Saturday, August 8, 2009

CPAP FAQ

Frequently Asked Questions
For the quickest way to get answers to all your questions concerning our products and web site, please send us an email. We will either respond via email or call you back. Please provide a contact phone number. For questions concerning products, product use, shipments and services, please email us at sales@BestCPAPprice.com.
Keep in mind that this FAQ Section is a work-in-progress. If you have a question that is not addressed on this page, let us know, and we will try to add it!

General WebSite Usage Questions
Machine Questions
Humidifier Questions
Mask Questions
Care & Maintenance
Insurance Questions
Prescriptions
Sleep Apnea Questions
Answers

How can I quickly find an item on your web site?
You can find an item by simply entering a part number or item name in the Search box that appears at the top right of each page and then clicking the Search button.
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How can I add items to the shopping cart?
You can add items to the shopping cart by simply clicking the "Add to Cart" button that appears below the product image. If you want to add more than one of the same item, change the number in the "quantity" field before clicking on the "Add to Cart" button. After you add the item(s) to your cart, the shopping cart screen will be displayed. Here you can either choose to checkout, update the quantities, or continue shopping. If you have added an item to your card by mistake, you can simply click on the "X" to remove it.
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Which web browsers can be used with this web site?
This web site should work with any of the leading web browsers such as Internet Explorer, Netscape Navigator, Firefox, Mozilla and Safari (Mac users). For best results, it is advisable to use the latest version of a given web browser. If you are not sure what the latest version is, contact the provider of your web browser software.
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Will my credit card information be safe if I place an order online?
Your personal data is transferred via a secure server using the latest industry-standard 128-bit Secured Socket Layer (SSL) encryption provided by Comodo Inc. You can verify that our website is secure by clicking on the Comodo logo on the bottom right corner of the screen. Your credit card number, expiration date and personal identification number are sent directly to the bank's card processing server for approval. We also perform a phone and address verification check as an extra level of fraud protection. To protect your sensitive information and to minimize the possibility of it falling into the hands of intruders, BestCPAPprice.com does not store any of your credit card information on our own servers. You should note that this makes it necessary to charge your card at the time that you place your order; therefore, if your order requires a prescription, it is best to have your prescription ready to be sent to us so that your order is shipped on the same day that the charges are placed on your card. Please review our privacy policy for additional information.
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Can I change my order or add more items to it after I have already checked out?
Yes, this can be handled several ways, depending on your preference. You can simply place another order and we can combine the two orders into one shipment, or you can call us at 1-888-346-CPAP and change your order over the phone. Please be sure to have your order number available when you call.
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How will I know that you have received my order?
As soon as you complete your order, your order number will appear on the screen. You should keep this number in case you have any questions regarding the status of your order. In additon to this, you will receive an order confirmation email at the email address that you specified while placing your order. This email will also include your order number, along with a summary of the products that you ordered, promotional discounts, shipping costs and sales tax (if applicable). After your order is shipped you will receive an email indicating that your order has been shipped, along with pertinent tracking information. This email will also contain a link that you can use to track your order at your convenience.
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How long does it take for you to fill my order?
Most of the time, orders will be completed on the same day they are placed, provided the order is placed (and the prescription is received, if required) by 4:30 PM Eastern Time. On the rare occasion that an item is out of stock, or if your order contains a product that we don't normally carry, the time it takes to complete the order can increase considerably. We pride ourselves in getting your order to you as quickly as possible, but occasionally circumstances that are beyond our control will prevent us from doing this. In these rare occasions, we will make every effort to communicate the delay to you as soon as possible.
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How do I know which machine I need?
First you must find out if your doctor prescribed for you a CPAP, CPAP with CFLEX, Auto-Titrating CPAP (Auto-PAP, APAP), Bi-Level (BiPAP), or an auto-titrating Bipap (Bipap Auto). The type of machine your doctor chooses for you is based on the information he received from your Sleep Study. If you are unsure, please ask your doctor why he chose a particular type of machine for you.
