Modern CPAP machines provide a myriad of information that can help you and your physician determine how well your CPAP is working for you. So much of this information is abbreviated or is shown as an acronym. This can make it really difficult to understand what in the world you are looking at. That is why we have taken the time to lay out a full explanation of all the things you see on those reports.

What are the categories on the CPAP report?

The first thing that you need to understand is what all the categories mean on your CPAP Report. Then, we can take a deeper dive below on what those categories represent. So, let’s start out by defining all those abbreviations and acronyms.

• AHI– Apnea Hypopnea Index.
• HI– Hypopnea Index
• AI– Apnea Index
• CAI– Central Apnea Index
• RERA– Respiratory Effort Related Arousal
• Cheyne Stokes– abnormal pattern of breathing
• Leak– Air escaping above normal thresholds
• Pressure– Amount of pressure created by the CPAP
• Compliance percentage– percentage of nights greater than 4 hours of usage

Now, let’s dive in a little deeper on each subject.

Apnea Hypopnea Index (AHI)

The AHI is the total number of Apnea and Hypopnea events that occur divided by the total numbers of hours that you slept on the CPAP. This metric shows you the number of times per hour that you stopped or partially stopped breathing. It is important to monitor this metric because it is the main method for determining how well the CPAP is working for you. Generally, it is considered “normal” if your AHI is under 5. Of course, that is different for everyone and only your doctor can tell you what a healthy AHI is for you. For CPAP users that are on an Auto CPAP the AHI may take time to reduce. This is because the Auto CPAP takes time to adjust to the most suitable therapeutic pressure for you.

Apnea Index (AI)

The Apnea Index is a further breakdown of the AHI. The AI is the number of times per hour that you had an apnea divided by the total hours that you were using the CPAP. The Apnea Index is typically broken down by: Obstructive Apnea, Central Apnea, and Unknown Apnea. All Apnea is defined as a stoppage of breathing for at least 10 seconds. Obviously, breathing is pretty important. Usually as you stop breathing for that length of time, your blood oxygen level falls as well. Enough Apnea events over time can cause all sorts of health concerns. Because the AI is part of your AHI score you should refer to the AHI metric for what should be determined as a “normal” score for this metric.

Hypopnea Index (HI)

A Hypopnea is very similar to the Apnea in how it is determined. The hypopnea index is the total number of hypopneas divided by the total hours of sleep. By definition a Hypopnea is when your breathing shallows to at least a 30% from your normal airflow, in addition to at least a 4% in your blood oxygen level. To boil that down, a hypopnea is when your breathing is partially blocked, and that partial blockage causes a reduction in blood oxygen. The hypopnea index is usually added to your apnea index and totals as your Apnea Hypopnea Index. That “normal’ range is cited above.

Central Apnea Index (CAI)

Central Apnea is another form of apnea that is added into the overall AI score. The Central Apnea Index is again the total number of Central Apneas divided by the total number of hours you slept. A Central Apnea is when you stop breathing, but your brain doesn’t tell you to breathe like it normally should. It is more a neurologic issue and, in most cases, requires a different therapy than standard CPAP. In many cases you may be prescribed an ASV (Auto Servo Ventilator). This total score is a part of your total AHI score, and the goal is typically to be under a total of 5 AHI. Of course, only your doctor could determine that for you. If your CAI is high even on your CPAP, you should certainly speak to your doctor about this to see if a more appropriate therapy should be prescribed.

Respiratory Effort Related Arousal (RERA)

The RERA is when your brain causes your breathing to become labored, and you are aroused from your sleep. Usually, it is represented by limitations in breathing, occurring for more than 10 seconds continuously. It is not classified as Apnea or Hypopnea but can cause some of the same symptoms if untreated. If you are seeing a significant amount of RERA on your CPAP Report, then it would be smart to consult your doctor. In most cases CPAP will resolve this issue, but if it continues on CPAP an alternative therapy may be necessary.

Cheyne Stokes Respirations

Cheyne Stokes are when you go into an abnormal breathing pattern. It is usually a progressive deeper breathing pattern than can become more rapid at first and then decreases resulting in complete stoppage of breathing (Apnea). This pattern can be repetitive for 1-2 minutes at a time in many cases. It also may repeat over and over throughout the night. In most cases your CPAP should resolve the Cheyne Stokes breathing, but in some rare cases it may not. If you have continued Cheyne Stokes on your CPAP Report, you should speak with your doctor about changing therapy or switching to a better alternative therapy.

