CPAP Humidifier

CPAP humidifier water chamber
Water chamber for CPAP humidifier – DeVilbiss Sleep Cude

If you find yourself waking up with a dry mouth, nose or throat, then a humidifier should instantly solve that problem and others. By adding moisture to the air provided by your CPAP machine, it helps to keep your mouth from drying out throughout the night. Similarly, if you find the air from your CPAP to be cold and uncomfortable, a humidifier adds warmth to the moist air, and this should make your therapy more comfortable.

It is clinically proven, through several studies, that humidification improves compliance and helps CPAP and BiPAP users avoid suffering from a dry nose, mouth and throat. A humidifier can be extremely beneficial for those who are often visiting countries with drier climates. Still, even in the UK and colder parts of Europe, CPAP users report significant benefits from a humidifier added to their setup.

For sufferers who are mouth breathers who need a full-face or oral mask, heated humidification is a must-have feature.

If you do breathe through your mouth, you probably will need a full mask, and this increases the chance you will need a humidifier.

When you breathe through your nose, the hairs in the nasal airway conditioning the air with heat and humidity before it enters the lungs.

When you breathe through your mouth, this process is not present and can lead to uncomfortable dryness. One other note is that allergies and illness can make the effects worse.

Intus healthcare advice:

All though we do believe that humidifiers can improve the comfort of the CPAP therapy for suffers, we would advise that if you’re new to CPAP therapy, you should try your mask and machine before you purchase a humidifier.

Everything you need to know about humidification

CPAP Heated Humidifier houses a water chamber, which it heats to add moisture to the air provided by your machine. They are ideal for those who find the device leaves them waking with a dry mouthsore nasal passages or find the air cold and therefore uncomfortable.

They are usually an additional piece of equipment that locks onto or into your main CPAP machine, but some CPAP machines come with a humidifier built-in. Most CPAP machines will have their specific humidifier available.

For some people, having a humidifier moisten and warm the air from their CPAP machine is an essential part of their therapy; for others, there is a little benefit so it can come down to personal preference. Those using a full face mask are more likely to require humidified air as they are more susceptible to a dry mouth. For those using an oral mask, humidified air is more or less essential.

 

I’m not sure I need a humidifier?

For most CPAP machines, humidifiers can be purchased at a later date and integrated separately, so you can order your CPAP machine without the humidifier and see how you go. However, if you do find yourself already waking up with a dry mouth before you’ve started CPAP therapy and are new to CPAP therapy, then CPAP is likely to make this condition worse, and we would recommend purchasing one immediately.

If you know you need a humidifier, then it could be worth considering a machine with a humidifier built-in. An example of this is the Fisher and Paykel ICON. This design adds greater convenience, and they’re often more compact than having two separate units (space on your bedside table).

Intus healthcare advice:

  • CPAP machines with built-in humidifiers can be delicate and require extra care in transit. Therefore it is advised the humidifier is entirely free of water – and preferably packed separately if you are travelling with your CPAP machine.
  • If you are running your CPAP machine from a 12V source (for example in a car or caravan), then your humidifier will not be able to run off of DC power. It can still be used passively (unpowered and unheated).
  • Overall, if you will be travelling, we would always advise you to leave the humidifier behind unless it is essential or you are away for an extended period.
  • If you are going to be travelling, we would recommend purchasing a CPAP machine that has a separate humidifier rather than one that is built-in.

 

Problems with humidified air from your CPAP humidifier

A possible drawback of humidified air is from, what we call Rainout, the proper name for condensation build up in the tubing and mask. It is likely to happen because the tubing and CPAP mask will be at room temperature (20–22 °C (68–72 °F)), causing the warmer air from the CPAP machine to cool and condense as a result. Rainout can result in a gargling noise or just general discomfort; it is particularly common in the winter months.

 

There are ways to counteract Rainout (condensation buildup)

One solution we offer is a hose fleece, which provides the CPAP machine’s hose with insulation (it can also make the tubing physically more comfortable to touch).

Our second and more comprehensive option is to use a heated CPAP hose, such as the Hybernite Heated Breathing Tube. The heated hose ensures the temperature difference inside the tubing is negligible, preventing Rainout and ensuring the air reaches you at the correct temperature.

CPAP Machine

BiPAP (Bilevel Positive Airway Pressure) is similar to CPAP (Continous Positive Airway Pressure). Your sleep/respiratory clinician or the Intus Healthcare sleep test/sleep study will prescribe which therapy and machine you will need.

BiPAP machines have two pressure setting. One pressure setting for inhalation (IPAP), and the second, a lower pressure setting for exhalation (EPAP).

  • The difference in inhalation and exhalation pressures reduces the work of breathing and allows the person to have a more restful sleep. These are some reasons BiPAP machines are sometimes used as a treatment method when CPAP has failed to treat their sleep-disordered breathing adequately.
  • Like CPAP, the BiPAP machine also increases the pressure when you inhale to keep the airways in the nose and throat from closing while you are sleeping and provide a lower pressure during exhalation that continues to maintain an open airway.
  • If you have OSA but without any other respiratory, cardiac or other severe health conditions, then CPAP would be the best form of treatment for you.
  • People with nerve and muscle problems may better benefit from the BiPAP machine rather than the CPAP machine. BiPAP machines can make sure users breathe a set number of times per minute.

If you think you may require BiPAP, then you should discuss this with your sleep or respiratory clinician first. Appropriate testing is essential to determine what treatment method would suit your needs better and what settings are appropriate for you.

The difference between the two types of machine

There are two types of CPAP (Continuous Positive Airway Pressure) machine, fixed-pressure or automatic.

 

Fixed Pressure CPAP Machine

 A fixed-pressure CPAP machine is designed to stay at one pressure level during use; this pressure setting should be provided by your sleep clinic, or possibly your doctor. This setting is calculated for your requirements based on several factors.

If you have been provided with a fixed supply-pressure setting by your clinic or GP, then a fixed-pressure CPAP machine should do nicely.

