- Good morning, guys.
Nick here from CPAP Reviews.
It's great to be with you again, as always.
Now, when you first start using a CPAP machine,
everyone starts throwing around
all this different terminology and phrases
and you have literally no idea what it all means.
So I thought it might be a good idea
to do a little video
just explaining some of that terminology
just so you have a better understanding
of where it all fits in and how it all works.
So the first term I'm gonna discuss is CPAP.
Yep, CPAP.
That's a word that has saved
thousands and thousands of people's lives
and it's very important.
So it stands for continuous positive airway pressure,
or constant.
So C is the type or the method of delivery of the therapy.
It's continuous.
It means it's set at,
the pressure's set at one fixed level of pressure, okay?
A constant pressure at one level throughout the night.
And the PAP, CPAP, stands for positive airway pressure.
That's just the type of therapy.
So when you have sleep apnea
and your upper airway is closing over of a nighttime,
becoming very restrictive,
and you're having apnea and hypopneas,
the positive airway pressure opens up the airway.
Think of it like a balloon
and your airway's like the walls of the balloon.
When you pressurize the balloon,
the walls just come nice and open
and so you can breathe nice and easy throughout the night.
Stops all the snoring, makes your sleep cycle better,
and you just have a better night's sleep in the long run.
So that's the CPAP.
The opposite of that is APAP,
or automatic positive airway pressure,
and instead of being constant,
an automatic machine varies the pressure
automatically through the night.
So it will adjust the pressure
minute by minute through the night
depending on what's required.
The machine itself actually monitors
your breathing with a flow sensor
and then computer inside basically analyzes that information
and then it adjusts the pressure
for whatever's required throughout the night.
So you end up with a variation in that pressure.
Terms that go with APAP are auto min and auto max.
So if we have an auto min at four
and an auto max at 10,
the machine can vary the pressure between those values.
So it can go five, six, seven, eight,
back to seven, back to nine,
wherever it wants to go,
but that's the range of pressures, okay?
You have the minimum level and the maximum level
and you can vary those different levels.
With continuous, we just have one set level,
which is whatever the pressure's gonna be.
And then that leads us on to our next term, which is ramp.
A ramp is a variation in pressure
between two values over a set period of time.
A good example is if we have the starting value at four
and then our CPAP pressure at 10
and a ramp set to 30 minutes,
it means the machine will gradually build up the pressure
from four to 10 over 30 minutes.
It's a gradual increase in the pressure
over a set period of time.
That's your ramp.
You don't really have to use a ramp with auto that often,
mainly because the machine will know when you're asleep
and it will ramp up the pressure
using its auto algorithm anyway.
Another term that's thrown around is pressure relief,
C-Flex, EPR, RESlex.
Pressure relief means
that when you're breathing out against the machine,
the machine will drop the pressure a little bit
to help you exhale,
and you normally have a value which you can set.
So the higher in the value you go,
the more the machine drops the pressure
as you breathe out against that pressure.
It's a comfort feature.
It's designed to make your life a little bit easier
when you're using the machine
and especially helpful for beginners
who don't quite have that lung capacity
just in the beginning
to really breathe out
against that pressure that's coming in.
Moving on, humidifier.
So a humidifier adds moisture to the air.
The reason it does this
is that with all that air coming in through the night,
people can sometimes have a tendency
to dry out in the mouth and throat.
It can become a little bit uncomfortable.
You can get a little bit hoarse in the throat.
But, also, humidified air can actually
sort of open up the airway.
It sort of dilates everything.
If you've ever had a cold and hopped into a hot shower
and that steamy, hot air comes up,
you know it can make life a bit easy to breathe.
Heated tubing.
Now, heated tubing was added originally
because if you have a lot of humidified air,
which is warm, moist air,
and you have a cold outside air,
like, just a cold environment,
you can get condensation.
So you can get, basically, water droplets forming
and they can form in the tube,
they can start getting on your face,
and it becomes quite annoying.
So a heated tube is designed to stop that,
they call it rainout,
but it's designed to stop that.
So it keeps the hot air inside the tubing insulated
and keeps the cold away from that air,
keeping the air moist, humidified, without condensating.
All right, now we'll go on to some sleep data.
So AHI is apnea hypopnea index.
An apnea means there's quite a large
restriction in your airway,
hypopnea just means there's a bit of a restriction
but not completely blocked off,
and the two of them together averaged out over an hour
gives you the apnea hypopnea index.
An example is if you have an AHI of seven,
it means seven times an hour
you're having either an apnea or a hypopnea.
Apneas are worse, hypopneas aren't as bad,
but at the same time, it's effecting your sleep,
it's effecting your breathing,
and it's effecting your health.
So the idea with the AHI is to give you just an indication
as to how severe your sleep apnea is to begin with
and also how well controlled it is
when you're using the CPAP therapy.
So they use it to diagnose
and give you sort of a severity level.
If your AHI is between five and 15, it's mild,
15 to 30 is moderate,
and once you hit 30,
(imitates explosion) you're in the severe category.
And I've seen people with AHIs over a hundred, okay?
So a hundred times an hour people stopping breathing.
It can get really, really bad.
But at the end of the day, no matter what it is,
it's effecting your sleep, it's effecting your health.
When we're using the CPAP machine,
the CPAP machine will give us data
and we look at that apnea hypopnea index
to see how well it's treating us.
Ideally, we like to get the AHI less than five,
which is considered normal.
But, look, it really depends
on how far down you're coming from in the beginning
and a few other factors,
but, ideally, less than five.