Leak

Leak is classified in liters per minute of air escaping from your mask or tubing. It can also be from a poorly attached humidifier. On the CPAP report the leak may be shown at multiple points such as: Median Pressure leak, Maximum Pressure leak and 95th Percentile leak. This is because a leak at the maximum pressure is not nearly as concerning as a leak at your 95th percentile pressure. By most opinions the leak should not be over 24 lpm. If it is over that threshold, you should do a close inspection of all connections to make sure that everything is together correctly. If everything is tightly attached, then you should work to adjust your mask for a more secure fit. With that being said there are a couple things to keep in mind about leak

1. There is a good chance that you will have some leak. Very rarely does anyone have a perfect mask fit throughout the entire night. Adjusting your mask to keep your leak in a proper range is good, but do not make yourself miserable over a minimal leak.
2. Your mask will have air escaping at all times. I can’t count the times customers have come in with a mask that had tape over an exhalation port. You do not want to do that. All CPAP masks have an exhalation port that allows you to properly exhale CO2. Usually, it is in an obvious area with small holes.

Pressure

Pressure is the measurement of force that the CPAP is pushing to keep your airways open. It is classified in Centimeters of water pressure, typically abbreviated as “cm”. If you are on a fixed pressure CPAP this will most likely be one pressure without much else on the CPAP Report. If you are on an Auto CPAP, then you may see a few different pressures. I will detail those below:

• Median Pressure– This is the average pressure that your CPAP is at from start of therapy to end.
• 95th percentile– This is the pressure that is providing the most effective therapy. In other words, this is the pressure that is working best to resolve your apnea. This may change from time to time.
• Maximum Pressure– This is the highest amount of pressure that your CPAP is reaching during your CPAP therapy.

Compliance Percentage

For a real detailed look at compliance percentages, I would refer you to our compliance video that lays CPAP compliance out in detail. In summary, the report will typically show nights greater than 4 hours of usage as compliant nights. The number of nights with 4+ hours of usage divided by the total number of nights used will give you that percentage on your CPAP Report. For Instance: if you had 21 nights of 4+ hours usage out of a total of 30 nights, then your compliance percentage will be at 70%.

  If you need a new CPAP then you need to learn from our experience. We deal with thousands of CPAP users. From first timers to 10 years plus CPAP veterans. We have taken all that feedback and combined it with our years of industry experience to give you the right advise on your next CPAP.

Why should I buy an Auto CPAP?

The first thing that you need to know is that there is NO REASON to buy a fixed pressure CPAP. In fact, most manufacturers seem to be moving away from selling them. If you need to understand the difference between fixed pressure CPAP and Auto CPAP, then click here to check out the blog on that subject. Even if you are prescribed a fixed pressure setting you are doing yourself a disservice to buy a CPAP that can only do a fixed pressure.

Our Top 4 Auto CPAP Picks

There are quite a few options in the CPAP world these days. For the sake of this article, we are going to focus in on the top 4 Auto CPAPs for home use. We have some great info on Travel CPAPs as well in another blog.

#4: Luna 2 Auto CPAP

The Luna 2 Auto CPAP is a great CPAP option overall. If you need a cost-effective Auto CPAP that will work great for years, then this is definitely in the consideration. It has a comfortable algorithm that works very well. It has universal connections so that you can use any standard mask or tubing. The Luna 2 is definitely durable. We have had very few issues. In fact, the only issue of significance has been humidifier failures. They have been few and far between, but we have had a handful of those. Let’s take a look at the major pros and cons for the Luna 2.

Luna 2 Pros:

• Simple and effective– While there aren’t many bells and whistles on the Luna 2 that isn’t a bad thing. You have all the standard features that you would expect and need without any fluff.
• Durable– We have had so few issues with the Luna 2 that we can confidently say it is very durable. The only issue we can site is humidifier issues. They have been very few and far between (less than 1%), and the CPAP will still operate just fine without humidity if you happen to be that unlucky.
• Cost effective– The Luna 2 CPAP is priced affordably. You can save 30% plus on the cost of Auto CPAP therapy without sacrificing quality or effectiveness.
• Universal connection– This CPAP features the standard 22mm tubing connection. This means that you can use any mask or standard CPAP tubing on the Luna 2.

