Every day we're asked questions about CPAP equipment. Lots of questions. Whether asked through email, live chat or over the phone, there's a standard set of questions that most customers ask. We'll outline the top five CPAP questions asked of us, and our answers to those questions.

Question 1: Why do I need a prescription?
This is an excellent question. I'm thinking pretty soon a prescription is going to be required for newborn babies before they're allowed to breathe air right after delivery. Think about it. The proud parents of a new baby boy or girl wouldn't notice the extra $200 prescription charge added to their $15,000 hospital bill.

The real answer to this question is a bit complex, and it doesn't have anything to do with therapy compliance, positive outcomes, or end-user safety. It has more to do with insurance company requirements and the manufacturers' desire to have insurance companies cover CPAP equipment. The prescription requirement also distances the manufacturers from the end user of the CPAP equipment, which probably allows the manufacturers to minimize their liability insurance premiums.

At the end of the day, prescriptions are required for some CPAP equipment because the manufacturers work with the FDA to make it so. It's really tragic to think that the FDA continues to facilitate the consumption of the neurotoxin aspartame in diet soda, while at the same time making it more difficult, and often more expensive, for sufferers of sleep apnea to get the equipment they need.

We've added a question regarding prescriptions to our CPAP Polls page. Visit the poll page to answer the questions and to find out how other customers answer the questions.

Question 2: Will a new CPAP mask fit my old CPAP machine?
Yes! There are no exceptions to this answer. All CPAP tubing has been standardized to a 22 millimeter diameter. CPAP machine air outlet ports and mask swivels are all designed to fit into the 22 millimeter diameter tubing.

Some people find that when they buy a new mask they can't make it fit in their old tube. This is the case when a part from the old mask - generally a swivel that attaches to the mask elbow - gets stuck in the tube. To check to see if you have a mask part stuck in your tubing, simply disconnect the tubing from the CPAP machine air outlet port (or from a bacterial and viral filter that you have attached to your machine air outlet port) and hold the tubing in a u-shape in front of you. When you compare the two ends of the CPAP tube they should look identical. If they don't look identical, then you know you've got a mask part stuck in one end. Remove the old mask part and the new mask will fit in the CPAP tube without a problem.

CPAP tube should look the same on both ends
Your tube should look the same on both ends, like the tube shown in the picture above. If it doesn't it means you have something stuck in one end of the tube.

Question 3: Do you take insurance?
We're in the business of catering to the uninsured and underinsured, so many of our customers are expecting to pay out-of-pocket. In this scenario finding the best deal is very important, and we're happy to provide these customers with a cost-effective alternative to their traditional brick-and-mortar supplier whose prices are usually significantly higher than our prices.

With that said, an increasing number of consumers with insurance policies that will cover CPAP equipment are becoming aware of unnecessary spending by insurance companies, and as a result are becoming conscientious shoppers, looking for ways to save their insurance companies - and ultimately themselves - money.

We don't take insurance as a primary form of payment. When you order from us you'll pay up front either with a credit card or with a PayPal account. After paying up front either we or you can file a claim for reimbursement with your insurance company. If you want to help your insurance company save money, and if you want to help keep your insurance premiums as low as possible, this is a good way to buy CPAP equipment. The only drawback is that you likely won't get reimbursed for a month or so.

Click here to read more about how we can help you with your insurance.

Question 4: What's an automatic CPAP machine?
We get this one all the time. Instead of programming a prescribed pressure setting on the CPAP machine, a pressure range is programmed. The automatic CPAP machine is then allowed to fluctuate within the pressure range, determining the correct pressure setting on a breath-by-breath basis. An automatic machine detects flow limitation events - apneas, hypopneas, and snoring events - and responds accordingly to restore flow. The primary advantage of an automatic machine is that you don't have to worry about whether your prescribed pressure setting is accurate, and you don't have to worry about going in for another sleep study in the future. Another advantage is that automatic machines typically deliver a lot less pressure throughout the night compared to a standard machine set at the prescribed pressure. This can help in terms of comfort, and can also help to minimize mask leaks.

Many people who are new to CPAP therapy assume an automatic CPAP machine is necessarily expensive. This isn't the case. At the time of this writing our most popular automatic CPAP machine - the IntelliPAP AutoAdjust - sells for $435.

About four years ago I wrote an article entitled The Benefits of Automatic CPAP Machines. That article is still relevant today and clearly outlines the advantages of using an automatic CPAP machine.

Question 5: What is C-Flex?
C-Flex is Philips Respironics' trade name for a feature generally known as exhalation pressure relief. C-Flex, found on many REMstar models, detects when the CPAP user begins to exhale and lowers the pressure by one, two or three units of pressure during exhalation. This is a comfort feature that is particularly useful for people who are new to CPAP therapy, or for anyone who has a particularly high prescribed pressure setting.

The exhalation pressure relief feature found on several models of CPAP machines makes an otherwise standard CPAP machine function much like a bilevel machine. The main difference between a machine with exhalation pressure relief and a bilevel machine is the amount of relief on exahalation. On a standard machine with exhalation pressure relief, the maximum presssure drop on exhale is about three units of pressure. On a more expensive bilevel machine, the pressure drop on exhale can be much higher.

Here are different trade names for exhalation pressure relief:

  • Philips Respironics - C-Flex or A-Flex
  • ResMed - EPR
  • DeVilbiss - SmartFlex
A lot of people ask about the difference between C-Flex and A-Flex. For all practical purposes there is no difference. A-Flex is only found on Philips Respironics REMstar Auto machines. These automatic machines with A-Flex also have C-Flex available as a separate feature (for people who like to split hairs, I guess). C-Flex is available on the REMstar Plus and REMstar Pro. There is no flex feature on the basic REMstar.

Exhalation pressure relief doesn't have anything to do with the automatic nature of an automatic CPAP machine. Automatic simply means that the machine will adjust the pressure automatically according to your needs at any given time. Exhalation pressure relief will drop the pressure on exhale, no matter what pressure the automatic machine has determined you need. This is true unless, of course, the automatic machine has determined you need a pressure equal to the minimum pressure supported by the machine. In that case, an exahalation pressure relief feature can't drop the pressure any lower.

We get hundres of questions per day, but these are the top five. We've tried to add other relevant and frequently asked questions to our FAQ page. Check it out. And if you have any CPAP questions yourself, don't hesitate to ask us!

Andrew Senske

CPAP-Supply.com is a leading online retailer of CPAP equipment. Located in Spokane, WA CPAP-Supply.com has been serving thousands of customers around the world since 2001. Founded on a belief that patients are their own best primary care providers, CPAP-Supply.com understands the importance of educating patients and customers on both the effects of and treatment for obstructive sleep apnea. For more information visit CPAP-Supply.com or call toll free 1-888-955-2727.

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