I’ve been using my CPAP machine for a few months now and can definitely feel the difference in how I feel when I use it and when I don’t. There is no question that I feel so much better when I use it and so I really try to make sure I use it every night.

Well, I am not always at home because I have to travel sometimes and so I’ve started to become used to carrying it along. Up until last week I had only had the opportunity to take it with me in the car when I traveled for business in the local area, and I have that down to a science. Frankly, other than having an extra bag to carry it just isn’t that big of a deal.

But last week I had to take a couple of different trips, one to California and one to Michigan, that required me to travel by airplane. I am a seasoned flier, but this was the first time I have traveled since being diagnosed with sleep apnea so I thought I would review some of the things I learned in case you ever need to fly with your CPAP machine.

Here are 4 Things I Learned While Flying with my CPAP Machine:

#1 – Learn about the TSA

One of the first things I did before leaving on my trip was to research whether or not I would have any problems traveling with my CPAP machine. I ended up finding a pretty official statement on the TSA website here. I actually printed that off and brought with me just in case I had any problems with unruly TSA agents but my fear was unfounded – everything went smoothly.

Here are the key points:

CPAPs are allowed through security checkpoints once they have undergone screening.

Passengers will be required to take their CPAP machine out of its carrying case and place the device in a bin for x-ray screening. Facemasks and tubing can remain in the carrying case.

In addition to x-ray inspection of your CPAP machine, a visual and physical inspection, and Explosive Trace Detection (ETD) sampling will be required.

#2 – Don’t take your humidifier

My ResMed S8 Elite II CPAP machine comes with a detachable humidifier that I normally use when I sleep at home or even when I am on the road traveling in my car. I decided not to hassle with bringing the humidifier on this trip for a couple of reasons.

First, it was an extra piece of equipment that I am pretty sure I would have to take out of the case and put through the scanner. I wasn’t 100% sure because I don’t know how much electronics it actually has in it, but I just didn’t want to have to deal with it.

Second, the humidifier requires distilled water to ensure the longevity of the equipment. When I am traveling by car I bring along a water bottle filled with distilled water but of course water bottles and the TSA do not go together so I would not be able to bring distilled water, meaning I either use tap water or buying distilled water on location. I didn’t want to do either.

So, I chose not to bring the humidifier. And I slept just fine, thank you very much.

#3 – Every TSA agent is different

The way the process usually works at security is if they need to pull you aside for additional screening, and if you have a CPAP machine you will need additional screening, then the TSA agent usually has you gather up all of your stuff and follow them to the bomb detection device. And that is how it worked at my security stops in Minneapolis. But TSA agents in Los Angeles and Grand Rapids handled it differently – in those locations they actually grabbed my CPAP machine and brought over themselves while I was putting my shoes on. In Grand Rapids I never even saw what they did to it because they did it behind a screen.

I have to admit I wasn’t 100% comfortable with that, but it happened so fast I didn’t have a chance to say anything. According to the TSA you have the right to ask the TSA agents to change their gloves, clean the inspection table and change the Explosive Trace Detection (ETD) sampling media before conducting the ETD sampling.

If you don’t like the idea of your device getting manhandled you probably should be very specific about what you want and make sure to catch them before they just grab it and go do their thing.

#4 – CPAP is mainstream

I’m probably a year too late but I am going to be buying stock in ResMed (RMD). CPAP is mainstream now and ResMed is the only big CPAP-focused player I am aware of that is public. Do you know of another? I’d love to hear about it.

Why did I decide to invest? One simple fact. When the TSA agents at the security line were barking out their instructions they now say something like “Please remove your shoes and put your laptops and cpap machines in a separate bin.” Yep, they actually mentioned CPAP. And they did this at every security line I went through. Now it is possible they have been doing this for years and I just never noticed because I wasn’t on CPAP at the time but I don’t think so – I think this is a recent development. And to me that signals that CPAP is mainstream and that means money.

So I’m putting some of my own money on ResMed. I’ll let you know how it works out.

I was a little apprehensive about travelling with the CPAP machine but all in all it went well. One things I didn’t try to push that I certainly could have is to see how well the airlines would handle having a 3rd bag of carry on. These days they limit you to two, and I was fine since I had a backback and my CPAP bag. However this time I checked a bag but I could have easily gotten away with taking that bag carry on. Would I have had a problem with the extra bag even though it was a medical device?

I’ll have to leave that testing for another time.

If you need to travel with your CPAP machine don’t worry – if my experience is standard you will have no problems.

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I’ve been using a CPAP machine for a few months now ever since being diagnosed with sleep apnea. I really struggled at the start, only averaging 2-3 hours per night with the machine. After that I would wake up and not be able to get back to sleep with the CPAP machine, so I would have to get up and finish my night’s sleep on the couch (my snoring would keep up my wife).