 

Automatic CPAP Machine

If you do not have a specific pressure setting (most do not), then you will be advised to use an automatic machine instead, also known as Auto-CPAP or APAP. Automatic CPAP machines have a range of sensors built-in that allow them to calculate how much pressure you require at any given time. It can detect when you are about to stop breathing and raises the air pressure accordingly. Once the danger has passed, it will drop the air pressure down again. This means, on average, you will get less pressurised air throughout the night than you would with a fixed pressure machine.

The fixed pressure CPAP machine would be set at the highest setting you might need.

Intus healthcare advice:

  • Many people find automatic CPAP machine therapy to be more comfortable and more effective. We often find even those who have been provided a fixed-pressure setting opt for an automatic machine as a result.
  • However, there is often an adjustment period as you get used to the different way an automatic machine provides pressure compared to a fixed-pressure one.
  • Initially, some find the lower pressure alarming, and it can seem like you are not getting enough air! You are, you do not need high pressure all of the time – particularly when you’re awake.
  • Equally, the automatic CPAP machine may go higher than you’re used to if it determines you need more pressure. 
  • It can take a little time to acclimatise when switching to an automatic initially, but in the long-term, your therapy should be more comfortable and more effective.

One thing to note is that the fixed-pressure setting you are prescribed will be accurate at that time. Unfortunately, over time your requirements can change. For example; gaining or losing weight, or drinking alcohol before sleep can affect the severity of your OSA and therefore the pressure you require. It is therefore essential to be assessed regularly by your sleep or respiratory clinician and make sure your pressure setting is still at the optimum level. Alternatively, you could choose an Auto-CPAP Machine which will always provide you with the exact pressure you need regardless of any changes.

So in short: If you have not been prescribed a fixed-pressure setting (for example, 12cmH2O), then you will need an Auto-CPAP Machine. If you have, you can either choose a fixed pressure CPAP Machine at that setting or choose an Auto-CPAP Machine anyway for the additional benefits it offers.

Are you wondering what a CPAP machine is and how to choose the one for you?

 

Choosing a CPAP machine may look like a minefield, but it depends on your therapy needs and to some extent, personal preferences.

The acronym C.P.A.P. stands for Continuous Positive Airway Pressure. A CPAP machine increases the air pressure in your throat to prevent your airway from collapsing when you inhale and can reduce your snoring.

CPAP therapy is a treatment for O.S.A. (Obstructive Sleep Apnoea). Sleep apnoea is a term for the collapsing of your airways while sleeping.

One thing to note at this time is that a CPAP machine is not a ventilator; it does not breathe for you. The CPAP machine generates only enough air pressure to keep your airways open.

 

Fixed Pressure CPAP Machine or Automatic CPAP Machine

There are two types of CPAP machine, fixed-pressure and automatic.

Fixed Pressure CPAP Machines stay at one pressure setting which should be provided by your sleep clinic, or possibly your doctor.

Automatic CPAP machines are for sufferers who do not have a specific air pressure requirement. What does that mean? Some people require different amounts of air pressure to stop the sleep apnea effect. Auto-CPAP or APAP machines have a range of sensors that allow them to calculate the correct air pressure.

 

CPAP Masks and your CPAP Machine

The CPAP Mask is critical to your therapy success and is used in conjunction with your machine to deliver the correct air pressure to your airways. We have an extensive FAQ section on our website about CPAP Masks if you want to learn more.

 

CPAP Machines and humidifiers

There are also CPAP machines which can have a humidifier as a separate piece of equipment added, or they can have the humidifier built-in. A humidifier heats water and adds moisture to the air from the CPAP machine to prevent drying in your nose, mouth and throat from the CPAP therapy; to improve comfort for the user.

Intus healthcare advice:

Before you can order a CPAP Machine from Intus Healthcare, you need to have written documentation to show you require CPAP therapy. Your documentation does not have to be a formal prescription; it could be a simple letter from your doctor. Intus healthcare also has a sleep test facility, which you can view here by clicking the link: The Sleep Test.

If you have done a sleep study but are unsure if you have any paperwork showing your need for CPAP, then please contact us. If you are yet to do a sleep study (either privately through our at-home service, or via the NHS) then your first step would be to read our Sleep Studies information page and progress from there – you could still be benefiting from CPAP therapy within a fortnight.

CPAP Mask

We do not currently have this facility. We do however provide detailed information about every mask that we supply. This includes a wide range of photographs, an assessment of the features, any brochures, guides or videos that are available, and for the majority of masks we provide a downloadable sizing gauge to ensure you purchase the correct size. We are also available via the contact us page to discuss the suitability of any given mask for your preferences and requirements. However, ultimately the choice is very personal and our advice, however much experience and knowledge our team have is a distant second to your personal needs.

Intus Healthcare advice:

We find that most CPAP masks tend to last around eight months to twelve months. The exact life expectancy of a CPAP mask can vary on the specific piece of equipment and many other factors. One major factor is the level and frequency the mask is cleaned.

CPAP masks are a consumable item that needs replacing to maintain effective treatment.

Regular cleaning of all your CPAP equipment is highly recommended, especially your CPAP mask. A CPAP mask can have many individual parts that are used heavily and therefor wear out. The cushions that rest on the user’s face can wear out quicker than the straps or the hose.

 

CPAP Mask’s silicone cushions

To make using a CPAP mask as comfortable as possible, manufacturers use silicone for the cushions, but the material can be affected by oils in the skin. If you use RemZzzs Mask Liners, you should experience fewer red marks, and you’ll also increase the usable life of your mask by reducing the oils that can damage the silicone material.

Other components from the mask’s headgear, cushions and pillows can stretch, and the tubing can develop tears and cracks.

How would I know when to replace my CPAP mask and other CPAP therapy equipment?

Examining the data card in your CPAP Machine to see how many apnoeas you have during the night is a good way of knowing how effectively your CPAP treatment is working. Please feel free to contact us directly if you want to know specifics about certain equipment or any other advice.

CPAP masks are a consumable item that needs replacing to maintain effective treatment.

