The recently introduced Devilbiss EasyFit SilkGel is essentially an upgraded version of the original EasyFit with some positive improvements. Firstly, the cushion has been completely upgraded. The internal gel section of the cushion is quite soft and pliable which increases comfort and creates an effective seal. The outer shell of the cushion has an ultra-soft coating which feels silky to the touch. This further enhances the ability of the cushion to seal properly and maintain that seal throughout the sleep cycle. Interestingly, the mask and cushion design was created after a computer analysis of the facial characteristics of 50,000 people globally. Using a special algorithm, the unique scallop shaped cushion was created for the SilkGel. Another new design change is the ball and socket tubing connector. The SilkGel is the first mask to employ such a socket which affords active sleepers a less frustrating CPAP mask experience. A few other notables on the SilkGel are the nose flange to help eliminate air blowing into the eyes, a customizable forehead support with an ultra-soft cushion, a whisper-quiet exhalation system and headgear which circles the crown of the head.

The Aloha is the first nasal pillow CPAP mask from Devilbiss. Although this is their first entry into the highly competitive nasal pillow field, the Aloha makes a very good impression. On first glance, you will notice how few parts there are to this mask. There also are very few locations the mask actually touches the face. Since there are so few parts to the mask, cleaning or replacing these parts make the long term cost quite good. Moreover, Devilbiss again employs the use of the ball and socket tubing connector which active sleepers can appreciate. Another interesting feature is the Arced Track technology which allows users the ability to adjust the angle and depth of the nasal pillow. This is most helpful for CPAP users who like the idea of a nasal pillow CPAP mask but don’t like the feeling of the actual nasal pillow. As with all nasal pillow systems, there is nothing blocking the field of vision. However, the Aloha allows users to customize the mask by routing the tubing over the head or down the chest. For CPAP users who prefer side sleeping, routing the tubing over the head may be the key to uninterrupted sleep. Devilbiss has even included headgear wraps for comfort, and small, medium and large nasal pillows for fitting ease.

Although Devilbiss is not the most popular or well known CPAP equipment manufacturer, they have recently become more committed to the CPAP equipment market.  The Devilbiss IntelliPAP line of CPAP machines along with both the EasyFit SilkGel and Aloha give CPAP users more choice and a reason to try something new.  You will not be disappointed with any of the choices offered by Devilbiss which all can be found at The CPAP Shop.

The ComfortGel Blue Full employs the patented seal technology which is a membrane thin layer that covers the gel cushion creating an effective seal on nearly all facial shapes and contours – men and women. The blue gel itself is quite soft and pliable and dramatically increases the comfort factor and reduces the weight. With both the cushion and the flap replaceable, the life of the mask is extended indefinitely.

Philips Respironics ComfortGel Blue Full 

The forehead assembly was also redesigned.  The addition of the premium forehead pad adds comfort and reduces pressure points on the forehead.  A stability selector was introduced to allow users to choose a more personalized and comfortable fit.  Micro exhalation ports have also been redesigned and angled away from the CPAP user and bed partner.  The 360° swivel allows the CPAP users more freedom of movement without worrying about tube placement.

Finally, Philips Respironics has specifically designed their masks for optimal performance on the new PR System One 60 Series Auto CPAP with Heated Tube.  If you are using the new PR System One 60 Series Auto CPAP with Heated Tube, it provides an optimal pressure numbering system which can be coupled with the ComfortGel Blue Full.  By numbering each mask, the CPAP is set to deliver optimal pressure given the specific resistance of the mask.  The overriding benefit is to offer the best possible solutions to increase comfort and compliance.

Our CPAP users have given the new Philips Respironics ComfortGel Blue Full Face CPAP mask a much better grade than the original.  They comment specifically on how comfortable the new gel feels on their face and the enhance forehead assembly design and feel.  Although they would prefer to get rid of the ball and socket, nearly all agree it is an upgrade worth doing.

• Heated Tube:  System One Series 60 features a heated tube to provide greater patient comfort and customization of therapy by helping to reduce rainout caused by condensation.  The heated tube squeeze connector is state of the art and uses power directly from the humidifier.

