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Obstructive Sleep Apnea (OSA)

woman waking up refreshed

Many of us take a good night’s sleep for granted, unaware that up to 9% of the adult population struggle to sleep with a potentially life threatening disorder known as Obstructive Sleep Apnea (OSA). Up to 80% of these people are undiagnosed. The following sections are designed to help people who have been diagnosed with OSA and their families understand more about the condition and the means by which it is treated.

Obstructive sleep apnea is a sleep-related breathing disorder that involves a decrease or complete halt in airflow despite an ongoing effort to breathe. It occurs when the muscles relax during sleep, causing the soft tissues in the back of the throat to collapse and block the upper airway.

When the airway is blocked, for ten seconds or more, the oxygen levels in the body drop causing the person to wake up long enough to begin breathing normally again. These awakenings are brief, sometimes only a few seconds, and this is the reason that the person with OSA is often not aware that they have awakenings during sleep. The pattern repeats during the night, and someone with severe sleep apnea may wake up hundreds of times each night. These awakenings fragment and interrupt the sleep cycle. Daytime fatigue and sleepiness result, which is a common symptom of sleep apnea.

Untreated OSA may lead to serious health problems such as high blood pressure, heart attack and stroke. Daytime sleepiness can also lead to road or workplace accidents.


Symptoms of OSA  

  • Snoring
  • Choking or gasping during sleep
  • Observed pauses in breathing
  • Feeling tired or sleepy during the day
  • Waking up frequently during the night to use the bathroom
  • Dry mouth/sore throat in the morning
  • Morning headaches
  • Trouble concentrating, forgetfulness
  • Irritability
  • Depression or anxiety
  • Decreased interest in sex

Diagnosis  

A comprehensive history and physical examination by a sleep physician followed by an overnight sleep study (polysomnogram) is necessary to diagnose OSA in children and adults.


Treatment for Obstructive Sleep Apnea  

CPAP -- Continuous Positive Airway Pressure is delivered by a mask from a small machine that sits at the bedside. Pressurized air keeps the airway open, allowing for uninterrupted sleep and the elimination of snoring. It is the most common and effective way to treat sleep apnea.

Although CPAP is the gold standard for the treatment of obstructive sleep apnea, there are other options available. Discuss other options with your sleep physician.

CPAP Therapy

refreshed man after CPAP sleep

If you have been diagnosed with obstructive sleep apnea (OSA), your sleep physician may recommend a specific therapy known as continuous positive airway pressure, commonly known as CPAP.

CPAP therapy is the gold standard treatment for OSA. CPAP keeps your airway open by gently providing a constant stream of air through a mask you wear while you sleep. This eliminates the breathing pauses caused by sleep apnea, so you will no longer snore or make choking noises in your sleep. You will be able to sleep through the night without waking up from lack of oxygen. When you use CPAP your bed partner may sleep better, too.

CPAP is a lifestyle change. It works best when used every night, all night, for the entire time you are asleep. You should also use CPAP when you are napping. The more you use CPAP, the better you will feel.

Most people who use CPAP find immediate symptom relief and are delighted with their increased energy and mental sharpness during the day.  Many patients say, “CPAP changed my life.”

Follow-up is the most important factor in compliance with CPAP.  Iowa CPAP uses advanced technology, like wireless modems; to monitor, make adjustments and offer suggestions to help patients with CPAP as soon as treatment begins. This, along with patient education helps create a positive first experience with CPAP.


Results of Using CPAP  

  • CPAP use in obstructive sleep apnea:
  • Restores a regular breathing pattern
  • Stops snoring
  • Restful sleep returns
  • Quality of life improves
  • Decreases daytime sleepiness
  • Lowers blood pressure during both the day and night
  • Decreases health risks of heart disease, heart attack, diabetes, and stroke

Types of Positive Airway Pressure Machines  

  • CPAP (Continuous Positive Airway Pressure) provides one constant, fixed pressure.
  • AutoPap or APAP automatically titrates, or changes, the amount of pressure delivered to the minimum required to maintain an unobstructed airway. AutoPap gives you the precise pressure required at any given moment and avoids the compromise of one fixed pressure.
  • VPAP or BIPAP (Variable/Bilevel Positive Airway Pressure) provides two levels of pressure, one for inhalation (IPAP) and a lower pressure during exhalation (EPAP).
  • ASV Bilevel (Adaptive servo-ventilator bilevel machine) is a highly specialized machine that self adjusts to keep your breathing at or above a specific target. level. It is used for central breathing disorders, such as Cheyne-Stokes respiration, Central Sleep Apnea and associated obstructive events.