Oils from your skin will damage the silicone in the mask seal. Depending on the type of silicone used, most mask seals will become also become softer overtime. When the mask makes a poor seal, air will escape and make your CPAP therapy much less effective. You or your partner might hear a hissing or burping noise from the air leak; you also may have very dry eyes in the morning. While you can tighten the mask straps to try to compensate somewhat, when the mask seal gets degraded sufficiently, you will need to replace your CPAP Mask.

Around a third of patients will experience nasal congestion when using a CPAP mask. The increased airflow through the nasal passages can dry them out and irritate. The use of a humidifier is often the solution to the problem, as this adds water to the air and provides moisture to the nasal passages. A humidifier also helps those who wake with a dry mouth. Another option for those with chronic sinus and nasal issues would be a nasal irrigator, such as the SinuPulse Elite. The SinuPulse Elite flushes out the sinuses with a salt solution, helping to reduce inflammation, moisturise the passages and clear blockages and congestion. Regular nasal irrigation can have significant health benefits.

The most simple solution would be to use a Nasal Pillows CPAP mask, as this avoids contact with the skin. They instead use two cones that sit on the entrance to the nostrils. However if you require a full face CPAP mask then a little extra creativity may be required. Some bearded CPAP patients use lanolin to soften the hairs and allow the CPAP mask to fit more easily. Those with beards are advised to use a gel mask if possible, as the cushions are usually more adaptable and can often compensate for facial hair better than a regular silicone mask.

In order to remain comfortable your CPAP mask should be cleaned daily, throughout its lifetime.

Clean your mask in the morning after each night’s use with some CPAP mask wipes or warm soapy water. Please be aware that non-CPAP mask wipes may contain alcohol which can damage your mask. In addition, regular washing of your mask and headgear is recommended on a bi-weekly basis. Your CPAP mask should be disassembled into it’s various components and along with the headgear, placed into a bowl filled with a solution of a mild soap detergent, or unscented washing up liquid and warm water.

There is no one mask that suits everybody. Suitability depends on your personal requirements. The first question is how do you breathe? Do you breathe through your nose or your mouth? The next requirement is the size. The size is vital to get a good seal, so the air does not leak. Are you allergic to synthetic materials (silicone)? Finally, it is personal preference and comfort. The best mask is the right mask for you.

CPAP machines use a standardised 22mm connection, allowing you to use any CPAP mask with any CPAP machine. Please note that CPAP masks are not typically compatible with ventilators.

The average life span of a CPAP mask is around 9 months; sometimes this can be longer and sometimes shorter. The life depends on a number of factors; how often it is used (and for long long), how it is a washed (and how often), the wearer’s skin oils and sweat levels and numerous other factors. Over time the cushion on the mask will wear out, much like if you were to wear the same shoes every day. When this happens, its ability to maintain a good seal reduces. Many CPAP masks have replacable cushions which provide a more cost-effective way of replacing the worn cushion rather than replacing the entire mask.

Red marks are caused by your skin being irritated by silicone. Often this can be reduced by loosening the headgear straps, reducing the pressure on the skin. However, if this causes air to leak then another solution would need to be found. A popular option is to use a CPAP mask liner to provide a protective barrier between the CPAP mask and your skin. In our experience, the most popular and effective liners are the RemZzzs fabric CPAP mask liners. Another option would be to try a fabric mask, which put far less pressure on the skin, and the fabric is far less likely to provoke a skin reaction than silicone. You can find the SleepWeaver CPAP mask range here.

If your CPAP mask previously sealed well and is now starting to leak then the cushion may be reaching the end of its life. Through use the silicone used in most CPAP masks loses strength and becomes sloppier and therefore less able to maintain a seal. Tightening the headgear can offset this to a degree but eventually this will not be sufficient. This tends to happen after around 9 months but can happen earlier. Replacing the cushion should solve that problem; though if the cushion alone is not replaceable then a new CPAP mask would be required.

If the mask is new and even after following fitting guides and videos (most masks have excellent fitting guides on YouTube from other CPAP users that we recommend) but are still finding the mask leaks then it may be the wrong size. Leaks into the eyes are particularly suggestive of the CPAP mask being too big, either in height or width. A smaller size may solve the problem.

If the mask seals well initially but gets dislodged by your pillow when you change position, then you can consider a CPAP pillow. These feature cut outs designed for your CPAP mask to fall into when you sleep on your side and therefore stops the mask from dislodging. You can find our Ultra CPAP Pillow here.

A CPAP Machine is primarily used to treat Obstructive Sleep Apnoea; a sleep disorder that causes multiple breathing interruptions throughout the night. It is typically caused by the throat collapsing, blocking or restricting the airflow. A CPAP machine blows air into the airway, creating enough pressure to prevent the airway from closing and therefore allowing the patient to breath without interruption.

Choosing a CPAP mask is key to successful CPAP therapy. Being comfortable while awake and asleep makes CPAP therapy much easier. But how do you know which mask is right for you? This guide looks to point you in the right direction.

In this section we explain the difference Types of CPAP Mask, explain How to Choose between them, and provide additional CPAP Mask Comfort tips. These pages should give you all the information you need to make an informed choice, and get a mask that is suited to your needs and preferences.

We also have a section dedicated to CPAP Mask Sizing, explaining how to decide which size would be right for you. It is surprising how many people guess or assume the size they need, and end up with an ill-fitting and uncomfortable mask. This guide explains how to avoid this problem and get a comfortable, well-fitting CPAP mask.

Sleep Test

Find out if you have Obstructive Sleep Apnoea

In-home Sleep Test provides a quick, convenient and affordable way to have Sleep Apnoea confirmed. All studies are independently analysed by experienced NHS-qualified sleep professionals, and use the WatchPAT recording device for unrivalled accuracy.

*INTUS Healthcare provide professional, confident, in-home Sleep Tests for Obstructive Sleep Apnoea.

(*Please note the tests are not intended to provide feedback on any other sleep disorders)

We will provide the equipment to be worn at home, in the comfort of your own bed. The data returned, along with a questionnaire we will ask you to complete, will be assessed by independent, NHS-trained sleep technicians with a minimum of 5 years sleep scoring experience. All sleep tests are confidential (only you will receive your results) and they are provided within 7 days of returning the equipment.

