If you were told you have a high AHI after a sleep study, it is likely that you have moderate (AHI 15-30) or severe (AHI >30) obstructive sleep apnoea (OSA).
However, interpretation of a sleep study has to be done by a doctor trained in sleep medicine as it is more than just the AHI.
A CPAP (Continuous Positive Airway Pressure) machine is the gold standard in the treatment of majority of OSA. It works by pumping air through a tube and mask into your upper airway. This keeps the upper airway open (splinted open) while you are sleeping, eliminating the likelihood of your upper airway closing during sleep.
It is great to know that you’ve taken the first major step in your treatment of OSA by deciding to use a CPAP machine. Most doctors managing OSA in Singapore do not sell CPAP machines.
You will likely be referred to a company/vendor and most vendors will carry the recommended/reputable CPAP brands and models commonly used in Singapore. They will go through the selection process with you depending on your needs and lifestyle.
Often, you will need to buy the mask and the company will loan you the machine for a period of 2 weeks or more. At the end of the 2 weeks, you will need to decide if you would like to purchase the CPAP machine and use it long term.
There is no such thing as a “bad” CPAP machine as long as it is from a reputable brand. Having said that, since you will likely be using this long-term, it is best to do your homework and here are some considerations to take into account when making your decision.
- Type of pressure required – There are 3 kinds of positive airway machine – CPAP, BiPAP (Bilevel positive airway pressure), APAP (Automatic positive airway pressure machine). It is beyond the scope of this Q&A to discuss the indications of each but most commonly, CPAP is most commonly recommended for OSA and you need to ensure that the machine that you are purchasing provides this type of positive airway pressure
- Comfort – This is important to make sure that you are compliant with the machine. You just have to try it out to find the machine that is most comfortable to you
- Humidification function – A CPAP machine with an attached/built in humidifier reduces nasal congestion/nosebleed
- Size/weight – If you are a frequent traveller, it is important to choose one that is portable
- Cleaning/maintenance – Most machines are easy to clean/maintain but some are easier than others
- Display option – Some machines can show you your parameters/statistics or pressure readings in real time.
- Pressure support or relief setting – This allows people to breathe out against less air pressure during CPAP, making it more tolerable
- Auto-ramp feature – This function allows your device to detect your breathing changes and allows you to fall asleep to a lower pressure and once asleep, the machine “ramps up” to higher pressure
- Leak compensation – This allows the correct pressure to be applied during CPAP despite leakage around the mask
- Alarm system – Alarm systems are important to alert you of any problems while using the CPAP machine, e.g. Mask off alarm (if your mask is no longer on your face), suffocation alarm (if there the carbon dioxide/oxygen are out of balance), respiratory rate alarm (if your breathing rate is too high or low) etc.
- Data recording – This is important so you and your doctor can monitor your CPAP usage, respiratory events, change in pressure and snoring data during sleep. The ease of which the data is retrieved is also an important consideration. Some machines require the patient to bring a “digital card” to the sleep center for analysis, some can be done via a USB drive and others wirelessly (through WIFI or Bluetooth)
- Automatic on/off switch – This smart option will automatically turn on or turn off the machine the moment you put on or remove your mask respectively.
I will list some of the reputable brands below (most good CPAP brands/models used in Singapore are from US) and summarize the recommendations by ConsumerAffairs (in brackets):
ResMed (often known locally as the Rolls Royce in CPAP – best for those looking for a variety of machines and mask to choose from)
Philips Respironics (best for those looking for a quiet, comfortable sleep therapy system)
Devilbiss (best for patients looking for a variety of CPAP machine options)
Fisher & Paykel (best for patients looking for a variety of CPAP machine options for maximum comfort)
Transcend (Best for frequent travellers or those who camp in remote locations)
Apex (Best for those looking for a compact CPAP design)
InnoMed Technologies (Best for those with a CPAP machine looking for a comfortable mask options)
SleepNet (Best for children and adult patients looking for a comfortable mask)
3B Medical (Best for those looking for a high-tech CPAP machine)
Circadiance (Best for those looking for a comfortable CPAP mask)
Do note that the list are not to be exhaustive and I am sure there many more good brands (Europeans, Asians etc) that I may not be familiar with or aware of.
Hope this helps.
