Suggestions on small CPAP unit

Hi everyone,

I've been using a Resmed Airsense 10 with an AirFit 10 full face mask for about two months. I never had a problem adapting to the unit and have worn it all night, every night, ever since. It's really changed my life for the better.

The problem came with the first of the year. I ended up with crappy insurance.

l learned today that I'll end up having to return the machine in March since the new insurance will end up refusing to pay. Due to lack of 60 days compliance they won't touch it. It doesn't matter that I have data on the machine's SD card showing compliance since I first got the machine, or that there's no physical way I could give them 60 day's data from January 1st to today. The Resmed lady suggested I give up and buy my own CPAP unit since they'll just demand it back anyway. The new insurance was no help when I called either, agreeing with what I was told.

I prefer to turn lemons into lemonade. I've seen this as an opportunity to get a machine that isn't a crappy brick with a mask that only works when I lay on my side. I'm not totally convinced the humidity function is necessary, either. Has anybody here noticed a huge difference between humidifier and not? Either way, I would like some suggestions for smaller units, conducive to travel if possible since we travel a lot. I'd also prefer to pay the lease amount possible, though cost doesn't matter.

I also don't completely understand how masks work when you need to order them. Are they brand specific? Is one a better deal than another, especially concerning pillows? They just threw one at me when I first got it.

Thanks!

Make whatever effort you need to get as much machine as possible - e.g. definitely an auto, as it can also do plain cpap, but at least you have the option of auto and it will help you a lot (esp. using free software like Sleepyhead) to be able to tweak your own settings when or if you want. Plus definitely get a humidifier because where you live, what climate and season can make a very big difference to your therapy comfortwise, as can heated hoses if you can manage one.

There are so many masks out there and if you're doing this yourself you'll have quite a choice, again find what is most comfortable, try on full face ones lying down because your face changes a lot then vs sitting, and even if you're not a mouth breather the FFM ones are good to have on hand when you have a cold and cannot nose breathe. You can order any type though from e.g. Cpap.com and can try various ones for 30 days for a small fee to see what you're comfortable with. Just about all masks fit all hoses and all hoses fit all machines, etc. etc. Look at the site to see pix, variety, info, etc.

ThEmAdDrshOck wrote:Has anybody here noticed a huge difference between humidifier and not?

Yes... I have noticed a big difference and it wasn't pretty. I need the moisture to keep my nasal mucosa happy and they get real ugly when they are unhappy.
Just a week or so ago I had a night where my humidifier lost connection to the blower...so it didn't work right all night and no water was used and I woke up with some nasty allergy like symptoms...congestion, sneezy, runny nose, itchy and generally felt pretty miserable that day.

For you to see how your nasal mucosa might react to no moisture...empty your water chamber and turn the humidity to off. Sleep with it and see what your nose does.

If you go with one of those tiny travel size machines...you might not like them...a bit noisier for one thing from what I read and not all that cheap.
And if you want data to evaluate using the software...stick with the regular brands because those tiny/cheap machines may not have full data or software easy to obtain.
Plus if you add in a humidifier the total footprint is pretty much the same as one of the other more well known brands.

ThEmAdDrshOck wrote:I also don't completely understand how masks work when you need to order them. Are they brand specific? Is one a better deal than another, especially concerning pillows? They just threw one at me when I first got it.

Not sure what you mean here. You are using a full face mask now ....are you wanting to try a nasal pillow mask of some sort and yes..they are all brand and type specific and can vary between brands.
What/which one are you wanting to try? There are ways to get a mask without it costing an arm and a leg.

Get a full efficacy data machine and get a good one...you are going to use it for a long time.
If you find you can totally do without a humidifier....look at the Respironics DreamStation Auto CPAP....the humidifier is easily removed and thus reducing the footprint about half.

Thanks for all your information. I do want a full face mask because the nose pillows irritate my skin. I also have sinus problems and those aggrivate it. With that in mind it also seems that a humidifier is what I'd find the most comfortable.

If pretty much all masks and hoses fit all machines then that's going to make my life a lot easier. I was asking if those fittings were machine specific, ie. One manufacturer has a tube of a perticular diameter that won't work with others, and then that tube has an end that's only big/small enough to fit a given brand's elbow.

Have you found various internet reviews of machines and masks generally accurate?

And thanks for letting me know about the downfalls of travel units. Those have been tempting but I figured you'd be giving up some sort of function for form.

Also, are there any you can suggest that handle altitude changes well? I live at 6200 ft and we go to places that can even be below sea level. Or do all of them auto adjust?

Thanks!

ThEmAdDrshOck wrote:If pretty much all masks and hoses fit all machines then that's going to make my life a lot easier. I was asking if those fittings were machine specific, ie. One manufacturer has a tube of a perticular diameter that won't work with others, and then that tube has an end that's only big/small enough to fit a given brand's elbow.

All regular tubes can be interchanged but heated hoses are model specific.

