CPAP Machine Reviews

In the last two decades, more and more people have come to be diagnosed with obstructive sleep apnea (OSA), and it is now estimated that more than 25% of all adults in the U.S. between age 30 and 70 have OSA. As a result, finding reliable solutions to OSA has taken on increasing importance.

OSA is a condition that is defined by the blockage of the airway in the back of the throat. These blockages prevent normal airflow and can cause shallow breathing and temporary periods of inability to breathe. OSA is often marked by loud, heavy snoring and/or gasping for air. These episodes disrupt sleep leading to considerable sleepiness during the day -- a hallmark symptom of OSA -- that can have major effects on a person’s day-to-day health and quality of life. Sleep apnea can have other health consequences as well including mood changes, headaches, and high blood pressure and other cardiovascular effects.

Positive airway pressure (PAP) devices, including continuous PAP (CPAP) and bi-level PAP (BiPAP), are among the most effective and commonly prescribed treatments for OSA. These devices working by pumping air through a mask into the airway and keeping the airway from closing or becoming obstructed. In a CPAP device, the amount of pressure stays the same (continuous), and in a Bi-PAP the level of pressure is variable.

In this guide, we’ll take a deeper dive into OSA and CPAP machines. We’ll provide more background about the causes, symptoms, and treatments of OSA. In addition, you can find detailed information about the key considerations when you’re shopping for a CPAP machine, recommendations for the best CPAP devices on the market, and other strategies for addressing sleep apnea other than using a CPAP.

How Do CPAP Machines Work?

What causes OSA?

An apnea is a stop in breathing, and obstructive sleep apnea means that this occurs because of a blockage of the airway that occurs during sleep. Physically, the principal cause of these obstructions is that the soft tissues and muscles near the back of throat become too relaxed and block the airway. This is what causes snoring because air that tries to pass through the airway vibrates this soft tissue, generating an audible sound. In people with OSA, apneas may occur dozens of times over the course of the night.

In some people, the anatomy of their throat is such that it makes them more prone to OSA. This includes people whose tongue, neck, tonsils, and/or adenoids are larger than normal. People who have a lower jaw that is shorter than their upper jaw are also at greater risk of OSA.

 

What Causes Obstructive Sleep Apnea

Source: Mayo Clinic

 

Obesity is a major risk factor for this condition as obese people are four times as likely to develop sleep apnea as people who are of normal weight. Men, older people, smokers, and regular users of alcohol or sedatives (both of which can cause further relaxing of the muscles in the back of the throat) are also at higher risk. Family history of sleep apnea can also contribute to a person’s risk.

Another thing that can cause or contribute to OSA is sleeping position. Sleeping on your back is associated with both chronic snoring and sleep apnea. This is because being on your back makes it easier for gravity to naturally pull the tissues in the back of your throat into a position where they block the airway.

What are the main functions and features of a CPAP machine?

The goal of a CPAP machine is to keep air moving through the airway to make sure that it does not get blocked or obstructed. It does this by taking in ambient air and then filtering, pressuring, and humidifying it. That air is then pumped it into the airway through a hose and mask. To accomplish this, a CPAP device is composed of several parts that in many cases may be sold separately:

Airflow generator

Inside the CPAP machine is the generator. This component takes air from outside the device and pressurizes it. This air is then pumped into the airway.

Filter

The filter is used to help clean air that is coming from outside the CPAP machine and into the airflow generator. It helps to improve the quality of the air that you breathe through the machine during the night and reduce your exposure to allergens or dust.

Humidifier

This part of the CPAP machine includes a reservoir for water that can be heated up and can help add moisture and humidity to the pressurized air from the machine. Some people find that having a heated humidifier helps keep their mouth and throat from being dried out and irritated. A humidifier may be built directly into the machine or it may be a separate part that is attached to the CPAP machine itself.

Hose

The hose is usually a few feet long and is the avenue by which the pressurized air from the CPAP is transferred to the mask (and thus into the airway).

Mask

The mask is the actual mechanism through which air is pushed from the CPAP into the airway. It is important for the mask to be connected and worn properly for the machine to work effectively.

There is considerable variation in masks that are used with CPAP machines, and users of a CPAP can generally choose among several options so long as the mask fits correctly with the hose. Masks are typically available for purchase separately from the rest of the machine.

There are three main types of masks that are used with CPAP devices:

  • Full face: this mask has the largest profile as it is designed to cover both the nose and mouth. It is the type of mask most traditionally associated with CPAP machines. A plastic insert for the mask is held in place using straps around the top and back of the head. This type of mask is commonly recommended for people who breathe through their mouth.
  • Nasal: a nasal mask, as the name implies, does not cover the mouth, and as such, it works better for people who breathe through their nose at night. These fit over the nose only. Some users of nasal masks also use a chin strap to help prevent the mouth from falling open and then breathing through the mouth.
  • Nasal cradle or pillow: this type of mask does not go over the nose but instead goes beneath the nose with air being pumped through the nostrils and into the airway.

