Talk:Positive airway pressure

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[edit] Merging CPAP and CPAP machine

I concur with the merge request. There is little point to having two articles. --JohnDO|Speak your mind I doubt it 01:51, 20 January 2006 (UTC)

Agree. The principles of CPAP go hand-in-hand with the design and operation of the machine. We need to incorporate recent evidence (JAMA earlier this month) that it is effective in pulmonary oedema. JFW | T@lk 21:43, 21 January 2006 (UTC)
Agree. It's two names for the same thing, and there is no real distinction of content where someone would be interested in one, but not the other.Algr 00:13, 14 March 2006 (UTC)
I also agree. A CPAP machine is a CPAP, and a CPAP is a CPAP machine. --Bmeloche 03:59, 31 March 2006 (UTC)
Agree for the same reasons. --A. B. 04:10, 28 September 2006 (UTC)

Agree to merge, however there is a difference. A simple CPAP device is a gas flow generator with a valve at one end (crudely put) the thing they are sometimes referring to here is a CPAP generator using mechanical switches. one is hospital based and usually used with high O2 levels; used for Type I and sometimes Type II respiratory failure. These are adjustable. The other is domiciliary air turbine generator and without O2 input, used for sleep apnoea in the home and uses a restrictor bleed (simple regulated hole in the mask or tube) They are very different beasts indeed. People also often confuse these with BiPAP machines(or BIPAP different again, one spontaneous, one machine based and patented delivery system [Drager]) They are completely different than assist machines, CPAP is just a flow device and possibly an alarm, often none.

CjW (talk) 16:34, 4 January 2008 (UTC)

[edit] Realistic needs

I'd like to see some info on realistic expectations of using the machine: Real cost of use, Life-span, mask & hose usage, ect. (Or at least links to sites with such info.) The salesmen here keep telling me absolutely ludicrous things, like that you have to buy a new mask every three months! And then they keep saying that the insurance will pay for it all, and encourage me to buy like a madman. (Anyone foolish enough to think they are talking to some kind of doctor is going to be paying thousands unnecessarily.) Algr 02:47, 15 March 2006 (UTC)

I'm getting one and supposedly medicaid is going to help with the payments, otherwise its $150.00 monthly rental through the hospital; and $250.00 through a private medical supplier. --Talen Soti 20:35, 11 April 2006 (UTC)


I agree with the merge request. These are definately the same things. Danapsimer 03:37, 22 March 2006 (UTC)


Merge these silly pages! I think the CPAP/APAP/BiPAP techniques are merging, though. Also might include discussion on supplemental oxygen usage - when indicated, and reasons not to pursue it. Also might include difficulties adjusting to breathing apparati, such as REM rebound.

[edit] The Merge

Rather than complaining, I thought I would just merge the two. I'm sure it will need a patch up by someone else, as this is my first major contribution to the wikiworld. Hope it will suffice for the moment. Cheers. --Sleepy_boy_on_the_tracks

[edit] History of CPAP

I think that heated humidification (in most climates), a comfortable mask, and, above all, intelligent electronics (e.g. C-Flex(tm) or EPR(tm)) are a must. Otherwise what you have is an oversized and expensive aquarium pump. Without every aid to minimize discomfort, what you get is non-compliance with use. From what I've seen and read, this can be particularly a problem with patients experiencing some degree of dementia--ironically those who may derive some of the greatest benefit from CPAP. See: CPAP curbs sleepiness in demented apnea patients

I would like to see most of the machines being discussed in this article moved to a new section titled "History of CPAP" that includes "simple fixed-pressure CPAP", "early auto-adjusting machines", etc. It should perhaps be remarked in passing these machines' surprising general lack of sophistication given the overall market for life-saving medical devices. Unfortunately, my remarks about a history section are at the point of this writing somewhat rhetorical, as what should be historical is still upon us, at the cost of unnecessary suffering (including that of loved ones) and premature decline and death for those who abandon treatment as a result.