Now, however, I am getting a full night’s sleep using the device. How did I do it? Here are 5 Tips to a Great Night’s Sleep with a CPAP Machine:

Tip#1 – Pay attention at your sleep study

In order to get off to a good start using your CPAP machine I highly recommend you listen to everything they tell you at your sleep study. Especially the next day, assuming they fit you with a machine. In my case I think I was really only half-listening and when I got home I was not 100% sure of some small things related to fitting the mask. They had sized it for me but there were some minor adjustments I could make and I wasn’t exactly sure how to properly wear the mask. It wasn’t until I visited the doctor a month later that I got around to asking about how to properly wear the mask. I am sure I would have gotten off to a better start had I listened on day one.

Tip#2 – Visit your doctor after a month

It’s very important to follow-up with your doctor relatively soon after you first start using the CPAP machine. In my case I was scheduled for another visit a little over a month after my sleep study. I don’t know if that is standard or not, but I think it is very important. It gave me a chance to ask questions about fitting the mask as well as having the pressure adjusted on the machine. Based on feedback I gave her my doctor suggested that they were not aggressive enough when they initially setup the machine and so she called their techie in to increase the airflow pressure. She made it sound like this was a fairly common practice – that if they set it correctly at first it could scare some people off. I adjusted to the increased pressure in no time and I am confident it is now set correctly for me. Don’t assume they will calibrate your machine correctly the first time!

Tip#3 – Invest in a memory foam pillow

Before I bought a memory foam pillow my wife was complaining that I was still snoring a little bit at night unless I rolled over on my side. Well, with the CPAP mask on it can be hard to roll to the side. I’m not sure exactly why I thought it would help, but I went out and bought a Serta 4-Pound Density Memory Foam Contour Pillow by Sleep Innovations and I will be darned if that didn’t do the trick. No more snoring at all! How does that help my sleep? No more poking me to get me to move on my side! Ah, blissfull sleep.

Tip#4 – Use ear plugs

On a whim I picked up an 80-pack of foam ear plugs while shopping at Home Depot. One of the things that had been waking me up in the middle of the night was various sounds emanating from my mask when I shifted positions – minor leaks, noise from the machine, etc. Using these cheap earplugs made a huge difference for me in that I rarely wake up in the middle of the night anymore.

Tip#5 – Develop a nightly routine

It took me awhile to develop a routine but once I did I think it has been helpful. When I am ready to sleep I make sure my nasal passages are clear, put in my ear plugs, don my mask (not yet hooked up), and rest my head on my pillow. I take some deep breaths. Then I turn on the machine and while the air is blowing out of the tubing I attach it to the mask, while breathing in. Then I focus on taking a number of really deep breaths, and then slowly decrease the “size” of my breaths. In no time I get into a rhythm and fall asleep. There were some nights where I just couldn’t get going because the mask didn’t feel right and I felt almost claustrophobic. That has not happened since developing this routine.

I can’t guarantee that you will ever get accustomed to your CPAP machine but these tips helped me and I hope they will help you too. Here’s to a good night’s sleep!

Technorati Tags: better sleep, cpap machine, ear plugs, sleep apnea

If you use a ResMed S8 CPAP Machine you may be wondering what the EPR option is. I’ve been having a little trouble with my CPAP Nasal mask being comfortable and I decided to read the user manual to see if there were some airflow settings I could change and I found that there was – EPR!

EPR is a ResMed feature that stands for Expiratory Pressure Relief. It is only available on the ResMed S8 version of their CPAP machine. Here is how ResMed describes it:

EPR™ (expiratory pressure relief) is an effective alternative to continuous positive airway pressure (CPAP) therapy. It features several options that enable you to reliably and predictably control patient therapy while delivering a higher level of patient comfort.

It seems a little weird to me that it is described as an alternative to CPAP therapy because to me it more seems to augment the existing therapy. There are 4 possible settings for EPR on an S8 machine:

OFF
Setting 1 = mild comfort (1 cm H20)
Setting 2 = medium comfort (2 cm H20)
Setting 3 = maximum comfort (3 cm H20)

When I looked at my machine it was set to setting 1. In the interest of experimenting to see if I could get additional comfort I moved the setting to 2 last night and it did seem to be a little bit better where I didn’t feel like I was sucking against as much pressure, however it wasn’t really a good test because I also bumped up the humidity and I set it too high so I was awakened with water in my breathing tube. I’ll try again tonight.

One of the interesting things about EPR is that it offers some control to turn itself off if certain events happen. For example, changes in a patient’s sleeping position or sleep stage (ie, REM sleep) may cause sudden, unpredictable events to occur without the typical preceding flow limitation or snoring. When such an event is detected, EPR immediately suspends, and the treatment pressure reverts to set CPAP. EPR remains suspended until the event concludes and normal breathing resumes.

