What is sleep apnea?
Derived from the Greek word for "lack of breath," sleep apnea is a serious, potentially life-threatening sleep-related breathing disorder that is often linked with loud, heavy snoring. The most common form of sleep apnea is obstructive sleep apnea (OSA). Individuals with OSA experience repetitive episodes of obstruction of the upper airway during sleep, lasting anywhere from 30 seconds up to 2 minutes. With no air flowing into the lungs, oxygen levels drop, and carbon dioxide levels rise in the blood. The reduction in oxygen and increased carbon dioxide alert the brain to resume breathing and cause an arousal. Finally, the patient awakens with a jolt, resumes breathing, quickly falls back to sleep, and resumes the loud snoring. In most cases, the sleeper is unaware of these breath stoppages because they do not trigger a full awakening. This pattern can repeat itself 5 to 30 times or more each hour, all night, impairing your ability to reach the deep, restful phases of sleep. The good news is sleep apnea is treatable.
When people sleep, the muscles that keep the airway open relax, along with the tongue, causing the airway to narrow. Normally, this relaxation does not prevent the flow of air in and out of the lungs, but in sleep apnea, it can. When the airway becomes completely blocked, the snoring stops and there is no breathing for a 10-20 second time period or until the brain senses the apnea and signals the muscles to tighten, returning the airflow. This pause in breathing is known as apnea.
The most common signs and symptoms of obstructive sleep apnea include:
- Episodes in which you stop breathing during sleep — which would be reported by another person
- Loud snoring
- Gasping for air during sleep
- Awakening with a dry mouth
- Difficulty staying asleep (insomnia)
- Excessive daytime sleepiness (hypersomnia)
- Poor memory and / or concentration
- Above average BMI
During periods of apnea, people receive less air, which results in decreased oxygen delivery to the body. The oxygen levels in the blood may fall repeatedly. This oxygen decrease is called an oxygen desaturation. It often drops by 3 or 4 percent, and sometimes much more, in association with sleep apnea events. When this happens:
- You stop breathing repeatedly, forcing you to wake up without realizing it.
- Your blood pressure goes up as oxygen levels drop, causing strain on your heart.
- You are prevented from getting the deep, restorative sleep needed to say healthy.
Sleep apnea is very common, as common as type 2 diabetes. It affects more than 22 million Americans, according to the American Sleep Apnea Association. Risk factors include being male, overweight, and over the age of 40, but sleep apnea can strike anyone at any age, even children and women. Yet still, because of the lack of awareness by the public and health care professionals, most sleep apnea patients remain undiagnosed and therefore untreated, even though this serious disorder can have significant consequences.
Untreated sleep apnea is not just about snoring or feeling tired — it can severely affect your health, well-being, and longevity. Complications from untreated sleep apnea include:
- Reduced Life Expectancy
- Weight gain
- Diabetes, heart disease, and stroke
- Sexual dysfunction
- Skin aging
- Certain cancers
- Poor performance at school and / or work
- Increased risk of car and workplace injury
- Sudden death
The stakes are just too high to ignore the signs of sleep apnea.
Sleep researchers know that sleep apnea can cause problems in marriages. Loud snoring will certainly make it difficult for anyone to sleep, and this includes even the most loving and understanding of partners. Moreover, for many bed partners forced to sleep with someone who has OSA, it's often a long and troubled sleep as they lay in bed listening to their partner's long periods of not breathing, followed by the violent gasping and struggle for air. Using a CPAP device on a nightly basis not only treats sleep apnea, but in almost all cases fully eliminates snoring.
You can get started by taking our free 30-second quiz to find out if you may be at risk. If you regularly experience symptoms of OSA, our In-Home Sleep Testing Program would be a great place to begin the journey to diagnose, treat and manage your sleep apnea – all from the comfort of your own home.
Still have questions? Our Hiro Health Wellness Team is standing by to answer any questions you may have. Call us at 866-764-2165 or email us at Support@hirohealth.com.