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What is a CPAP Machine?
CPAP stands for Continuous Positive Airway Pressure. A CPAP machine delivers a constant flow of air into your mask, at a constant pressure determined by your doctor, to open your airway, and deliver air to your lungs. With a CPAP system, you must exhale your air back thru your mask and against the pressure of the CPAP. For most sleep apnea patients, this can be uncomfortable at first, but easily adapted to within a few weeks. However, some patients, especially those at higher pressure settings, still have a hard time adjusting to their machine. For those patients, some of the manufacturers have developed a feature on their machines that slightly lessens the air pressure when the patient exhales. For instance, Respironics calls their expiratory pressure relief feature "C-Flex". C-Flex drops the machine's pressure slightly at the beginning of the exhale cycle, which makes the therapy more tolerable for many patients.
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What is an Auto-Machine or APAP?
With an APAP, sometimes referred to as an auto-titrating machine, the machine is set to a "range" of pressures and will move up or down within that range to provide the patient with the right amount of pressure during the night to overcome airway obstructions or apneas. If you are constantly fighting with your cpap, you can ask your Doctor to write you a prescription for this type of machine. Many people who cannot tolerate cpap can tolerate the auto titrating machines. APAP machines have the benefit of automatically compensating for your changing CPAP pressure needs. Your pressure needs can vary over time as you gain or lose weight, or as you get older. Your pressures can even vary from night to night, for instance, if you have taken cold medication or consumed alcohol; this can cause the muscle tone in your airways to lessen, and it will take more air pressure to keep them open.
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What is a BiLevel or BiPAP machine?
A BiPAP, or BiLevel has two different pressure settings; one for inhalation (IPAP) and one for exhalation (EPAP). The machine provides the inhalation pressure, and then switches to a lower pressure during exhalation. This differs from CFlex because the exhale pressure is an exact setting, not just a drop in pressure. BiLevel machines are sometimes required by patients who have relatively high pressure settings and find it uncomfortable to exhale against the pressure. Also, some patients have underlying conditions like weak chest wall muscles or COPD that make it difficult or impossible to exhale against higher pressures.
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What is a BiPAP ST?
Like the regular Bipap, the Bipap ST has two different pressure settings, one for inhalation (IPAP) and one for exhalation (EPAP), but, the Bipap ST will actually give you a breath if you don’t breathe for a certain amount of seconds (this is a setting on the machine which your Doctor prescribes) and is commonly called a ‘back up rate.’ This machine is normally ordered for people who, during their sleep study have what is called Central Sleep Apnea. Central sleep apnea means that your central nervous system is occasionally ceasing to send the signal to your diaphragm to breathe. Unlike the more common obstructive sleep apnea, central sleep apnea cannot be adequately treated with a conventional CPAP, APAP, or BilLevel machine.
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What is C-Flex or Bi-Flex?
Respironics has developed a proprietary technology that “softens” the air pressure at the beginning of each exhale. The rise and fall of the pressure makes this a much easier machine to get used to for new patients. There are three different levels of "flex" that these machines can achieve. A level 3 drops the pressure on exhale by 3 cm/H2O, level 2 drops it by 2 cm, and level 1 drops it by 1 cm. The Cflex can also be disabled if desired. This technology mimics a more natural breathing pattern and can really make a difference in patient comfort. Respironics also offers very similar technology on their BiPAP machines called BiFlex.Click here for more information about C-Flex.
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Do your machines come with a warranty?
Yes - all of the machines that we sell have at least a two-year warranty provided by the manufacturer (DeVilbiss IntelliPAP machines have a three-year warranty). If you have a problem with your machine within the first 30 days of receiving it that is due to a manufacturing defect, we will ship you another brand new machine to replace the defective one. After 30 days, the warranty is handled by the manufacturer, but you need to contact us to set up a return authorization with the manufacturer to provide service for the machine. Please note that the manufacturers are not set up to deal directly with the customer - all waranty issues must be coordnated through BestCPAPprice.com.
