Question 1

What is CPAP?

Answer

Invented in 1981, CPAP (Continuous Positive Airway Pressure) is a widely recognized method for treating obstructive sleep apnea. It is the golden standard for improving sleep apnea and other afflictions, such as sleepiness syndrome. Unfortunately, there is no one-off solution for obstructive sleep apnea. Nowadays, doctors strongly advice patients to use CPAP. CPAP is a very efficient method, successfully combating against various degrees of sleep apnea. The theory of CPAP is where an increased air pressure is released into the patient’s nasal cavity and throat, forcing away the tissue blocking the respiratory tract and keeping the airway open, preventing the occurrence of asphyxia.

Question 2

What is the difference between automatic and fixed CPAP?

Answer

Fixed CPAP releases a determined pressure prescribed by the doctor. This machine is also more affordable than automatic CPAP. On the other hand, automatic CPAP adjusts the pressure according to the patient’s current degree of sleep apnea, making it more comfortable to use and preventing occurrence of insufficient or excessive air pressure. Different sleep stages and sleeping positions can affect the degree of sleep apnea. Smoking or drinking alcohol before sleeping will cause airway tissue to loosen, increasing the severity of sleep apnea. Furthermore, sleeping in a supine position increases the chances of airway obstruction compared to sleeping in a lateral position. Automatic CPAP can detect and adjust to the level of airway obstruction by moderating the air pressure, ensuring comfort for people undergoing long-term CPAP treatment. Hence, an increasing number of customers have been purchasing automatic CPAP.

Question 3

How can I try, rent or buy a CPAP machine?

Initially, most customers are not familiar with CPAP machine and sleep apnea. Therefore, we will personally invite them to our company to let them try our machines in a private bedroom. If the customer is pleased with the CPAP treatment, they can buy their own CPAP machine right away. However, if the customer is still unsure about the treatment, they can choose to rent a CPAP machine. This requires rental fees, deposit fees and a new set of accessories. Afterwards, they can bring home the CPAP machine and make the decision of purchasing their own later. For the first few weeks of renting or purchasing, we will keep in close touch and help when needed.

Answer

Purchasing a CPAP machine is included in the welfare of refundable medical expenses for working or retired civil servants in Hong Kong. An example would be a reimbursement of $5800 when purchasing a basic model in 2019. Civil servants need to complete an application form and provide a valid medical certificate and CPAP machine receipt. This needs to be sent to the department of health to receive the reimbursement. Furthermore, civil servants can request a government subsidy in purchasing CPAP’s accessories every year (e.g. nasal mask, tubing and filter). As an example, in 2019, the reimbursement for these consumables was $1900. You may download the application form on the civil servant bureau website or ask your medical suppliers for more information.

Answer

Initially, we recommend you put on the nasal mask in front of a mirror. Firstly, place the headgear on your head and the cushioning between your nose and mouth. Finally, adjust the straps on your head. If the mask is too loose, air will leak out. If the mask is too tight, the customer may feel uncomfortable, which will affect the treatment and damage the nasal mask. Do note that you must use both hands when adjusting the straps. This prevents an imbalance in the left or right side, which leads to more air leakage.

Answer

The nasal mask and water chamber need to be cleaned daily. The tubing, chin strap (if needed), headgear and mask’s washable filter (depending which type of nasal mask) need to be cleaned weekly. 【Cleaning the Water Chamber】 After a daily cleansing of the water chamber with water and mild soap, customers must wash it again with distilled water and dry it with a paper towel. Then, they must place it in a cool area to dry. This will prevent scale dirt from happening. Furthermore, note the silicone ring at the edge of the water chamber. Accumulation of stagnant water may cause mold to form. Also, do not place it in a location of direct sunlight or dry it in high temperature. When the weather is humid, customers can use a hairdryer (set to no heat), fan or dehumidifier to dry the water chamber. Do not use bleach, antibacterial hand sanitizer or other stimulating chemical detergents to clean it. 【Cleaning Other Accessories】 Place the tubing, nasal mask cushion, headgear (make sure the Velcro straps are stuck together), washable filter (depending on the type of nasal mask) and chin strap in diluted soap water. Submerge for about 2-3 minutes (not over 10 minutes) and wash away all residue with water, placing it in a cool area to dry. If the accessories are not completely dry, a hairdryer (set to no heat) can be used. To prevent damaging the accessories, avoid using a washing or drying machine.

Answer

In general, we advise customers to change their nasal mask annually. Customers can also change their nasal mask depending on the condition. For example: If their nasal mask has aged severely, it will cause air leakage, reducing the treatment’s efficacy. According to CMS (Centers for Medicare and Medicaid Services) in United States, nasal masks should be changed every three months. The average American medical insurance supports changing a nasal mask every six months. In Hong Kong, civil servants can apply to change their nasal mask accessories annually. This includes a nasal mask, headgear, tubing, and filter.