There is no cure for sleep apnea, which means the condition cannot be completely eliminated. The reality is that those with sleep apnea have only two options: maintain treatment or ignore it. Ignoring sleep apnea is not only ill-advised but a guarantee that you will develop other even more dangerous chronic illnesses as a result.
The most common treatment for sleep apnea is the use of a small bedside device that delivers positive airway pressure (PAP) through a mask that you wear during sleep. The air pressure is somewhat greater than that of the surrounding air and is just enough to keep your upper airway passages open, preventing apnea and snoring. To see a list of our devices and how they may help you with your personalized sleep treatment, click here
What is CPAP Therapy?
CPAP stands for Continuous Positive Airway Pressure. CPAP therapy is the most recommended, and the most effective treatment for obstructive sleep apnea (OSA).
A CPAP machine provides a constant airflow that keeps the airway open so uninterrupted breathing is maintained during sleep. The air is delivered to you through a tube and a CPAP mask. The air stream eliminates sleep apnea events and allows you to get a restful night of sleep.
CPAP therapy is typically delivered through a nasal mask that seals around the nose. Full face masks are available for a person who breathes through both the nose and mouth.
There are lots of benefits to using CPAP therapy for those who are diagnosed with OSA. Some of the most commonly reported benefits include:
- Sleep refreshment
- Energy and motivation
- Mood and disposition
- School and work performance
- Sexual drive and performance
- Alertness while driving
- Emotional stability
- Overall health
Depending on the individual, it can take 2-12 weeks to get used to CPAP therapy. There are several ways that you can speed up the adjustment process through desensitization techniques. A few of these techniques are listed below:
- To become accustomed to the CPAP mask, try wearing it for a while without the tube and CPAP machine attached. You can read, listen to music, watch TV, or just relax. This will allow you to figure out the best fit to ensure comfort.
- Next, wear your headgear and mask with a comfortable fit, attach it to the CPAP machine, and allow the pressure to gradually increase to the prescribed air pressure – this is the "ramp upstage". Try lying down once this pressure has been reached.
- Try using your CPAP machine at home while you are awake for 1-hour every day, and then gradually increase the usage:
- Use the CPAP machine during 1-hour naps.
- Use the CPAP machine during the first 3-4 hours of nighttime sleep.
- Use the CPAP machine throughout the whole night of sleep.
Side effects are usually mild and temporary. The most common complaints are about air pressure or discomfort from the mask itself, and these issues can generally be reduced by adjusting the settings of your machine or the fit of your mask. Some side effects include:
- Skin marks or rashes
- Dryness in the nose or mouth
- Discomfort breathing out
- Air swallowing
CPAP is a prescribed therapy with multiple variables to consider, so do not make changes to machine settings on your own or you may experience harmful effects.
If you need assistance with updating these settings, call us at 866-764-2165 or email us at Support@hirohealth.com, and one of our Hiro Health Wellness Team Members will be glad to walk you through the steps to optimize your CPAP therapy.
If you are experiencing any of the CPAP side effects mentioned above, do not give up on the treatment just yet. There are solutions to these common problems. Try these different strategies to reduce or completely halt your CPAP side effects.
- Clean your CPAP mask and machine regularly
- Avoid using oily products
- Make sure you have the proper CPAP mask
- Check your humidifier
- Try switching to heated tubing
- Try using CPAP mask barriers
- Make sure your CPAP mask is secured
Coronavirus does not change your sleep apnea diagnosis or your need to continue using CPAP therapy. You should continue to use your CPAP machine because a full night's sleep benefits your overall health. If you have been diagnosed with COVID-19, you need to follow the medical advice from your healthcare provider.
CPAP Machines Overview:
A CPAP machine provides air at a constant prescribed pressure. The air is delivered to you through a tube and a CPAP mask. CPAP therapy provides a constant airflow that keeps the airway open so uninterrupted breathing is maintained during sleep. The airstream eliminates sleep apnea events and allows the person to get a restful sleep.
The average price for CPAP machines ranges from about $500 – $3000, with an estimated average price of around $850. Hiro Health offers some of the most affordable pricing on the market for CPAP machines without sacrificing the product quality and features that are most important to a successful sleep therapy plan. Additionally, we offer 0% interest payment plans on almost everything we sell.