Nebulisers

Please visit the Nebuliser Accessories section of our website, where you will find an extensive range of spare filters, tubes, masks and other parts for nebulisers.

If you cannot find what you need, please contact us as we may well be able to help.

Nebulisers can be purchased at 0% VAT (in other words, VAT free) under certain conditions.

Any product we sell that can have VAT relief claimed on it will have its price shown with 0% VAT as standard. This is because most of our customers qualify for VAT relief, and is therefore the price most customers will pay.

If you do not qualify then 20% VAT will be charged on top of the prices shown on the website.

If you order products that are eligible for VAT relief, then during the checkout process, you will have the option to declare yourself eligible for that relief. The process is very simple – you will see a VAT relief declaration, and a simple check box to confirm if this applies to you.

Who qualifies for VAT relief on nebulisers?

If you are buying a product that is eligible for VAT relief and the recipient of the eligible goods has a ‘chronic illness’ such as asthma or COPD and will be using the goods for their personal or domestic use, then VAT relief can be claimed. A simple tick declaration during the checkout is all that is required.

For clarity, if the recipient of the product will be using the device for reason other than treating a chronic illness, or will be using it in a non-domestic setting (ie in the workplace), or the purchase is being made or funded by a company, then VAT relief should not be claimed, and VAT will be charged at 20%.

The vast majority of our orders have VAT relief claimed because they meet the requirement explained above. If you are unsure of your eligibility, please contact us before you order and we will be happy to advise.

VAT relief is only available to UK customers.

For the Republic of Ireland, VAT must be applied at 21% on all deliveries to the Republic of Ireland.

For all other EU customers no VAT will be charged at the point of order, however, there may be tax on import.

Up until the declaration, the website will presume that VAT is to be charged at 20% (for example, at the Shopping Basket stage all orders will show 20% VAT being applied). Rest assured that this will be easily changed to 0% on eligible products during the checkout process, provided you declare that you qualify for relief as explained.

The checkout declaration is as follows:

Dear Customer, one or more of the products you are purchasing may be eligible for VAT relief (0% rated) if: the recipient of the eligible goods has a ‘chronic illness’ such as Obstructive Sleep Apnoea and will be using the goods for their personal or domestic use. (For more information see HMRC VAT Notice 701/7).’

Tick the box below to claim VAT relief with a simple declaration. If you do not tick the box, VAT will be applied at the standard rate.

This applies to all EU orders except deliveries to Ireland, which must have VAT added at the Irish standard rate.

UK companies must always pay UK standard VAT rates and leave the box unticked.

Supplier’s Declaration:

Intus Healthcare Ltd, of: 2 Walton Business Centre, 46 Terrace Road, Walton-on-Thames, KT12 2SD, UK declare that we are supplying the qualifying products you are purchasing, under the condition that the recipient is a disabled person (defined above) and is using them for their personal or domestic use.

Customer’s Declaration:

I, (identified by my registered name and billing address), declare that the recipient of these goods has Obstructive Sleep Apnoea and is receiving the goods detailed in this order for their domestic or personal use and I, therefore, claim relief from VAT. By ticking the box below, I acknowledge that I am electronically signing this declaration as of the date of this order.

Please see ‘Notice 701/7 VAT reliefs for disabled people’ on the GOV.uk website for full details.

Nebulisers are not prescription items and can be purchased by anyone. You do not need to provide a prescription or any proof of requirement to purchase.

However, unless you have a prescribed medicine that requires a nebuliser you should not purchase one.

We do not recommend purchasing a nebuliser unless advised that you need one by your prescriber.

If you purchase a nebuliser and discover you do not need it, we can only accept a return if unopened.

Once opened, a nebuliser cannot be returned as they are medical devices with hygiene restrictions. This applies even if the device hasn’t actually been used.

Therefore we strongly recommend that you only order your nebuliser if you have been prescribed a medicine that requires one.

Almost all of our nebulisers have good stock levels and all have a next-day delivery option available.

Orders placed before 2pm are almost always dispatched the next day and if a next working day option is chosen at the checkout, you should get it the following day.

If you want to be 100% sure about which nebulisers we can get to you quickly please do contact us – one of our team will be more than happy to help and put your mind at ease. If possible we would recommend calling, as emails can take a little longer to be seen and replied to.

We do not have a physical shop where items can be collected in person.

There is no list of officially approved nebulisers from the NHS.

Different clinics or prescribers may express a preference or recommendation for a particle brand, type of nebuliser or even a specific model.

However, this is very much down to the clinic or prescriber’s preference, based on their own experience of various options.

Equally, there is no one brand, type or model used predominantly within NHS hospitals themselves. Each will acquire nebulisers based on their own requirements, experience and preferences.

If you are looking for a nebuliser and are unsure which would be most suitable for you, then you should speak to your prescriber. They will know which type of nebuliser is most suitable for you and your medication.

Most commonly this will be a Jet Nebuliser like the Philips InnoSpire Deluxe, but they may also suggest a Mesh Nebuliser such as the Philips InnoSpire Go is more suitable. If in doubt, ask your prescriber.

 

A nebuliser takes liquid medicines and transforms them into a fine mist that can be inhaled. There are several different types of nebulisers and they achieve this in different ways.

Jet Nebuliser – Also called Compressor or Nozzle Nebuliser

These types of nebulisers use a compressor to create a flow of air through the nebuliser and past the medicine, converting into tiny particles that create a mist.

Jet Nebulisers often have more than one attachment available, allowing them to create different sizes of particles. This means they are compatible with almost commonly prescribed medications, making them a highly versatile choice.

They are also the most affordable option. Our most popular Jet Nebuliser currently is the Philips InnoSpire Deluxe.

Mesh Nebuliser – Also called Membrane or Portable Nebuliser

A Mesh nebuliser uses a very fine piece of mesh that vibrates and pulls the liquid through it, converting it into a mist in the process.

Because the mesh is a fixed size they are only suitable for certain medicines, such as Salbutamol. The mesh is too fine for steroids, enzymes or antibiotics to be used.

However because the mesh method is so small, light and energy-efficient, this type of nebuliser is usually handheld and battery-powered. This allows for it to be used almost anywhere.