There is also a timeout period based on exhalation. If a patient’s exhalation period exceeds 15 seconds, EPR immediately suspends. The treatment pressure reverts to set CPAP and remains suspended until the next inhalation phase is detected.

The writing is still on the wall for me as to whether this setting will improve my own comfort (I’ll test setting 3 if setting 2 doesn’t seem to work) and I would encourage you to try this feature out yourself.

Technorati Tags: cpap, cpap therapy, epr, expiratory pressure relief, resmed cpap

One of the hassles of using a CPAP machine for sleep apnea is that there is some routine maintenance involved in making sure it works properly.  While this really doesn’t involve a lot of work it is important to do the cleaning lest you subject yourself to illness or other issues like facial acne.

I have broken the maintenance into three distinct periods – daily, weekly and quarterly:

Daily CPAP Cleaning

The daily cleaning regimen of your CPAP machine is very easy and only needs to be done just prior to using the machine.  First, if you are using a humidifier attached to your unit, make sure it is filled with clean distilled water.  There is no reason to throw out what is already in there – simply top it off.  Next, you should use unscented baby wipes to clean off all of the contact points of the mask – don’t forget the pads that rest on your forehead!  In addition to using the wipe to clean the machine you should also clean on your face around where the mask will sit.  This will help ensure you don’t have a CPAP problem like facial acne.

Weekly CPAP Cleaning

The weekly cleaning is more rigorous than the daily cleaning and will require a little more of your time.  What I do is do the cleaning when I first get up on Sunday morning, that way the machine is already to go when I go to bed that night.  Here is what you need to do:

Making sure you have a clean and empty sink, put the following CPAP equipment into the sinkfull of luke-warm water: CPAP mask (don’t remove the straps at all), chin strap if you use one, humidifier water container and hose.  Put in a little bit of Dreft baby clothes detergent and let it soak for about 30 minutes.  After the 30 minutes rinse well and hang everything up to dry.  You’ll be good to go for another week!

Quarterly CPAP Cleaning

The quarterly work is not so much cleaning as it is maintenance.  There is a filter that comes with your machine and you should have recieved a couple of extra ones.  You should replace this filter on a quarterly basis.

With proper cleaning and maintenance there is no reason your CPAP machine can’t last a long time.  Good luck and remember, no matter how uncomfortable it feels you need to wear your mask!

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While a continuous positive airflow pressure (CPAP) machine is the overwhelmingly popular choice for treatment of obstructive sleep apnea it is not without it’s problems.  In this article we outline some of the common problems users of CPAP machines report and what you can do about them.

Problem #1 – Embarrassment

Your CPAP machine is only useful if it is used!  Unfortunately some people really struggle with the nightly routine of donning the mask, particularly when they have a loved one who shares their bed.  Like most issues the solution is communication.  Be open with your partner about your feelings and ensure they know the importance of your treatment.  They need to understand that the CPAP machine is literally extending your life.  The more you talk about the machine and acknowledge its existence the faster you will get over your embarrassment over using it.

Problem #2 – Redness or Sore Spots on Face After Use

This is a common problem because the sleep apnea sufferer is wearing a mask tight to their face all night long.  This can causes indentations in the skin around where the mask is pressing against your face and it may cause red sore spots where those pressure points exist.  While most modern masks handle this pretty well there are a few things you can do:

• Loosen your straps slightly so that they are not too tight. Make sure that your mask is still snug enough to prevent air leaks, but not so tight that it hurts your skin.
• Consider buying pads that slip over your straps. Made of fleece or other soft material, they keep the straps from rubbing against your skin.
• Talk to your CPAP supplier about trying a mask that will mold to the shape of your face.

Problem #3 – Acne

In addition to the sore spots where the mask presses against your face you may also find that you develop acne at the same spots.  In addition to following the tips in problem #2 you can help eliminate this problem by making sure your mask is clean.  I suggest washing it with Dreft every week and every night before you put your mask on wipe your face and the mask with a no-odor baby wipe.  This will help prevent acne from appearing.

Problem #4: – Red eyes, continue snoring or stop breathing during sleep

If your partner reports that you are still snoring or stopping to breathe while sleeping or if you wake up with red eyes these are signs that your mask is not fitted properly and that air is leaking out.  Here are some tips to address this problem:

• Adjust the straps and headgear on your mask to obtain a better fit.
• If you have had your mask for a while, check to make sure that it is not worn or torn.
• You may need to try a different size mask.
• A different type of mask may work better for you. Either a full face mask or nasal pillows may eliminate the air leaks.
• Talk to your doctor or CPAP supplier about trying a mask that will mold to the shape of your face.