Features of CPAP Machines  

  • Humidifier—A heated water chamber that adds moisture to the air. It can increase comfort by eliminating the dryness of the pressurized air. The temperature can be adjusted or turned off, if desired.
  • Ramp—is used to temporarily lower the pressure to allow you to more easily fall asleep. Once it detects you are asleep, it comfortably ramps up the pressure to ensure the prescribed pressure level is delivered the moment you need it.
  • Exhalation pressure relief gives a short drop in pressure during exhalation to make it easier to exhale. This feature is known by the trade name C-Flex in some PAP’s made by Respironics and EPR in ResMed machines.

Traveling with CPAP

traveling with cpap

A common question we get asked at Iowa CPAP is “Can I travel with my CPAP machine?” Many of our customers travel frequently for work and pleasure, and some enjoy camping, fishing, and other rustic vacations.

The answer is “yes”, and you definitely shouldn’t leave your machine at home, even for short trips. People may not realize that traveling with a CPAP machine is much easier than previously thought. Also, by getting a good night’s sleep every night while away will make you feel great, and you’ll be rewarded with a memorable and enjoyable vacation.

Here are some helpful tips for traveling with a CPAP machine:


Pre-Trip Planning  

  • Always travel with a copy of your CPAP prescription. If your equipment gets lost, stolen or breaks down, you’ll need this document to obtain replacement supplies along the way.
  • Keep the following information handy:
  • The model and serial number of your CPAP machine
  • Your treatment pressure
  • Your mask type and size
  • Contact details for your equipment provider and physician
  • Your health insurance information
  • Bring extra supplies, especially cushions. You never know when your mask cushion will fail.
  • Before packing your CPAP machine, make sure the humidifier chamber is empty and dry to prevent water damage to your machine.
  • At your destination, try to use distilled or deionized water to fill your humidifier chamber.
  • Your hotel may not have a power socket located near the head of the bed, so pack a 6 to 10 foot extension cord so that you may use your CPAP machine and mask comfortably. Make sure that the extension cord is rated to handle the voltage of electrical current coming from the power outlet if traveling abroad (110VAC vs. 220VAC).
  • If you will be flying overnight, or plan on using your CPAP on the plane, contact your airline at least two weeks prior to traveling to get clearance for CPAP use. (if your approval is in the form of a letter, carry a copy with you). Also confirm the type of power cord or adapter you will need.

Air Travel (Pre-Flight)  

cpap pre-flight

It is recommended to label your CPAP case with a medical equipment luggage tag. However, most TSA agents are familiar with CPAP machines, and will easily recognize them as medical equipment.

Never check your CPAP machine. It does not count toward your carry-on bag total since it is medical equipment. There is also less of a chance of your equipment being lost or damaged. Be sure to include your contact information inside your CPAP carry-on bag, in case it gets lost.

Airline security may request to see a copy of your CPAP prescription. It will also be used if you need any supplies or replacements due to damage, loss, or theft along the way.

Your CPAP will need to be x-rayed. Take the machine out of the carry case and place it in an individual screening bin. You may put your CPAP in a clear plastic bag while being scanned for sanitation reasons. Request that TSA agents change gloves and wipe down the table before inspecting your machine. The rest of your equipment can stay in its case.


Air Travel (In-flight)  

On boarding, tell the flight attendant that you are going to use your CPAP machine during the flight. Make sure there is an outlet next to your seat, and check if you will need an adaptor.

Remember, you can use your CPAP on the plane, but not your humidifier, as aircraft turbulence increases the risk of water spillage and damage to the machine.

Most CPAP devices automatically compensate for altitude changes.


Traveling Abroad  

cpap travel abroad

Most devices automatically adjust to the various power supplies used in different parts of the world without any special adjustment.

You will need to use the correct plug adapter as power outlets differ in each country. Adaptors can be purchased from most electronics and travel stores, as well as in airports.


Outdoor and Rustic Travel  

using cpap outdoors

Whether you’ll be camping in an RV, staying the night in your vehicle, tenting it in a remote wilderness, or going to that remote fishing cabin, you can take your CPAP machine along with little worry over having to deal with heavy, bulky batteries and equipment.

If you are in a situation where added weight is not a problem, use a 12-volt deep cell marine battery. It will last longer between charges. A smaller 12-volt battery will also work, but needs to be charged more often. A 12-volt battery charger is required for both options.

CPAP Battery Back-Up Systems, made by various manufacturers are small, some weighing only 1.5 pounds, and can power your unit for 14-16 hours per charge.

Solar chargers can be used while camping off the grid, far from civilization and power sources. Solar chargers are foldable panels that can charge your batteries to full in just 6-12 hours depending on your battery. You can connect the solar panel to the battery during the day in direct sunlight and be confident that your CPAP machine’s batteries will be fully charged before you go to sleep at night.