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Do your machines come with instructions?
Yes-all machines are shipped with detailed printed instruction manuals. If you would like to see one in advance, please go to the manufacturer’s website and you can view and print a manual on any machine. Please take the time to read your manual. It offers many many tips and information on your machine.
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What are the benefits of adding humidification to CPAP therapy?
Many people who are prescribed a regular CPAP regimen end up suffering from dryness and congestion in their nasal passages and throat, sore throats, and even nose bleeds. This is caused by the drying effect of the pressurized air moving across the mucous membranes. Humidification can help by adding additional moisture to the air that travels into the lungs. The additional moisture can help compensate for dried out nasal and throat tissues, preventing the problems mentioned above.
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What is the difference between a cool passover humidifier and a heated humidifier?
Humidifiers function through the process of water evaporation as air is drawn across a pool of water. A cool passover humidifier tries to use the surface area of the water to maximize humidification. Therefore, these units are usually wide and flat, and are usually stand-alone units. Since they do not use electricity to heat the water, they can be beneficial if the power source is limited, such as when using 12V. Heated humidifiers increase the evaporation rate by heating the body of water. The evaporative process is enhanced due to the higher temperature of the water. Since the surface area of the water is not as important, heated humidifiers can usually be much more compact than passover humidifiers. However, they do take a substantial amount of electricity to heat the water, and thus cannot usually be used with a 12V power input.
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What is the advantage of having a heated humidifier for my CPAP machine?
A heated humidifier can provide a much higher level of humidification because water that is at a higher temperature evaporates much more readily. This allows the air flowing across the surface of the water to pick up the moisture more easily, resulting in more moisture being delivered to you through your interface. Additionally, warmer air has more capacity to hold moisture, although you should not notice any air temperature difference because humidified air usually feels cooler.
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What is the difference between a stand-alone humidifier and an integrated humidifier?
Stand-alone humidifiers are separate from the CPAP machine itself and attach via a short tube. The breathing tube is then attached to the outlet of the humidifier chamber. The advantage of a stand-alone unit is that it can be used with a number of different brands and models of CPAP machines. Integrated humidifiers are designed for a specific make and model of CPAP machine, and are physically attached. These units often derive their electrical power source from the machine itself, which means only one power cord is required. The advantage of these is compact size and portability.
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I am getting excessive water condensing in my mask and breathing tube. Is there any way to stop this from happening?
"Rainout" is the term that is commonly applied to this condition, and it is usually caused by moisture condensing from the warm, moist air moving through the relatively cool breathing tube. Some possible solutions to this problem would be to make sure that the humidifier is not positioned at a level above the patient. Also, sometimes this can be alleviated by simply routing the breathing tube under the covers to keep it warm. If this is not an option, there are hose wraps made of fleece-like material that can be wrapped around the breathing tube to insulate it. Sometimes, simply turning the humidifier setting down slightly will cure this, or raising the temperature of the room a little bit. Finally, Fisher & Paykel has confronted this issue with a novel technology called ThermoSmart, which employs a breathing tube that has a built-in heating element to prevent rainout. It is available in their HC-600 Series CPAP machines.
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What is a nasal mask?
A nasal masks seals around the entire nose and is held in place with straps, or headgear. ** Please Note - if your mouth comes open at night-you may need to use a chin strap (a strap that goes underneath your chin and fastens on top of your head-this helps to keep your mouth closed) or a Full Face Mask (a full face mask covers your nose and mouth)
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What is a full face mask?
A full face mask seals around both the nose and mouth and is held in place with straps, or headgear. Full face masks are used for 'mouth breathers'. For some people the mouth tends to drop open unknowingly during sleep. This allows the treatment pressure (what your machine pressure is) blowing through the nose through a nasal mask to escape through your mouth, which means your airways are not held open by your prescription pressure any longer. The full face mask allows you to continue to receive your therapeutic pressure because your nose and mouth are covered and you are not losing your pressure. Sometimes nasal blockages like a common cold or those who have nasal congestion due to illness or allergies might also need a full face for consistent treatment. Many people will use a nasal mask during most of the year and will switch to their full face mask when they can’t breathe through their nose.