Luna 2 Cons:

• Larger and heavier than others– It is definitely bigger and heavier than the other options. If you don’t plan on traveling with it, then that may not be an issue.
• Compliance reports aren’t as easy– You can use the i-code or SD card to obtain a compliance report from the Luna 2 without any additional accessories, but both of those options are manual. We have a detailed blog on the Luna 2 compliance reporting.
• Poor heated tubing option– 3B did try a heated tubing that has a cord for the Luna 2, but it was not good. Now the only tubing option we carry for the Luna 2 is standard tubing. If you need significant humidity while on CPAP you may have issues.
• Poor warranty process– On the rare occasion that we have had to work through warranty repair of replacement for a Luna 2 it has been very slow. In most cases it took weeks to get a broken device resolved.

#3 iBreeze Auto CPAP

The iBreeze Auto CPAP is a fairly new CPAP to the market here in the U.S. It has been in foreign markets like Asia and Europe for years and has a great track record there. We have been carrying it now for about 8 months and it has been a great option. It is quiet and simple. Plus, the iBreeze is as small as the larger brands. So, finding space on your nightstand or traveling with it is a “breeze” ;). We have had very few repair issues so far which is great. It is a fairly cost-effective option and it works well.

iBreeze Pros:

• Small footprint on the nightstand– Whether you have limited nightstand space or you plan to travel often with your CPAP the iBreeze is sized right.
• Simple to use– There is nothing complicated on the iBreeze. Simple on/off button, and easy to navigate the patient menu.
• Wi-Fi connectivity option– The iBreeze now has an optional integrated Wi-Fi modem. This allows you to connect your CPAP to your home Wi-Fi network for automated uploads. This makes compliance reporting much easier. Check out our iBreeze compliance blog.
• Universal Connection– Use any mask or tubing on the iBreeze. It has the standard 22mm connection which allows for any standard CPAP tubing.

iBreeze Cons:

• No heated tubing option– If you need high humidity while using CPAP then you need to consider the limitations of standard tubing.
• Poor SmartPhone App– Resvent has launched an app for the iBreeze, but to date, it does not work at all.
• Exhalation relief setting is overly sensitive– We have found through feedback and experience that the IPR setting can be a little tricky. At the higher IPR setting many users have told us that they feel a very dramatic pressure decline. The IPR setting of 1 seems to do the trick in most cases.

#2: DreamStation 2 Auto CPAP

The DreamStation 2 from Philips Respironics is an awesome Auto CPAP. It is very small and lightweight. Additionally, it has awesome connectivity options, a great app to follow your sleep, as well as great durability. The unfortunate thing about the DreamStation 2 is it’s current availability. At the time of this blog writing the DreamStation 2 is unavailable for purchase due to the Philips Respironics recall. It has a great algorithm that has been time-tested for comfort and effectiveness. The DreamStation 2 features a touchscreen menu for easy navigation as well as a fully integrated heated humidifier. Let’s take a look at some detailed Pros and Cons:

DreamStation 2 Pros:

• Very Small and lightweight– The DreamStation 2 is extremely lightweight and takes up very little room on your nightstand. It makes a great option for travel.
• Great DreamMapper smartphone app– The DreamMapper app offers daily insights into how well the DreamStation 2 is working for you. It does this easily through bluetooth connectivity.
• Easy compliance reporting– The DreamStation 2 has Bluetooth connectivity as well as cellular connectivity. This means that we can access your data remotely and provide great compliance reporting easily. If you need reports for your job or for follow up with your Physician, this is a great option.
• Best heated tubing option– The heated tubing that was designed for the DreamStation 2 is the smallest and lightest available. Most times adding in heated tubing means bulkier and heavier tubing, but not in this case.

DreamStation 2 Cons:

• Touchscreen can be a little wonky– The touchscreen is not exactly the most responsive. It may take an extra swipe or press from time to time to get where you need to in the patient menu.
• Availability– Currently it is completely unavailable. We anticipate having them again soon and you can click here to see current availability.
• Filter location– You have to completely remove the humidifier chamber to access the filters. Adding an extra step to your normal filter maintenance.