To get longer CPAP run times, do not use a humidifier while camping.

Contact Iowa CPAP for the best solution for you.

Common CPAP Problems

woman waking up refreshed

It’s true, starting CPAP therapy takes some getting used to; it takes patience, practice and a positive attitude to make CPAP therapy successful.

Knowing that using CPAP to treat sleep apnea can help reduce risks from high blood pressure, heart attack, stroke, diabetes, weight gain and depression can be a powerful motivator to stick with CPAP therapy.

Most individuals experience a problem with their CPAP in the early stages of therapy. The good news is that these problems can be easily fixed with the help of your Respiratory Therapist at Iowa CPAP. Read on to learn practical tips for dealing with the most common CPAP problems.


Mask Isn’t Fitting Right or Is Leaking  

There could be many reasons why this is happening. The most common cause is not getting properly fitted for the ideal mask for your face. The good news is that there are many available masks in different sizes and features that will suit your needs. Different types of masks include: nasal, nasal pillows and full-face. Check with your CPAP provider and ask them to fit you to the mask that meets your needs.

A leaking mask changes the delivered air pressure and reduces the effectiveness of CPAP therapy. Once you have the correct size and style of mask, and you are still experiencing leaks, it may be that the headgear straps are not adjusted correctly. The mask should be loose, as it will be drawn to your face when the CPAP machine starts delivering pressure. Experiment with loosening and tightening the headgear straps to give you a perfect seal.

For some individuals, facial hair, including moustaches and beards can cause minor leaks. Consider a trim if the leak is on or around your moustache.

Another reason might be that the mask is too old and the silicone or gel insert has hardened. If your mask shows signs of wear and tear, or is broken you need to replace it as soon as possible, since it will never form a proper seal. Follow the cleaning procedures that are contained in this website, and replace nasal cushions and pillows frequently to get the best night’s sleep.

Many times individuals put their masks on improperly. Cushions and headgear can get turned around and placed in the wrong positions causing leaks and skin irritations. Refer to the manufacturer’s product instructions or review the proper mask set up with your CPAP provider.

Always wash your face before going to sleep. Oils on the skin may prevent the mask from forming a good seal.

Use a pillow that can be adjusted into different shapes, especially if you are a side-sleeper. Plump it into a shape that supports your head, but doesn’t interfere with your mask and tubing. Many people like a special CPAP pillow, with cut outs for mask and tubing. CPAP pillows can be purchased at Iowa CPAP (in-store or on-line).

Lastly, make sure the tubing isn’t getting in the way of your mask. Try supporting your tubing above your head, such as draping it over the headboard of your bed.

Having a well-fitting, comfortable mask is probably the most important factor in succeeding and being compliant with CPAP.


Difficulty Falling Asleep  

This is a normal, temporary problem, especially if you are new to CPAP therapy. Using the CPAP device while you’re awake, while watching TV or reading, will help you get accustomed to how it feels.

Many people find success in using the “ramp” feature, which provides an automatic, gradual increase in pressure as you fall asleep. Ask your CPAP provider to set the parameters of this feature on your machine.

Following good sleep hygiene practices can help you get to sleep

Turn off the TV, computer, iPad and mobile phone.

It’s helpful to make sure your bedroom is dark and cool.

Follow a consistent sleep schedule, even on the weekend. You will be programming yourself to become tired at a certain time of day, which will help you fall asleep faster.

Adding exercise to your daily routine can help you fall asleep at night.

Avoid heavy meals, and finish eating at least 2 – 3hours before bedtime. It’s best to avoid caffeine within 6 to 8 hours of going to bed. Also, avoid alcohol before bedtime.

There are various herbal teas that help some individuals relax and fall asleep.

Biofeedback and relaxation exercises can be helpful, as well.


Dry Mouth  

If you are experiencing a dry mouth in the morning and you have a nasal or nasal pillows mask, more than likely you are dropping your mouth open during sleep. A chin strap may help keep the bottom jaw up, preventing large amounts of air escaping through your mouth. Using a full face mask (one that covers your mouth and nose) may cure the problem.

Lastly, try adjusting your CPAP machine’s heated humidifier to a higher level.


Noise  

Most new models of CPAP devices are almost silent. If the noise from your machine is excessive or gets louder over time, the machine may be defective, and should be checked by your CPAP provider. Most insurance companies will pay for a new machine every 5 years.

Make sure the device’s air filter is clean and unblocked. Bothersome noise is often related to the mask’s exhalation valve. Switching to a quieter mask may help.