•  Improved humidity output and control:  Coupled with the heated tube to provide improved humidity output, System One Series 60 offers five patient-selected relative humidity settings to deliver customized comfort while dramatically reducing rainout.  These settings enable the Series 60 to maintain temperatures between 4 and 16 degrees above room temperature.

•  Redesigned Chamber with Dry Box technology: Series 60 water chamber has increased surface area to allow for more humidification.  The patented dry box technology prevents water from the chamber getting into the CPAP.

•  Mask fit and seal monitoring:  With the Mask Fit feature, System One Auto devices give patients the ability to check the seal of their masks in real time and lets them and their clinicians know what leaks may result when pressures increase from baseline throughout the night.

 The CPAP Shop is pleased to offer the new Philips Respironics PR System One Series 60 and all other Philips Respironics CPAP equipment.

Although a CPAP machine has been proven to be the most effective and popular treatment in the sleep apnea battle, some CPAP machines tend to end up under the bed or in a closet gathering dust. For various reasons, people, although having been diagnosed with sleep apnea, decide that they cannot tolerate a CPAP machine. This is understandable since the idea of a constant stream of air keeping your throat open even when you’re not asleep is uncomfortable to many.

Standard vs. Automatic CPAP Machines

Prior to the release of APAPs, the only option available for treating sleep apnea was a standard CPAP machine. CPAP machines have treated millions of people successfully over the course of many years. But, as you may understand, a standard CPAP machine pushes a constant flow of pressurize air into a mask in order to keep the airway open during an apnea event. However, as the pressure increases, so too does the level of discomfort from the use of standard CPAP machines. The discomfort is genrally caused from dryness in the nasal passages due to the constant pressure, inability to tolerate high pressures or too much air coming through at times during the sleep cycle. Considering the typical sleep apnea sufferer seldom has the exact same pressure needs during each breath throughout the sleep cycle, it is understandable why a standard CPAP machine might not be optimal for some. In fact, a person’s pressure can change if they are sleeping on their side as opposed to their back, if they have gained or lost weight, and even if they had a few cocktails prior to bed.

It is true that some standard CPAP machines have added features such as Philips Respironics’ C-Flex and ResMed’s EPR to help reduce the pressure during non-apnea sleep. These features offer some relief by ramping slightly up or down to make CPAP therapy feel more natural. C-Flex and EPR work well but are quite limited in their ability to significantly reduce the standard pressure. Nevertheless, at high pressures, the level of discomfort can still be quite significant enough to stop CPAP therapy.

The design and technology behind an automatically adjusting CPAP machine make perfect sense. Why not give a person with sleep apnea the least amount of pressurized air needed to maintain air passage integrity at every given moment? Sometimes CPAP users will need less pressure and other times they will require a more. Since the air passages of a person with sleep apnea is not in a constant state of being closed, a CPAP machine which can automatically adjust to the needs of the individual on a breath by breath basis has plenty of merit.

An APAP machine does just that; it provides just enough air to keep the windpipe open on a breath by breath basis, increasing or decreasing depending upon the needs of the user. If a CPAP user is sleeping on their side without an apnea event, the pressure is automatically reduced to make it comfortable to sleep. If that person flips to their back and has an apnea event, the APAP automatically adjusts up with just enough pressure increase to keep the windpipe open. Once over, it will re-adjust down to appropriate levels. Obviously, the goal is to make it unnoticeable with a completely natural feeling in order to maintain quality sleep.

APAP’s have undoubtedly been doing exactly what they were designed to do; making CPAP therapy more comfortable and tolerable which increases compliance and quality of sleep. For this reason, most people new to CPAP therapy or who are buying a new CPAP machine most often choose an automatically adjusting machine. Not only is the slightly higher price worth it in the long run, the quality of sleep increases.

Best Auto CPAP Machines - ResMed’s S9 Autoset and Philips Respironics PR System One Auto

Both ResMed and Philips Respironics have advanced their CPAP platforms to include some high quality APAP machines.