You will need to have a prescription to purchase a CPAP machine, mask, or humidifier. These devices are classified by the FDA as Class II Medical Devices1. Unfortunately, we cannot legally sell a CPAP machine, CPAP mask, or CPAP humidifier without having a valid prescription. Please note that CPAP supplies and parts such as filters, tubing, water chambers, mask parts, cushions, and pillows do not require a prescription.
If you already have a prescription, you can mail, fax, or email it to us. You can also contact our Hiro Health Wellness Team at 866-764-2165, and they will walk you through the process.
If you have never had a prescription, the In-Home Sleep Testing Program is an excellent resource to guide you through a journey to diagnose, treat and manage your sleep apnea – all from the comfort of your own home.
If you are experiencing symptoms of sleep apnea and would like to see whether CPAP therapy is right for you, you may take the following steps to acquire a prescription for a CPAP machine, mask, and humidifier:
- Start by ordering one of Hiro Health’s In-Home Sleep Apnea Tests.
- Once you receive the In-Home Sleep Apnea Test in the mail, follow the instructions provided in the package to perform the sleep study.
- Upon completion, one of our Board-Certified Sleep Physicians will conduct an in-depth review and analysis of your sleep study results.
- If it is determined that you suffer from sleep apnea, the physician will write you a prescription for a CPAP machine and other products to begin your sleep apnea treatment.
The ResMed AirSense™ 10 Autoset CPAP machine is one of the highest quality CPAP machines on the market. It adjusts completely to your sleeping pattern as well as therapy needs. The unit is made to ensure comfortable sleep as it provides direct and immediate air pressure levels adjustment.
The AirSense™ 10 Autoset is also considered to be one of the most reliable units on the market, as it features an advanced airflow level detection system. This system ensures optimal therapy and a good night's sleep for the patient.
Some of the other advantages to this machine are:
- Integrated humidifier
- EasyBreathe motor
- LCD screen and user-friendly controls
- SmartStart™ function
- AutoRamp feature
- Adjustable brightness
If you are diagnosed with sleep apnea, your sleep doctor will prescribe a type of machine based on your therapy needs and determine your airflow pressure level.
During your appointment with your sleep doctor, ask questions! Discuss the different machines and the various airflow and pressure settings so you both decide what is going to be most comfortable for you.
If you still have questions or need recommendations, our Hiro Health Wellness Team is standing by to help you. You can call us at 866-764-2165 or email us at Support@hirohealth.com.
Each month, we recommend disconnecting the CPAP machine from the power supply and wiping the outside with a damp cloth and mild detergent. Avoid wetting the electrical areas. You must allow your CPAP machine to dry properly. Make sure that standing water can drip out of the tube. You can hang your tube so that it drapes down to the ground allowing all water to drip out of it. Manually drying exterior surfaces will speed up the process.
Studies show that at least 6.5 hours of CPAP usage per night is needed to reduce the long-term health risks of obstructive sleep apnea. When you do not use CPAP for the entire night, you miss out on the full range of CPAP's health benefits.
If you have a cold, it is a good idea to try to continue your CPAP therapy, if you can. Having a cold will make you tired, and if you are also feeling tired from not treating your sleep apnea, you are not going to have much energy. If you continue CPAP therapy, you may be able to keep your sleep apnea symptoms in check, giving you more energy to fight the cold. Using a heated humidifier along with a decongestant and nasal spray will ease your use of CPAP therapy while fighting a cold.
The life expectancy of a CPAP machine differs based on the specific piece of equipment. In general, CPAP machines are used for roughly 3-5 years. CPAP masks, however, should be replaced one or more times per year.
While you are not required to use the humidifier on your CPAP machine, it is highly recommended. When we breathe naturally, our noses act as humidifiers, warming up the inhaled air to our bodies' temperature so that it is more comfortable to breathe. Air coming through a CPAP machine needs its humidification because it is entering our upper airway faster than our noses can warm it. This is especially true for those who live in colder or drier climates and/or require high pressures.