ThEmAdDrshOck wrote:Also, are there any you can suggest that handle altitude changes well? I live at 6200 ft and we go to places that can even be below sea level. Or do all of them auto adjust?

I believe all newer models auto adjust. I know ResMed states they auto adjust.

Reviews on Cpap.com should be valid - they're generally from known members and I can't imagine that the site owners (who we know well) would ever pay for them, let alone false ones.

On Masks, any mask will and can work with any Pap machine. Choice of mask is a personal thing, each of our facial structure is different.

Mask Primer
Getting the right mask is one of the hardest parts of PAP therapy. This article is intended to help guide you through your choice of a mask.
First, all masks can and do handle all pressures associated with PAP therapy machines, this is from 3 to 20 (CPAP) or 25 (BiLevel/BiPAP) cmH2O.
Second, each of us has a different facial structure. This means that what works for me may or may not work for you, and what works for you may or may not work for me. You have to TRY the masks to see what works for you.
Third, You will have to try masks to see what works for you.

I’m going to call out 1 particular online vendor for 2 reasons. First they list masks by popularity within the mask type. This means that you can assume that the more popular masks work for more people. The second is that they offer “return insurance”, some free, some low cost, so that you can return a mask that does not work for you. That Vendor is CPAP.COM.
Your DME is an excellent resource to try different masks. Use them for this purpose. Make an appointment for a mask fitting. If you are using a DME it is their job to help you use your PAP system for effective therapy. If the mask doesn’t fit or is extremely uncomfortable they are not doing their job.
A Mask Trial Strategy
First, even a mouth breather can use ANY style of mask, even the simplest, most unobtrusive, Nasal Pillow. See the Mouth Breathing section to see what to do.
Try masks from the most unobtrusive to the biggest bulkiest of masks. This would typically be starting with Nasal Pillows, Nasal Mask, Hybrid Masks, then finally the Full Face Mask. The smaller masks that you start with leave you with less mask on your face and more visibility.
Finally, as I have said before, you have to try masks on, under pressure, and preferably lying down in sleeping position.

Mask Types
Nasal Pillows
Nasal pillows rest under the nose covering the nasal openings and sealing against them. This mask style is among the least intrusive of all masks. Typically they easily seal and have very low mask leak rates. The main disadvantage of this style is with the light touch if you are a very active sleeper the headgear can shift and cause a mask leak. Generally these masks are for non-mouth breathers. There are ways (chin strap, cervical collar, tape) to eliminate mouth breathing and allow you to use this type of mask.
Brands are different. The headgear can be anywhere from bulky to minimal, and they will fit differently. The only way to tell what works for you is to try them.
Size matters. Try the different sizes, I have trouble with the small and the medium here, the large works for me. This may differ depending on brands
Some users do not like anything touching their nose. I’d try a pillow to see if this is an issue for you. Don’t assume.

Nasal Prongs
Nasal Prongs are similar to Nasal Pillows except for the fact that they actually sit inside your nose and expand slightly to seal. Nasal Pillows have mostly replaced Nasal Prongs in the marketplace. This mask style is among the least intrusive of all masks. Typically they easily seal and have very low mask leak rates. The main disadvantage of this style is with the light touch if you are a very active sleeper the headgear can shift and cause a mask leak. Generally these masks are for non-mouth breathers. There are ways (chin strap, cervical collar, tape) to eliminate mouth breathing and allow you to use this type of mask.
Brands are different. The headgear can be anywhere from minimal to bulky and they will fit differently. The only way to tell what works for you is to try them.
Size matters. Try the different sizes, I have trouble with the small and the medium here, the large works for me. This may differ depending on brands
Some users do not like anything in their nose. I’d try a prong to see if this is an issue for you. Don’t assume.

Nasal Mask
These masks cover the nose from the upper lip to the bridge of the nose. The volume of these goes from minimum, just barely covering the nose with minimal volume otherwise to considerably bigger. Most have a hard mask mount up to the forehead, but a few do not. These tend to have mask leaks a bit larger than the Nasal Pillows or Nasal Prongs. This is because they have more area to seal. With this type of mask it is important to try them because of the difference facial structures. You have to find what works for you. Again these are mostly for non-mouth breathers. There are ways (chin strap, cervical collar, tape) to eliminate mouth breathing and allow you to use this type of mask.
Brands are different. The headgear can be anywhere from minimal to bulky and they will fit differently. The only way to tell what works for you is to try.
Size matters. Try the different sizes. This may differ depending on brands

Hybrid Masks
Hybrid masks are mix between a Full Face Mask, for the mouth, and Nasal Pillows for the nose, all incorporated into one mask. These masks are growing in popularity because there is NOTHING on the bridge of the nose and nothing blocking vision. The mask does not extend above the bottom of the nose. Like the FFM below this style mask is primarily for mouth breathers.
Like all masks, Brands are different. The headgear can be anywhere from minimal to bulky and they will fit differently. The only way to tell what works for you is to try.
Size matters. Try the different sizes. This may differ depending on brands

