Tag Archive for: Everything CPAP

From Surgery to CPAP – Sleep Therapy Evolution

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Before there was CPAP

Before the invention of the Continuous Positive Airway Pressure (CPAP) machine, people still suffered from sleep apnea, we just didn’t have very good ways of coping with it.

Documentation of sleep problems goes back centuries, but modern sleep studies began in earnest in the late 1960s, leading to approaches and treatments that have improved lives dramatically over the years – although it wasn’t always easy.

Earliest days of treatment

Before the 1980s, the only treatment for severe Obstructive Sleep Apnea (OSA) was to perform a tracheotomy. As a child, I learned to my horror what this procedure meant while watching a rerun of M*A*S*H: in it a hapless Father Mulcahy had to follow radioed instructions to do the surgery from the back of a jeep – using only a pocket knife and a snipped-off eye-dropper.

In case you missed that one, the operation means cutting a hole in the patient’s throat and sticking a tube in to let them breathe. Clearly, not to be done lightly – even in a more sterile environment than the bomb-rattled countryside of 1950s Korea.

tracheotomy mash

Best sleep in years

In 1980, Australian doctor Colin Sullivan made a major breakthrough with an experimental treatment for OSA. After working as a Postdoctoral Research Fellow in the Department of Medicine at the University of Toronto from 1976-78, Dr. Sullivan made his way back to the University of Sydney, where he dove deep into understanding obstructive sleep disorders.

Establishing a sleep lab, Dr. Sullivan followed a revolutionary new treatment course, beginning with tests on dogs (specifically breeds like pugs, known for their breathing and snoring issues). He figured that constant air pressure would prevent the collapse of tissue that causes breathing interruptions, so he hooked a motor from a vacuum cleaner to hoses and a mask, creating the first effective CPAP machine.

When he tried his machine on a human patient, though the motor was so loud it had to be kept in a separate room, the patient reported feeling more rested and alert than they had in years. It was the beginning of a new era for apnea sufferers.

pug tired e1599760446534

CPAP becomes a thing

The results were so encouraging that more work was done to make CPAP practical for home treatment. Early machines were loud and hard to regulate, and masks had to be custom-made and stuck to the face with silicone glue to stop them from sliding off. But with Dr. Sullivan’s advances, CPAP became commercially available from a (then) new company called ResMed, and OSA patients have never looked back.

As ResMed grew to become a global provider, they continued to pay homage to Dr. Sullivan for years by maintaining an “S” at the start of their model numbers. As time went on, others entered the market and brought further advancements, like New Zealand offshoot Fisher & Paykel Healthcare, and the Respironics division of Philips. These players have added to the field of advanced CPAP machines and provide patients with a range of options.

Colin Sullivan showing an early CPAP machine model

Humidification Innovation

Over the years, CPAP machines started taking shape as the go-to treatment option for obstructive sleep apnea. The first machines were very large, heavy and noisy. Though they provided much needed relief, they lacked convenience. The early machines such as the Sullivan CPAP (yes named after the CPAP inventor) lacked even simple comfort features like humidification, a feature that most wouldn’t want to live without today.

At first, an external humidifier was introduced; a tube connected the CPAP to the humidifier, and another tube connected the humidifier to the mask. This worked, but made the CPAP setup pretty unwieldy. Humidifier units that attached directly to the CPAP were finally introduced in 1995, so the setup got a lot simpler to deal with.

Side view of an opened water chamber

Fisher and Paykel raised the bar with heated humidification.

You may recognize the popular model below that was used in Europe and North America, and was the go-to CPAP for patients with chronic congestion and allergies or folks living in dry northern climates.

Now all top 3 CPAP makers have a completely integrated humidifier, meaning it is a standard part of the machine and takes up barely any space at all.

CPAP

Auto-Titrating Technology Changes CPAP Forever

In the earlier 2000s, CPAP  technology had a major breakthrough. The first auto-titrating machine, the S8 AutoSet II, was released. Auto-titrating machines are revolutionary because they can detect what pressure you need to eliminate your apnea and they re-adjust throughout the night.

Old machines were set to one prescribed pressure determined during a sleep study. Fixed pressure machines can be incredibly inconvenient because your needs change over time due to weight, age, health and stress level. Your needs can even change during the course of a single night! With a fixed pressure machine, you would often have to go through another expensive and uncomfortable sleep study to get your machine adjusted. Not anymore – auto-titrating machines made that a thing of the past. Just turn on the machine and go. It detects the optimal setting for you, ensuring you’re always getting the pressure you need.

old CPAP machine

Heated Tube Conquers Rain Out

The next step in evolution was the heated tube, and it certainly has changed CPAP treatment for Canadians. Our cold winters were responsible for condensation in the tube, also called rain out, making for a wet and irritating night.

