Reading Time: 9 Minutes
What’s inside?:
- How I got flack for my CPAP placement
- Am I a Muppet?
- What do the experts have to say?
- So, there you are... I think...
Have you ever been having a private conversation when someone overhears you and takes offence on behalf of the human race?
Well, I’ve had that experience a few times… usually because I have a habit of speaking without a filter.
What I didn’t expect was the flack I got on a Facebook group (not our own Cracking Sleep FB Group) when discussing where best to place a CPAP machine.
Now, I don’t claim to be an expert on anything. I’m clearly not even very good at the standard human need to breath… and most people have cracked that one.
What I am good at is giving people room to say what they think… and the results can range from 10 out of 10 delightful to negatively dismal. This one went negative in a way Ron Burgundy would be proud of.
The question was simple enough… “what’s the best position for a CPAP machine and did anyone have any advice on specialised furniture?”.
There were already a few comments saying you should keep the CPAP machine at or below head-level, which I generally agree with. As I said, I’m pretty good at giving people room to say what they think.
Then I made a simple comment to say I kept mine on top of my headboard. I didn’t add a photo to the conversation, but the main pic at the top of this post is my CPAP machine on top of my headboard. Please let me know if you find it offensive.
What do you think caused such inbound grief?
Well… apparently – in some circles – nobody should keep the machine so far above head-height.
Why?
Well, I wondered that too.
Apparently, my comment was dangerous as anyone experiencing rainout would risk drowning.
Really?
Now, you’ll see from the photo, my CPAP machine doesn’t currently have a humidifier attached. Going into why that is just now would risk heading off on an ADHD tangent… so I will leave that for another day.
The point is… until recently, I used a humidifier every night – even when travelling. I’m pretty experienced with humidifiers, have experienced rainout and even wrote an article on the subject. And while anything is possible… I reckon the CPAP wearer would need to be severely knocked-out to result in drowning before the gurgling noise and little splashes of water woke them up.
There’s a clue in the name… it’s Rainout… not Tsunamiout.
Am I a Muppet?
However, to have a sense check, and ensure I wasn’t being a complete Muppet, I thought I’d run this whole question of CPAP positioning past some sleep experts. That is… people who get paid to run sleep studies, supply kit and provide ongoing advice.
My goal was 10. I thought it was a decent round number. Enough to see if there was a consensus or general disagreement… and not too big that I would need to delay this blog post waiting for answers.
In the end, I’ve run with 9 responses. The final one just didn’t want to play ball.
So, what did they say when asked a non-leading question, which went like this:
“What advice do you give sleep apnea patients when they ask about positioning of their CPAP equipment and why do you give this advice?”
Some were kind enough to provide more than one answer in a ‘if you can’t do this then do that’ kinda way.
In general, their answers covered 5 main reasons:
- Ensuring Optimal Airflow: The machine should be positioned to deliver air effectively without obstruction or long hose lengths, which can lead to air resistance and pressure loss.
- Reducing Noise and Vibration: Correct placement can minimize noise and vibrations, contributing to a quiet sleep environment.
- Ease of Access: The machine should be easily accessible for adjustments and troubleshooting without disturbing the user’s sleep.
- Preventing Hose Tangles: Proper positioning can prevent the hose from tangling or pulling, which can cause mask leakage or discomfort.
- Maintaining Hygiene: Correct placement can help keep the machine clean and reduce the risk of contamination from dust or other particles.
What do the experts have to say?..
- Bedside Table
Placing the CPAP machine on a bedside table is the most commonly suggested position. It’s generally available to most bedroom setups and keeps the machine within reach. There is a downside though when your bedside table isn’t big enough for your CPAP kit and those books and bedside lamp you kinda like having around.
Some of the reasons given for using the bedside table were:
- Height Relative to the Bed: If using a humidifier, the machine should ideally be at the same height or slightly lower than the level of the patient’s head when sleeping. This positioning allows the hose to run upwards towards the patient’s head, reducing the risk of water condensation collecting in the mask.
Yes, I know this appears to go against my own setup, but we’re not finished yet.
- Proximity to the Patient’s Head: The machine should be close enough to the bed to minimise the length of the hose, ideally within arm’s reach. This proximity makes it easier to adjust settings or turn the machine on and off without getting out of bed and reduces the risk of tangling. A standard single hose, as supplied by manufacturers, is suggested.
- Stability and Surface: Bedside tables tend to be a level and stable surface, which should prevent the machine from vibrating or tipping-over. Using a non-slip mat was also mentioned as an option to keep the machine in-place.