Shopping Considerations

If you’ve only recently been diagnosed with sleep apnea, you may be overwhelmed by how much information is out there and about all the different CPAP options that are available. With so many different devices on the market, it can be hard to know where to start or what to look for.

In the next section, we’ll get right to the chase by listing our top 5 best CPAP machines. But we know that you may want to do your own research and understand what separates some CPAP machines from others. For that reason, this section will cover some of the key factors and considerations that you should have in mind when you’re researching and shopping for a CPAP machine.

Remember that CPAP machines are prescribed by a health professional after testing that helps assess your sleep and breathing. The doctor or sleep specialist that you work with can usually help you understand your needs in a CPAP device and is the best source to consult for any specific concerns that you have about finding a CPAP device that will work optimally for you.

 

 

Type of sleep apnea

A CPAP machines is normally prescribed for people who have obstructive sleep apnea as opposed to another type of sleep apnea known as central sleep apnea (CSA). If you have OSA, a CPAP is usually a better and cheaper place to start than a BiPAP. You can always ask your doctor for any specific guidance about the type of machine that you need.

CPAP size and weight

Not all CPAP machines are the same size. Some are more compact and/or lighter than others. The extent to which this is a priority for you can depend on how much space you have to put the CPAP (such as on a nightstand or table near the bed). You should also think about how much you expect to travel since you will need to pack your CPAP with you. If you travel regularly, it can be extremely valuable to have a smaller and lighter CPAP. You can also look at the carrying case that comes with the machine to get a sense of the full traveling size.

Pressure range

Every CPAP device is capable of delivering a range of different levels of pressurized air. The pressure is measured using centimeters of water (cmH20). Unless otherwise directed by your doctor or a health professional, look for a CPAP with a range of 4 to 20 cmH20. This wider range encompasses almost all of the ranges needed by people with OSA (usually between 4 and 16).

Noise

One complaint that is often leveled against CPAP machines is that they can be noisy. This noise can be disruptive for the person using the CPAP as well as anyone who they share the bed with. The amount of noise is primarily determined by the motor that the CPAP uses, and thankfully, modern CPAP machines are generally much less noisy than their predecessors. However, it makes sense to look for a quieter machine, especially if you share the bed with a partner. CPAP noise is measured in dbA (a-weight decibels).

Humidifier

If your mouth or throat dry out or get irritated easily, having a humidifier can help make using a CPAP more comfortable for you. The humidifier can either be built-in (requiring you to pour in water) or detachable (allowing you to add water directly at the tap). A larger reservoir means that the CPAP can be used for longer without having to refill the water.

Power source

While all CPAP devices should have a built in power cord that can be plugged into the wall, look for a CPAP that is battery operable in case you need additional flexibility with regard to when and where you are using your CPAP. This can come in especially handy if you are traveling and have limited access to power outlets.

Automatic controls

Some CPAP machines can make certain adjustments automatically. These include adjustments related to altitude (as this affects the pressurization of the air). These are not essential features for a CPAP to work, but if you want a machine that does more, these types of automatic controls are an extra feature that is available on some machines.

Ramp time

This is how long it takes for the CPAP to start having the air pressurized to the set level. In general, you’ll find most CPAPs have a ramp time of less than 60 minutes.

Sleep data

As with more and more consumer and medical devices, some CPAP machines have the ability to collect data about your sleep and usage of the machine. If you're trying to improve tracking of sleep-related data, this may be a feature that you seek out in a CPAP.

Warranty

Because a CPAP usually costs several hundred dollars, it’s comforting to have some protection for your purchase. Look for a warranty of at least 2 years and that covers any defects in materials or workmanship for the machine.

Best CPAP Machines

Shopping for a new CPAP can feel like a daunting task. Just starting the process and narrowing down your choices may feel intimidating with so much information out there. To help you in this process, we’ve gone through the details and reviews and selected for your consideration the top 5 best CPAP machines. A rundown of the key information for each of these models can be found in the table below.

