First, let me explain about prescribed processes. All of the equipment delivers air pressure via a mask, which acts as a splint to the upper airway. The particular pressure that is prescribed by the doctor is the amount of pressure that has been shown to break and resolve the apnea during the treatment portion of the sleep study. Prior to the sleep study, a diagnostic portion must be done, where is documented that the patient has apnea. Sometimes the sleep studies are done in two nights; a diagnostic night, followed by a treatment night. Sometimes a split-night can be done, where the first 4 hours are diagnostic followed then by a treatment section which is called the titration portion. It is crucial that the titration portion be done to find out exactly how much pressure is needed to break the apnea. A correct pressure can not be arbitrarily decided by a physician, although I have heard about plenty of quacks (ignorant physicians who think they know about all about sleep disorders after reading a couple of medical journal articles ) that have done it.

To give you all an understanding of the various equipment:

CPAP- (Continuous Positive Airway Pressure)- delivers one preset continuous pressure to the patient. It can be set to any pressure in the range between 3 (CM/H2O) to 20 (CM/H2O). This unit came first, before BiPAPs or APAPS.

BiPAP/VPAP- (BiLevel Positive Airway Pressure/Variable Positive Airway Pressure)- These units were the second generation of airway therapy. The machines have two presettable pressures and will alternate between the two as the patient inhales and exhales. The internal pressure sensors can sense when the patient inhales and exhales and will drop to the lower preset pressure during exhalation and raise back up to a higher preset pressure during inhalation. The two preset pressures are called IPAP (inspiratory Positive Airway Pressure) and EPAP (Expiratory Positive Airway Pressure)

APAP- (AutoSet Positive Airway Pressure)- automatically senses when you have apneas, and attempts to deliver the correct amount of pressure to resolve the apneas. It will try to deliver the lowest amount of pressure required to effectively eliminate the events. Unfortunately, depending on the particular patient and the types and severity of the events, the machine can many times keep changing constantly, and thusly end up disturbing the patient by the feel of the changes in pressure and volume of the machines. The are other nuances that I just don't want to get into right now on a Sunday afternoon.

The types of machines and features come at a price. The stripped down models are cheapest, and of course the more elaborate ones with the bells and whistles are pricier. Software is available on many that will give you (or the Home Medical equipment company) all sorts of important information on what is going on while you sleep, such as AHI (Apnea/Hypopnea Index), and many other statistical information. Some patients are capable of understanding this information, while others either are not capable or do not what to get involved in it, or are intimidated by the information and choose not to possible mess things up.

Other considerations the patient should keep in mind when deciding on a machine are:

Size, weight, (especially if they travel), the ability of the machine to compensate for altitude changes from where it was set up. Again important if you travel. How quiet is the unit, which can be more important to the bed partner then it is to the patient).

Yes, the various blogs and message boards can be often times helpful and it's good to see that others can the same issues that you do, but please beware. Beware of what you read, because they are quite often written by people that can give incorrect or partially correct information. Just as if you read a post here asking "What's the best way to clean my chips" and you hear from a guy that has had fantastic results using a mixture of bleach and water mixed at 50-50" . Take that up a few notches and ask yourself "Do I want to leave the direction of my treatment in the hands of a non professional?" It can be okay for little things like learning about a power converter to plug in the AC power to a car lighter. It's good to find out that it's a lot cheaper to buy one from Radio Shack then buying the very same unit from Respironics or Resmed. However, I would be very, very careful in what I listen to at some of these patient forums.

i HAVE FOUND THAT SOME OF THE BEST PATIENT INFORMATION CAN BE FOUND ON THE MANUFGACTURER'S WEBSITES:

www.resmed.com
www.myresmed.com

www.respironics.com
www.SleepApnea.com
www.healthysleep.com