Fortunately, most CPAP machines run quieter than 30 decibels (dBA). That's comparable to someone whispering or a clock ticking. However, there are still some that run quieter than others.
The ResMed AirSense™ 10 AutoSet™ CPAP Machine features an Easy-Breathe motor and isolating materials incorporated into the base of the device. It produces minimal turbulence, delivering more performance, and virtually eliminates the noise radiated into the room.
Though not a lot of people sleep on their stomachs, there are some CPAP masks explicitly designed for stomach sleepers. One option is the nasal pillow mask, such as the AirFit™ P10, that offers high-level performance without that feeling of claustrophobia. Plus, the nasal pillows compress up and down depending on your body and head position.
Flexible Spending Account (FSA) or Health Savings Account (HSA)
Flexible spending accounts (FSA) and health savings accounts (HSA) are programs that allow you to set aside money (before taxes) for specific health care expenses. If you are unsure whether you have an FSA or HSA, please check with your employer or insurance company.
Hiro Health accepts FSA and HSA dollars for all products and services we sell. It is your responsibility to determine eligibility and obtain approval under your plan. Hiro Health is not a party to your decision to utilize HSA or FSA dollars for our products and services.
In-Home Sleep Apnea Testing
In-home sleep apnea testing is an easy, cost-effective way to figure out whether you're having trouble breathing. It involves the use of a very simplified breathing monitor that tracks your breathing, oxygen levels, and breathing effort while worn.
The sleep study comes in a kit with a few different sensors, each for measuring different things. Typically, you will get:
- Electrodes for the chest (soft electrodes that conform to the wearer’s skin).
- A small oxygen sensor probe to be placed over the participant’s finger.
- A chest belt to measure breaths and, if needed, sleep position.
These sensors are hooked up to a tiny computer, recording the data. When the night is over, the data is sent back to the sleep lab for analysis, and the results are sent to the physician or primary care provider. Your doctor will then discuss a diagnosis with you.
There are several advantages of taking an in-home sleep apnea test vs. an in-lab test. Some of those advantages include:
- Access to care for those in rural areas.
- Improved timeliness of study results.
- More cost-effective than an in-lab sleep study.
- You can complete the test without ever leaving the comfort of your own home.
- You may be more likely to complete an in-home sleep study.
Hiro Health offers an in-home sleep apnea test for $189. After your sleep study is complete your results will be analyzed by one of our Board-Certified Sleep Physicians, and you may be prescribed CPAP therapy. If this is the case, the cost of the sleep study will be applied toward your purchase of a CPAP machine and CPAP mask. If you feel that you have symptoms of sleep apnea the In-Home Sleep Testing Program is an excellent resource to get you started on the path to a better night's sleep.
ResMed CPAP Machines:
AirSense™ 10 AutoSet™:
The AirSense™ 10 AutoSet™ is ResMed's premium CPAP machine designed to keep you healthy and comfortable by automatically determining the lowest pressure needed for successful treatment. The AutoSet™ algorithm monitors your breathing and, when it detects flow limitations, it gently increases pressure until the event has cleared. After an event, AutoSet™ decreases pressure again to improve overall sleep comfort. The AirSense™ 10 AutoSet™ can also be set to the standard CPAP mode.
The Hiro Health Wellness Team will be most happy to assist you in choosing the most appropriate mask interface style based on how you breathe. As a general rule we like to see our clients gravitate towards more minimalistic nasal style masks but of course, this is not always possible if you have difficulty breathing through your nose or believe you are generally a mouth breather.
Typically, if you can breathe well through your nose, we can help you learn quickly how to refrain from mouth breathing through simple suggestions and perhaps the use of a chin strap for a short time.
The AirSense™ 10 AutoSet™ has disposable filters that should be replaced once per month or sooner if needed. We also suggested that you replace your tubing a few times per year and your water reservoir once per year for optimal hygiene.
The AirSense™ 10 AutoSet™ is one of the quietest PAP devices on the market. The quiet Easy-Breathe motor makes for a peaceful environment for you and your bed partner.