Problem #5 -  You wake with a dry throat or mouth.

Waking up with a dry throat or mouth while using a CPAP machine is a classic sign of a mouth breather.  You really only have two choices.  Use a chin strap or get a full-face CPAP mask.  I use a chin strap myself and it seems to work pretty well as I no longer wake up with a dry mouth.

Problem #6 – You seem to have more nasal congestion from using CPAP.

Nasal stuffiness is the most common side effect of CPAP therapy. You may also have a runny, itchy or dry nose, or nosebleeds. Nasal congestion often goes away after your first month of use. Keep in mind that many people with OSA naturally have an increased level of nasal congestion. This congestion is more common in the winter and during allergy season. It is not always a result of CPAP. Talk to your doctor if your congestion is severe, or if you have nasal, sinus or ear pain.  The best solution is to invest in a CPAP humidifier.  Top-end CPAP machines usually come equiped with them already so if your are not using yours be sure to do so.

Problem #7 – Trouble breathing against the pressure.

The whole point of a CPAP machine is to apply a continuous flow of positive airflow that you breath against, both on inhale and on exhale.  For some this can be a difficult adjustment even though it is the basis for the treatment.  This really is just a matter of adjustment, getting used to the machine.  One way to solve this problem is to use the CPAP machine at various times throughout the day, even when awake like while watching television.  Another way to solve this problem is to utilize the ramp feature of your CPAP machine which starts the pressure low and then gradually increases it.  I have my ramp time set for 20 minutes and it works great – I’m asleep by the time the maximum pressure hits.

I hope these common CPAP problems and solutions were helpful to you.  Once diagnosed with sleep apnea it is very important to continue to use your CPAP machine and getting over these problems is an important step in ensuring use.

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The primary purpose of the CPAP Review website is to evaluate the many continuous positive airflow pressure (CPAP) machines and accessories that are on the market.  However before we start looking at the remedy we need to look at the problem, which is Sleep Apnea.

What is Sleep Apnea?

The Greek word “apnea” literally means “without breath.”  Sleep Apnea is a medical condition characterized by pauses in breath during sleep.  To qualify as an official apnea these pauses must be at least 10 seconds in duration.  Quite literally during these 10 seconds the patient is not breathing and only receives life-giving oxygen when jolted into action by the bodies reflexes.  Severe Sleep Apnea means having at least 35 of these apnea episodes per hour.

Three Types of Sleep Apnea

The three types of sleep apnea are obstructive, central and mixed.   Obstructive sleep apnea (OSA) is caused by a blockage of the airway, usually when the soft tissue in the rear of the throat collapses and closes during sleep. In central sleep apnea, the airway is not blocked but the brain fails to signal the muscles to breathe. Mixed apnea, as the name implies, is a combination of the two. With each apnea event, the brain briefly arouses people with sleep apnea in order for them to resume breathing, but consequently sleep is extremely fragmented and of poor quality.  In addition blood oxygen level are decreased resulting in a host of problems.

Who Gets Sleep Apnea?

Sleep Apena is a common medical condition; almost as common as adult onset diabetes.  According to the National Institutes of Health over twelve million Americans are suffering from some form of Sleep Apnea.  There are several risk factors for Sleep Apnea including being male, overweight and over the age of forty.  However it is important to note that Sleep Apnea can strike anyone, even children.  The sad thing is that because of a lack of awareness by the public and halthcare professionals, the vast majority of Americans who have Sleep Apnea remain undiagnosed and untreated, despite the fact this serious disorder can have significant health consequences.

What Problems Are Associated with Sleep Apnea?

Left untreated, sleep apnea can cause high blood pressure and other cardiovascular disease, memory problems, weight gain, impotency, and headaches. Moreover, untreated sleep apnea may be responsible for job impairment and motor vehicle crashes.

What Are The Treatments for Sleep Apnea?

There are  many treatments available for sleep apnea.  We will go over these in more detail in future posts, however here is a quick summary:

• Self treatments like losing weight, stopping the use of alchohol or smoking, sleep on your side or using a nasal dilater.
• CPAP (Continuous Positive Airway Pressure) machine – CPAP is the most widely recommended treatment for moderate to severe obstructive sleep apnea. CPAP entails wearing a mask-like device while you sleep, which provides pressurized air to prevent the airway from collapsing.
• Dental appliances, oral devices, and lower jaw adjustment devices
• Surgery to increase the size of the airway

What Next?

Not sure if you or your partner have sleep apnea?  Take this quiz to find out.  Arrange for a sleep study if it looks like you may have sleep apnea.  Come back to CPAP Review if you require a CPAP machine for treatment of your Sleep Apnea.

Technorati Tags: apnea, cpap, cpap machine, sleep apnea, snoring