Relatedly, I am concerned that the latest innovations in effective treatment do not make it into Wikipedia in a timely manner. This is a general concern that crosses all medical diagnosis and treatment topics, not just on Wikipedia, but elsewhere as well. Where content can't be edited directly, I'd like to see indicators of "superseded" or "obsolete" on studies and articles so deemed by their authors. For instance, I read that early attempts at electronic enhancements could some cause harm, including episodes of Central Sleep Apnea by auto-titrating machines ramping up pressure too high. However, I don't know what the state of the art is as far as whether this is situation is ameliorated enough by additional technological enhancements.--John Majerus 15:10, 7 June 2006 (UTC)

[edit] Photo

Can we have a photo of the machine and its various parts? Ppe42 01:18, 4 August 2006 (UTC)

I think I can take some pictures of mine and my sisters vpap and bipap macheins. In about a weeks time.

[edit] Merge with VPAP

Should we also think about merging the separate VPAP article into CPAP? The ideas behind the devices are essentially the same. Robert K S 09:15, 3 September 2006 (UTC)

A single page for all nPAP devices is ideal. With a few very small exceptions, there's really not a big difference between once nPAP device and another nPAP device. It makes a lot of sense to have them on one page. External links (don't remember one off hand but will post one after I find one later today) generally have information on all of the nPAP devices on one page anyway, so why not on Wiki? Superslacker87 09:29, 6 September 2006 (UTC)
That sounds like one vote "yes"... Robert K S 16:39, 6 September 2006 (UTC)
I would recommend that the combined article be titled Positive airway pressure, since VPAP and APAP are perforce not subsets of CPAP. Robert A.West (Talk) 03:09, 29 September 2006 (UTC)
I agree they all should be combined. James R. Skinner 02:56, 1 November 2006 (UTC)

[edit] BiPAP and C-Flex are NOT the same thing

The article indicates that VPAP/BiPAP is the same as C-Flex. On the contrary though, they are very different. BiPAP has a fixed inhale and a fixed exhale pressure, and is viewed as a form of noninvasive (no throat tube) ventilation. C-Flex on a CPAP machine, on the other hand, is just an ordinary CPAP machine that happens to momentarily reduce pressure slightly at the beginning of each exhale. There is no fixed exhale pressure that's different from a fixed inhale pressure, and CPAP-with-C-Flex machines are not considered to be noninvasive ventilators. These distinctions should be made clear in the text. —Preceding unsigned comment added by 198.133.105.244 (talk • contribs)

  • This is true. Exhalation relief technologies such as C-Flex (Resperonics) or EPR (Resmed) are not VPAP/BiPAP and should be discussed in a different section James R. Skinner 03:00, 1 November 2006 (UTC)

[edit] CPAP and uses beside sleep apnoea

"CPAP has also been used to prevent premature infants from going into respiratory failure thereby preventing the need for intubation. [reference from 1978]"

I know from personal experience (two premature babies in 2000 and 2004) that CPAP is still very commonly used for that purpose, at least in Denmark. It should be possible to find some newer references and add a section about this! Apus 13:07, 10 October 2006 (UTC)

  • Thousands (possibly 10s of thousands) worldwide are put on some form of non-invasive positive airway pressure ventilation each day for reasons beside sleep apnoea. This article has a few 'asides' as to other reasons, but the scope is very limited, and the article omits many important uses. The article is written almost exclusively for people on home CPAP as treatment of sleep apnoea. The explanation as to splinting the airway does not apply to the majority of people placed on CPAP for acute respiratory illness. People who read the article in its current form wishing to understand positive pressure ventilation because their child or relative had been commenced on PAP support in hospital would be absolutely no better informed for reading the article. I attempted to address the issue here, but this was deleted for 'not answering the whys & wherefores'. Whyso 04:52, 30 November 2006 (UTC)
Whyso, your new intro was a good attempt, but it also deleted useful information. Can you find some way to integrate the information in the current introduction with the information in your introduction? (In particular, I objected to the removal of "used primarily in the treatment of sleep apnea, for which it was first developed" from the first sentence of the introduction, since the introduction of an article about a therapy should establish for the reader the raison d'etre for the therapy.) There were also two other major problems with your version of the introduction which led me to revert it rather than trying to improve it. First, it had a number of typographical and stylistic problems, making it unreadable in spots. Second, it provided too much detail for an introduction. Bulleted lists should be integrated in other parts of the article. Robert K S 08:39, 30 November 2006 (UTC)
OK I'll try againWhyso 06:22, 1 December 2006 (UTC)