Plus, they usually create the mist more quickly than a Jet nebuliser, reducing treatment times to under 5 minutes. Their portability and quick usage times has seen this become the go-to option for many. The Philips InnoSpire Go is a very popular option.

Ultrasonic Nebuliser

Ultrasonic Nebulisers use a piezo-electric vibrator that generates high-frequency vibrations (2-3 million every second). The strong vibrations generate small particles from the liquid medication.

Similar to the Mesh Nebulisers, they cannot be used for all medications. They are unsuitable for thicker medicines, such as antibiotics or steroids.

They also leave a higher amount of residual medicine, meaning that less reaches your airway and simply goes to waste.

These limitations mean they are far less frequently used than either of the other options. We do not currently offer any Ultrasonic Nebulisers for these reasons.

Every nebuliser will have its own cleaning process. This will be detailed in the instruction manual. Many manufacturers will also put short but very helpful video instructions on YouTube.

Please ensure you follow the instructions provided and remember to regularly clean your device. Else residue and dirt can restrict your nebulisers performance and, ultimately, can cause it to fail.

Some parts of the machine should also be replaced regularly. For example, most compressor nebulisers contain filters that should be changed (not washed!) regularly. If you use a mask, this should be replaced roughly every three months. Other items such as the tube may also need to be replaced regularly.

All of your machines requirements will be clearly explained in your user manual. Do ensure you keep on top of your cleaning and the replacement of any consumable parts of your nebuliser to ensure your treatment maintains its effectiveness, and the device’s lifespan isn’t reduced.

You should use your nebuliser as frequently as instructed to by the prescription for your medication. If unsure, consult your prescriber.

This will depend on the nebuliser, the medicine and the size of the dose you need.

For example, the Philips InnoSpire Go can administer a 2ml dose of Budesonide or Ipratropium Bromide in under 4 minutes.

Whereas thicker medications such as Colomycin take longer to convert into a mist and can take up to 20 minutes.

Where possible we put the average time taken for various medicines in the specifications of each nebuliser that we provide so that you get a good idea of how long it will take with each use.

None of the nebulisers we provide require routine servicing. You simply need to ensure that you clean it as instructed by the user manual, and replace the filters (if applicable) when required to. This is the only routine maintenance our nebulisers require.

The most appropriate nebuliser for you depends primarily on your medication and the condition it is being used to treat.

Most nebuliser treatments fall into two categories; those for upper airway treatment, and those for lower airway treatment. Most nebulisers will be designed primarily for lower airways treatments as this is the more common requirement of the two. These are typically asthma medicines such as Salbutamol.

Upper airway treatments are often medicines that use steroids, enzymes or antibiotics. Most nebulisers can provide these types of medication but need a different attachment or chamber than its standard one. Some nebulisers – such as “mesh” type devices – cannot be used with this type of medicine.

Most compressor nebulisers can be used for either treatment, for example the Philips InnoSpire Deluxe. When used with the SideStream Reusable chamber (which comes included) it provides lower airway treatment such as Salbutamol. When used with the SideStream Plus chamber (sold separately) it can be used for upper airway treatments.

If you are unsure about your medication’s requirement, please do not ask us! We will be unable to advise you of this, it is your prescriber who you will need to contact.  We can of course advise a suitable nebuliser once you know the medicine’s requirements.

 

 

Nebulisers are not typically provided by the NHS, even if you are prescribed medicine that requires one.

Some consultants or respiratory clinics may arrange for a device to be loaned to you, but this is not the norm. In most cases, the nebuliser is to be purchased by the patient.

If you need to purchase a nebuliser but are concerned about the expense, please browse our range of mains-powered nebulisers. We provide some affordable nebulisers, such as the Philips InnoSpire Essence.

A nebuliser is a device that converts certain medicines from liquid to a fine mist that can be inhaled. They are therefore most associated with respiratory conditions such as asthma and COPD, as they allow medicines to reach the lungs quickly and easily even if the patient’s breathing capacity is limited.

The mist is typically inhaled through a mask or mouthpiece, with is travelling from the machine itself through a tube.

Sleep Apnea

You do need to provide written confirmation of CPAP suitability when ordering a machine, but this is not required for a CPAP mask. You will need to tick a self-declaration of CPAP usage at the checkout but this is all that is required.

Find out if you have Obstructive Sleep Apnoea

In-home Sleep Test provides a quick, convenient and affordable way to have Sleep Apnoea confirmed. All studies are independently analysed by experienced NHS-qualified sleep professionals, and use the WatchPAT recording device for unrivalled accuracy.

*INTUS Healthcare provide professional, confident, in-home Sleep Tests for Obstructive Sleep Apnoea.

(*Please note the tests are not intended to provide feedback on any other sleep disorders)

We will provide the equipment to be worn at home, in the comfort of your own bed. The data returned, along with a questionnaire we will ask you to complete, will be assessed by independent, NHS-trained sleep technicians with a minimum of 5 years sleep scoring experience. All sleep tests are confidential (only you will receive your results) and they are provided within 7 days of returning the equipment.

1. CPAP (Continuous Positive Airway Pressure) Therapy

CPAP is the most widely used method of treating OSAHS of all severities. It consists of a CPAP Machine to pump air through a connecting hose into a CPAP mask worn while sleeping, which gently creates an ‘air splint’ keeping the airway open. The pressure provided by the machine stops the throat from constricting and closing, preventing the apnoeas and hypopnoeas from occurring so you can sleep and breathe normally. While this may sound like a ventilator, CPAP does not do the breathing for you nor does it provide oxygen. You breathe air normally while the increased pressure from the machine prevents OSAHS from occurring.

You may be able to obtain the equipment via the NHS (although waiting times can be several months) or you can purchase privately from our sister website CPAP.co.uk.

 

2. OAT (Oral Appliance Therapy)

Oral Appliance Therapy (OAT) uses a splint worn in the mouth to move the lower jaw slightly forward to allow for more airflow. As OSAHS is caused by the throat narrowing or closing, positioning the lower jaw further forward creates more space inside the throat for passage of air and reduces the frequency of apnoeas and hypopnoeas as a result. In many cases snoring is also reduced.