If everything is working properly, and the noise still bothers you, try wearing earplugs, using a fan at night, or using a white-noise sound machine to mask the noise.


Difficulty Tolerating Forced Air  

You may be able to overcome this by using the “ramp” feature on your machine. The “ramp” feature allows you to start with low air pressure, followed by an automatic, gradual increase until you are asleep and the proper setting has been reached. The rate of “ramp” can be adjusted to your liking. Check with your CPAP provider if you need assistance.

If this doesn’t help, talk with your sleep doctor about switching to a Bi-Pap or Bi-Level machine. This type of device provides more air pressure when you inhale and less when you exhale, making it more comfortable for some individuals.


Unintentionally removing the CPAP mask during the night  

A common complaint is removing the CPAP mask during sleep. This may be due to a poor fitting mask. A related problem is waking up to use the bathroom and forgetting to put the CPAP mask back on. Changing the type of most likely will help these problems.

You may pull off the mask when your nose is congested. If so, make sure your mask fits properly and you are using the heated humidifier.

If removing the mask at night is a consistent problem, some people set an alarm for sometime in the night, to check whether the mask is still on. The thought is to progressively set the alarm for later and later into the night until the mask is being keep on all night.


Mask Causing Skin Irritation or Pressure Sores  

Red marks and pressure sores are most likely caused by the headgear straps being too tight.

When putting your mask on, turn your machine on to start the pressure and loosen the Velcro straps on both sides. Tighten the straps at the same time until the leak stops. Don’t over-tighten.

A “gecko” pad, which is a gel pad that fits over the bridge of the nose may help. It creates a soft barrier between your skin and the mask. The addition of “cozy pads” on the straps of the headgear help put a soft barrier between the straps and your face and may help eliminate mask marks.

If you have a nasal pillow mask and it is causing redness or pain around the nostrils, you may try a water-soluble lubricant or gel.

If these tips don’t work, you may need to switch to a different style mask.

If your skin is getting irritated or breaking out, your mask may be dirty. Wash your mask every morning, and wash your face each night before bedtime. Mask liners called Remzies are also an option to help reduce or eliminate skin irritations, Following the recommended replacement schedule can help to prevent these issues.


Dry, Stuffy Nose  

Be sure to use the heated humidifier on your CPAP machine. Moist air helps prevent the mucous membranes of the nose and throat from drying out. Try using a nasal saline spray at bedtime to prevent a dry nose.

It’s also important that your mask fits well. A leaky mask can dry out your nose.


Feeling Claustrophobic  

To deal with claustrophobia, feelings of suffocation or panic attacks, try the following suggestions. While you’re awake, practice by just holding the mask up to your face without the headgear or the machine being turned on. Progress to wearing the mask with the straps in place, while watching TV. Next, wear the mask while it’s connected to the tubing and the CPAP machine is on at a low pressure and with the “ramp” feature turned on. Watch TV and relax. After you’re comfortable with that, try sleeping with it on.

Relaxation exercises may also help reduce your anxiety. It may help to get a different style of mask, like nasal pillows that cover less of your face.

If you’re still feeling claustrophobic, talk to your sleep doctor or CPAP provider.

Using CPAP can be frustrating as you try to get used to it, but it’s important to stick with it. The treatment is crucial to avoiding the complications of untreated sleep apnea, such as heart problems and diabetes.

Work with your sleep doctor and CPAP provider to get the best mask fit and device for you.

It may take time and lots of adjustments to overcome some of the common CPAP problems.

With time and patience, CPAP can positively affect your quality of life and health. Before long you’ll be one of those individuals who says, “I just can’t sleep without my CPAP!”

Newly Diagnosed with Sleep Apnea — Tips for Succeeding on CPAP

sleeping peacefully with cpap

Proper Mask Fit

Make sure you work with you CPAP equipment provider to find the correct mask that suits your needs. The main categories of masks are: full-face, nasal, and nasal pillows. Most masks come in different sizes and just because you’re a certain size in one mask doesn’t mean you’ll be the same size in another. Everyone has different needs and face shapes and the biggest key to success is finding the right mask for you. New and improved models of masks come out frequently, so stop by Iowa CPAP to see what’s new.


Practice...Practice...Practice 

Inconsistently wearing the CPAP device may delay getting used to it. Stick with it for several weeks to see if the mask and pressure settings you have will work for you. It may help to start by practicing for short periods of time while you’re awake, for example while watching TV, reading or listening to music. Once you become accustomed to how it feels to breathe against pressure, shift to using the CPAP device every time you sleep—at night and during naps. Adjust the headgear to fix any leaks, and move around to get used to the mask in your preferred sleeping position. Practicing before bedtime may also help reduce the feeling of being claustrophobic. The more you use CPAP, the more successful you will be in managing your sleep apnea.