#1: AirSense 11 AutoSet

For our top pick of 2022 we have chosen the AirSense 11. It is the latest CPAP from ResMed. It has a ton of great features and is a real user-friendly CPAP option. The main thing that makes this CPAP great is the same thing that has made ResMed CPAPs great for decades. It is the algorithm. The algorithm in this CPAP is tried and true for comfort and effectiveness. That means that when the AirSense 11 is adjusting to your most suitable pressure it is doing so in the most comfortable manner. Every manufacturer has their own proprietary algorithm, and ResMed leads the pack for sure. Let’s check out some of the Pros and Cons on the ResMed AirSense 11 AutoSet:

AirSense 11 Pros:

• Very small and lightweight– The AirSense 11 is one of the smallest and lightest options available. You can travel with ease using the slim travel case that is included.
• User friendly menu and touchscreen– The touchscreen is very nice and very responsive on the AirSense 11. It allows you to navigate your patient level menu easily.
• Great MyAir app– The ResMed MyAir app is a great way to follow your sleep therapy results. It provides a daily score as well as great input and instructions for your AirSense 11 CPAP.
• The best Auto Algorithm available– For decades now ResMed has made a top tier Auto-titrating algorithm. This means that it will adjust to the best pressure in a comfortable way. Instead of making abrupt changes that will interrupt your sleep.

AirSense 11 Cons:

• Availability– Much like other CPAPs currently, the AirSense 11 is super-hard to find right now. Most of that due to its popularity and industry wide CPAP shortages. Click here to check current supply. We do receive them regularly and they go in and out of stock frequently.
• Not cheap– Because it is a very high-quality Auto CPAP, and industry wide shortages the AirSense 11 is not the cheapest option. It is a premium price for the premium product.
• Filter door is brittle– The only quality issue we have encountered so far is a brittle filter door. On inspection we accidentally broke it. They are available separately if you encounter the same issue.

After my wife asked me last week, “why isn’t my CPAP using water anymore?”, I finally thought to write a blog on the topic. She would wake up and pull her humidifier chamber in the morning, only to find that the water level had not changed at all. This happens from time to time, usually as seasons change, and most likely is not an issue at all. So, what is going on?

Why isn’t my CPAP using water?

Most modern CPAP machines are built with a hydrometer and thermometer that constantly monitor your room’s ambient conditions. The CPAP is doing this because it is trying to avoid excess condensation. Better known as “rainout”. That happens when the CPAP adds more humidity than the air in your room can hold. When that happens you literally end up with rain inside your tubing. By monitoring the humidity and the temperature the CPAP tries to minimize the chances of adding too much humidity. That means that if your CPAP is detecting that the room is too cold or that the room already has too much humidity, then it will not add any additional humidity. In turn, your water chamber will still be full in the morning.

How can I tell if the Humidifier is actually working?

The first thing to determine if the humidifier is actually doing its job or not is to ask yourself a simple question: “Do I feel dried out?”. If your answer is no, then you don’t have a problem. Just because there is no change in water level, doesn’t mean that there is an issue. If your answer to that question is yes, then the first thing that you should do is increase the humidity setting. This setting should be located in your patient menu. If you have increased the humidity to the max and there is still no change, then we need to bypass the check system. We detail how to do that below. Additionally, on some newer CPAP models like the ResMed AirSense 11, you can see on the sleep report whether or not the humidifier is working correctly.

How can I add more humidity without rainout?

So maybe you are dried out because the CPAP will not add enough humidity. In that case there is a pretty simple solution. You can add heated tubing to your humidification system. Almost all of the newer CPAP models have an available heated tube. ResMed has one called ClimateLine and Respironics has heated tubing for theirs as well. These heated tubes will keep a controlled environment from the outlet of the CPAP all the way to your CPAP mask. This means that the ambient humidity and temperature conditions in your room will not matter. Once the heated tube is added you can increase humidity level to a comfortable setting without the risk of rainout or the CPAP capping your humidity. We also have a great Blog on the rainout issue as well.

Things to consider about your CPAP Humidifier:

• Empty the water chamber daily– Regardless of whether or not your CPAP used any water, you still need to empty it and allow it to dry out daily. This will prevent mold, mildew, and bacteria from growing in the stagnant water.
• Stick to distilled water– As the water evaporates it leaves behind the minerals that were in the water. These minerals can be harmful to the CPAP parts. Causing corrosion as well as a breeding ground for all sort of nasty things.
• Clean the water chamber at least weekly– If there is one, most-important thing, on your CPAP that can make you sick, it is the water chamber. You wouldn’t fill your chamber with pond water so don’t let the water chamber turn in to a pond. Clean it at least once per week with mild soap and water.