The splint can be either a custom-made appliance fitted by a dentist or a much lower cost ‘heat and bite’ device that provides simple customisation. OAT is a clinically-proven method of treating mild OSAHS, and some find it more comfortable or less invasive than CPAP.

 

3. Positional Therapy

Positional therapy is used to treat people who have sleep apnoea primarily when they sleep on their backs. When they sleep on their sides, their breathing returns to normal. For positional therapy, you will wear a special device around your back or waist. This will keep you sleeping on your side. Or, you might try a small vibrating device on the back of your neck. It won’t wake you up, but will start vibrating when you roll onto your back — which sends your body a message that prevents the rollover. Many people need positional therapy in addition to other sleep apnoea treatments.

 

4. Nutrition, lifestyle and weight loss

If appropriate, a nutrition and weight-loss program can often provide benefit. Living with a healthier body is known to have a significant, direct positive effect on sleep, OSAHS and many other health issues. A direct link between excess weight and both OSAHS and snoring severity has been shown, so if you are overweight you may find that weight loss provides an improvement in your OSA symptoms.

Symptoms of Obstructive Sleep Apnoea

 Obstructive sleep apnoea (OSA) is a pause in your breathing when you are asleep, caused by an obstruction; usually the soft tissue around your airways. Episodes of interrupted breathing are often easily observed by someone when an individual is sleeping, but the sleeper might not know it’s happening. Obstructive sleep apnea or OSA can also cause other symptoms, usually due to tiredness resulting from a lack of deep sleep.

Most people with OSA snore loudly. Their breathing may be noisy and laboured, and it is often interrupted by gasping and snorting with each episode of apnoea.

If you have OSA, you may have no memory of your interrupted breathing during the night. However, when you wake up, you are likely to feel as though you have not had a good night’s sleep.

Signs and Symptoms of Sleep Apnoea:

  • Gasping or choking during sleep
  • Snoring
  • Feeling excessively tired during the day
  • Anxiety
  • Depression
  • High Blood Pressure
  • Lack of interest in sex
  • Irritability and a short temper
  • Poor memory and concentration
  • Frequent toilet visits during the night
  • Headaches (particularly in the morning)
  • In men, impotence
OSA animation
Obstructive Sleep Apnoea – what you need to know

Obstructive Sleep Apnoea (OSA) is when apnoeas (breathing pauses) and hypopnoeas (breathing restrictions) repeatedly occur as your upper airway becomes obstructed. The obstruction is due to the relaxing of muscles and the subsequent collapse of the tissue surrounding the passageway, generally preceded by snoring. These pauses in breathing and reductions in airflow can be followed by a gasping/choking sound as the brain reacts to the oxygen drop, by momentarily waking you from your sleep. The sufferer can actually stop breathing for as much as 10 seconds (which is shown in the animation) with each event.

 

Sleep apnoea can occur up to one hundred times every hour.

The whole process then repeats regularly as the person drifts off into a deeper sleep only to be roused again soon after having another apnoea event. The individual is usually completely unaware of all this and rarely do they wake entirely but merely return to a lighter level of sleep. They then wake up still tired, having had little or no quality sleep.

Snoring

Snoring is a snorting or rattling noise made during sleep. For some, it is limited to short individual snorts. For others, their snoring is consistent during all stages of their sleep and occurs every night. Similarly, some people’s snoring can be quite quiet, while others can be heard in the next room.

Here is an explanation as to why you snore, and how to stop it.

 

What causes you to snore?

As you sleep the soft tissue in your airways can relax and vibrates as air passes over it, causing the snoring noise. The soft tissue in the nasal passages, the soft layer at the back of your mouth, the base of your tongue, your tonsils or your uvula can cause you to snore.

 

When I’m awake, why don’t I make snoring noises?

When you are asleep, your muscles and body relax. This causes the soft tissue in your airways to loosen, making them soft and more susceptible to vibrations. The vibrations are the source of the noises. Plus, the loosened tissue reduces the size of your airway. This means air passes through the airway more quickly, and this increases the vibrations, causing you to snore. Often illnesses such as a common cold can cause your snoring to worsen, as it can further restrict the airways.

 

What can make you more likely to snore?

Many factors can affect the severity of somebody’s snoring. They include:

  • Weight – being overweight or clinically obese can increase the amount of soft tissue around the throat. This increases the pressure on the throat during sleep, causing it to narrow further. Typically a person who is obese, and/or has a neck size above 17 inches, are more likely to snore. Often they will snore more loudly and more frequently than somebody of average weight.
  • Smoking – smoke causes inflammation in the airway, restricting the airflow and increasing the likelihood of snoring.
  • Alcohol – alcohol relaxes the muscles and makes the tissue in your throat and mouth more prone to vibrations.
  • Allergies – any allergy that results in rhinitis (runny nose) will cause the nasal passages to become inflamed. This restricts them, making snoring more likely.

Often snoring worsens with age, as more tissue develops, and muscles weaken.

 

How to snore no more!

Now that you know what causes you to snore, you are better placed to find a solution. Proven treatment methods include:

 

Lifestyle Changes

If your BMI (body mass index) is above 25, you are likely to notice a reduction in the intensity of your snoring if you can lose weight. Reducing your weight may prevent your snoring entirely.

Stopping (or at least reducing) your smoking and or alcohol consumption can lead to a reduction in the severity of your snoring.

 

Anti-Snoring Products

There are numerous products to help people who snore. You can read our guide to the proven Anti-Snoring Products here.

 

Obstructive Sleep Apnoea testing

Being told that you snore may be embarrassing, but in most cases, snoring is harmless to the snorer and mostly an annoyance to the listener. However, if you experience any or all of these other problems, then it could be more serious:

  • Excessive sleepiness during the day
  • Lack of concentration
  • You have been told you choke or stop breathing during sleep
  • You have a BMI above 25
  • Have a recessed jaw or deviated septum
  • Need to urinate frequently at night

These problems are indicators that you might have obstructive sleep apnoea. Obstructive sleep apnea or OSA is a sleep disorder, where a person’s airway regularly closes, and they stop breathing during sleep. These regular interruptions disrupt sleep, causing the person to wake up not feeling refreshed and often tired throughout the day.