[edit] Limited geographic scope

  • Can someone explain why this article has been added to the Limited geographic scope category? James R. Skinner 22:58, 1 November 2006 (UTC)
    • I have no clue. In my opinion, this type of tag should be explained when it is placed. Since it has not been explained, I am removing it. Robert A.West (Talk) 21:40, 2 November 2006 (UTC)
      • The tag was added in September by Robert K S -- you could ask him. --A. B. 23:06, 2 November 2006 (UTC)
        • Perhaps I will. I have a long-standing beef with editors who tag an article and then don't explain. Robert A.West (Talk) 23:41, 2 November 2006 (UTC)
Hi. I added the tag because the "Availability" section only references the U.S., UK, and Australia. I do not believe the solution is to enhance this section with availability discussions for other areas. I believe the information should be generalized or removed entirely. Actually, I believe that the "Availability" section, along with the "Care and Maintenance" and "Travelling" sections, are in violation of established Wikipedia policy. Refer to item 4 under "Wikipedia is not an indiscriminate collection of information" on What Wikipedia is not. Wikipedia is not a how-to guide. I'm not the sort who promotes deletions, so I would prefer to see the information generalized and the article improved rather than have the sections axed outright. I'm restoring the Worldwide view tag. Robert K S 04:38, 3 November 2006 (UTC)
I think you are overapplying policy in this instance. Detailed instructions are prohibited, but this differs from general information about how a device is used, safety issues, etc., all of which are of encyclopedic interest. It would be improper to describe how to change a filter, but it is fine to note that such devices normally contain a filter, and to mention why it should be changed on a regular basis. IMO, the article comes far closer to the latter than to the former.
A description of how durable medical equipment is handled in the health systems of different countries is, IMO, encyclopedic. It strikes me as an odd argument that it is better not to have that information than to have incomplete information. Robert A.West (Talk) 15:25, 3 November 2006 (UTC)
Take, for example, the following excerpt: "These procedures should be performed weekly. Note: These procedures are for general information only and are not intended to replace those recommended by the PAP machine manufacturer. Always follow the manufacturer’s recommendations that are included with your PAP machine." Stating the frequency of maintainance procedures (and doing so devoid of any reference)—is this encyclopedic? Including a disclaimer—is this something that should be included in an encyclopedia? The use of the personal pronoun "your", assuming and implying the reader is a PAP patient—is that encyclopedic? The travel section is slightly more palatable, but it may be—I don't recall—because of edits that I made a long time ago. Finally, you imply the argument that incomplete information should be deleted, but I specifically said that I do not promote deletion of useful information and, in fact, I have not made deletions. As it stands, the maintenance section is most certainly a how-to section and a violation of policy; the information should be generalized to improve the section, and the worldwide view tag is warranted because the specific information in the article caters only to three (wealthy, English-speaking) nations. I do not believe I am qualified to improve the article, which is why I have left it to the hands of those who are more knowledgable about the subject. Robert K S 15:55, 3 November 2006 (UTC)
I agree that it reads too much like an instruction manual -- I just think it overstates the case to say it violates policy. It's a semantic distinction, and not worth discussing further, since we agree that the text needs improving.
I am at a loss how to satisfy your geographical scope request without removing information. Sometimes removing information is the right thing for an article -- after all, to edit is to choose. Some of the detail can probably go, but I still think that comparison being conducted is important and encyclopedic. Well, one issue at a time. Robert A.West (Talk) 16:55, 3 November 2006 (UTC)
Excellent job improving the maintenance and travelling sections. Thanks! Robert K S 17:56, 3 November 2006 (UTC)
Thanks. The geographic issue will require more thought. Much of the information I put in comes from the wall of the local respiratory and cardiac rehabilitation clinic, so I will check for some good citations. Robert A.West (Talk) 18:05, 3 November 2006 (UTC)
I think Robert K S made many good points and I think the article has been improved. I disagree with removing useful information on availability in different countries. I have also moved the geographic scope to that section:
  • It's the only section I see that's limited in scope.
  • Just maybe it will flag someone reading that section to think -- "Oh, well here's what they do in Italy ..." and add material for another country.
If the availability section gets too unwieldy with countries, then it can always be calved off to a separate, linked article. --A. B. 18:50, 3 November 2006 (UTC)

[edit] Price

I would love to know average costs to purchase, rent, etc.