The ResMed S9 Autoset has proven to be a big hit amongst CPAP users. Technologically, it offers many features such as a highly sensitive algorithm, heated tubing, ultra quiet motor, and advance data management that will satisfy even the most discriminating CPAP user. The S9’s modern design also gives the APAP machine a stylish and modern look.

The Philips Respironics PR System One Auto has also proven to be extremely popular among APAP buyers. Although the design is less stylish, the PR System One succeeds on technology. This enhanced APAP has an advanced event detection and response system that can detect symptoms outside of typical obstructive sleep apnea. Moreover, the “flex” technology enhances therapy beyond typical APAP adjustments, while the CPAP mask fit and seal monitoring checks the seal of the mask in real time. Overall, the Philips Respironics PR System One Auto will meet the needs of nearly every CPAP user.

Ease of Use

One of the advantages of the ResMed S9 Elite CPAP is the machine’s ease of use. The S9 Elite includes an LCD screen and functionality, making it simple for people to turn on and make any necessary adjustments for optimal sleep quality. Separating the humidifier from the main unit is also quite easy thanks to the effortless latch sytem. This makes it easy to clean the humidifier or to leave the humidifier at home for overnight travel.

Less Noise, More Sleep

Since the original CPAP machine was basically a vacuum motor pushing air out instead of sucking it in, it’s easy to understand why early CPAP models were large and noisy. Noise has been one of the most common complaints of CPAP users. But the ResMed S9 Elite has tackled this problem with improved technology. The superior design of the main motor creates less turbulence than older CPAP machines. In addition, noise-reducing materials located throughout the base of the machine help to muffle any sound. These improvements result in a much quieter machine, and less noise means more quality sleep for the CPAP user and any bed partner. In fact, clinical tests have shown that the new model has a noise level of approximately 24 decibels. How quiet is that? About the same amount of noise created by a person breathing normally and through their nose without obstruction.

Adapts to Your Room’s Environment

Heated humidification is an option on nearly all CPAP machines today. The advancements with the heated humidifier for the ResMed S9 Elite are second to none. First, the system has a heated tube which helps to eliminate rainout by reducing the affect of ambient temperature. This single feature adds a level of comfort for CPAP users never before seen. Secondly, the ResMed S9 Elite CPAP machine has an optional heated humidifier, the H5i, developed by ResMed to remove any congestion or dryness from CPAP use. The H5i humidifier regulates output based on the existing humidity and ambient temperature. This type of “intelligent” technology makes the machine adaptable to almost any climate and condition experienced by the average consumer.

More Feedback from the Machine

The ResMed S9 Elite also records data about the patient’s sleep cycle. Patients can assess the information to review any leaks, amount of usage, and AHI data. Sleep information is stored on the system for up to one year. This is valuable data for people who wish to see how many hours of sleep they are getting per night, how long they have been using their machine, and the average air pressure supplied during the sleep cycle.

If you are uncertain about the type of CPAP machine to purchase, consider the ResMed S9 Elite. The quietness, ease of use and one-of-a-kind climate adaptability makes this a remarkable machine.

Fast forward to today – through extensive clinical research and education by Fisher & Paykel, they have essentially convinced the sleep community of the benefits of heated humidification.  Now, every machine on the market has an optional heated humidifier.  Fisher & Paykel itself offers a comprehensive range of CPAP machines integrated with advanced heated humidification technology.

Why Heated Humidification

According to sources, a person’s lungs function best when receiving air that is 89.6° Fahrenheit (37° C) and 100% saturated with water. Obviously, the air we breathe is generally not at this temperature or humidity, especially if you live anyone in the Northeast.  Thus, before making its way to the lungs, air needs to be warmed and moistened.  The nasal airway is the body’s heated humidifier.  By converting each breath into the perfect air temperature and moisture level, the lungs are able to operate optimally.

When a person is using CPAP, the nasal airway’s ability to add warmth and moisture can be sabotaged.  Basically, the body attempts to heat the increase in air flow by directing more blood to the blood vessels in the nasal area.  This increased blood flow to the nose causes swelling and congestion of nasal tissues, better known as nasal congestion. With a congested nose, breathing on CPAP is not only difficult but much more uncomfortable.

