CPAP Machine: How Does It Work, Cost and Sleep Apnea?

Every person with a sleep disorder spends approximately $7,000 more per year in overall health care expenses, compared to those without a sleep disorder, according to a survey of more than 22,000 Americans. An estimated $94.9 billion is spent each year on medical expenses related to sleep disorders, but researchers at Massachusetts Eye and Ear Infirmary, a member hospital of Mass General Brigham, think those costs are probably much higher.

In their new analysis, published in the Journal of Clinical Sleep Medicine, the researchers found the number of medical visits and prescriptions filled were nearly doubled in people with sleep disorders such as sleep apnea and insomnia, compared to similar people without. Affected patients were also more likely to visit the emergency department and have more comorbid medical conditions.

Sleep disorders can lead to fatigue, mental fog and an increased risk of accidents. One of the most common sleeping disorders is obstructive sleep apnea.

Sleep apnea is a potentially serious sleep disorder in which breathing repeatedly stops and starts. If you snore loudly and feel tired even after a full night's sleep, you might have sleep apnea. Breathing might stop during sleep cycles, often several dozen times a night, sleep apnea can lead to high blood pressure, headaches, diabetes, weight gain, depression, dangerous levels of daytime drowsiness, and even heart disease and stroke, making it crucial to both diagnose and treat sleep apnea appropriately.
sleep apnea

What Is Sleep Apnea?

There are two distinct types of sleep apnea that affect individuals. 

The first, more common form of the sleep disorder, obstructive sleep apnea (OSA), occurs when the muscles of the throat relax too much during sleep, resulting in the obstruction of airways. As these airways close, the body and brain will have lack of oxygen until the body’s autonomic response is to wake up partially in order to clear the obstruction. Obstructive Sleep Apnea (OSA) is normally diagnosed via a sleep study, ordered by a doctor. 

The second type of sleep apnea, known as central sleep apnea, is neurological in nature. A condition where the brain doesn’t send the proper signals to the muscles of an individual’s body that are responsible for controlling breathing. Again, the result is lack of oxygen and partial awakening in order to shock the body into breathing involuntarily once more.

CPAP machine

Obstructive Sleep Apnea (OSA) and CPAP Machine

The recommended treatment for most OSA was to start using a CPAP Machine. For most people, talking to the doctor is an important first step. In order to get a CPAP machine, you’ll first need to get a prescription for one. We’ll cover prescriptions in the next section.

How to Get a Prescription for a CPAP Machine?

Before you can buy a CPAP machine, you’ll need to get a prescription from a medical professional that specifies which kind of machine you should get. It will also specify what pressure setting is needed to treat Sleep Apnea. Getting a prescription is not as simple as going into the doctor’s office and asking for one. A CPAP machine is a specialised medical device, and the doctor will need to conduct a sleep study to know if you even have Sleep Apnea to begin with.

A sleep study measures the following:

  • heart rate
  • breathing
  • blood oxygen levels
  • how many times you stop breathing in the night
  • how many times you wake up in the night

If the results of the sleep study show that you have Sleep Apnea, they’ll prescribe a course of treatment, which may be done with a CPAP machine. The doctor could also prescribe BiPAP therapy, oral appliances, or recommend surgery.

What is a CPAP Machine?

“CPAP” is an acronym that stands for “Continuous Positive Airway Pressure”. Continuous Positive Airway Pressure therapy, commonly known as CPAP, is the most prevalent form of therapy used to treat OSA. Many patients learn they’re suffering from OSA by getting diagnosed after a sleep study.

CPAP devices come in three different varieties:

  • there’s the traditional CPAP, which supplies therapy air at only one pressure.
  • APAP machines provide variable pressures that change based on user needs during the night.
  • BiPAP (or BiLevel) machines have one setting for inhale and then a lower pressure setting for exhale.

Each type of CPAP machine does something a little bit different, and each type is good for certain things. Generally, most people use APAPs because of the versatility and flexibility. Once you understand what sleep apnea machine works best for you, your next step in the buying process is to choose a brand.

How to Choose a CPAP Machine Manufacturer

When you get a CPAP machine through your insurance, you don’t get to choose your CPAP machine manufacturer, and you don’t get to select the features you want. Just like certain car companies rank higher in terms of overall satisfaction, build quality, or value for the dollar, CPAP manufacturers follow the same route.

Some of the top CPAP machine brands today are Philips Respironics, ResMed, DeVilbiss, Fisher & Paykel, Somnetics, and Human Design Medical (HDM). There are several other key players in the field that you can confidently consider, too. Here’s a cheat sheet to the different manufacturers and what they bring to the table:

Philips Respironics: Formerly known as just “Respironics”, this company debuted the first CPAP machine and continues to make high-quality machines with all the bells and whistles. On price, they aren’t usually the least expensive, but they aren’t the most expensive either.