Use the “Ramp” Feature 

If you are having difficulty tolerating forced air, try the ramp feature on your machine. “Ramp” allows you to start with a low pressure followed by a gradual increase in pressure as you fall asleep. Ramp and other comfort features on your CPAP machine can be easily adjusted by your Iowa CPAP Respiratory Therapist.


Prevent Dryness 

Nasal congestion can be a problem with CPAP treatment. Most CPAP machines have heated humidifiers that can be used in conjunction with the CPAP device. Heated humidity ensures that you are breathing warm, moist air through your mask. Heated humidifiers allow a selection of temperatures so that you can tailor the air temperature to your liking. You may want to raise your humidifier settings during the winter months when the air is drier, and lower your humidifier settings in summer months when the air is warmer and holds more water.


Frequent Downloads 

Most CPAP devices have the ability to store information about how the therapy is working for you. Iowa CPAP provides internal modems in all CPAP machines. This allows your Respiratory Therapist and your Sleep Physician to complete a download to check for any problems and make necessary adjustments to your CPAP machine settings via the internet. Have your CPAP equipment provider look at this data to ensure that the therapy pressures are where they need to be and that the equipment and supplies are working optimally. If you are having difficulty tolerating the therapy, it’s important to follow up with your sleep physician.


Keep on Replacing your Supplies 

The disposables such as the mask, headgear, tubing, cushions, filters and water chamber will need to be replaced on a regular interval to maintain optimal therapy and ensure that the CPAP device will last for years to come. It’s also important to remember to clean/disinfect the mask, tubing and water chamber at least once a week. Be sure to visit our section on Replacement Schedules and Cleaning Your Equipment on this website,

And don’t forget, our Respiratory Therapists are always available to help you through the first critical weeks of therapy – and for any questions that arise as you progress with CPAP.

Central Iowa A.W.A.K.E. Group

central iowa awake group cpap

Central Iowa A.W.A.K.E is a health awareness group for individuals with sleep apnea, family members and friends. The group is part of the American Sleep Apnea Association’s A.W.A.K.E Network (Alert, Well And Keeping Energetic). Our desire is to give those with sleep apnea the tools to manage their own health care successfully.

Central Iowa A.W.A.K.E is a group that provides community support, sleep education and discussion on different therapy options for sleep apnea. There is no charge for attending A.W.A.K.E sessions. Sessions are held at 7 pm. on the 3rd Thursday of every month at Iowa CPAP, 4040 Westown Parkway, West Des Moines, Iowa.

Sessions will include: mini-lecture on a specific topic, open group discussion, and a time to chat with others about their experiences. Reserve your spot at central.iowa.awake@gmail.com.

Upcoming Sessions:

Click to find session topics and dates on the Iowa Sleep website.

FAQs


Do all masks come with headgear?  

All masks are sold factory sealed, to include headgear.


Do I need a prescription to order a CPAP?  

All CPAP/BI-PAP machines are considered Class II medical devices and require a 'doctor's note'. If you already use a CPAP and are looking for a replacement, back up, or travel machine, please call us. We have created a prescription form to assist you in getting your doctor to sign off on your new or used CPAP. Many times, your doctor's office will assist you without requiring an office visit; they understand that you need replacement equipment and in many cases your insurance company does not cover the equipment. We can help you facilitate this process, as there are several options available to you. The bottom line is that we will be happy to work with you to get the machine you need. Please send us an email, or give us a call.


How do I breathe when I have a cold or plugged nose?  

There are various ways to address this issue. The most common way is to use a Breathe-Right nasal Strip or nasal decongestant spray. Having a full face mask on standby is also a good idea. If you experience any discomfort when wearing your CPAP or BI-PAP during a period of sinus congestion, ear infection, etc., it is recommended to cease use of the machine for a few days until you are feeling better. If you are not better in a few days it’s important to consult with your sleep doctor.


How do I know which CPAP I need?  

The specification of which flow device you require should be outlined on your prescription. Most commonly it will either read 'CPAP', 'BIPAP', "VPAP" or 'APAP'. There are some variations on these designations. If you have any questions, please feel free to contact us.


How do I know which size mask to buy?  

There are free downloadable sizing templates to help you find the right fit. Feel free to make an appointment to come into one of our Iowa CPAP stores to be fit by a respiratory therapist.


How do you keep dust from entering your mask?  