Full Face Mask (FFM)
The primary purpose of the Full Face Mask is to eliminate the need to correct for mouth breathing. The FFM covers the nose in a manner similar to a Nasal Mask but the lower seal is below the lips so it surrounds the entire mouth and nose. This is the traditional method of solving mouth breathing. These masks are bigger than most other masks and because of their size have more area to seal. Generally the bigger the mask the higher the mask leak will be.
Brands are different. The headgear can be anywhere from minimal to bulky and they will fit differently. The only way to tell what works for you is to try.
Size matters. Try the different sizes. This may differ depending on brands
One specific FFM I will call out is the Amara View. I’m not saying that this mask is better than any other mask. This mask seals differently than other full face masks so it is one to try if you are having trouble finding one that fits and works for you.
OK, one more. The “Total” Face Mask. This mask covers the entire face including the eyes and is occasionally used when other choices are not working.

Mouth Breathing
Mouth Breathing is when you open your mouth and the air pressure from your PAP is venting out your mouth typically showing on your charts as a large leak which can substantially negate the effectiveness of your therapy. It is generally not good. The solution varies depending on the person
How to manage Mouth Breathing, not in any particular order.
Chin Strap. A chin strap is to manage mouth leaks from a variety of causes. Most result from the jaw dropping or opening either partially or wider. The chin strap is to gently keep the jaw closed. If you have to crank it shut to make it work this is not the correct solution. Note that your jaw is strong enough to open if it wants to.
Cervical collar. A Cervical Collar may also be used to keep the jaw from dropping.
Mouth Guard. The concept here is a closed mouth guard to keep the air from leaking out.
Taping. The purpose of taping is to seal the lips and prevent mouth leaks / mouth breathing. It is not to stop the mouth from opening. I make sure that I can easily open my mouth, when taped, if I need to.
FFM – Full Face Mask or Hybrid Mask. This is a very traditional solution and it is generally effective.

to come later
Mask Leak Prevention
Fitting a Mask

I have a Resmed Airsense 10 Autoset machine as my main machine, with humidifier.

I used to have nasal congestion all the time (day and night), but this appears to have gone since I started CPAP with humidifier 3 months ago, so I guess the humidifier has some benefits, beyond just comfort. I leave it in auto mode, and I also have the heated hose.

I was looking for a travel machine and also a backup machine in case the main Resmed one fails. I wanted something smaller than the Resmed one, and could do without a humidifier for a few days. I also wanted something cheaper than a top of the range Resmed machine, for backup.

I ended up buying an Apex XT Auto APAP machine from Second Wind, refurbished, for only $225. Machine was like new, with all accessories, new hose and travel bag. Communication and advice from that supplier was great (main owner seems to be a Respiratory specialist), and I can't say the same from the main sponsor of this forum (cpap.com, quite useless, slow and a few unhelpful people). I guess one is a family business, and one is a more commercial outfit.

The Apex XT machine is quite smaller and lighter than the Resmed one, but also doesn't need an external power supply (it has a universal 110/220v power supply built in). It's however noisier than the Resmed one (high pitch noise coming through the hose), and has fewer settings. As an APAP machine, with official warranty, the refurbished version has an unbeatable price.

If it doesn't give lots of data it's not good for anything but travel.

The Apex XT auto can display the AHI on the machine (and other indicators, like leaks), and also has an SD card (which is probably not going to be used when traveling anyway). The bottom of the range Apex XT fit does not show any data, and is CPAP only, so that's why I am recommending to buy a XT Auto (APAP) model.

I don't think the SD card can be read by SleepyHead, so Apex software will have to be used.

http://www.apexmedicalusa.com/EN/download

another derpy suggestion by salad fixins.

Apex? Definitely from somewhere near the BOTTOM of the heap.
Spammer, we got your number!

chunkyfrog wrote:Apex? Definitely from somewhere near the BOTTOM of the heap.
Spammer, we got your number!

Are you talking about me?

What's your suggestion then (if you are capable of posting something constructive)?

Do you have an Apex machine yourself, as you seem to have an opinion on it?

Is your CPAP therapy working, because you seem very bitter?

An Apex machine was discussed here several years ago.
Several remarks mentioned excessive noise, and a rough algorithm.
The size was tempting, but the trade-offs seem to be excessive.
EDIT: I see the XT auto is listed on the cpap.com site.
Some reviews are positive, but the negatives are a bit numerous for comfort.
I would suggest that anyone considering the machine should read all the reviews
and make an informed decision.

chunkyfrog wrote:An Apex machine was discussed here several years ago.
Several remarks mentioned excessive noise, and a rough algorithm.
The size was tempting, but the trade-offs seem to be excessive.
No idea this was still around after all these years.

So you don't actually have one or tried one, but are just providing comments on this forum from stuff discussed a few years ago...

What a great way to contribute...

What's your advice for a small, cheap CPAP/APAP unit then?