Heated tubes solve the problem by preventing water from condensing in your tube and dripping into your mask. Heated tubes control temperature and humidity so you get optimal moisture.

The first to introduce the heated tube was Fisher& Paykel, and throughout the 90s and early 2000s, clinicians recommended F&P for anyone with chronic allergies or congestion. In the 2010s, Resmed and Respironics followed suit.

climate tube e1599764956642

Smallest CPAP Ever

In the old days, CPAP machines were heavy bricks that were impossible to lug around, which made traveling with your CPAP a nightmare. Today’s CPAP machines have gotten way smaller and more portable. Respironics has released the DreamStation Go and Resmed the AirMini – CPAP machines that can fit in your hand and work with battery backup – you can even take your CPAP camping!

Twenty years ago, CPAP users and manufacturers never dreamed of such advanced sleep apnea fighting technology. What started as a novel way to avoid slicing into patients’ necks became the most accepted OSA treatment around, with over a million patients worldwide using CPAP to improve their sleep.

Thirty-something, professional woman in a hotel room putting her Resmed AirMini portable CPAP machine in a carry-on suitcase

Smartest CPAP ever

In the early years, clinicians helped patients with CPAP by simply asking questions about their daytime and nighttime symptoms. In the 2000s, data cards were introduced which allowed your respiratory therapist to see how your CPAP was working for you, and adjust pressures as needed. You would have to pop into the clinic to have your card read.

Today, with bluetooth and wifi connectivity, your RT monitors your progress without the need for you to come in at all. He or she can also adjust pressures remotely.

In the age of the coronavirus, it has meant that at Apnée Santé, we can continue to monitor our sleep apnea patients.

During lockdown, our respiratory therapists were as busy as ever supporting you.

guy cpap

There’s an app for that!

On top of remote monitoring, there’s even a smartphone app for today’s advanced auto CPAPs.

You can keep track of your nightly stats to get the most out of your sleep therapy, all on your own phone or tablet.

The apps include detailed reports of your night’s sleep, and come with helpful tips to make your sleep therapy the best it can be.

They’ll even give new users mask setup guidance and help you learn how to assemble and fit a mask for a proper seal.

old man smartphone

Some other advances that came over the years include:

  • Autoramp: The first machines were an all-or-nothing affair, running at full pressure from the word “go.” The CPAPs we offer these days at Apnée Santé all have the option to gradually ramp up to full pressure, making falling asleep feel as natural as, well, falling asleep.
  • Better masks: New generation masks and straps are more comfortable than ever. Whether nasal-pillow style or full-face, there’s always a perfect fit and Apnée Santé can help you find it.
  • Smart cleaners: Even cleaning your CPAP keeps getting easier – the Lumin UV cleaner makes sanitizing a breeze. Read our CPAP cleaning blog to get more dirt on cleaning.
kills 99% of viruses similar to coronavirus

Shop lumin

Conclusion

Anyway you look at it, CPAP therapy blows away previous sleep apnea treatments.

And with its rapid evolution from dogs plugged into vacuum cleaners to whisper-quiet smart machines, who knows what other exciting advances are to come.

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Saving money on a used CPAP machine could prove costly

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The world is a connected place.

Finding online groups to buy second-hand stuff is second nature by now, and why not? Save the environment and save a few bucks by giving something another life? Sign me up!

But while it can be a great idea to take someone’s “good intentions” exercise equipment off their hands, or pick up a pair of slightly used skates for your kid whose feet grew three sizes in as many months, getting into a second-hand CPAP can end up costing more money and costing your health in ways you don’t want.

If you don’t have insurance or some extra savings put away, the cost of a new CPAP can be off-putting, but there are still ways to do it without breaking the bank and without gambling with your health. Flea markets are great for vintage memorabilia, not so much for used medical equipment.

Because, well, EW.

That sounds silly but really – even if it looks clean on the outside, the inside of a CPAP machine is a warm, moist environment that’s an absolute playground for contaminants like mold, fungus, bacteria and viruses. Taking care of your machine and keeping it clean is easy enough, and you can learn more about it here. But how do you know the previous owner took care of their machine as well as you should?

Whatever contaminants a previous owner breathed out into the equipment could still be there, and in these days of COVID-19 it doesn’t seem like a smart chance to take. COVID-19 is new and our understanding of it is still evolving, but it’s far from the only issue. Whether it’s a from a buildup of oil, sweat and dead skin cells, or a more pathogenic agent, there can be many negative health impacts from an improperly maintained CPAP. They can be as mild as skin rashes or infections, or as severe as pneumonia or other serious lung infections like bronchitis or tuberculosis.

