Many urbanites are troubled by sleep apnea. It is estimated that some 200,000 Hong Kong people suffer from sleep apnea, comprising about 4% of men, 2% of women and 2% of children. While men face a higher risk than women, particularly those middle-aged or above, many women were found suffering from sleep apnea after menopause. Obesity is also a risk factor. Apart from affecting quality of sleep, sleep apnea may also cause other serious illnesses such as hypertension and cardiovascular diseases if no proper medical treatment is applied.
There are two types of sleep apnea: obstructive and central sleep apnea. Most patients suffer the obstructive type, in which the upper respiratory tract is blocked when the patient is asleep, preventing air from entering the lungs and making breathing pause. The latter type is due to intermittent respiratory arrest caused by a wrong signal from the central nervous system, and is most commonly found in patients with history of stroke, over indulging in alcohol or taking certain psychiatric medications.
The Consumer Council compared 53 models of positive airway pressure (PAP) machines offered by 9 companies in the market which help alleviate symptoms of sleep apnea with retail price varies in more than 10 times. Since not all patients could get used to wearing masks or nasal masks of the PAP machine in sleeping, those intended to purchase a PAP machine after diagnosis are recommended to take user trial, or opt for renting before buying one.
Some PAP machines come with an automatic pressure regulating function which adjusts the output pressure according to the patients' respiratory rhythm to bring more comfort to users. Prices of these products are thus higher. Another type, the fixed pressure PAP machine offered at a lower price, but it requires patients to take continuous PAP titration tests first to identify the most suitable pressure rate.
The 53 models of PAP machines surveyed are priced between $3,800 and $45,000, representing a difference of more than 10 times. Users should also beware that they may have to use a humidifier at the same time. While some models have a built-in humidifier, most do not, so consumers have to purchase separately at prices between $1,000 and $6,000.
Of patients opted to rent the machine for trial first, they have to be aware that rental fee for some models are not cheap, ranging from $400 to $2,000 per month. There is a case in which the rental fee of that model for 8 months already equals the product's retail price. In other words, long-term user can consider the rent-first-buy-later mode for a try-out before making a purchase decision. The shortest lease term offered by the 9 companies ranges from 2 weeks to 1 month.
In addition to price and rent, patients should also pay attention to the details of warranty and maintenance services of PAP machines including the maintenance coverage and price, and whether rental service is available during maintenance and repair period.
Apart from the use of a breathing machine, patients can also wear a specially made plastic oral appliance. However, it may cause discomfort and increase the chance of tooth displacement and painful temporomandibular joint. It therefore may not be suitable for all patients. Operation is not a mainstream treatment measure. Although there are also some specially made pillows and nasal strips available and all claimed to be able to cure sleep apnea, the effects are generally unsatisfactory.
Consumers affected by sleep apnea should note the followings when choosing a PAP machine:
- Patients should choose a model with a suitable machine size and tube length that fits the available space nearby their bed;
- Make use of the trial service offered by some suppliers to assess whether the model suits you in terms of ease-of-use, mask comfort level and the noise generated by the machine, etc.;
- Enquire the warranty coverage as well as the maintenance cost, and whether the supplier will give you another machine for use during the repair within the warranty period;
- As the mask and tubes are consumables, remember to ask for the expiry date and charges for maintenance and replacement of parts;
- Clean or replace the filter regularly according to the user guide.