ResMed: ResMed is considered to be a leader in innovation, and consistently produce high-quality products that are well-liked by consumers. ResMed products are among the best in the business, and many people swear by ResMed’s quality. On price, you get what you pay for. ResMed machines are among the most expensive, but most customers find that their products are worth the money.

DeVilbiss: DeVilbiss makes the IntelliPAP brand of machines, and isn’t a major player in the machine space. They make quite a few masks and have been around for a while. On price, their machines are somewhat less expensive, and so are their masks.

Fisher & Paykel: Fisher & Paykel is the manufacturer of the Icon line of machines, and was a major player in the space. They’re the makers of the popular Simplus mask and have quite a few masks in their catalog. On price, they tend to be a more expensive brand, but people really enjoy the level of quality.

Somnetics: Somnetics currently manufactures the Transcend series of machines, and has been around for a while. People seem to like Somnetics’ line of smaller travel machines, and they’ve done a lot to make CPAP smaller and more portable. On price, they’re mostly on the mid-to-lower end of the spectrum.

Human Design Medical: Makers of the Z1 series of CPAP machines, currently the only machines sold on by Human Design Medical. They manufacture less expensive machines.

As with any big purchase, it helps to read the reviews. Customer Reviews will tell you a lot about the machine, and generally, it’s better to go with a machine that has mostly good reviews.

Consider a Travel CPAP Machine

Unless you’re 100% certain you’ll never sleep in a bed other than your own, the portability factor is something to consider when looking to buy a CPAP machine. If you spend a good part of your life on the road, a specially-designed, travel CPAP machine may be the answer.

Even if you don’t travel often, there’s always going to be situations in which you’ll need to bring your machine to new sleeping environments. A machine that’s lightweight and portable is going to be a better fit than a large, bulky, heavy machine. Most modern CPAP machines are lightweight, and some even come with a carrying case, so there’s a chance you can find a highly portable machine even if it’s not listed as a travel machine. All it takes is paying attention to the weight and finding one that fits your needs.

Why is Humidification Important?

Not all CPAP devices offer a built-in or add-on humidifier, but this is an important accessory that should be considered by anyone looking for the most comfortable experience possible. When you’re starting out with CPAP therapy, you may not think you need a humidifier. In fact, the first couple of times I used my machine, I didn’t put water in it. Boy, was I surprised when I first used the humidifier.

I found that I didn’t get a severely dry mouth from using my machine, and the difference was as dramatic as light and dark. I soon learned that the humidifier keeps nasal passages and your mouth from drying out during CPAP use. Humidifiers also help lower the chance of:

A humidification unit that disconnects from the main CPAP machine comes in handy when traveling, as the user then has the option of leaving the often-bulky humidifier section home for a night or two. For me, humidification is a must-have when using a CPAP machine.

Find a Quiet CPAP Machine Under 30 dB

Yes, you’ll be sleeping while you use the CPAP machine, but you have to be able to fall asleep in the first place. And, anyone you share a bed with will certainly appreciate a CPAP machine with a low noise level. You can find the noise rating in the specifications section for any CPAP machine, and the magic number you’ll want to keep in mind is 30.

Any unit rated at 30 dB or lower operates at what is generally referred to as a “whisper-level”. Here are some tips to keep in mind when evaluating noise:

Learn About the Ramp-up Feature and Whether You Need It

When I first started using a CPAP machine, I found the pressure to be very difficult to get used to. I recall a meeting in the doctor’s office, ready to give up, when he told me about the ramp feature that my machine had. What’s a ramp feature? It’s the ability of a CPAP machine to start out at the lowest pressure, and gradually, over the course of 45 minutes or so to reach the recommended pressure for CPAP therapy.

Being advised to use the ramp feature was a big help, and one of the reasons my treatment has been a success. When the machine starts off at the low pressure, you’ll barely notice it. Once you fall asleep, the machine increases to the recommended pressure. This way, you’re asleep before you would normally notice the pressure.

Most of the CPAP machines that we sell at have the ramp feature, and it’s becoming more and more common in the marketplace today.

Consider the Smart Data Recording Features

Modern CPAP machines that include some type of onboard data recording feature enable the user to conduct their own makeshift “sleep studies” at home. This provides relevant and important data gleaned during the patient’s sleep cycles. Some record basic information only – like how long the individual slept or how long the machine was in use. Others offer detailed readings like:

  • leak rates
  • pressure changes
  • apnea events
  • snoring episodes, and more.

Some CPAP machines will send this data to a device via Wi-Fi or Bluetooth, while others record to a memory card to be analyzed through a computer.