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What are Nasal Pillows or Nasal Cushions?
Nasal pillows sit right at the entrance to your nose-or, your nostrils. They don’t go in far, they form a gentle cushiony seal and are held in by a formed headgear. The cushion does not fit over the tip of the nose or rest on the bridge. A nasal cushion normally seals over both nostrils and is similar to the nasal pillows.
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Does every mask work with every machine?
Yes-every mask works with every machine. In other words, if you have a Respironics machine and want a Fisher/Paykel mask-they are all compatible-no matter what combination. However, always read the manual that comes with your machine and mask for up to date information on compatibility issues with auto-titrating machines.
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Does every mask fit on my tubing?
Yes, every mask is made with a universal fit to your tubing. Occasionally, we hear that people are having trouble getting their new mask on their old tubing-it is almost ALWAYS because a piece of your old mask is stuck on the end of your tubing by mistake.
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Do mask sizes correspond for different brands and models?
No - the mask sizes can vary from one brand to another, and even from one model to another, even if they are made by the same manufacturer. For instance, a medium Respironics ComfortGel mask is NOT the same size as a medium Soyala mask. Some of the manufacturers provide mask fitting and sizing guides on their websites that assist you in selecting the proper size mask. Respironics, in particular, has sizing gauges that can be downloaded and printed to assist you in selecting the proper size. Also, there are some models that come with multiple sizes included, which gives you more options in selecting the correct size. If you are having difficulty selecting a size, we recommend that you contact us via email or our toll-free number, and we will be glad to assist you.
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I purchased a mask from you and it does not fit. Can I exchange it for another size?
Unfortunately, we cannot accept the return of any mask that has been opened. The FDA (Food and Drug Administration) has imposed strict guidelines regarding cross-contamination of medical equipment, and the resale of used masks is prohibited. Once a mask is removed from its original packaging, it is considered to be "used" by the FDA. If you are trying out a new model of mask that you have never used before, sometimes it is in your best interesst to visit a "brick and mortar" DME (Durable Medical Equipment) company in your area that will let you actually try on a mask for fit and comfort before purchasing. The cost is much higher, but you have a better chance of getting the right fit. Otherwise, contact us and we will do our best to help you find the right size.
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How frequently should I clean my equipment, and how should I do it?

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Will the CPAP equipment that I puchase be covered by my insurance company?
Your insurance company may reimbuse you for all or part of your purchase. This is dependent on your insurance company and the type of coverage provided by the particular policy that you have. Some providers, such as Medicare, will require that you rent a machine for a period of time before they will purchase it. This monthly rental price is frequently much higher than what it would cost to buy the same machine outright through BestCPAPprice.com. Likewise, even companies that will reimburse your purchase will often charge a copay or deductible that is higher than an actual out-of-pocket purchase from our site. The only way to know for sure is to contact your insurance company via the toll-free number that appears on the card, and ask them what their coverage levels are for durable medical equipment (specifically for the treatment of sleep apnea). You will want to have the policy number and possibly the group number that appears on the front of the card handy when you make your call.
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Will you bill my insurance company?
No - in order to keep our prices as low as they are, we cannot afford to employ the staff that would be necessary to file the paperwork and make the phone calls necessary for follow-up of hundreds of claims. Although there are some sites out there that will file your paperwork for you, you will probably find that their prices are considerably higher than BestCPAPprice.com, and few if any will guarantee that you will receive reimbursement.
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What does HCPCS stand for?