So we can use that number as a goal
and we can adjust the therapy settings
to try and get to that goal.
Algorithm, an algorithm is basically a mathematical formula
that the machine uses to determine what pressure
to deliver at a set period of time.
It's with the APAP machines, the auto machines.
So they will monitor your breathing,
they'll monitor the flow of your breathing,
and then they'll use this algorithm,
basically a computer,
to adjust the pressure
based on that information that's coming in all the time.
So the machine's constantly getting information,
constantly getting funneled through,
and then the algorithm
is gonna adjust the therapy accordingly.
Now, the algorithms are quite guarded secrets
in the CPAP world.
Each manufacturer has their own way
of determining what is apnea
and when it should adjust and all that sort of stuff.
The end result, you can check out your apnea hypopnea index
and still make sure that you're getting
good therapy at the end of the day.
All right, now we're gonna go onto the masks.
And it's changed a bit since when I started.
There used to just be nasal pillow,
nasal, and full face masks,
and now there's just a whole bunch of different terms.
Probably too many, really, to even talk about today,
but I'll go through some of them.
So we'll start with a nasal pillow.
Pillow mask is one,
I might have one here actually,
a pillow mask is one that seals at the nostrils, okay?
So they generally have two little prongs that sort of sit
just at the base of the nose there like this,
and that's what we call a nasal pillow mask.
The good thing about the nasal pillow masks
are they are very small,
generally they're very lightweight,
they're very minimalistic.
The downside of any nasal-type mask
is that you need to be breathing
exclusively through your nose.
Just your nose, no mouth breathing.
If you open your mouth, it'll feel very strange.
You'll find it very hard to sleep with your mouth open.
So that's your nasal pillow mask.
Next is just a standard nasal mask
and that generally just covers around your nose, okay?
It just seals around the nose,
not in the nostrils, just around the nose,
and they normally have headgear as well.
Same thing with a nasal pillow mask,
still small, still lightweight,
and you just need to be using your nose to breathe.
The next one is your full face masks.
They're obviously a little bit bigger.
I've got a couple here actually.
These are ones I've done reviews on before.
This is the F30i here.
This is a Vitera from Fisher & Paykel.
The full face masks, at the end of the day,
cover your nose and your mouth.
They seal around the nose and the mouth
and so because they completely seal the nose and the mouth,
you can breathe through your nose, through your mouth,
any which way you like, it's up to you.
So that's the good thing about the full face mask.
The downside of the full face mask
is they generally are a bit bigger,
and the bigger they are,
they're a bit more cumbersome to sleep with,
you've gotta seal more area,
so you're more likely to get mask leaks, and so forth.
But each mask has its pros and cons.
The best way to go about it
is to try them on and see how you go.
I will give you one piece of advice here,
which is a lot of people get told
they're mouth breathers because they snore
and when they're sleeping of a nighttime,
they have their mouth open.
That's mainly because they have sleep apnea,
that they're mouth breathers to begin with.
Now they're on the CPAP machine,
they're not gonna have sleep apnea anymore.
So don't let anyone push you into wearing a full face mask
just because they say you're a mouth breather.
Unless you have some sort
of chronic nasal obstruction going on,
maybe you got hit in the head with a football
when you were younger or something
and deviated septum in the nose,
unless you have something like that,
or chronic sinusitis,
you're probably gonna be able
to get used to one of these nasal ones
just with a bit of time and bit of practice.
So make sure you always start with a nasal,
persist with a nasal in the beginning,
or a nasal pillow,
and then if you really can't do it after a bit of time,
go to a full face mask and see how you go with that.
But if you can get onto the nasal masks,
they're much more enjoyable over the long run.
So that's my little bit of advice for you.
But nowadays, anyway, they're the old three types.
Now there's all sorts of news ones.
There's hybrids, so there's nasal cradles.
I've got one here.
So these are nasal cradles.
They don't actually go into the nose
but they sit below the nose.
So this is a N30i by ResMed.
You can sorta see this cradle section here.
This one here I just did a video on last night,
the Evora, Fisher & Paykel,
and once again, cradle.
So nothing going into the nostrils
but sitting very low just down the base of your nose there.
And then there's cloth masks and all sorts of other stuff,
but they're your main varieties.
So your nasal, your nasal pillow, your full,
and sort of your hybrid-y type masks.
And I'm sure in one year's time
there'll be another one to add to list.
It's pretty crazy how it's all changing.
Last thing is clinical settings.
So machines have two setting modes,
patient settings and clinical settings.
Your patient settings are your general things
like changing the humidifier settings,
maybe changing the ramp time,
really basic type stuff that is quite,
it's in the manual.
Your clinical settings, you won't find in the manual.
They're for gurus like myself
to change things like your CPAP pressures.
I always recommend to you guys,
and that's why I show you all the videos,
on learning how to get to those clinical settings
and learning how to change them.
There's normally a little bit of a secret button press
that you've gotta do, or hold down this.
But really learn how to do that.
Gives you great control,
so much more control over your machine,
and if you can learn how to just read your data
and then fine tune those pressure levels,
it's gonna make life a whole lot more enjoyable for you.
All right, guys, that's it for today.
I hope you found the video useful.
If you did, please show your love
and hit that Like button
and also subscribe to the video.
Really appreciate it.
In the meantime, hope everything's going well
with your CPAP therapy.
If you're new to CPAP, just stick at it.
It does take a bit of time
but in the long run you'll be so much better off
getting a good night's sleep.
All right, I'll leave it at there.
Cheers. Thanks for watching.