One way to minimize or prevent this nasal congestion is to use a heated humidifier with your CPAP machine.  In adding a heated humidifier, air from the CPAP machine passes over the warm water before it is delivered into the mask for inhalation. Nasal congestion is prevented due to the ability of the heated humidifier to balance out the system.  Of course, in order to balance effectively, determining appropriate and comfortable heater settings is necessary.

Heated humidifiers can come as a separate piece of equipment that attaches to a CPAP machine via some tubing—alternatively some CPAPs come with an integrated humidifier (see below).

The Importance of a CPAP humidifier

During CPAP therapy, a significant number of users experience side affects such as a sore/dry throat, nasal congestion, a runny nose, or in extreme cases, a bleeding nose a result of the dry CPAP air.  As mentioned, healthy lungs function under very specific conditions and, thus, it is important to add warmth and moisture from the CPAP air for our lungs.  A heated humidifier can be used to minimize or eliminate nearly all of the irritating symptoms of CPAP therapy.  By preventing unnecessary nasal symptoms, CPAP compliance and quality of sleep rise.

Fisher & Paykel’s Answer to Humidification – ThermoSmart Technology

The effectiveness of conventional humidification is limited by room (ambient) temperature.  As air travels from the humidifier, it tends to cool due to the room temperature.  This drop in temperature causes condensation to form in the tube.  Anyone who has awoken to a rush of water coming through the tube and into the mask understands the annoyance of rainout!  As a result of this imbalance in temperature levels, CPAP therapy is less than optimal.

To combat rainout, Fisher & Paykel introduced ThermoSmart™ Technology which includes an advanced humidification algorithm and a heated breathing tube.  This combination works together to provide optimal humidity and reduce condensation.  ThermoSmart™ Technology, with its unique heated breathing tube, delivers higher, customized humidity levels that are maintained through the night, regardless of ambient temperature change.  These higher humidity levels help maintain normal airway conditions without the side effect of condensation.

In essence, the ThermoSmart™ Technology mimics the ability of the nose to heat and humidify the air. CPAP users will experience new levels of sleep comfort as humidity levels remain constant through the night, regardless of ambient temperature change.

The clinical evidence to support the effectiveness of ThermoSmart™ is clear:

• ThermoSmart™ provides a more comfortable CPAP experience¹
• ThermoSmart™ improves sleep quality and total sleep time²
• ThermoSmart™ lowers nasal airway resistance for 10% lower pressure³
• ThermoSmart™ virtually eliminates condensation even in a cool sleeping environment² whilst delivering high levels of absolute humidity⁴
• ThermoSmart™ is as effective as a nasal steroid in improving compliance and nasal symptoms⁵

Those who will benefit the most from ThermoSmart™ include:

• Patients over 60.
• Patients on medication.
• Patients who prefer a cold room.
• Patients with pre-existing nasal conditions.

Along with the various nasal CPAP masks, Fisher & Paykel’s line of full face masks include the Flexifit 431, Flexifit 432 and the Forma.  Although each mask is slightly different, they all bring a level of comfort equal to any other full face mask available.  Below is a brief description each of these full face masks from Fisher & Paykel.

Fisher & Paykel Flexifit 431 CPAP Mask

The Flexifit 431 was the first full face CPAP mask from Fisher & Paykel.  Unlike all other full face masks, Fisher & Paykel decided to utilize an under the chin design to increase stability and enhance comfort.  This under chin fit provides a constant point of reference when putting the mask on and maintains the seal even with jaw movement during the night.  Another obvious difference with other full face masks is the unique “milk bottle” mask shape which tends to provide a more accurate representation of a person’s nose and mouth structure.

An important part of any CPAP mask is the cushion.  The Flexifit 431 utilizes the pressurized air from the CPAP to help automatically adjust to a wide range of facial features.  The cushion is also frosted to optimize the seal and give it a smooth feel.  To help with proper sizing, the CPAP mask frame assembly can actually accommodate a small, medium or large cushion.  Finally, the CPAP headgear is crown shaped so there is no strap to irritate the back of the head while sleeping.  The headgear attaches to an innovative “glider” strap which reduces leaks by helping to maintain equal force when the head rotates from side to side.