CPAP machine can be a breeding ground for mold, fungus, bacteria and viruses

You get what you pay for

Kind of like a car, that runs into more problems the older it is and the more kilometres are on it, CPAP machines and accessories wear with time and use.

If you buy a used car through a reputable dealer, you’ll usually get some sort of guarantee that it will keep running at least for the first little while, but can you say the same for a CPAP you bought through a Facebook group or some other online garage sale?

While it’s tempting to save a few bucks up front, you might find that the machine quits on you a month after you bought it and you’ll have absolutely no recourse.

Not only will you have no way to know how many thousands of hours have been logged on the machine (for reference, it could easily be as many as 15,000 hours for a 5-year old CPAP) but you’ll also likely be missing out on newer comfort and tracking features that come with the most up-to-date equipment.

broken down car

Service makes all the difference

In spite of the above concerns, really the biggest thing you’ll be missing out on if you buy something, you know, from your neighbour’s friend’s cousin, is service.

When you buy a CPAP from Apnea Health, you get the advantage of our CPAP Care for Life Program, which means you’ll get the support of a respiratory therapist for as long as you own your machine, access to sleep physicians, remote monitoring and follow-ups, free CPAP replacements while your machine is in for service and automatic progress updates to all of your healthcare providers.

A solid team in your corner makes all the difference for getting the most out of your CPAP treatment and getting the kind of sleep you deserve.

We’ll make sure your equipment fits properly and is set up to meet your needs – if you go it alone and the settings on your used machine are not right for you, you’ll likely make your sleep worse instead of better. One size definitely does not fit all, and we’re here to help you get it just right.

Apnée Santé Team

 

Related links:

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Sleep Testing and CPAP Supplies Insurance Coverage

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At Apnea Health we always go the extra mile.

Because we know that private health insurance coverage can be confusing and tricky, as experts in sleep medicine, we offer our patients assistance with insurance benefits. Read on to hear how it works.

When you visit our clinic, together we can contact your insurer to verify your insurance benefits and coverage for both rentals and purchases

We’ll also find out the terms of the rental or purchase and we can provide you with an estimate of your expected financial responsibility at the time of set-up and monthly for the term of your rental.

If you’re comfortable asking your CPAP provider on your own, we will supply you with the necessary equipment estimate and your prescription or sleep results for those who were seen in our sleep clinic. Get direct access to your insurer contact details here.

In general, Apnea Health is unable to bill your private health insurer directly, but we are able to help people like yourself by providing you with quick turnaround, affordable prices, and dependable custom service.

Delson clinic employee talking to patient

Insurance Claims FAQs

What is covered by Health Insurance Benefits?

Health Benefits plans offered by employers often cover the full or partial cost of CPAP machines (typically 80% of cost) and CPAP supplies, such as masks, tubing, filters etc. Coverage may vary, so we recommend confirming your coverage with your Insurance Provider. A contact list of common Canadian Insurance providers can be found below.

How can I obtain a quote or estimate for supplies?

If you need a quote or estimate for your Insurance Provider to confirm coverage prior to purchasing, you can either call us directly (1-800-727-8748) and we’ll be happy to assist your or you can do it yourself at shop.apneesante.com through the following steps:

How do I submit for reimbursement after purchase?

If you’re eligible for reimbursement for your CPAP equipment, you will likely need to submit your receipt for reimbursement. When you purchase from Apnea Health online or in our clinic, you’ll receive a hard copy and soft copy (pdf by email) of your paid invoice.

replacement schedule en 1

What’s NOT covered by insurance provider

CPAP Cleaning Products:

PURDOUX CPAP wipes – Aloe Vera (unscented)

CPAP Premium 2 in 1 Hose Brush

Lumin CPAP cleaning and disinfecting machine

purdoux soap

 

CPAP Comfort Products:

CY K8405 E 1 BCP 900508 contourPillow 1 e1587749383883KG 5590 E 1

Insurance Claim Forms and Contact information

Great West Life:

BlueCross:

SunLife:

MÉDIC Construction:

Desjardins:

Manulife:

Industrielle Alliance:

Standard Life:

Greenshield:

The Co-operators:

Equitable Life:

RWAM Extended Healthcare:

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Why is there water in my cpap mask?

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If you’re a CPAP user, waking up with water on your face can be a truly disturbing experience.

Half awake, you start worrying that something is wrong with your CPAP. Don’t be alarmed. This is a fairly common problem known as rainout.

What is rainout?

Rainout is something that only occurs when CPAP users have a humidifier attached to their CPAP machine. When the temperature of the room is colder than the temperature of the humidified air traveling through your CPAP tube, water condensation builds up on the sides of the tube. The water will then drip onto the user as it exits the tube—essentially raining on you.