Every CPAP machine comes with one or more filters. Some systems come with a washable foam style filter that traps most dust and pollen. You can hand wash this type of filter and re-use it for many months. A disposable filter is available for most CPAP machines and should be replaced at least monthly or more often for patients with allergy problems. This type of filter is commonly called an "ultra-fine filter" and traps much smaller particles.


How long does it take to get used to CPAP/BI-PAP Therapy?  

On average, it takes about 1-3 weeks before you are sleeping all night with the mask on. Some people will take to therapy without a period of acclimation; although they are the exception to the rule. The point is that the length of time varies from person to person. The important thing to remember is that, as with anything else, with a little practice and some patience, using a CPAP/BI-PAP machine will become second nature.


How long does it take to start feeling better using CPAP?  

You should notice a decrease in daytime sleepiness, improved alertness, and an increase in quality of life in the first two weeks of use. For some, it may take a bit longer to work out common CPAP problems.


How long will my CPAP last?  

The average life expectancy of a CPAP or BI-PAP machine is approximately 15,000 hours, or roughly 5 to 6 years of full time use. That said, many times, if properly cared for, these devices will last much longer.


How loud is a CPAP Machine?  

Most manufacturers list the noise output level of a standard CPAP machine between 25- 30 decibels. Formally, 30 decibels is considered "almost total silence". The sound a machine outputs does vary with every make and model.


How often should I replace disposable equipment?  

If you use Continuous Positive Airway Pressure (CPAP) or bi-level therapy to treat sleep apnea, it is important to know how often you should replace your supplies. These items include the mask, headgear, cushion, chinstrap, tubing, filters, humidifier chamber, and the CPAP unit itself. Most of these supplies are designed to be disposable. Replacing supplies on a set schedule and faithfully and thoroughly cleaning the equipment between times will ensure your health and treatment efficacy.

Filters are inexpensive and easy to replace. They keep debris from your bedroom environment—pet dander, dust, pollen, or cigarette smoke from entering the machine, and ultimately your nose, mouth or lungs. Not changing filters frequently may contribute to allergies, congestion, or other health problems. Your CPAP machine’s filter is typically located on the rear side of the unit, newer ResMed models have their filters located on the side of the unit. Some machines use two different filters, a disposable and a reusable filter. The reusable filters are typically dark grey or black in color and have a foam or sponge consistency. These filters can be washed out, dried and used several times before replacement.

The most common CPAP filters are disposable. They are white in color and fibrous in texture. These filters must be replaced on a regular basis. It’s recommended that you replace the disposable filters every two weeks.

Older equipment and supplies become less effective. Delicate silicone mask cushions gradually break down. CPAP tubing may develop small holes. Together these changes can cause an increased leak and poor mask fit.

For these reasons, it is important to regularly replace your CPAP equipment. Insurance companies allow frequent replacement of CPAP supplies for good reason. They realize new CPAP supplies will increase the likelihood that you will consistently use your CPAP. This means better health for you and less overall health care costs for you and your insurance company. For example, a $125 mask is much cheaper than an ER visit or the lifetime cost of hypertension or diabetes.

Iowa CPAP will remind you when your CPAP supplies are due for replacement. Utilize this service to be sure you are consistently getting the very best CPAP therapy. Also, feel free to call anytime if you’d like to order new supplies—we’ll let you know if it’s covered by your insurance.

Below you will find our Recommended Replacement Schedule for CPAP and Bi-Level Supplies, based on information from Blue Cross and Blue Shield.

Item Replacement Frequency HCPCS Code
Full Face Mask 1 per 6 months A7030
Full Face Mask Cushion 3 per 6 months A7031
Nasal Mask 1 per 3 months A7034
Nasal Cushion 2 per month A7032
Nasal Pillows 2 per month A7033
Headgear 1 per 6 months A7035
Chinstrap 1 per 6 months A7036
Filter (Non Disposable) 1 per 6 months A7039
Filter (Disposable) 2 per month A7037
Heated Tubing 1 per 3 months A4604
Tubing 1 per 3 months A7037
Water Chamber 1 per 6 months A7046
Auto Pap Machine 1 per 5 years E0601

Everyone’s private insurance replacement schedule will vary slightly. Visit Iowa CPAP or call to request a replacement schedule for your particular insurance.


I frequently notice water in my CPAP tubing. What should I do?  

Water collects in the tubing when the ambient room air is colder than the heated air coming from the humidifier, or when the humidifier is producing too much moisture. Try turning down the temperature of the heated humidifier. Add a tubing wrap, or try using heated CPAP tubing. This will help maintain the temperature from the machine all the way to the mask, reducing the occurrence of water condensation inside the tubing, or rainout.


If I gain or lose weight during therapy, what should I do?  