Answer

We understand that purchasing a CPAP machine is not an easy decision. It is expensive, with each machine costing around 10,000 HKD. Simultaneously, you may doubt whether you can fully adjust to the treatment. Furthermore, adapting to a new sleep lifestyle is not easy. Before and after you sleep, you must spend time putting on and washing your accessories, which puts more pressure on your schedule. During the first few weeks, many customers fear that moving too much in their sleep will cause the position of the nasal mask to shift, so they fall asleep in uncomfortable positions, causing a backache. Customers also find it hard to breathe due to the increased air pressure, leading to nasal allergies such as a runny or stuffy nose. If the nasal mask is too tight, it can cause headaches or facial indents, affecting the customer’s physical appearance. Despite the concerns listed above, customers should know that the CPAP treatment is the golden standard for improving sleep apnea and other consequential issues like cardiovascular disease. If the customer is provided proper assistance and learns how to use a CPAP machine diligently, they can avoid many of the issues stated above and smoothly transition into the treatment.

Answer

(A) Notify Your Airline Beforehand We highly recommend messaging your airline or going on its website to confirm the details on bringing a CPAP machine before purchasing plane tickets. Every airline has different rules and guidelines for bringing a CPAP machine and it is best you know them beforehand. Also, you must notify the airline 3-5 days prior your flight what your CPAP machine brand and model is. (B) Bring Certified Documents You will be given a certificate from certified medical suppliers with details on your CPAP’s brand, model, dimensions and serial number. You should also bring a valid medical certificate and a CPAP instruction manual as evidence. (C) Bring A Conversion Plug Most CPAP machines can adapt to different international voltages. Before you board the flight, you must know that area’s plug type and bring a corresponding conversion plug. (D) Carry CPAP On Board To prevent your CPAP from getting damaged or lost during the flight, we highly recommend carrying it on board using a travel bag. During the flight, you should place the CPAP machine in front of your seat to keep it safe. (E) Airport Security When going through airport security, you should remove the CPAP machine from the travel bag and allow it to be X-rayed. This will not damage your machine.

Question 4

What if I am a civil servant purchasing a CPAP machine?

Question 5

What is AHI (Apnea Hypopnea Index)?

AHI is a scale used to indicate the severity of sleep apnea and is presented by the number of apnea and hypopnea events per hour of sleep. An AHI of 5-15 is classified as mild, 15-30 as moderate and 30+ as severe. If your AHI has been lowered to 5 or less after your CPAP treatment, this means you have successfully improved your sleep apnea.

Question 6

How can I choose the right mask?

There are many types of masks on the market. They are classified as nasal masks, direct nasal masks and full-face masks. Masks depend on how the customer feels when they wear it, which is why we highly recommend customers to try on masks before buying it. According to our experience, more than 80% of customers prefer nasal masks because of its lightweight and adaptable design. If you dislike a restrictive design and have a low prescribed pressure, consider using a direct nasal mask. But note that this may cause a dry or bleeding nose if you have chronic nasal allergy. If you have a severely blocked nose or open your mouth when sleeping, consider using a full-face mask to prevent pressure leakage.

Question 7

How do I properly put on the nasal mask?

Question 8

How do I clean the CPAP accessories?

Question 9

When do I need to change my nasal mask?

Question 10

Do I have to change the CPAP machine’s filter regularly?

All CPAP machines have a vent hole which sucks in air to the machine. Along with the air, other fine particles may also go into the machine. This may not only damage the machine’s motor, it will also cause discomfort for the user. Therefore, a high-density filter is placed in front of the vent hole of the machine, protecting the motor and user. Over a period of time, the vent’s efficiency may decrease due to accumulation of dust particles in the filter. Hence, users should follow the guidelines of the manufacturer and regularly change their filter.

Question 11

Why undergo an oximetry test after buying a CPAP machine?

Undergoing an oximetry test can confirm the effectiveness of the CPAP treatment, making sure there is enough oxygen in the blood for normal bodily function. Hong Kong medical professionals recommend patients to have a 95%-98% of blood oxygen saturation when using CPAP. If your blood oxygen saturation drops below 90%, check if your nasal mask is properly fitted and any excessive air leakage. If you are using a fixed CPAP machine, you may have to adjust the air pressure to ensure better treatment.

Question 12

Does my CPAP machine need regular checkups?

The CPAP machine is a medical product, with a high specification compared to home appliances. Therefore, it must be constantly retained at a high quality to ensure patients are receiving the best treatment. Specialized instruments are used to see whether the air pressure is normal, whether the air flow volume will automatically adjust itself if there is a leak in the nasal mask, whether the CPAP startup, functioning noises and tremors are normal and whether the machine’s surface is damaged (e.g. screen, buttons, power cables). Hence, it is necessary to have regular checkups on your CPAP machine.

Question 13

Common Reasons for Rejecting CPAP

Question 14

How does a heated humidifier help with comfortability during the CPAP treatment?

A heated humidifier is an effective tool in CPAP treatment. Customers commonly complain about how the CPAP machine leads to sneezing, a dry mouth and a stuffy nose. These issues can be reduced by using a heated humidifier. When using a CPAP machine, it will extract the surrounding air and release it through the customer’s nasal mask and tubing. Most of the Hong Kong people have a habit of using air-conditioner during the summer and heater in the winter. Both appliances cause the surrounding air to become very dry, meaning the air released through the nasal mask is equally arid. A heated humidifier can adjust the surrounding air to a more comfortable humidity and temperature, lowering the customer’s oral and nasal discomfort.

Question 15

What should I do when travelling with my CPAP machine?

Question 16

When do I need to change my CPAP?

According to CMS (Centers for Medicare and Medicaid Services) in United States, CPAP machines should be changed every five years. This advice is further supported by many American medical insurance companies. The Hong Kong government allows civil servants to apply for a new CPAP machine every four years.