Man asleep with condensation on the window behind him

What are the consequences of rainout?

First and foremost, rainout can wake you up when dripping on your face, but it also has other consequences as well. These include:

  • Noisy sleep therapy: The moisture in the tube can cause a variety of unusual noises during the night, from gurgling to banging as the air pressure flows down the tube full of droplets.
  • Mold growth on CPAP supplies: Your supplies become less sanitary if not dried out properly after your CPAP session ends, as the waiting moisture is a breeding ground for germs and molds.
  • Shortened lifespan of equipment: Moisture leftover from rainout can even lead to your supplies degrading faster, contributing to small holes in your tubing that are hard to notice.

How can you deal with rainout?

  1. Customize your humidification settings.

    The main cause of rainout is the difference in the temperature of your room and the temperature in your tubing. The ResMed AirSense 10 AutoSet, Respironics DreamStation and F&P Sleep Style prevent rainout with their climate control functions:

    • Automated Climate Control: Adjusts the humidity level of your water chamber and the temperature of your heated hose to match your room’s climate
    • Heated Tubing: Controls the the moisture levels and the air temperature in your tube
    • Tube Drier: After using your CPAP, a snowflake symbol will flash and the machine will dry out any moisture that remains in your hose

  2. Upgrade to a heated tube.

    If you don’t already have a heated tube or yours is defective, consider also purchasing a new one. The heating function will keep water droplets from forming inside the tube and prevent rainout from happening. Find your tube here.

    When CPAP supplies don’t function as well as they used to, replacing them is the quickest and most effective solution. Private health insurance covers replenishment parts yearly.

    If you already have a heated tube but you’re still experiencing rainout, you probably need to manually adjust the settings. Below find out how to adjust for each CPAP machine we carry:

    woman wearing a cpap mask, using an ipad and thinking about CPAP heated tubing accessories

    Shop heated tubing

  3. Insulate your tube with a tube cover.

    If you don’t have a CPAP machine compatible with a heated hose yet, then a tube cover can help lower the amount of rainout that occurs. Tube covers provide an extra layer of protection between the temperature in your room and the temperature in your tube. This helps keep rainout down by insulating your tube from your room’s cool air that would otherwise condense the water vapour in your tube back into droplets.

    sleeping man wearing a CPAP mask, with a cover on his CPAP tubing

    Shop tube covers

  4. Make sure you’re cleaning your CPAP.

    Water buildup can restrict airflow from your CPAP, but rainout isn’t just a problem that prevents you from having a peaceful night’s sleep. If you aren’t cleaning your supplies every day, the moisture buildup can allow bacteria and mold to grow in your CPAP tube. The Lumin CPAP Cleaner will sanitize your equipment and prevent you from breathing in those harmful particles.

    • One-click cleaning: Just press a button and let the Lumin do the rest
    • Completely compatible: No adapter needed to use with any mask and machine

    Lumin CPAP cleaning and disinfecting machine

    Shop the Lumin

Related links and products

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How to adjust the humidity on your Resmed AirSense?

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If you want success with your CPAP treatment, the number one concern is comfort.

And if you’re suffering from a dry mouth or water in your tube, you’re not setting yourself up for success. Besides choosing the right mask, you need to know how to use your CPAP humidifier to enjoy maximum comfort.

At Apnée Santé, all our CPAP include a heated humidifier and a heated tube. When you begin treatment with us, we set the humidity to Climate Control Auto.

Normally, the Climate Control Auto settings provide the best protection against rain-out (an uncomfortable condition in which humidified air cools too quickly and condenses in your mask, becoming water droplets that dampen your face).

But some nights, it helps to have more control over your humidification to meet your individual needs. To be able to adjust the humidity yourself, you can set your CPAP to Climate Control Manual mode.

woman adjusting the settings on her Resmed Airsense

How do I find the Climate Control Manual mode?

Resmed AirSense users: You can access the Climate Control Manual setting anytime. From your machine’s Home screen:

  1. Select My Options
  2. Select Climate Ctrl
  3. Change default “Auto” setting to Manual
  4. Select Humidity Level and turn the dial to change the humidity (1–8; default setting is 4)
  5. Select Tube Temp and turn the dial to set the ClimateLine/ClimateLineAir heated tube to the temperature you find most comfortable (60–86⁰F; default setting is 81⁰F).

For more details, see your ClimateLineAir user guide.

resmed airsense 10 cpap machine 1

S9 users: Your equipment supplier must turn on your Climate Control Manual setting for you if they haven’t already.