  • As prices change and vary greatly across the globe, does it really add to this article? Would be something for price comparison sites more than an encyclopedia IMO. JoeMcBogof 16:49, 12 September 2007 (UTC)

Although it probably doesn't add to the article, I too would like to know how much one should pay for a decent unit. Does anyone know? —Preceding unsigned comment added by 83.248.19.161 (talk) 18:09, 24 September 2007 (UTC)


An average machine costs $500 wholesale and is billable through most insurances under the DMI portion. A VPAP machine is about $4500 but typically needs a lot of paperwork pushed around to get it covered IF they will. Masks run about $150, rental is about $170 a month, however insurance typically picks up 50% or more of it. A VPAP rental is about $1000 a month. However these machines are on a rent to purchase plan. Hope this helps. —Preceding unsigned comment added by 64.252.123.115 (talk) 17:57, 3 December 2007 (UTC)

[edit] Citations and References

New to proper Wikipedia editing but certainly not new to CPAP and OSA, I started to add some references here and there to journals I've read. Can someone please verify I've done them correctly? I've done in-text citations, do I also list them again at the bottom? Also, what else do we need to get rid of the top warning about the lack of references? JoeMcBogof 16:42, 12 September 2007 (UTC)

Thanks to whoever moved my citations to the appropriate spot. Now I know! I have some more coming up when I have a minute. The warning at the top still says "this has no citations" which is now incorrect. Who can remove or alter that notice? JoeMcBogof 10:45, 25 October 2007 (UTC)

[edit] External Links

I know of many quality sources out there and this article is currently a bit sparse. For starters, I run a portal for CPAP users myself. Not wanting to be unethical, can someone please look at www dot cpap dot co dot uk and give me feedback on correctness for Wikipedia?

Also, there are many great CPAP pictures on Flickr and OSA/CPAP videos on YouTube. Is it accepted practice to link to such sources?

What else are we looking for to add to the article as far as external sources are concerned? JoeMcBogof 16:48, 12 September 2007 (UTC)

[edit] VPAP vs. BiPAP

Does anyone have any information on the difference between VPAP and BiPAP? I keep seeing BiPAP come up in my web searches about apnea, but this article doesn't mention it at all. It would be a useful addition.

Thanks. —Preceding unsigned comment added by 75.181.10.243 (talk) 03:47, 11 December 2007 (UTC)

  • They're different names for the same type of machine. I think the name BiPAP may be trademarked by Respironics...? --24.166.2.5 (talk) 06:30, 15 April 2008 (UTC)

[edit] In a hospital setting

This section contains numerous statements of questionable accuracy. The bullet list items adide, anyway. PAP ventilation often sees home use for the exact same reasons as what is suggested as being hospital use specific. Neuromuscular disease patients for example make such use of PAP at home. And patients with other problems as well. In summation, this section needs some work. --24.166.2.5 (talk) 13:01, 27 April 2008 (UTC)

[edit] Disadvantages

The disadvantages section talks only about compliance. There are other issues. If humidification does not happen, there can be throat issues. Also, I've heard of severe issues with CPAP and runny nose and have experienced minor ones. Finally, air can get forced into the GI system and cause bloating, pressure, and gas. Since wikipedia shouldn't be a SOURCE for this sort of information, I'm hoping someone will know of an article or articles with this information to cite. (Even with all these "disadvantages" I can't go a night without my CPAP). -- Anon —Preceding unsigned comment added by 12.38.15.2 (talk) 15:25, 6 May 2008 (UTC)