While many insurance companies will provide reimbursement for devices such as the AirSense™ 10, Hiro Health does not accept any insurance outside of Health and Flexible Spending Accounts (HSA and FSA). You should also contact your insurance company for reimbursement if that is how you would like to proceed. However, Hiro Health does not influence the decision for reimbursement.
For complete information please see the Hiro Health insurance guidelines on the FAQs page found here
AirCurve™ 10 VAuto and AirCurve™ 10S:
The AirCurve™ 10 VAuto and AirCurve™ 10S bilevel devices have the enhanced ability for separate pressure ranges to be set for inhalation and exhalation. The dual settings allow the patient to get more air in and out of their lungs. Bilevel devices also have the unique ability to set a breath timing feature that measures the number of breaths per minute a person should be taking. If the time between breaths exceeds the set limit, the machine can force the person to breathe by temporarily increasing the air pressure by delivering back-up pressure from the device.
CPAP therapy is unique to each individual, however, those who benefit most from using a bilevel device include:
- Individuals with a need for higher pressure settings or with low oxygen levels.
- Individuals that have had difficulty adapting to PAP therapy on a standard non-bilevel device.
- Individuals with cardiopulmonary disorders such as congestive heart failure.
- Individuals with lung disorders or certain neuromuscular disorders.
Expiratory Pressure Relief (EPR) offers pressure relief as you exhale to prevent the sensation that you are fighting against the incoming airflow during exhalation. For those who need only a little pressure relief, EPR on an AirSense™ 10 AutoSet™ device may be a good choice. Also, EPR pressure relief is not a fixed amount, and the pressure drop can vary from breath to breath, whereas the bilevel maintains a set, prescribed exhalation pressure.
The AirCurve™ 10 VAuto and the AirCurve™ 10S have disposable filters that should be replaced once per month or sooner if needed. We also suggested that you replace your tubing a few times per year and your water reservoir once per year for optimal hygiene.
Full Face Masks
- Full face masks cover the nose and mouth, making them the best choice if you breathe through your mouth. They are also recommended for patients who are or side sleepers, those with nasal congestion, or those with facial hair.
Nasal Pillow Masks
- Nasal pillows rest below your nose, at the entrance of your nostrils. Nasal pillow masks work best for patients who sleep with their mouths closed and can inhale and exhale well through their nostrils only. They are the most streamlined option, provide a clear field of vision, and can easily be worn with glasses.
Traditional Nasal Masks
- Nasal masks cover your nose. They are smaller and lighter than full face masks but provide more coverage than nasal pillows. This mask works best for patients who sleep with their mouths closed and can inhale and exhale well through their nostrils only.
The AirFit™ P10 Nasal Pillows Mask by ResMed has been declared as being the quietest CPAP mask manufactured by ResMed. The mask is equipped with the latest technology in sleep apnea therapy. The mask is up to 50% lighter and 50% quieter than other masks produced by ResMed. The AirFit™ P10 features a short tube design that allows for greater movement and flexibility while sleeping. For most people who breathe through their nose, this mask makes it easy to fall and stay asleep.
The ResMed AirFit™ F20 Full Face mask and the ResMed AirFit™ F30 Full Face mask is our recommended CPAP masks for those who breathe through their mouth while sleeping (including people who have stuffy noses from colds). Mouth breathers enjoy the benefit of less irritation to their nasal cavities because a full-face CPAP mask sends the air into both the mouth and nose. Also, CPAP users with a deviated septum or other nasal issues will benefit significantly by employing a full-face mask.
The ResMed AirFit™ P10 Nasal Pillow Mask and the ResMed AirFit™ F20 Nasal Mask are the recommended CPAP masks for side sleepers as they allow for movement and flexibility while also having few facial touchpoints.
Finding the right CPAP mask is arguably the most important part of treating sleep apnea. Your mask ensures you are receiving proper CPAP therapy without discomfort, leakage, or interruption of your sleep. The recommended mask is dependent upon sleep style, comfort requirements, and other individual needs.