Overall, the mask is a well made and comfortable with most users giving it positive feedback.  The ability to replace the cushion and headgear give the mask a good cost per use ratio.

Fisher & Paykel Flexifit 432 CPAP Mask

Fisher & Paykel’s second generation mask, Flexifit 432, improves upon the under chin design of the 431, making it an excellent option for people looking for something slightly different but with similar design features.

The primary difference between the Flexifit 431 and 432 is the cushion.  The Flexifit 431’s cushion is a soft, frosted silicone which seals well due to the flexiifit technology that automatically adjusts to the facial contours.  The Flexifit 432 offers an improved seal and more comfortable fit with the inclusion of a soft foam cushion that interacts with the silicone seal.  The foam cushion is a separate piece which can be removed for cleaning or replacing when necessary.  With the addition of the foam cushion, the Flexifit 432 increases the stability and comfort over the 431.  Moreover, the Flexifit 432 maintains the under chin design which further increases the comfort factor.

The Flexifit 432 preserves all the excellent features of the 431 including the frosted silicone seal to optimize fit and the “glider” and easy release strap for ease of use.

Similar to the Flexifit 431, the 432 gets high marks from users.  The addition of the foam cushion produces a more comfortable feel along with increased stability.  By incorporating the under chin design with the foam cushion, the Flexifit 432 improves upon the already popular design of Fisher & Paykel’s full face mask offerings.  Again, the cost per use ratio is high due to the replaceable cushion and headgear.

Forma Fisher & Paykel CPAP Mask

The Forma’s shape and lightweight design provides full face CPAP mask users with the basics for a positive experience.

As mentioned, the cushion is one of the most important features of a CPAP mask.  The Forma’s cushion sets the mask apart from competitors.  The cushion is composed of an outer silicone shell with a unique foam insert.  This uniquely designed FlexiFoam cushion is a soft, light and supportive foam which provides an excellent seal and advances the active contouring that conforms naturally to a CPAP users face.  The silicon seal which surrounds the foam is also frosted which again enhances the feel and optimizes the mask seal.  Fisher & Paykel Forma employs their patented Flexifoam Technology which automatically adjusts to a wide range of nasal and facial contours.

The Final Word on Fisher & Pakel CPAP Masks

Although all of Fisher & Paykel’s CPAP masks are highly effective in meeting the needs of CPAP users, they do have obvious differences which may or may not be beneficial to users’ individual needs and tastes.  Choosing a CPAP mask is a personal decision and should be based on comfort, fit, usability and design.  It is important to remember that the choice rests with the user not the equipment provider.  The Flexifit 431, Flexifit 432 and Forma are just a few choices in the full face CPAP mask world but each offers a unique option which is attractive to nearly any CPAP user.  At The CPAP Shop, we strive to bring you products we trust.  If you have additional questions, we are happy to discuss them with you.

In particular, Philips Respironics has built in even more CPAP machine intelligence. This new Auto CPAP machine addresses advanced sleep assessment parameters, including Apnea Hypopnea Index, Leak, Flow Limitations, snores and leaks to provide optimum therapy for obstructive sleep apnea (OSA).  Moreover, it can also detect symptoms beyond classic OSA such as clear airway apneas and periodic breathing that may indicate the need for specialized therapy.

With this new system, events can now be verified by looking at detailed patient flow waveform data captured by the device. The PR System One REMstar Auto CPAP includes all of the great features you come to expect from a sleep therapy system including a wide pressure range (4-20cm), patient adjustable ramp, automatic altitude adjustment, data card, the latest “flex” comfort technologies, and a universal power supply. In addition, the REMstar Auto CPAP is an auto-adjusting CPAP system so it will adjust your therapy levels throughout the night to ensure you are receiving optimum pressure for the most comfortable and successful sleep experience.