From your machine’s Home screen:

  1. For humidity: Turn the dial to highlight the water drop icon; push the dial, turning the background yellow. Then turn the dial again to set the humidity (1–6, default setting is 3). Push the dial once more to set the new humidity level.
  2. For tube temperature: Turn the dial to highlight the thermometer icon; push the dial, turning that background yellow. Then turn the dial again to set the ClimateLine/ClimateLineAir tube temperature (15–30⁰ C, default setting is 27⁰ C). Push the dial once more to set the new temp.

(Watch this helpful S9 video.)

resmed s9 autoset with h5i profile

When should I change the temp in my humidifier and in my heated tube?

Most patients find cooler air easier to breathe while trying to sleep, especially those who are new to CPAP, wear a full face CPAP mask, and women experiencing hot flashes at bedtime. However, warmer air provides the best humidity and helps reduce nasal irritation since your nose doesn’t have to warm all that CPAP air on its own. It generally helps to increase:

  • Humidity if dry air is causing you to wake up with dry mouth, an uncomfortable side effect that 40% of CPAP users experience. If you want more humidity, try manually adjusting it and the temperature one notch at a time. If you reach the highest levels and still feel dry, please contact your respiratory therapist at Apnée Santé. There may be other factors causing your dryness. (You should also check for mask leak if you wake up to find your humidifier’s water chamber empty.)
  • Tube temperature if you’re experiencing dryness despite increasing the humidity. Consider increasing your tube temperature by just 1⁰C to see if that provides the best comfort.

A few important things to note

There are no right or wrong settings with the humidifier. You need to adjust your CPAP according to your individual needs throughout the year. You may sleep with the windows open during the winter and require more heat in your tube to reduce condensation.

In the summer, when it’s hot and humid in Quebec, you’ll certainly need to turn down the level in your humidifier and you may even turn off the Climate Line heated tube. Trial and error is the best.

And, if you’re still experiencing difficulty please contact your local Apnée Santé clinic. Our clinicians will be happy to help you!

Related blog: Do you really need a humidifier with your CPAP?

Apnée Santé Team

Helpful videos from Resmed, Philips and Fisher & Paykel

Resmed:

Philips Respironics:

Fisher & Paykel:

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Do I really have to clean my CPAP all the time?

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Yes! Did you know that patients who use CPAP and don’t regularly clean their equipment are 32 percent more likely to get pneumonia?

CPAP cleaning can present a real challenge to some CPAP users. Sometimes understanding the REASON behind the recommended maintenance, along with some simple guidelines, can go a long way to making the process less of a chore. The proper maintenance of your CPAP unit and accessories plays a significant role in success of the treatment of your obstructive sleep apnea. A proper hygiene of the equipment will avoid complications such as leaks, bacterial and fungal growth and further health complications.

germ icon Reasons to clean your CPAP

  1. Oil, sweat and dead skin cells can accumulate in the CPAP mask every time it’s used.
    The mask accumulates oil, sweat, dead skin cells and dirt which are absorbed by our skin and can lead to irritation. If you are waking up with acne, soreness or skin peeling, this is an indication that your mask is due for a good wash.
  2. The water in the machine and the moisture in the mask and hose are potential breeding grounds for bacteria and germs.
    A study from Brigham and Women’s Hospital and Harvard Medical School found 2,000+ bacteria counts evident after just 48 hours on 48 percent of samples from CPAP masks they collected. By implementing a cleaning regimen, you’ll be reducing the risks of infection and disease. Your equipment will also smell and look better and be more effective, which will contribute to the longevity of use of your CPAP.

kills 99% of viruses similar to coronavirus

note icon What you need to clean your CPAP

  • CPAP mask wipes or a damp cloth
  • Warm water
  • CPAP soap or dishwashing soap

If you opt for dishwashing soap, it is important to select a soap that is neither antibacterial or hydrating. The alcohol in an antibacterial soap will cause the cushion of your mask to dry out and break sooner than expected. Avoid hydrating soap as the hydrating agent in the soap will leave a greasy residue on your equipment. If you want to ensure that you are eliminating all bacteria in your mask or if you’re not cleaning your mask daily because of the inconvenience, we recommend the Lumin to sterilize your mask, water chamber.

cleaning kit grapefruit

Shop Cleaning Kit – Grapefruit

cleaning kit mint

Shop Cleaning Kit – Mint and Green Tea

Lumin UVC sterilizer from Kego

Shop Lumin UV-C Sterilizer

CPAP Premium 2 in 1 Hose Brush

Shop CPAP Premium in 1 pipe brush

calendar icon How and when to clean your CPAP and accessories

daily

Daily

Wipe down your mask

Use soap and warm water to wipe down your mask, especially the cushion which comes in contact with your skin, and allow to air dry. This will remove any oily residue, sweat and dead skin cells. For faster cleaning, pre-moistened wipes made specifically for CPAP masks are available .