HCPCS (sometimes pronounced “hick-picks”) is an acronym for Healthcare Common Procedure Coding System and refers to the system of coding for services and equipment used by physicians, medical equipment suppliers, and insurance companies. Established in 1978, HCPCS is a national standard code set used by healthcare practitioners, providers and suppliers throughout the United States when filing insurance claims for drugs, medical devices, and other items and services. Medicare, Medicaid, and other health insurance programs use HCPCS to ensure that insurance claims are processed in an orderly and consistent manner. HCPCS codes are broken down into two principal subsystems - Level I and Level II. Level I includes CPT codes established by the AMA to describe medical services and procedures, while Level II codes (also known as "DME codes") identify products, supplies, and some services that are not included in Level I.
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What is a CPT code?
CPT is an acronym for Current Procedure Terminology, and is a category of the HCPCS codes (Level I - see the answer above). CPT codes refer to procedures or services performed by physicians on or for patients. CPT codes are sometimes confused with DME codes, which is an acronym for Durable Medical Equipment. A DME code (Level II HCPCS code) refers to the equipment you purchase and it is the code that is more commonly provided to your insurance company when filing a claim for CPAP equipment.
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What are the HCPCS codes for the equipment I purchased?
Click here for a list of CPAP-related HCPCS Codes.
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Is a prescription required for my order?
If your order includes any type of CPAP, Auto-CPAP or BiLevel machine, then a prescription will be required. This requirement is dictated by the U.S. Food and Drug Administration (FDA). Basically, the FDA restricts the sale of CPAP machines to be based on a doctor's written order. The prescription serves as this written order. If your order does not contain a machine, then no pressure settings are necessary. Please note that the purchase of ResMed masks does require a prescription. Feel free to contact us if you have questions.
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What information should be on the prescription?
The prescription should have the patient's name, the type of device (i.e. "CPAP", "BiLevel or BiPAP", "APAP", or similar), a pressure setting for non-auto adjusting machines, and the doctor's name, contact information and signature. Bi-Level machines will require both an inspiratory and expiratory pressure setting, i.e., "IPAP=15, EPAP=10" or "15/10 cm/h20. Prescriptions for auto-adjusting machines may optionally specify a minimum and maximum pressure setting; otherwise, if the pressure is omitted, the machines factory settings (usually 4-20 cm/h2o) will be used. Also, if an order is placed for a bi-level machine that uses a timed backup breathing rate, the backup rate expressed in breaths-per-minute (BPM) should be included.
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Can you accept a prescription that is written for a CPAP machine if I am purchasing an Auto machine?
Yes. If the prescription simply specifies "CPAP" and does not specify a pressure setting, then the machine's factory settings of 4-20 cm/h2o will be used. If a single pressure setting is specified, it is our preference to set the machine to run in CPAP mode at the prescribed pressure (most Auto machines can also run in straight CPAP mode). We do this because we do not want to get in the mode of possibly overriding a doctor's intentions. All of our machines are shipped with instructions on how to access the provider menus to change the pressure setting and other parameters, so it will be a simple procedure for the customer to change it back to APAP mode if desired. Please note that we strongly encourage you to contact your doctor before making any pressure changes. It is possible to cause bodily harm if the pressure is set too high, and you may not be getting the full benefit of your CPAP therapy if the pressure is set too low. Please contact us if you have any questions about this.
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Can you accept a prescription that is written in a language other than English?
Yes, in most cases we can accept a prescription that is not written in English, but we will need to have the patient's name translated, and we will need to have the pressure setting expressed in a unit of measure that is recognizable to us. If possible, please translate this information.
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I have a prescription that is several years old. Do I need to get a new one?
No, prescriptions for CPAP equipment state a lifetime necessity, and, as such, do not expire. However, if you plan to seek reimbursement from your insurance company, keep in mind that many insurance companies place a limit on how old the prescription can be.
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Can you accept a copy of my sleep study instead of a prescription?
In most cases, a sleep study CAN NOT serve as a substitute for a prescription. The exception would be if it has a summary page that clearly states the need for a CPAP or BiLevel device, the pressure setting, and has a signature or electronic signature of the physician. If you are in doubt, please contact us.