If you suspect that you may have OSA, then we recommend reading our guide to getting a Sleep Study conducted. You could be receiving treatment and sleeping soundly again within weeks. Even better – as well as treating OSA, you may also no longer snore!

CPAP Equipment

We are working on a convenient way for you to tell us you want to send in your data key card / smart stick so we can track its progress and process it promptly. For now, please contact us by e-mail and we can assist you promptly.

We provide our data reporting service free of charge for the first two years after purchase, after which there will be a small fee purely to cover costs. We will also guarantee to be able to provide reports for your machine for at least four years after purchase.

 

DeVilbiss SleepCube Reporting

If you use a DeVilbiss SleepCube, you can simply call up the SmartCodes on your screen, and e-mail these in. To call up the SmartCodes on the LCD screen, simply turn the (Auto-)CPAP blower on and press the LEFT arrow key once. Use the UP arrow or DOWN arrow keys to change the SmartCode reporting period. Take note of all four codes; Last Day, Last 7 Days, Last 30 Days and Last 90 Days. Press the LEFT arrow key again to display the Adherence Score and take note of this code too. E-mail all 5 codes in along with your name and a brief description of your recent sleep related experiences and you will receive a PDF report and feedback shortly.

 

Fisher & Paykel SleepStyle Reporting

If you own a Fisher & Paykel SleepStyle machine with a memory stick, please contact us by e-mail before sending this in.

 

Respironics REMstar Reporting

If you have a Respironics REMstar machine like the M Series and its predecessor, with a credit card sized data card, please contact us by e-mail before sending this card in.

 

Respironics System One REMstar Reporting

If you have a Respironics REMstar System One machine with a stamp-sized SD data card, please contact us by e-mail before sending this card in. The files from the memory card can be emailed rather than posting the card itself – we can provide full instruction on how this is done on request.

 

ResMed Reporting

We regret to advise we currently cannot process any ResMed data cards. Please contact your hospital instead.

 

Other Makes & Models

If you use a machine not listed, please contact us to see whether we can assist you with your data reporting needs.

BiPAP (Bilevel Positive Airway Pressure) is similar to CPAP (Continous Positive Airway Pressure). Your sleep/respiratory clinician or the Intus Healthcare sleep test/sleep study will prescribe which therapy and machine you will need.

BiPAP machines have two pressure setting. One pressure setting for inhalation (IPAP), and the second, a lower pressure setting for exhalation (EPAP).

  • The difference in inhalation and exhalation pressures reduces the work of breathing and allows the person to have a more restful sleep. These are some reasons BiPAP machines are sometimes used as a treatment method when CPAP has failed to treat their sleep-disordered breathing adequately.
  • Like CPAP, the BiPAP machine also increases the pressure when you inhale to keep the airways in the nose and throat from closing while you are sleeping and provide a lower pressure during exhalation that continues to maintain an open airway.
  • If you have OSA but without any other respiratory, cardiac or other severe health conditions, then CPAP would be the best form of treatment for you.
  • People with nerve and muscle problems may better benefit from the BiPAP machine rather than the CPAP machine. BiPAP machines can make sure users breathe a set number of times per minute.

If you think you may require BiPAP, then you should discuss this with your sleep or respiratory clinician first. Appropriate testing is essential to determine what treatment method would suit your needs better and what settings are appropriate for you.

For us to be able to provide a CPAP machine we would need to see written documentation to show you require CPAP therapy. This does not have to be a formal prescription; it could be a simple letter from your doctor. If you have taken our sleep test before ordering, then you should and the results show you need CPAP therapy you can purchase a CPAP machine. If you have done a sleep study but are unsure if you have any paperwork showing your need for CPAP, then please contact us. If you are yet to do a sleep study (either privately through our at-home service, or via the NHS) then your first step would be to read our Sleep Studies information page and progress from there – you could still be benefiting from CPAP therapy within a fortnight.

Any item marked as “In Stock” means that it is available, either in our extensive warehouse or in one of our suppliers’. 90% of orders can be shipped the same working day from our warehouse. For the remaining 10%, our excellent relationships with our suppliers mean that these orders should ship within 24-48 hours. We will let you know if your order is subject to any delay, and you can call us or email to enquire about exact stock availability at any time. Our Customer Care Team can let you know the availability of any item listed on our website and give an honest estimate of when you can expect to receive it.

Shipping

We are an online company and we only sell through our websites. There are currently no physical shops selling CPAP products in the UK, and this is unlikely to change. We have shipped thousands of orders during our years of providing CPAP equipment.

We ship to all countries within the European Union, and also to selected European countries that are not currently EU member states such as Croatia, Norway and Switzerland. We do not ship anywhere outside of Europe for logistical and contractual reasons. However, if you are based outside of Europe, we could deliver your order to a friend or relative within Europe for them to send on. We will not ship outside of Europe directly for the foreseeable future.

To calculate the shipping costs of your order, after you have added the items to your basket, you can go to the My Basket page and use the delivery calculator. The price this displays will be what you are charged for those items to be delivered to your chosen destination – so no surprises when you get the payment. We constantly review our shipping prices for all countries to ensure they are as accurate as possible for whichever items you are ordering.

For overseas deliveries, delivery options will range from Airmail Post up to Courier, with estimated delivery times displayed for each option. Heavier and higher value orders will ship via a courier service, which will take between two and eight working days, depending on the distance from the UK. For more accurate times for our courier service, feel free to contact us. Please let us know if you have any urgent time constraints and we can let you know your options and can see what we can offer to get your order to you as promptly and safely as possible.

Note: Orders for CPAP machines will require some form of documentation to be provided by you before your order can be despatched. High-value orders may require additional checks before being despatched.

We aim to ship all items within one to two days.

For UK customers, there will usually be a selection of delivery options ranging from Royal Mail Second Class up to Next Day Courier. Estimated delivery times will be given for each option, and every UK order will have a free delivery option. Heavier and higher-value orders will usually ship via a courier service, which is the next working day (or two working days for Northern Ireland and the Scottish Highlands).

