What is CPAP?
Can you give me some tips about using my CPAP machine?
What is a polysomnogram?
Is my CPAP machine covered by my insurance company or Medicare/Medicaid
What is AHI?
CPAP FAQ
What is sleep apnea?
The word "Apnea" in Greek means "without breath." Shuteye.com defines sleep apnea as "a condition characterized by temporary breathing interruptions." There are two types of sleep apnea: obstructive and central. Familydoctor.org defines obstructive sleep apnea as a stoppage of breathing caused by something (tongue, tonsils or uvula) blocking the air passageway. Obstructive sleep apnea is the most common type of sleep apnea. The website defines central sleep apnea as a stoppage in breathing caused by signals in the brain being interrupted or before they can reach the muscle or the signal isn't being transmitted at all. Central sleep apnea is rare and probably present with other neurological problems. Shuteye.com continues to explain that the number of interruptions vary from a dozen to hundreds of times per night. Typically these periods of stopped breathing last longer than ten seconds.The Mayo Clinic describes the following symptoms of sleep apnea:
- Excessive daytime sleepiness
- Loud snoring (more common with obstructive sleep apnea)
- observed incidents of breathing stopping during sleep
- Awakening with a dry mouth or sore throat
- Difficulty staying asleep
- Shortness of breath (central sleep apnea)
- Throat muscles and tongue relax excessively
- Tonsils and adenoids are larger than normal
- Excessive weight. The additional tissue in the throat makes it harder to keep the throat open. (measure your BMI with Vitality Medical's BMI calculator)
- The bones in the head and neck are disproportionate to the size of the mouth and throat.
What is CPAP?
Sleepcompliance.com defines CPAP(continuous positive airway pressure) as 'a type of therapy used to effectively treat obstructive sleep apnea in which an air compressor forces air through the nose and airway..."CPAP treatment consists of three parts: the CPAP compressor, tubing and a special CPAP mask or cannula (comparisons between the different types of CPAP machines, CPAP masks and tubing are located below in this FAQ). The CPAP machine is essentially a quiet air compressor that continually forces air thorough the tubing to the mask or cannula (cannulas are small tubes that fit within the nose). The continuous air pressure forces the airway to remain open, which allows for normal breathing for the entire night.
Back to top Difference between Bi-level and Auto CPAP machines: Bi-level CPAP machines has two different settings, one for inhalation and one for exhalation. Auto CPAP machines automatically adjust to the resistance a patient's breath gives and provides the appropriate amount of pressure. While Bi-level CPAP machines will work without problems, Auto CPAP machines provide maximum comfort.
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What type of mask should I use?
There are three types of CPAP headgear: full-face masks, nasal masks and nasal pillows. Full-face masks covers both the nose and face. For patients who breathe through their mouths or have sensitive nasal passages, a full-face is the best solution. The disadvantages of full-face masks are that they are bulky and it can be difficult to find a good fit that doesn't leak air. Nasal masks are similar to full-face masks, but only cover the nose. Because nasal masks only cover the nose, they are less bulky than full-face masks. The disadvantages of nasal masks are that they don't cover the mouth and that some people feel uncomfortable having their nose covered. For patients who feel claustrophobic with masks, nasal pillows are ideal. Nasal pillows are small tubes that fit within the nose and have connectors on the ends, so they fit securely within the nose. Of the three mask options, nasal pillows have the least amount of bulk and work well with heated humidifiers. Nasal pillows are not recommended for people with sensitive nasal passages because the pillows can be irritating. This problem, for some, can be solved with a moisturizer or lubricant, like KY Jelly.Which type of mask you use depends on your individual needs. If you breathe through your mouth, you will most likely want a full-face mask. If the bulkiness of the mask is uncomfortable for you, nasal pillows might be appropriate. Note: It is important you talk with your doctor about CPAP mask options before starting treatment.
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Can you give me some tips about using my CPAP machine?
Adjusting to the CPAP machine in the first month can be difficult. Proper use of the CPAP machine can go a long way to eliminating uncomfortable side effect. The Sleep Foundation reports that most problems with CPAP are mask related. Often CPAP masks are too tight or loose. If the CPAP mask is too tight, you will feel uncomfortable. If the mask is too loose, continuous pressure isn't being applied and the treatment is not working. For the proper fitting of the mask, adjust the headstrap and pads until they fit snugly, but not uncomfortably. You may also have to buy a smaller or larger CPAP mask if the adjustments aren't enough. Another mask-related problem is that you might feeling claustrophobic wearing the CPAP mask. Both Metrohealth and the Sleep Foundation recommends that the wearing the CPAP mask while doing a task that requires attention, such as reading or watching TV, for short periods of time. By wearing the CPAP mask for short periods of time, patients get accustomed to wearing the mask.Probably the second-most common side effect of CPAP treatment is the dry or congested nasal passages. There are several solutions to this problem. One solution is to use a CPAP machine that has a heated humidifier. The heated humidifier, with the help of the CPAP machine, blows wet, warm air through the nasal passages, which helps keep them moist and comfortable. Another solution offered by Metrohealth is to purchase a saline nasal solution, which is essentially a mixture of salt and water. Saline nasal solution can be purchased for a low price at a local drug store. A final option would be to use a nasal decongestant, although you will want to consult with a physician before taking a decongestant for an extended period of time.