Brand ResMed Philips Respironics DeVilbiss Fisher and Paykel ResMed
Model AirSense 10 Elite DreamStation IntelliPAP AutoAdjust with SmartFlex Icon Auto S9 Auto Set
Price $810 $450 $490 $1,025 $880
Dimensions 10"L x 4.6"W x 5.9"H 11.7"L x 7.6"W x 3.3"H 6.4"L x 6.5"W x 8.4"H 6.3"L x 6.7"W x 8.7"H 11.25"L x 6.25"W x 3.25"H
Weight 5.2 lbs 4.5 lbs 6.1 lbs 8.7 lbs 7.4 lbs
Pressure Range 4 - 20 cmH20 4 - 20 cmH20 3 - 20 cmH20 4 - 20 cmH20 4 - 20 cmH20
Ramp Time 0-30 minutes 0-45 minutes 0-45 minutes 20 minutes 0-45 minutes
Humidifier Built-In? Yes No No Yes No
Humidifier Capacity 380 mL 375 mL 400 mL 420 mL 380 mL
Sound 27 dbA 26 dbA 26 dbA 29 dbA 26 dbA
Hose Length 6 feet N/A 6 feet 6 feet 6 feet
Max Altitude 8,500 feet 7,500 feet 9,000 feet 9,000 feet 8,500 feet
Sleep / Machine Data? Yes Yes Yes Yes Yes
Warranty Length 2 years 2 years 5 years 2 years 2 years
Customer Rating 4.9 (28 reviews) 4.6 (20 reviews) 4.8 (775 reviews) 4.7 (352 reviews) 4.9 (287 reviews)
Buy Now Buy Now Buy Now Buy Now Buy Now

Other Strategies for Sleep Apnea Treatment

While a CPAP is a proven and effective way of managing obstructive sleep apnea, it’s not the only way. Some people may find that a CPAP doesn’t work well for them. For example, the mask may be impossible to get used to, or the noise from the machine may be a significant issue for them or their partner. Or before opting for a CPAP, some people may want to try out other OSA treatments. This section delves into what those alternative strategies and treatments are for trying to get a good night’s sleep even if you’ve been diagnosed with OSA.

Non-mask devices

The discomfort of wearing the CPAP mask is one of the most common reasons why patients may not continue with using a CPAP. An alternative in that case is non-mask therapy such as with Provent.

Provent is a disposable device that is put into the nostrils and held in place with a mild adhesive. Inside each Provent device is a small valve that can open and close in response to your breathing. The effect of the valve is to create pressure in the airway that keeps it from becoming obstructed or closing down. Provent may be an option for people who struggle with a CPAP mask, who are bothered by the noise of a CPAP device, or who travel regularly and need an alternative that is easier to travel with. Provent has been shown to help with OSA in clinical studies and is approved by the FDA. It requires a prescription, so it is necessary to talk with your doctor if you are interested in this as an alternative to using a CPAP device.

Oral appliance therapy (OAT)

Oral appliance therapy (OAT) uses dental equipment to adjust the positioning of the anatomy of the mouth in ways that can help prevent airway obstruction. These devices normally need to be custom-built and/or custom-fitted by a dentist in order to offer the most benefit and avoid any secondary dental problems. The goal of a dental device is often to move the lower jaw forward or to prevent the tongue from sinking back toward the back of the throat. Each of these things can help some people keep the airway open, although rarely is this as effective as using a CPAP, especially for people with more serious OSA. In some situations, these devices may be used in conjunction with a CPAP.

Lifestyle changes

Depending on the severity of your OSA, lifestyle changes may be able to reduce or eliminate your airway obstructions. In particular, weight loss may be able to help address OSA in people who have less severe cases. Quitting smoking can also eliminate another risk factor for sleep apnea. In both cases, these lifestyle changes have additional health benefits and may be able to improve overall sleep quality as well. If you are interested in trying to lose weight and/or quit smoking, you can talk to your doctor or a health professional for any specific guidance about strategies that may be most effective and safe for you.

Adjustable beds

An adjustable bed is a frame that holds the mattress that is able to move in many directions and keep the bed from only being in a flat position parallel to the ground. For example, an adjustable bed frame allows you to increase the height of the head of the bed so that your upper body is at an upward angle. This can help reduce the extent to which the soft tissue in the back of the throat sags into the airway, especially if you sleep on your back. Some adjustable beds also allow the legs to be adjusted as well. These features can sometimes help with achieving a comfortable sleeping position and/or in dealing with other health issues (such as acid reflux or swelling of the legs).

Pillows

Because the positioning of your head and neck can influence how much the airway is blocked, your pillows can play a role in trying to reduce sleep interruptions from sleep apnea. The most important way that a pillow can help is by adding tilt to your head so that airway obstructions are limited, especially if you are sleeping on your back.

Though this means having some loft to your pillow, it doesn’t necessarily mean that you should just buy the tallest or highest-loft pillow that you can. That may just create undue pressure on your neck and cause you to wake up in pain. But you do want to consider your sleeping position, your head size, and the firmness of your mattress in making sure that your pillow provides enough loft to keep your head from being perfectly flat and parallel to the mattress. While adding tilt to your neck position from your pillow won’t assure an open airway, it can help and may go a long way for people who have only a minor case of sleep apnea.

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