Rinse and refill your water chamber

Empty the chamber, rinse with tap water and allow to air dry. Then refill with distilled water right before bedtime. Do not allow water to sit in your chamber all day as it is a good environment for bacteria and mold to thrive.

weekly

Weekly

Wash your mask

Fill your sink with warm, soapy water and gently wash your mask, including the headgear. Ideally, this should be scheduled early in the morning to allow your equipment to air dry.

Wash your air hose

Fill your tube with warm, soapy water and gently swirl the liquid back and forth. Run clean water through to rinse, and hang to air dry. Special brushes exist to help with the scrubbing inside the air hose.

Wash and sanitize your water chamber

Gently scrub the inside with soapy water then properly rinse it. Next, pour in a mixture of one-part vinegar and two-parts water, let sit for 30 minutes, then properly rinse and air dry. This will sanitize and decalcify your water chamber.

yearly

Every 3 Months

Replace your filter

By replacing your filter, you limit the deposit of dust and impurities in the compressor of your CPAP. It is important to replace the air filter of your CPAP once every three months especially if you have allergies.

Annually

Replace the mask, air hose and water chamber

This recommendation is widely known so most insurance company cover a certain percentage of the cost. With the proper upkeep of your CPAP device, your CPAP will continue to work optimally, you will be breathing clean air and be able achieve your goal of better night’s sleep.

Free CPAP check-up

video icon Let us show you how!

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Do you really need a humidifier with your CPAP?

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Every CPAP user in Quebec has to deal with it: the need for humidity in our climate.

Even if you’re already using a humidifier, you might have been asking yourself some common questions – like why is a CPAP humidifier important anyway? Does distilled water really make a difference? How do I deal when I travel?

Well, once again Apnea Health has your answers.

Why is a humidifier important? One word: comfort.

By using a heated humidifier, you reduce your chances of waking up with dry mouth in the morning, and being bothered by nasal congestion at night. While in the southern US it’s common to buy just the compressor without a humidifier, here in our Canadian climate, the extra humidity is a must. Because of that, humidifiers are usually included with CPAP machines sold here, so make sure you don’t miss out on their benefits!

Here’s what’s happening with your CPAP. In simple terms, your CPAP draws the ambient air from the room, filters out impurities, then passes it through the tube into your lungs at just the right pressure. It’s like a vacuum in reverse – just less noisy. Now imagine how you’d feel if it were blowing cold, dry air at you all night – ouch!

That’s where heated humidifiers and tubes come in

By using your humidifier, you’ll experience less dryness in your nose, sinuses and lungs. You can also reduce the risk of nasal congestion, inflammation, infections, and nosebleeds.1

As for a heated tube, well, that can help too. With standard tubing you can run into condensation problems – especially if the temperature in your room is on the cooler side. Humidity produced by your CPAP can wind up condensing in the tube if it’s cold, and get stuck there instead of making it to your nose where you want it. You may have noticed some “rainout” in your tube in the morning – which means you’re not getting the benefit of the humidifier and will probably still be stuck with some of the symptoms above.

Resmed ClimateLine Heated Tube for S9 Series

The water level in my humidifier hasn’t budged. Why?

Don’t panic! Your CPAP is working properly.

As we said before, the CPAP takes the air from your bedroom and sends it into your tube. An amazing thing with these machines is they constantly measure the humidity of the air they draw – if it already meets the comfort level you chose for your CPAP, the machine will leave the water tank alone and blow the air as is.

So, depending on the weather, the season, and personal preference, your CPAP’s thirst for distilled water will be different. Most of our patients need less distilled water in the summer, and ramp up in the winter when the air gets drier. Even in summer though, we recommend leaving a little water in your humidifier each night to prevent it from running dry and potentially damaging the heating element over time.

If it feels like your CPAP is causing dryness in your nose, sinuses or lungs, please let us know. We’re all about your sleep comfort. Just give us a call, or drop by anytime we’re open, and one of our respiratory therapists will be happy to help!

What’s with the fancy distilled water?

Lots of patients ask why they can’t just use tap water with their CPAP. After all, we’ve got some of the best tap water in the world – and it’s free – so why not use it?

The reason is there are still microorganisms and minerals in the water from your tap. According to Brandon Peters (2019), a board-certified neurologist and sleep medicine specialist:

“Boiling water will kill microbes, but it will not remove minerals or chemical contaminants. These minerals that make water ‘hard’ include calcium, magnesium, iron, and others—if they are present in the water put in the humidifier’s water chamber, over time scale will develop that discolors the container and could damage the machine. Filtered water may remove some of the minerals but may not remove living organisms or other chemicals. Bottled water that has been distilled is certainly the safest option.’’2

Using distilled water reduces mineral deposits in your water chamber

The odd splash of tap water won’t hurt the tank, but long term, mineral build-up from using hard water will damage the plastic and shorten its life. That’s why most CPAP manufacturers recommend distilled water.

water pouring

What about when I travel?