Contact your sleep doctor, especially if old symptoms reappear. The pressure of your CPAP may need to be adjusted. A “download” of data from your CPAP will be performed, or if your machine has an internal modem, your sleep doctor can view how your therapy is working for you, and make any necessary adjustments.


If I go to the hospital, should I bring my CPAP?  

Yes, it is important to have your CPAP with you. Also, if you are having surgery, tell your surgeon and anesthesiologist that you use CPAP.


My eyes are frequently sore and irritated. What should I do?  

The mask may be leaking air into your eyes. Pull the mask straight out from your face to reposition it. The mask may be too loose or too tight, adjust the headgear straps.


My mask is leaking. What should I do?  

Air leaks are caused by poorly fitting masks, masks that are too old, or masks that are the wrong style for your face. You may try to readjust the headgear straps. The mask should be as loose as possible, while still forming a seal. A tight mask will cause leaks, as well. You may need a different size or style of mask.


What if I still snore while using CPAP?  

Snoring should not occur while using CPAP. It may be an indication that your pressure settings need to be adjusted. Contact your sleep doctor.


What is a BI-PAP (Bi-level)?  

A BI-PAP machine is fundamentally different then a CPAP machine. With a BI-PAP device, you set an inspiratory pressure and a separate, lesser expiratory pressure (in setting them both to the same pressure, you would have CPAP). BI-PAP's are most commonly prescribed for individuals that have higher inspiratory pressure requirements or for those individuals that are having a hard time adjusting to CPAP therapy. It may also be noted that the sensation of breathing on a BI-PAP machine is much different than breathing on a CPAP machine. Many individuals find it much easier to breathe on a BI-PAP device because of the added feature of pressure support, and various other comfort options available exclusively to BI-PAP machines.


What is a CPAP with EPR or C-Flex?  

C-FLEX is a technology patented by Philips Respironics several years ago. C-FLEX is a comfort option that can be turned on or off. If turned on, it will decrease pressure during exhalation, by up to 1, 2 or 3 cm of water pressure. A setting of C-FLEX translates, literally, to the amount of pressure decreased during exhalation - i.e. a C-FLEX of 2 means the pressure given during inhalation will drop by approximately 2 cm of water pressure during exhalation. This option is of great assistance to new users of CPAP therapy. During the first couple weeks of therapy, it can be a challenge to adjust to the sensation of breathing against pressure – C-FLEX goes a long way in easing the CPAP user into this new way of breathing. The same technology in the ResMed product is called EPR, or Expiratory Pressure Relief.


What is a CPAP?  

CPAP is an acronym for Continuous Positive Airway Pressure. A CPAP machine delivers a single, constant pressure. The pressure insures an open airway by displacing the soft tissue causing the obstruction.


What is a humidifier, and why do I need one?  

The use of a humidifier is subjective to the individual. Ideally a humidifier should be incorporated into your therapy regimen because it does what the nose does not have time to do, when using the CPAP/BI-PAP. When you breathe in normally, without the use of a CPAP or BI-PAP, the nose will slowly warm and humidify the air before it reaches the lung field. When using a CPAP/BI-PAP, the nose does not have time to provide adequate warmth or humidity due to the increased flow air. The humidifier will moisturize the air being delivered by your CPAP/BI-PAP, making therapy more comfortable and may prevent the side effects of breathing dry air. A humidifier should be emptied daily, and refilled nightly, prior to sleep with distilled or de-ionized water. It should be thoroughly cleaned at least once a week with a (3:1) water and vinegar solution. You increase your susceptibility to upper respiratory tract infections if you do not keep up good maintenance on your humidifier reservoir.


What is an APAP (Auto-Titrating CPAP)?  

Auto titration machines will 'self-adjust' to deliver the least amount of pressure required to keep the airway open, or 'patent'. An auto titration device is set using a maximum and minimum pressure 'window'. The machine will operate within these given parameters using an algorithm to deliver the least amount of pressure needed with any given breath.


What is an Intentional Leak Port?  

Every mask system requires exhalation ports. This is a way to remove your exhaled air from the mask system. Some vent at the elbow, and some vent in the swivel. When you wear your mask and have your machine turned on, you will be able to feel air escaping where the vent ports are located.


What is the benefit of buying from Iowa CPAP?  

Iowa CPAP was created in 2010 to assist those who find themselves in a position of having to pay out of pocket for CPAP or BI-PAP equipment. We are a small business, located in Iowa. We are truly a family owned and operated business. We take great pride in providing an excellent product, and knowledgeable, personalized customer service. When you call, we take as much time as YOU need to get all your questions answered. We have been accredited with BOC and no complaints have been logged against us. We have worked hard for our reputation, and look forward to working with you to fulfill your sleep therapy needs.

