unbroken sleep because your house power burped.  Before I bought the UPS for my CPAP I ran an extension cord from the inverter in my car into the house to the CPAP when the power failed.  A couple times of running the cord in the middle of the night convinced me to have battery power inside.  Remember, I live in an area where power irregularity is the norm.

Downside: when my UPS is using battery power, it beeps.  Maybe you can sleep through the beep but I cannot.  But then I have at least 4 things beeping as soon as I lose house power.  This many things beeping -- not in cadence -- should wake anyone up.  Make sure your UPS has a mute option.

CPAP Suppliers

I have had one good experience with a supplier and 2 bad ones.  The supplier is probably not of your choice.  Since the insurance company will generally pay for the unit, they select a supplier.  The supplier will have his own favorite brand.  You may have to argue to get the brand you want.  His preference is probably determined by his profit markup.

Caveat:   The world changes.  Different people have different experiences.  Different offices of the same company have different world views.  My experiences over the last ten years  are my own and after ten years might be quite different if I started new today.

Bad Guys

Noah's Ark (found by Yahoo search online) is just bad news -- avoid them
When they say they have a no-return policy – they mean it even after they promise to make an exception for you.

Home Sleep Diagnostics, Now Sleep Med, is even worse. 
See my permanent grudges page for them (Home Sleep/Sleep Med)

Apria
2001:  I just got a new Respironics from Apria .  This is also a schlock place.  They gave me part of a headset and it took some serious problem solving to get the remainder.  These people really have no concept of what they are doing.  Does someone have to die?  My insurance company has paid $1,200 for a second-hand CPAP that can be purchased new off-the-shelf for $400.  Did you ever wonder why your insurance is so high?  Oh.  It took 6 months to get this unit with new insurance, new doctors, new suppliers, etc.  And then April found a way to escalate their profits!  They charge the insurance one month's rent prior to presenting the bill for the unit.  The claim is that many people may not continue usage.  Right.  Every doctor, Apria, and the test center all know that I am just going through the process because my old CPAP was stolen.  They all know I am not renting on a trial basis.  This is just a way for Apria to make more money and my insurance premiums to go up next year.

Oh.  And I have dealt with the El Centro, Phoenix, and a Silicon Valley offices.  They do not talk to each other.  They want serial numbers each time because they do not have a database for this.  Walk into the wrong store and it may be a good idea to have the receipt and papers from the original unit if you want service from Apria.  And they wanted my Social Security number or they would not service me in the future.  This is a threat?  I avoid them like the plague.

2011:  Something has changed.  I have dealt with the El Centro Apria office and find good people willing to help.  You cannot call them on the phone.  Even when you call the "local" number, you get switched to their corporate office  I got much better results walking in the door.  I cannot speak for the rest of Apria but if their corporate phone agents are any indication, you are on your own.

2012: It is worse than I thought and you are on your own.  Maybe you cannot blame the local office.  i found the El Centro office very helpful.  But the Apria company is just plain bad news.  They sell seconds and broken items as new and charge your insurance company premium prices.  For example, I now have Medicare.  Like many insurance companies, Medicare has been convinced to use a rent-to-own contract.  This prevents people from accepting a CPAP and then selling it on eBay.  In my current Apria situation, they sold me a "new" CPAP with a used humidifier.  The amount charged comes to almost exactly 4 times the amount as if it were bought directly from CPAP Supply.  I exchanged the "new" CPAP for a used one several months into the rental contract.  The "new" unit randomly lost pressure.  The used one (for which Medicare is still paying as if it were new), seems to work just fine.  The humidifier leaks water onto the bottom of the CPAP unit; the floor, the table.  Anything it sits on.  I have tried very carefully to fill the humidifier to the indicated maximum fill level.  About half way there the leak starts.  I have looked for the leak hole but have not found it.  I must presume that Apria also sold me (Medicare) a defective humidifier.