When do I change my Water Chamber?

Changing out your Humidifier Water Chamber is completely dependent on how well you are maintaining your water chamber. If you are emptying it daily and washing it at least once per week, then you may get as much as a full year out of the tank. If you are using tap water, well water, or aren’t cleaning the water chamber then you may get as little as 3 months. On average it is best to change out your water chamber about every 6 months.

Signs that it is time to change out your CPAP water chamber:

• Leaking water tank and/or water on your nightstand.
• Mineral buildup inside the tank
• Mold or mildew growing inside
• Air leaking from the silicone seals
• Significant discoloration

 

There are a few Travel CPAP options available these days. Many of which are limited in availability due to nationwide CPAP shortages. However, there are options and it is important to make a good decision. Below is a breakdown of our top 4 Travel CPAP picks for 2022.

 

AirMini Travel CPAP

The AirMini has been around for about 5 years now and I can think of maybe 2 or three units that have ever had an issue over that period of time. We can confidently say that it is a VERY reliable Travel CPAP. Additionally, it is the smallest and the lightest available today. Weighing in at just 0.66 lbs you probably will not even recognize that you packed it in your bag. It is 5.4″ x 3.3″ x 2″ dimensionally, so it literally can fit in the palm of your hand. You are restricted to ResMed brand masks on this Travel CPAP. While that is a limiting factor, ResMed does make some of the best masks on the market. Meaning that quality will not be an issue in your mask selection. It operates at just 25 dBa which is very quiet for a Travel CPAP.

AirMini Pros:

• Very Small and lightweight– You really cannot get any smaller and lighter for a Travel CPAP
• Quieter than some of the cheaper models– We have heard some negative feedback on cheaper Travel CPAP models. Many of those customers chose to upgrade later to the AirMini and noticed much improvement.
• Great AirMini app and connectivity for reporting– You can download the “AirMini App” in iTunes or the google store. It connects via Bluetooth to the AirMini and works really well.
• Very Reliable– We have had so few issues with the AirMini that we would score it a perfect 10 on durability. We even have customers that use it as their primary device. This Travel CPAP is genuinely tried and true.

AirMini Cons:

• You can only use AirMini Masks and accessories– You are restricted to the AirMini Humidx HMEs, the ResMed compatible masks (F20, F30, N20, P10, N30). Additionally, you must use the AirMini Tubing designed to attach to the AirMini.
• HME can be a little loud– While the AirMini itself is very quiet, we have had some complaints on the sound of your breathing in the HME. It still is one of the quietest options but keep that in mind.
• Can be a little pricier– If you are looking for the cheapest option, then this one may not be for you. ResMed is known for quality and durability. So naturally, they are usually a bit more expensive.

DreamStation Go Travel CPAP

This has been one of our favorites for a very long time now. Unfortunately, at the time we are writing this blog it is unavailable. We hope to have it as an option again very soon. The DreamStation Go Travel CPAP is our “Go To” for CPAP users that want a travel CPAP for everyday use. That is because it is quiet, durable, and can be paired with a Heated Humidifier. Many other Travel CPAPs can only use an HME. While an HME can work well it is not the best option for everyday use. It has a really nice touchscreen, and a very simple operation. While it is a little larger than some other options you have to keep in mind that the converter brick is built in to the DreamStation go. That means that you don’t have to have that bulky power cord. It weighs 1.86 lbs and is 5.94″L x 5.94″W x 2.32″H dimensionally. Another great feature on this Travel CPAP option is that you can pair it with a home DreamStation CPAP in the software. This means that your compliance information can be combined into one report on both devices. This is great for truck drivers, and users that require compliance reporting.