If you need assistance then please call us on 0800 024 8050

One of our Customer Care Team will give you an honest and accurate assessment of when your order can be despatched (see our stock information on the next question) and let you know which delivery options are open to you. We can often upgrade your delivery option to ensure your order arrives promptly for a small fee.

Sleep Apnoea

For us to be able to provide a CPAP machine we would need to see written documentation to show you require CPAP therapy. This does not have to be a formal prescription; it could be a simple letter from your doctor. If you have taken our sleep test before ordering, then you should and the results show you need CPAP therapy you can purchase a CPAP machine. If you have done a sleep study but are unsure if you have any paperwork showing your need for CPAP, then please contact us. If you are yet to do a sleep study (either privately through our at-home service, or via the NHS) then your first step would be to read our Sleep Studies information page and progress from there – you could still be benefiting from CPAP therapy within a fortnight.

Sleep Test

For us to be able to provide a CPAP machine we would need to see written documentation to show you require CPAP therapy. This does not have to be a formal prescription; it could be a simple letter from your doctor. If you have taken our sleep test before ordering, then you should and the results show you need CPAP therapy you can purchase a CPAP machine. If you have done a sleep study but are unsure if you have any paperwork showing your need for CPAP, then please contact us. If you are yet to do a sleep study (either privately through our at-home service, or via the NHS) then your first step would be to read our Sleep Studies information page and progress from there – you could still be benefiting from CPAP therapy within a fortnight.

You do need to provide written confirmation of CPAP suitability when ordering a machine, but this is not required for a CPAP mask. You will need to tick a self-declaration of CPAP usage at the checkout but this is all that is required.

Website Questions

We are working on a convenient way for you to tell us you want to send in your data key card / smart stick so we can track its progress and process it promptly. For now, please contact us by e-mail and we can assist you promptly.

We provide our data reporting service free of charge for the first two years after purchase, after which there will be a small fee purely to cover costs. We will also guarantee to be able to provide reports for your machine for at least four years after purchase.

 

DeVilbiss SleepCube Reporting

If you use a DeVilbiss SleepCube, you can simply call up the SmartCodes on your screen, and e-mail these in. To call up the SmartCodes on the LCD screen, simply turn the (Auto-)CPAP blower on and press the LEFT arrow key once. Use the UP arrow or DOWN arrow keys to change the SmartCode reporting period. Take note of all four codes; Last Day, Last 7 Days, Last 30 Days and Last 90 Days. Press the LEFT arrow key again to display the Adherence Score and take note of this code too. E-mail all 5 codes in along with your name and a brief description of your recent sleep related experiences and you will receive a PDF report and feedback shortly.

 

Fisher & Paykel SleepStyle Reporting

If you own a Fisher & Paykel SleepStyle machine with a memory stick, please contact us by e-mail before sending this in.

 

Respironics REMstar Reporting

If you have a Respironics REMstar machine like the M Series and its predecessor, with a credit card sized data card, please contact us by e-mail before sending this card in.

 

Respironics System One REMstar Reporting

If you have a Respironics REMstar System One machine with a stamp-sized SD data card, please contact us by e-mail before sending this card in. The files from the memory card can be emailed rather than posting the card itself – we can provide full instruction on how this is done on request.

 

ResMed Reporting

We regret to advise we currently cannot process any ResMed data cards. Please contact your hospital instead.

 

Other Makes & Models

If you use a machine not listed, please contact us to see whether we can assist you with your data reporting needs.

If you order products that are eligible for VAT relief, then during the checkout process, you will have the option to declare yourself eligible for that relief. At this point, you can decide if you qualify for VAT relief. It should be self-explanatory, however, if you have any doubts about whether or not you are eligible for the 0% VAT rate, then please Contact Us before purchase, and we will be happy to advise.

All eligible products are clearly marked, and if one or more of the products you are purchasing is eligible for VAT relief and the recipient of the eligible goods has a ‘chronic illness’ such as Obstructive Sleep Apnoea and will be using the goods for their personal or domestic use, then VAT can be charged at 0%. A simple tick declaration during the checkout is all that is required.

VAT relief is available to residents of all European Union member states except the Republic of Ireland.

For the Republic of Ireland, VAT must be applied at 21% on all deliveries to the Republic of Ireland.

Up until the declaration, the website will presume that VAT is to be charged at 20% (for example, at the Shopping Basket stage all orders will show 20% VAT being applied). Rest assured that this will be easily changed to 0% on eligible products during the checkout process, provided you declare that you qualify for relief as explained.

The checkout declaration is as follows:

‘Dear Customer one or more of the products you are purchasing may be eligible for VAT relief (0% rated) if: the recipient of the eligible goods has a ‘chronic illness’ such as Obstructive Sleep Apnoea and will be using the goods for their personal or domestic use. (For more information see HMRC VAT Notice 701/7).’

Tick the box below to claim VAT relief with a simple declaration. If you do not tick the box, VAT will be applied at the standard rate.

This applies to all EU orders except deliveries to Ireland, which must have VAT added at the Irish standard rate.

UK companies must always pay UK standard VAT rates and leave the box unticked.

 

Supplier’s Declaration:

Intus Healthcare Ltd, of: 2 Walton Business Centre, 46 Terrace Road, Walton-on-Thames, KT12 2SD, UK declare that we are supplying the qualifying products you are purchasing, under the condition that the recipient is a disabled person (defined above) and is using them for their personal or domestic use.

 

Customer’s Declaration:

I, (identified by my registered name and billing address), declare that the recipient of these goods has Obstructive Sleep Apnoea and is receiving the goods detailed in this order for their domestic or personal use and I, therefore, claim relief from VAT. By ticking the box below, I acknowledge that I am electronically signing this declaration as of the date of this order.

 

Please see ‘Notice 701/7 VAT reliefs for disabled people’ on the GOV.uk website for full details.

We are an online company and we only sell through our websites. There are currently no physical shops selling CPAP products in the UK, and this is unlikely to change. We have shipped thousands of orders during our years of providing CPAP equipment.