When you have sleep apnea, your upper airway gets blocked during your sleep. This can lead to fatigue, heart problems, high blood pressure, and other serious health problems. A continuous positive airway pressure (CPAP) machine -- a device that delivers air pressure through a mask while you sleep -- is the most common treatment for sleep apnea. With it, your airways can stay open and your body can get more oxygen to help it work well.
With all the options available, it may feel overwhelming to choose the right machine for you. Together with your doctor and these tips, you can find the one that'll give you what you need.
1. Start with an expert.
You can find a lot of information about the “best” kind of CPAP machines on your own, but only your doctor can really figure out what’s going to work for you.
“A CPAP machine is medical equipment, so your doctor should be the one to make a recommendation for you,” says Matthew Ebben, PhD, a sleep specialist at Weill Cornell Medicine.
You need a prescription to get a CPAP machine, so a primary care provider, pulmonologist, or sleep specialist who can review your sleep studies should be your first stop.
“Think of it like getting glasses,” Ebben says. “You wouldn't go to your eye doc and just tell them you think you want bifocals. They’ll test your eyes first and see what kind of lens is best for you. The same is true for a PAP machine.”
2. Prioritize fit.
Your CPAP mask connects the machine to your airways. Masks come in different sizes. In order for your machine to do its job, the mask needs to fit properly.
“Fit can make a big difference in both comfort and in leakage,” says Ajay Sampat, MD, an assistant clinical professor in the Division of Sleep Medicine at UC Davis Health.
A mask that’s too big, he says, can leak around its sides and up into your eyes. This could make it less comfortable, so you’d be less likely to keep using it.
Sampat says a sleep technician, sleep technologist, or respiratory technologist can work with you directly to fit you to the right mask.
3. Consider comfort.
Size is only one part of fit. You also want to think about the type of mask that will work best with your features.
“I'm seeing someone in my clinic, I look for certain things to help determine what they need,” Sampat says. “I look at their facial features: Do they have a beard? Do they have a large chin? What kind of nose structure do they have?”
“If someone breathes through their mouth only, for example, then choosing a mask that doesn't cover the mouth is probably not going to be as effective,” Sampat says.
4. Explore accessories.
CPAP machines not only come with masks, tubing, and filters, they also have add-ons you can get to make your machine more comfortable and easier to use.
“Sometimes, people have trouble with the hose getting tangled up during the night, and so they use a hose hanger attached to their headboard to help keep it out of the way,” Ebben says.
There's a whole range of “extras” that can enhance your experience. For example, pads can help soften the feel of the straps, and heated hoses can moisten the air as it enters your nose.
Not all accessories will fit all machines and masks, so be sure you know what will work with yours.
5. Research who will repair it.
Your machine may have issues from time to time, so it’s good to know where you’ll turn for a fix.
“If your machine is malfunctioning, the ability to replace or speak with a real person to troubleshoot is key,” says Chidinma Chima-Melton, MD, medical director for quality specialty care and regional medical director for pulmonary at UCLA Health.
6. Check your coverage.
Most private health insurance policies cover CPAP machines and equipment like tubing, filters, masks, and headgear. The level of coverage will depend on your specific plan. Your plan may require you to rent your machine instead of buying one.
If you have a high-deductible plan, you may have to pay a lot right away for your machine. In this case, you might find that paying for it yourself without using your insurance -- the “self-pay” option -- is cheaper.
Be sure to check with your insurance company to learn about your options.
“Most medical insurance companies use durable medical equipment [DME] middleman to deliver and support the machines,” Chima-Melton says. “They’re not all the same -- some provide more responsiveness and support than others. It’s important to be aware of who insurance works with and what machines they have in stock.”
7. Think through the details.
Some machines are louder than others. Some take up more space than others. Consider how the machine you choose will work with your lifestyle.
“If you’re someone who is frequently on the road, you may want a smaller CPAP machine than someone who doesn’t travel,” Chima-Melton says.
8. Be patient.
It's not unusual to cycle through a few different masks before you find the right one for you, Ebben says. And even then, you should give a mask a chance before moving on to another.
“It's kind of like shoes,” he says. “They might feel pretty good on your feet at the shoe store, but after you walk a few blocks, they might start rubbing your foot in one spot. It may take a breaking-in period before you’re fully comfortable.”
Using a CPAP for the first time is also a whole new experience in general, so give yourself time to adjust.
“Going from not using a CPAP to sleeping with one can be scary and takes some getting used to,” Chima-Melton says. “However, the vast majority of people do, and actually love their CPAP once they’re finally getting quality sleep.”