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Should I place my order before I fax in my prescription or after?
In most cases, if the name on the order matches the name on the prescription, it does not matter if you place your order before or after you send us your prescription. However, if the names differ, or you want to ensure that your order is fulfilled as quickly as possible, then it is best if you place your order first and then fax or email your prescription. In this case, it is helpful if you include the invoice number (ex. "AB-9999") that is emailed to you with your order confirmation on the cover sheet or in the email. PLEASE KEEP IN MIND THAT NO MACHINES WILL BE SHIPPED BEFORE A VALID PRESCRIPTION IS RECEIVED - NO EXCEPTIONS. Please try to have a copy of your prescription on hand when you place your order.
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What is Sleep Apnea?
Sleep Apnea is a breathing disorder. The Greek word "apnea" literally means "without breath." There are three types of apnea: obstructive, central, and mixed; of the three, obstructive is the most common. Despite the difference in the root cause of each type, in all three, people with untreated sleep apnea stop breathing repeatedly during their sleep, sometimes hundreds of times during the night and often for a minute or longer. This prevents them from achieving restful sleep, since they never complete the different sleep cycles that are necessary to rejuvenate the mind and body.
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What are the symptoms of Obstructive Sleep Apnea (OSA)?
The most common symptoms of OSA in adults are loud snoring and excessive daytime sleepiness. Almost all people who have OSA snore, but not all people who snore have OSA. Other signs and symptoms of OSA include: episodes of not breathing; Restless tossing and turning during sleep; nighttime choking spells, sweating, and chest pain; waking with an unrefreshed feeling after sleep, having problems with memory and concentration, feeling irritable and tired, and experiencing personality changes; morning headaches; heartburn or a sour taste in the mouth at night; in obese adults, swelling of the legs; getting up during the night to urinate; daytime naps or sleeping during inappropriate times or activities. People with Sleep Apnea may exhibit onset high blood pressure, unexplained weight gain, depression and other health conditions.
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What is the most common treatment for Sleep Apnea?
The most common treatment for Sleep Apnea is CPAP, or Continuous Positive Airway Pressure (CPAP), therapy. There are several different types of machines for Positive Airway Pressure (PAP). Treatment involves a PAP machine and a mask.
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I'm not overweight. Could I still have Sleep Apnea?
Yes. While many people with Sleep Apnea are overweight, not all sufferers have a weight problem. If you exhibit other characteristics of Sleep Apnea, you should be evaluated.
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How can I be evaluated for Sleep Apnea? What steps should I take?
Talk to your doctor about your symptoms, and ask for a referral to have a sleep study performed. Also known as a polysomnogram (PSG), the sleep study is usually performed overnight in a sleep lab, which is a bedroom-like environment that has the necessary equipment on hand to monitor your sleep. The PSG records several body functions during sleep, including brain activity, eye movement, oxygen and carbon dioxide blood levels, heart rate and rhythm, breathing rate and rhythm, the flow of air through your mouth and nose, snoring, body muscle movements, and chest and belly movement. After the sleep study is conducted, the sleep doctor (usually a pulmonologist) will evaluate the results and write a prescription for CPAP therapy if necessary.
Back to General Sleep Apnea Questions.

So I have sleep apnea. Is it really something that I need to worry about?
Some of the consequences of untreated sleep apnea include high blood pressure and other cardiovascular problems, increased risk of stroke, and weight gain. Sleep apnea puts an incredible strain on your body when it occurs - just imagine your body's reaction to being smothered! People with untreated sleep apnea may also complain of excessive daytime sleepiness, headaches, memory problems, and depression. Many motor vehicle accidents can be attributed indirectly to sleepiness while driving due to sleep apnea. Also, keep in mind that the problems are not just reserved for the person with sleep apnea - other family members can suffer from lack of sleep due to the excessive snoring and tossing and turning of the person with sleep apnea.
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