Detailing some of the Philips Respironics PR System One Remstar Auto CPAP include:

System One Resistance Control: System One Resistance Control achieves complete system comfort by enabling the device and mask to work optimally together. Through simple settings, the technology instructs the device to compensate for variable resistance characteristics related to different masks. The result is synchronous pressure delivery and the assurance you can enjoy the full benefits of Respironics Flex comfort technologies no matter which mask is used.

Advanced Event Detection & Response: The System One Sleep Therapy System tracks many common OSA related systems like Apnea Hypopnea Index, Flow Limitation, Respiratory Effort Related Arousal, Snores, and Leaks; but it can also detect symptoms beyond classic OSA. With intelligent technology the System One REMstar Auto can identify conditions such as clear airway apneas and periodic breathing that may indicate the need for specialized therapy.

Mask Fit and Seal Monitoring:  The Mask Fit feature gives patients the ability to check the seal of their masks in real time and lets them and their clinicians know what leaks may result when pressures increase from baseline throughout the night.

System One Humidity Control with Dry Box Technology: The optional PR System One Heated Humidifier analyzes ambient temperature, changing environmental conditions, relative humidity, and therapy flow to deliver optimum humidity – and ultimate comfort – throughout the night while also dramatically reducing rainout. Dry Box technology isolates the humidfier’s water source from the inner workings of the device to protect against accidental spillage and water damage.

Proponents of the auto-adjusting CPAP machine suggest the automatic pressure adjustments lead to more effective Obstructive Sleep Apnea therapy.  The auto-adjusting process ensures the minimum amount of pressure is provided leading to less apnea and hypopnea events.

The APAP aids in reducing incidents of aerophagia. Aerophagia is the act of swallowing air which leads to gas and bloating.

The auto-adjusting CPAP machine is a bit more costly than the standard CPAP machine. However, this cost is considered to be offset by the lack of need for subsequent sleep studies. 

There are a couple APAP machines which have not only garnered high praise among users but have proven to be highly effective.  The ResMed S9 AutoSet CPAP machine was introduced last year and has become the #1 machine.  Not far behind is the Philips Respironics PR System One Resmstar Auto CPAP.  Although different in a few ways, it is fairly equal in its technology.  Finally, the Devilibiss IntelliPAP Auto CPAP machine is a great value with high quality standards but without all the bells and whistles.  Whateve auto CPAP machine you choose, there may be a slight adjustment from a standard CPAP machine.  Nevertheless, you will end up appreciating the benefits of an auto adjusting CPAP machine.

What followed was the Swift II.  The upgraded Swift II addressed the noise issue with a 50% reduction.  With little serious competition, the Swift II again claimed the nasal pillow throne.  Today, ResMed has three different masks in their Swifts line; the Swift II, Swift LT and the Swift FX.  With all these Swifts available, the question becomes which Swift CPAP mask should a CPAP user choose and why?  Since this is a personal choice and no true correct answer, we will profile each mask in hopes of bringing some clarity to the situation.

ResMed Swift II

The ResMed Swift II has had quite a run as many people switched from traditional nasal CPAP mask to the Swift II when it was released.  The Swift II offered minimal facial contact and an unobstructed line of vision when compared to the typical nasal mask.  The nasal pillow, which rises slightly into the nostril, is held stable by a small cylinder or “barrel” which rests just below the nose.  The most significant difference with the Swift II from the other Swift masks is the barrel design which allows the CPAP tube to be positioned to the right or left.  This positioning is helpful especially if you tend to sleep on one side as the tube can be positioned to the opposite side.  The tube can also be run up or down depending on preference.  The Swift II’s minimal design and lightweight feel (2.5 ounces) offers the CPAP user a comfortable and simple CPAP therapy experience.  One drawback derived from user feedback is the buckle at the back of the head.  Although not a big issue for most, some users consider the buckle uncomfortable when lying on their backs.  Nevertheless, the mask consistently gets high marks from users.

ResMed Swift LT

ResMed continued to improve upon the Swift platform by creating the next generation Swift LT.  The ResMed Swift LT has all of the attributes CPAP users like about the Swift II including some strategic design changes.  For example, ResMed continued with the minimal, lightweight design (2.3 ounces) while improving upon its quietness.  One major change from the Swift II is a departure from the barrel design.