The goal is to identify a mask interface that delivers optimal therapy outcomes, without sacrificing comfort. Hiro Health offers guidance in helping you choose the best mask interface. Call one of our Hiro Health Wellness Team members at 866-764-2165 to discuss your options.
The most likely cause of you pulling the mask off during sleep is due to improper pressure settings or problems related to mask discomfort. If it annoys you, you will take it off. If you are struggling with your mask interface and keeping it on through the entire night a Hiro Health Wellness Team member can help. Call us at 866-764-2165 and we will be happy to discuss the best ways to ensure successful therapy.
Fitting a mask properly depends a great deal on your position. Facial muscles change when we lie down and relax even further once we are asleep, so it's always best to fit the mask while you're in your sleeping position. Whether you sleep in a bed with no pillows or in a recliner, you should fit your mask in your usual sleeping position. If you experience difficulties in fitting your mask, please refer to your mask user guide for complete fitting instructions or contact a Hiro Health Wellness Team member at 866-764-2165.
Mask leaks should not be ignored as any type of leak can compromise your ability to maintain positive pressure, which is an important aspect of therapy efficacy. Often mask leaks are due to an incorrect fit, worn-out mask cushion and parts, or a less than an ideal mask style choice. If you are having any difficulties contact a Hiro Health Wellness Team member at 866-764-2165.
It is imperative to replace your mask cushion often to ensure optimal therapy results even when it visibly may not appear to require replacement. Hiro Health suggests replacing your mask pillows every 2 weeks or cushions every 30 days. Many of our clients replace their entire mask and start fresh once or twice a year.
CPAP mask headgear and chin straps may become stretched and lose their elasticity, leading to over-tightening and discomfort. They can also trap bacteria from sweat and moisture. Your mask headgear should be replaced every 6 months. A Hiro Health Wellness Team member will be happy to place a re-supply order for you over the phone at 866-764-2165, or of course, you can place your order right here online.
You should clean the elbow, frame, and cushion daily. The headgear only requires weekly cleaning. Facial oil and dirt can easily build up on your mask parts when they are not cleaned properly, which can lead to skin irritation. Cleaning your mask does not take long, so working it into your morning routine should be a breeze.
Supplies you will need to clean your mask:
- Sink or tub
- Warm, drinking-quality water (86°F / 30°C)
- Mild or hypoallergenic soap, or baby shampoo
Unplug your CPAP machine from the power source and disconnect your mask/tubing from your machine.
Supplies you will need to clean your mask:
- Undo the fastening tab on the upper headgear straps, pull the straps out of the frame and keep the magnetic clips attached to the lower headgear straps.
- Remove the elbow from the mask by pressing the side button and pulling the elbow away.
- Hold the top and bottom of the cushion and pull it away from the frame.
In the sink, clean your mask parts by gently rubbing (or using a soft-bristle brush) with warm, drinking-quality water and soap. Avoid harsh cleaning products and dish detergents.
Rinse again thoroughly with warm, drinking-quality water.
Place mask components on the towel and allow to air-dry away from direct sunlight.
Humidification Water Chamber
In general, the water tub should be washed every day in warm water with a mild detergent, then rinsed thoroughly with clean water and left to dry away from direct sunlight. Every month, the water tub should be inspected for wear and deterioration and replaced if any component is cracked, cloudy, or pitted.
You should not use any of the following to clean their humidifiers as these solutions may cause damage and reduce the life of the product:
- Bleach, chlorine-, alcohol- or ammonia-based solutions
- Moisturizing, antibacterial or glycerin-based soaps
- Water softening and unapproved descaling agents
The disassembled tub lid, plate, and base may also be washed in a dishwasher on the delicate or glassware cycle (top shelf only). White powder deposits in the water tub can be removed using a solution of one-part household vinegar to 10 parts water.
- Wash the disassembled tub lid, plate and base in warm water using a mild detergent.
- Rinse thoroughly in clean water and allow them to dry away from direct sunlight.
- Peel the flip lid seal from the flip lid and wash it in warm water using a mild detergent.
- Wipe the exterior of the humidifier with a damp cloth and mild detergent.