For some of the most popular machines, you’ll have a downloadable app that you can use to check your sleep. For my machine, the app tells me how long I used it; how many times I experienced blockages; and whether my mask is leaking.

All of this is very helpful. If I see that I had a lot of blockages during the night, it would tell me that something wasn’t right, and to consult with my physician. It can also help me troubleshoot some issues that I may have with my sleep at home.

What Does a CPAP Machine Cost?

Getting a CPAP Machine on the cash market (like buying from or other online retailer) is going to cost less than what it would cost through the insurance company. CPAP machine cost also varies throughout the year, as machines go on and off sales, but generally:

  • A CPAP machine is the least “fancy” of the three types, and cost between $300 – $700 dollars
  • APAP machines have greater sophistication, and cost between $600 – $1,000
  • BiPAP machines are the most complicated, and cost between $1,000 – $2,000

Prices between different models of CPAP machines tend to fluctuate a lot, as different machines have different features. There’s a big difference in the degree of sophistication between a machine that costs $300 and a machine that costs $1,000. As is true of almost any product, you do get what you pay for, and the best CPAP machines are among the most expensive.

Where Can You Buy a CPAP Machine?

Most people that are new to treating Sleep Apnea may not realize that they have options when it comes to starting CPAP therapy. It may seem like the only option is to go through your insurance company to get a CPAP machine. That’s only one way to get started. You could also visit a local CPAP shop, but you may not find the selection is very good.

One of the best ways to get a CPAP machine is to order online. There you’ll get the opportunity to get the exact quality and type of machine that you need for your therapy, and not get bogged down by insurance red-tape and regulations. If you want a travel machine, you can get a travel machine. If you want a top-of-the-line machine, you can get one. If you want built-in humidification, you can get that too. As long as your prescription calls for it, you can order it.

When you go through insurance, they choose the machine and give you the mask they think works the best. You have very little say in the type of machine you get. Since the insurance company gets reimbursed the same whether you get a great machine or an average machine, they have little incentive to give you the highest quality machine.

They give you the machine that works for them. The best way is to get the machine that works for you. This is why the cash market for CPAP machines has grown rapidly over the past decade. Customers find that they don’t have to compromise.

You’ll also save on rental fees when you get a CPAP machine through the cash market online. Typically, when you get a CPAP machine from your insurance company, you’re actually renting it. If you go through a period where you don’t use the machine, the insurance company can take it from you. This is possible because the insurance company is able to monitor machine usage statistics through the modem on the machine. If they notice usage slows or stops, many insurers will no longer cover their portion of the rental and demand you send the machine back. When buying a machine on the cash market, the retailer won’t track or report on the data coming out of it. This is another reason to buy online, that most people may not know about.

Don’t forget! CPAP machines don’t come with masks so if you need to, read up on our “different types of CPAP masks” to make the best decision!

What's the difference between CPAP supplies and accessories?

CPAP supplies are items that require regular replacement to maintain optimal performance, such as mask parts due to daily wear and tear. In contrast, CPAP accessories are convenient comfort items to enhance your CPAP therapy, such as CPAP specific pillows, aromatherapy kits, handy cleaning supplies, mask liners, and hose covers.

What happens if I don’t replace my CPAP supplies when I need to?

If you aren't following a good replacement schedule for the parts on your machine, the quality of the air you breathe will go down—leaving you exposed to infections, mold, colds, and other harmful bacteria. Following a good replacement schedule will keep you healthy, and may extend the life of your machine.

When should I replace my CPAP Supplies?

  • Disposable Filters: Replace disposable filters once every four weeks.
  • Reusable Filters: Wash reusable filters regularly and replace them every six months (or sooner if the filer starts to deteriorate).
  • Bacteria Filters: Replace bacteria filters after 30 days (or sooner if discolored).
  • CPAP Mask Cushions: Replace cushions every three to six months.
  • CPAP Mask Headgear: Replace headgears every six to nine months.
  • CPAP Mask: Replace the entire mask every six to twelve months.
  • CPAP Hoses and Tubing: Hoses should be washed regularly and replaced every six to twelve months.
  • CPAP Machine Parts: Replace CPAP machine parts when broken.
  • CPAP Humidifier Parts: Replace CPAP humidifier parts (like chambers) every six to twelve months, or sooner if discolored or displaying signs of deposit buildup.

CPAP Supplies vs CPAP Machine Replacement Parts?

Most CPAP parts (power cords, machine parts, DC cables etc.) don't have a specific replacement schedule (unlike more disposable items like cushions, filters, hoses, and masks). In general, they should be replaced when broken or not functioning.


Related: Inspire Sleep Apnea Device Review


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