Then there is the new mask every six months and new face things every three months policy.  After the first 3 months, the national Apria called me and asked what mask I needed face parts for.  I told them.  The first agent was so rude that I gave up.  A second agent called.  More polite but obviously not more honest.  I received overnight from somewhere the parts.  Of course they were broken and unusable.  But Medicare got billed as if they were new and at twice to three times the price available elsewhere.  I mean hundreds of dollars for a few broken pieces of plastic.  This was in June.  In December they called me back and asked if they could defraud Medicare by sending more overpriced and broken parts.  Sorry, Apria,  I hate fraud so much that I will buy my own equipment and keep you from further defrauding my Medicare.  And why did you not call me back in September when the 6 month period expired?  You would have gotten the same response but according to insurance regulations you could have tried to cheat Medicare out of hundreds of more dollars.

Bottom line: If you have any sense of honesty and integrity, ditch Apria and find an honest supplier.

Good Guys

CPAP Supply

The one place that seems really good to me is CPAP Supply in Washington.  I found them on the web in a Google search.  Mike there gave me a good price, found a good unit for me, and shipped it UPS: I had a good unit in 2 days!.  Website: CPAP-Supply.com.

2009 Notes

I just heard from my cousin who just invested in a CPAP.  She found these pages interesting and helpful.  I made a few minor changes to the text above but not many -- but I added a fair amount.

I had another sleep study, this time in a hospital with a ward for sleep studies.  Apparently the Sleep Apnea condition is being recognized and treated so fewer people will die of random strokes.  I sort of liked the Home Sleep Office/bedrooms better than the hospital.  I found the imitation bedroom sort of cute.  A hospital room is a hospital room.  Sterile.

The entire sections on Masks and Nose Health are new.

CPAP-Supply.com

I think more of them than ever.  I am on their email list and rarely buy anything from them.  Mostly because I rarely buy anything any more.  I have two CPAP units and multiple masks.  WIth CPAP-Supply I can see what is on the market.  They now accept insurance so you do not have to fear using them.  But you now need that prescription!

Inverters and 12V

I have an inverter (500w $35 Costco) in my car.  I gave up on trying to use 12v with my Respironics units.  The units drop pressure using 12V and I do not care what their literature says or the fact that they have a plug in the back.  I sleep all night long and my battery does not seem to notice that I have been living off of it.  Another reason for the inverter: I can charge anything from my toothbrush to my razor to my PC Laptop.  Just not all at once and never when I am using the CPAP.  The inverter costs less than Respironics charges for its 12 VDC cable.

Comments From Others

Mr. Haufschild in 9th grade general science once posed us a problem: The trousers keep sliding off the hanger.  What do we do.  The class proposed various hanger alternatives.  Mr. Haufschild suggested that the trouser legs should be placed on the hanger one at a time in alternate directions.  The solution was in the process and not the equipment.  A lesson well (but never perfectly) learned.

Smoke Alarm

I heard from a person whose CPAP set off the smoke alarm.  There had been a lightening storm in the area.  Their smoke detector was by local zoning ordinance of the permanent 110v type.  I gave several suggestions including voltage meters, alternative smoke detectors, and other things.  The problem was the CPAP machine and when replaced the problem went away.  Who would have ever thought?

Carbon Dioxide and Carbon Monoxide

Someone was concerned about Carbon Monoxide poisoning.  Monoxide comes from improper burning -- mostly of petroleum products.  It does not come from your breathing.  The CPAP mask will not make you breath monoxide unless you have it hooked up to your car exhaust -- with the current pollution controls maybe not even then. 
With the mask, you will be breathing increased Dioxide.  If this becomes a problem, you will choke and wake up before any damage is done to your system.  The reason for your CPAP mask is that your brain, even when sleeping, is determined to obtain sufficient oxygen.  The CPAP system is designed to prevent Dioxide overload.

 If your power is cut and no air is pressured down the tube, your brain will react promptly: you will choke and you will search in the dark for the power problem.

Questions?  Comments?  Push the Home/eMail above.
Written:  2001          Updated:  January 2, 2012          Back To Top