The third most common problem with CPAP machines is adjusting to the continuous pressure. The Hopedale Medical Complex recommends using the CPAP's machine "ramp" setting. The "ramp" setting allows users start out with very little pressure with the machine gradually increasing it until the optimal pressure level is achieved. Consult with your physician about what ramp setting is right for you. The method of adjusting the ramp setting varies between CPAP machines; consult the owner's manual or manufacturer for more information.
There are a few other things you can do to avoid CPAP problems. The most important thing is to clean the tubing, headgear and mask regularly. Bacteria grows in the tubing over time, especially when used with a heated humidifier, which can cause respiratory problems. Unclean headgear and masks can also accumulate bacteria and cause infections. Another important tip is to stay consistant and committed to the CPAP treatment. If you don't stay consistant with treatment, it will be more difficult to continue because you have not gotten accustomed to mask and continuous pressure. Finally, if you still have trouble, consult your physician and get help from CPAP support forums, such as Apneasupport.org or CPAP Talk.
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What is a polysomnogram?
A polysomnogram is a sleep test usually conducted at a sleep center or hospital. According to Central DuPage hospital a polysomnogram measures: brain waves, eye movement, chin muscle tone, heart rate, leg movements, breath, breathing efforet, oxygen level as well as audio and video of the room. During the test sensors are placed on parts of the body gather measurements. Polysomnograms are used to help diagnose several disorders such as hypersomnia, insomnia, narcolepsy and obstructive sleep apnea. Your doctor will be able to tell you whether a polysomnogram is appropriate for you.If you do get a polysomnogram, do not take any sleeping pills, alcohol or caffeinated beverages before the test because they will throw off the accuracy of the polysomnogram. When you start the polysomnogram sensors will be placed over parts of the body to gather the necessary measurements. Most people are able to sleep with the sensors on because they're small and unobtrusive. The testing area is typically set up as like a bedroom, so patients can feel comfortable.
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Is my CPAP machine covered by my insurance company or Medicare/Medicaid
CPAP machine coverage varies by plan, but many insurance companies do cover the cost of the machine and necessary parts such as CPAP masks and tubing. Usually the insurance companies will require some proof of need, so it may be necessary to take a polysomnogram or some other sleep test to determine whether you have a sleep disorder. Resmed, a CPAP machine manufacturer, states that Medicare requires an AHI(see next question) of 15 or more per hour. A patient may also qualify with an AHI of 5 if there is documented symptoms of excessive daytime sleepiness, impaired cognition, mood disorders, insomnia, hypertension, ischemic heart disease or history of stroke. For more information, consult your insurance/Medicare/Medicaid representative. Vitality Medical does not bill insurance companies, Medicaid or Medicare.Back to top
What is AHI?
Pulmonary Reviews reports that AHI stands for Apnea-Hypopnea Index and it measures how many times breathing is disrupted. Pulmonary Reviews notes that AHI can sometimes be misleading because disruptive sleep may appear in the form of increased blood pressure, rather than stopped breathing. Although it is not a definitive measurement, it can be a good indication that treatment is needed. An AHI measurement of less than 10 can be considered normal. Measurements between 10-20are in a "gray area" in which it might indicate a sleep disorder. AHI measurements of over 20 usually indicate some type of sleep disorder.Back to top
Sources
Shuteye.com - Glossary of Terms
American Sleep Apnea Association - Sleep Apnea Information
Mayo Clinic - Sleep Apnea
National Heart, Lung and Blood Institute - What Causes Sleep Apnea
Familydoctor.org - Sleep Apnea
Sleep Apnea:
Symptoms, Causes, Diagnosis, and Treatment
DeVilbiss - Sleep Glossary
CPAP Talk
Sleep and CPAP Adherence
MetroHealth - Making CPAP Work For You
Central DuPage Hospital - Sleep Studies FAQ
ResMed - Medicare Coverage for CPAP Therapy in the Treatment of Obstructive Sleep Apnea (OSA)
PulmonaryReviews.com - The Apnea - Hypopnea Index: Useful or Useless?