DreamStation Go Pros:

• Reliability– This travel CPAP is also extremely reliable. We have had very few issues over the years.
• Very quiet– The DreamStation Go is very quiet and does not have any noisy HME. Probably the quietest Travel CPAP option that we carry.
• Use any CPAP mask or HME– It has a standard 22mm tubing connection. This means that you can use any standard CPAP tubing, any CPAP mask, and any HME with 22mm connection. That is pretty much everything.
• Great Compliance reporting– Whether you are using the DreamStation Go alone or in conjunction with a home DreamStation CPAP, you can get great compliance reporting. It connects easily to the DreamMapper app via Bluetooth and relays great reporting directly to your smart phone.
• Smallest and lightest tubing available– The DreamStation go comes with a 12mm tubing that is so thin and lightweight you probably won’t feel tube drag at all. This tubing only fits the DreamStation Go so you can only use it with this Travel CPAP.
• Heated Humidifier Option- You can connect the Heated humidifier when at home and leave it when you hit the road. This gives you a lot of versatility.
• Integrated Battery Option- The battery option for the DreamStation Go is super easy and works great.

DreamStation Go Cons:

• It is a little heavy– While it isn’t heavy in comparison to a home CPAP it is to other Travel options. At 1.86 lbs it is almost 3 times heavier than the AirMini Travel CPAP.
• Currently unavailable– After an issue with the foam Philips has decided to replace or repair all of these unit. Until they have completed the recall this unit will be unavailable. You can click here to check current stock any time. We hope to have them back in stock in the months to come.
• Not the smallest option– In addition to the weight it is also a little larger than other options. We think the versatility outweighs the size difference, but it is something to consider.

Transcend 3 Travel CPAP:

The Transend 3 Travel CPAP is made by Somnetics. Somnetics was the original Travel CPAP maker. They have a great track record of durability and longevity. They even have the longest warranty of any Travel CPAP made. The Transcend 3 is a very simple design without a whole lot of bells and whistles. For those needing a good CPAP for an affordable price this model is worth considering. It weighs just over 1 pound and is 7.5″ x 3.7″ x 3.7″, so it packs away with ease. Additionally, the Transcend 3 comes with universal power adapter for the entire world. No need to source adapters and connectors.

Transcend 3 Pros:

• Less costly than high end models– The Transcend 3 gives you the ability to travel much easier than with a home CPAP at a very affordable price.
• Simple use and design– There are no special bells, whistles, settings or buttons. This Travel CPAP is as simple as on and off.
• Universal power supplies– The adapters for all mainstream areas in the world are included. Hit the road to the UK, or to India without having to purchase extra electrical adapters.
• Universal connection– It incorporates a standard 22mm connection. This means that you can use any standard CPAP tubing as well as any CPAP mask. No Special parts needed.

Transcend 3 Cons;

• No reporting ability– There is no special app or easy to use compliance software. If you need compliance reporting, this may not be the model for you.
• A bit more audible– I can’t say that the transcend 3 is loud, it just isn’t as quiet as the higher end models. If you are a very light sleeper or sleep next to one, you should consider the noise level.
• No humidifier option– Somnetics no longer makes a heated humidifier for this model. This means that you can only use an HME (heat moisture exchanger) for humidification on this Travel CPAP.

Z2 Travel CPAP

The Z2 Travel CPAP is another very lightweight and small device. It weighs just .5 lbs and is just 6.3″ X 3.5″ X 2″ dimensionally. You would probably have an easier time losing it in your travel bag than noticing that it was there. It does have Bluetooth for connection to the nitelog app where you can track your results. It also has a universal 22 mm connection so that you can use any mask on the market with your Z2.

Z2 Pros:

• Very small and lightweight– You really can’t get much smaller or lighter in the CPAP world. This is a great option for those with limited space or weight restriction while traveling.
• Affordable pricing– The Z2 is a great mid-level priced Travel CPAP. It is affordable and still has some great features that make it very modern.
• Universal connection– With the universal adapter the Z2 Travel CPAP can connect to any standard tubing and CPAP mask.
• Great battery setup– The Z2 power shell integrates really well with the Z2 and will run the CPAP up to two nights without power.

Z2 Cons:

• Can be a little loud– The Q-tube adapter (included with Z2) helps, but we have had enough noise complaints on this model to mention that for sure.
• Different algorithm– In the auto mode we have had a few customers that did not like the way that it adjusted to their breathing. You do have the option of setting your algorithm to be more or less aggressive, but many have had trouble navigating that setting.
• Not a great primary unit– We have not had a very good track record on this unit when used as a primary unit. Great for travel, but not so great if you work it too hard.