Travelling’s awesome. It means getting exposed to new cultures, architecture, food, and lifestyles. But it also means getting exposed to some fun new microbes your body isn’t used to. Even if the water’s safe to drink, that doesn’t mean it’s a good idea to put it in your CPAP. Peters mentions that “tap water within Neti pots in Louisiana has led to a few reports of harmful parasite infections affecting the brain. This condition can be fatal and treatment may be ineffective.’’1

All right, that sounds scary, and he goes on to say that “the same risk has not been demonstrated with the use of CPAP,” but think about it – everything in your water chamber gets vapourized and inhaled to your nose, sinuses and lungs. Do you really want to take the risk?

We recommend that you take the time to go buy a bottle of distilled water when you arrive at your destination. Call it a tourist experience – why not? So you get to go check out a grocery store in a new country. Hey, you can even pick up a little of what the locals eat at the same time… you might find it an interesting switch from what’s on the “tourist menu” at the restaurants!

the dreamstation is a great travel buddy

What NOT to do with your water chamber

If you keep in mind that everything that goes in your water chamber can go into your lungs, you should be ok. Wash it every day with mild soap and regular water, rinse carefully, then let it air dry. That’s enough to get rid of any bacteria before you fill it back up with distilled water.

Don’t get any silly ideas about putting alcohol, bleach or ammonia in there, or any perfumes or essential oils to make the air smell pretty – your lungs won’t thank you! Use nothing but soap and water for cleaning, and distilled water for therapy, and everything should be fine.

no bleach

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Care for Life at Apnea Health

Don’t forget, the Apnea Health team wants to give you the best CPAP care you can get.

All of our patients are made part of our Care for Life Program, so whether it’s helping you tweak the level of humidity in your CPAP, answering any questions you might have, our respirologists and sleep experts are here for you!

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  1. https://www.sleepapnea.org/treat/cpap-therapy/what-you-should-know-about-cpap-humidification/
  2. Peters, B. (2019). Do You Have to Use Only Distilled Water in the CPAP Humidifier?. [online] Verywell health. Available at: https://www.verywellhealth.com/do-you-need-distilled-water-for-the-cpap-humidifier-3015017 [Accessed 5 Oct. 2019].
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Alcohol and apnea: a risky mix

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Alcohol and sleep make for strange bedfellows at the best of times.

While having a drink (or three) before bed can relax your muscles and indeed lead to falling asleep faster, in reality your body is not achieving restorative sleep when you’ve been drinking.

Even if we aren’t talking about enough alcohol to land you with a head-ringing hangover the next day, your nighttime celebration alters your sleeping brain wave patterns,1 so even if you’re in bed “sleeping” for several hours, you’ll likely feel tired the next morning. Add Obstructive Sleep Apnea to the mix, and you are going to pay a heavier price than you may have bargained for when you accepted that last round at the end of the night.

How does alcohol make us snore?

Alcohol is a depressant that causes muscle relaxation. While you sleep, the muscles of your throat relax, your tongue falls backward, and your throat becomes narrow.  What you hear as snoring is simply the vibration of the throat tissues as you breathe. The narrower your airway becomes, the greater the vibration and the louder your snoring.  For this reason, even people who don’t suffer from OSA are likely to saw logs during sleep.

man sleeping with his mouth open

Faster sleep doesn’t mean better sleep

Using a CPAP machine can help sufferers of OSA get a much better night’s sleep, but sometimes settling down at bedtime can be a problem for anyone. When you drink alcohol, you may fall asleep hard and fast, but alcohol will only exacerbate your sleep apnea, essentially doubling down on your sleep disruption.  Drinking alcohol can actually increase the apnea events and their duration, and you’re likely to feel the symptoms in the morning.

As mentioned above, one  of the effects of alcohol is to cause muscle relaxation. If you remember what they told you when you first sought treatment for OSA, it all begins with relaxation of the muscles of the soft palate, which then descends to block your airway and cause repeated micro-waking events throughout the night.

You don’t usually notice it, but you’re actually being robbed of restorative REM sleep and that’s why you awaken feeling as though you were up half the night. Muscle relaxation caused by alcohol has the same effect, even on people without OSA,2 so combining the two means you’re in for a rough morning.

how alcohol affects your sleep 1

Apnea never sleeps

If you regularly use a CPAP machine, having had a few drinks is no reason to take a “night off” and flop into your bed with the mask hanging beside you like an awkward wallflower at a party. For most patients who have adapted to sleeping with a CPAP machine, the restfulness it brings makes it a cherished companion they wouldn’t want to do without. For some though, early struggles to get used to the machine may leave a lingering resistance, even if they know that regular use is better for them. That’s completely normal.