The vast majority of on-line CPAP and BI-PAP outlets do not provide a licensed, nationally Registered Respiratory Therapist to assist their customers. We do. Give us a call today. We are here to assist you--before, during and after the sale.


What types of mask systems are available?  

There are three basic nasal interface systems available. The most popular system is the nasal mask. The nasal mask is an interface that completely covers your nose, and is held in place with headgear. You must be able to keep your mouth closed at all times to make this mask system work. Another very popular and less cumbersome interface system is the nasal pillow mask. This type of mask system is held in place by headgear, and the interface only touches your nose just inside the nostrils. This works well for those individuals that like to read or watch TV prior to bed. The third nasal interface system is called a full face mask - which is a bit of a misnomer as the mask only covers your nose and mouth. This mask is most commonly used in those individuals that start to mouth breathe upon entering REM sleep. Many times the muscles controlling your jaw will relax and cause you to open your mouth and allow air to leak through. If this happens, it largely renders your positive pressure therapy ineffective.


When and how should I clean my CPAP Equipment?  

One of the most important duties in successful CPAP therapy is taking proper care of your CPAP equipment. Cleaning and disinfecting the components of your CPAP machine and mask are vital to ensure optimum therapy and proper infection control. This must become routine so that your CPAP therapy is as safe, and remains as effective as the day you got the equipment.

There are also components to your CPAP machine and mask that need to be replaced to maintain optimal seal and comfort. See our section on CPAP Replacement Schedules in FAQs.

Daily Cleaning (CPAP cushion and water chamber)

It’s important to clean the mask cushion of facial oils daily to minimize the risk of skin irritations and leaks from the mask during sleep.

After washing your hands, disconnect the mask and tubing, next remove the headgear from your mask. Remove the water chamber from the humidifier and empty any water remaining. Fill a large bowl or your sink with mild soapy warm water and gently wash the cushion and water chamber thoroughly. Rinse all the pieces and allow to air dry on a towel away from direct sunlight. By following this 3 to 5 minute procedure every morning, you will have a clean, dry mask ready to use that night. Remember to refill your water chamber with distilled water before you go to bed, as well.

NOTE: Never wipe down your supplies with alcohol or bleach, as this can cause skin irritations and damage the supplies.

Weekly Disinfection

Disinfect all plastic equipment (mask, tubing, water chamber) in a solution of one-part white vinegar and three-parts of water. Allow all parts to sit in the solution for approximately 30 minutes. Rinse all parts well with warm water and allow to air dry on a towel away from direct sunlight. This should be completed more frequently if you have a respiratory infection.

On a weekly basis, wash your headgear and chin strap (if used) in a bowl of warm soapy water, then rinse. Allow to air dry, do not put it in the dryer.

Wash non-disposable filters (usually foam) with warm soapy water and rinse thoroughly. Make sure filters are dry prior to re-installing in your CPAP machine.

General CPAP Cleaning Tips

  • Your CPAP machine housing does not need to be cleaned, but you may want to dust it with a dry, clean cloth. Unplug your machine and use a moist cloth, if you wish. Never submerge your CPAP in water.
  • Make CPAP cleaning part of your morning routine, allowing the equipment ample time to dry during the day.
  • Keep machine and accessories out of direct sunlight.
  • Use gentle unscented dish soap for cleaning mask and tubing. Never use harsh soaps, chlorine bleach, antibacterial or alcohol based solutions.
  • Keep track of when you should order replacement parts for your mask and accessories so that you always get the most out of your CPAP therapy.
  • Use distilled water to fill your water chamber. Tap water may contain minerals and chemicals that can damage components of the machine. It is also not recommended to use filtered water (i.e; through a Brita filter) for the same reasons.
  • Contact us at Iowa CPAP for any of your CPAP needs or questions at : 515-223-CPAP (2727)


Which is better, a nasal pillow mask or a nasal mask?  

Deciding on what mask works best for you, is much like deciding on your favorite pair of shoes. It is a very individual decision. It is recommended that you start with the least invasive mask system that you can. The smaller the product on your face the easier it is to get used to. After you get used to using CPAP therapy, don’t be afraid to look into other options and try different styles of mask systems.


New to CPAP or looking to upgrade outdated equipment? Iowa CPAP can help.

Call 515-223-CPAP (2727) or 1-855-830-CPAP(2727)

Starting on CPAP did the trick! My wife is glad that my snoring has stopped. I feel better than ever—so awake and alert during the day.

Dave, Des Moines

2005 S Ankeny Blvd Ste 600

Ankeny, Iowa

4040 Westown Pkwy

West Des Moines, Iowa