- Under the Bed
This one surprised me. I would never have thought of placing my CPAP machine under the bed. My internal mumblings tell me dust and general crap get under there and forgotten about until the next room clean. While filters are cheap, I wouldn’t want to be changing them every day.
However, I’m okay (not happy, but okay) admitting when I’m wrong.
Here’s what the experts had to say on this one:
- Convenience: Where space is tight, under the bed can be a space-saving option and can help reduce bedside noise – especially if the machine is older and nosier than modern machines.
- Think About Airflow: Ensure there is adequate space around the machine for proper ventilation and try to raise it from sitting directly on flooring… especially carpet. Blocking the machine’s air intake or exhaust vents will affect performance and can increase noise.
- Hose Length and Routing: Placing under a bed can sometimes mean using a longer hose. The experts say users should keep hose extensions to a minimum as air pressure can drop over distance and risk of tangling increases although this part can be at least partially controlled with hose hooks or routing around your bedframe.
- Accessibility: Under the bed is generally less convenient for making adjustments or checking the machine. Afterall, by the time you get out of bed and crawl onto the floor, you are probably wide awake.
- Wall-Mounted Shelf
A wall-mounted shelf was next-up, but with the provision for the machine to be secure if your hose tugs at it during sleep:
- Customisable Height: Installing the shelf at a height aligning with or slightly lower than the bed, optimising the hose angle.
This pretty much copies the desired positioning on a bedside table… just connected to the wall instead.
- Stability: The advice given included the shelf being securely mounted and able support the weight of the CPAP machine using brackets rated for a higher weight as a safety net.
- Accessibility: Positioning the shelf where the machine is within easy reach for adjustments and monitoring. This setup can also keep the machine out of the way and reduce the risk of accidental damage.
- Headboard Attachment
Not top of the list but my own preference did meet enough approval to appear on the recommendations. I have to confess not adhering to the additional recommendations though:
- Custom Mounts and Holders: The expert advice is to use specially designed mounts or holders that can be securely attached to the headboard.
- Proximity and Hose Management: The higher angle can cause different issues with hose tangling than experienced when the machine is at head level. Using the bed frame or hose hooks to manage the hose can help reduce the risk of tangling.
- Vibration and Noise Control: Although I’ve never experienced any noise or vibration issues, the experts still thought it important enough to mention. They say attachments should include vibration-dampening features to minimise noise transmitted through the headboard. Again, not something I experience but I’m just a test case of one… which I accept really doesn’t stand for much.
- CPAP Stand or Cart
Number 5… and less suggested than using your headboard (just saying) was the use of a specially designed CPAP Stand or Cart.
I remember a while ago seeing an online video where someone built a bedside cabinet from scratch and had a hidden compartment at the back for a CPAP machine. Although I still think that is a great idea, it wasn’t enough for me to remember where I saw it. Otherwise, I would have shared the link here. If I find it in the future, I will post it in the Cracking Sleep Facebook Group.
Back to the expert views on this one, which are:
- Mobility and Flexibility: Bespoke stands often have wheels, making it easy to move the machine as needed. Often patients only want the machine close to the bed when they are using it. Preferring to store it elsewhere during the day.
Some CPAP stands also come with height adjustment, so you can find that perfect sweet spot.
- Organisation: Many stands have built-in compartments for storing masks, hoses, and other accessories, keeping everything organised and within reach.
- Stability: This one was mentioned as a risk rather than a benefit. As many CPAP stands are moveable, this often has a downside of being less stable. Ensuring the stand is stable and positioned on a flat surface to prevent tipping, before using each night, is a repeated suggestion.
So, there you are... I think...
My own habit of planting my machine on my headboard comes in at number 4 out of the top 5.
By not following the recommendations of securing it to the headboard means I am at a slightly higher risk of pulling it over in the night. My experience, so far, though is by feeding the power cable down the back of the headboard the machine stays in place even when I occasionally pull on the hose while rolling around in glorious slumber.
Personally, I’m willing to take that risk but I do not – in any way – suggest you do the same. This works for me… you do what works for you.
The only thing I do suggest you do is keep safe.
And, of course, Keep Breathing!
Cheers,
Alan
P.S. I have taken to creating various bits on sleep and sleep apnea. If you would enjoy hearing more and find out where else you can find stuff like this, you can get my weekly Triple Whammy email, which has 3 short topics each week. Some written or recorded by me and others I’ve found out there in the strange world we live in.
If this is you, sign up here and you will get the very next one.