The trouble with “tying one on” is that it can lead to questionable decision making, and the decision to leave the mask hanging after you’ve had a few is definitely not a good one. You can take a break from treatment, but your apnea won’t – so if you’ve already impaired your sleep cycle with drinking, do yourself a favour and at least make sure you’re getting the assistance of your CPAP while you sleep it off.

dame dort avec son masque CPAP à côté d'elle

Limit your intake

Numerous studies, going back to the 1980s, have clearly established the ways that alcohol can worsen sleep apnea.3

Even without the science, ever since the stone age humans discovered that drinking the funny-tasting grape juice made them feel good, we’ve known that there’s a price to pay for drinking. If you’re planning a night that might include alcoholic beverages, consider planning to cut yourself off after a fixed number so you don’t over-indulge.

deux hommes habillés en lutins dorment dans un bar

Allowing time for alcohol to wear off before bed

It takes time for your body to metabolise alcohol so it’s best to Quit while you’re ahead. There’s really no way around it. Even one or two drinks before bed are enough to throw off your sleep cycle, so the tradition of the nightcap was clearly invented by someone who didn’t understand the value of a good night’s sleep.

To avoid disruption, consider giving yourself a “last call” a few hours before you hit the sack. It varies based on weight and gender, but as a general rule it takes about an hour to process one unit of alcohol (it doesn’t matter if that means a beer, a glass of wine, or a shot of tequila) so try to give yourself 2-3 hours between your last drink and bedtime.4 You’ll be thanking yourself in the morning.

dame endormi avec un verre de vin vide dans les mains

Tempering alcohol with water

There’s an old expression about mixing types of alcohol that goes something like, “beer then liquor, makes you sicker, liquor then beer in the clear.”

While that might have some merit with regards to impulse control and the temptation to drink faster if you’re piling on shots at the end of the night, it doesn’t really help when it comes to your ability to get restorative sleep. Alcohol is alcohol as far as your brain and body are concerned. One trick is to alternate water or some other (non-sugary or caffeinated) drink between each alcoholic one. Call it, “water between booze, helps you snooze.”

It’ll not only help you stay at the party without embarrassing yourself, but it will also mean that your overall consumption is lowered so you’ll be better off when you call it a night. Just be careful not think you can carry this trick to the extreme and balance out a bender with a giant jug of water – that much consumption of any liquid before bed is likely to mean you’re waking up for a different reason.

de l'eau qui se fait verser dans un verre

Balance is key

There’s nothing wrong with having a few drinks with friends from time to time. The trouble with alcohol is it can easily fool you into thinking that you’re sleeping better because you fall asleep faster, when in fact the opposite is true. Because of the allure of falling asleep quickly when you’re regularly tired, many people succumb to the trap of “self medicating” with a drink or two before bedtime, which in the long term will not only rob you of rest but can also lead to alcohol dependence.

If you choose to drink that’s fine, but doing so in moderation, stopping early, and making sure to always use your CPAP will greatly improve your quality of sleep. And remember that if you’re struggling with sleep habits or the use of your CPAP machine, the team at Apnée Santé is always there to help.

drinking with friends

If you are a habitual drinker with OSA, consider using Auto-CPAP

Probably the most important thing you can do after drinking a few glasses is to use an Auto-CPAP machine. Why is this? As your muscle tissue relaxes, an increase in pressure may be needed to keep your airway open. An auto CPAP machine can detect variations in airflow and self-adjust as need be so that you get optimal air pressure throughout the night. If you’re in a fixed pressure, your CPAP is set to a constant pressure that reflects a typical night’s sleep and not a night affected by alcohol.

You should also keep in mind the importance of setting up your continuous positive airway pressure (CPAP) under typical sleeping conditions. Therefore, if you drink alcohol daily but abstain prior to your sleep study, the pressure may not be adequate to maintain your airway when you drink.

To maximize your response to therapy, let us check verify that your CPAP is delivering the right pressure for your needs.

un verre et une bouteille de vin sur une table de nuit à côté d'une machine CPAP

  1. https://www.sleepfoundation.org/articles/how-alcohol-affects-quality-and-quantity-sleep
  2. https://www.sleepfoundation.org/articles/how-alcohol-affects-quality-and-quantity-sleep
  3. https://www.atsjournals.org/doi/abs/10.1164/arrd.1985.132.6.1238
  4. https://www.verywellhealth.com/wait-between-alcohol-sleep-3014979
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