Dr. Worawat Suwanarak - CEO, NK Sleepcare Co., Ltd

Hello, I'm Dr. Worawat Suwanarak, a specialized plastic surgeon at Bangkok Hospital and Vichaiyut. I'm the CEO and CEO of NK Sleep Care Co., Ltd. Welcome everyone to visit our website.

If you have any questions Please leave a message below. Thank you.

115 Comments

  1. dear teacher
    already using the machine But the mask at the nose rubber is torn, the air leaks, the agency can reimburse 4000 baht, but must have a doctor's prescription to buy Can you issue it?

    1. I can't get it out. Must be issued by doctors in government hospitals such as Chulalongkorn University or Ramathibodi Hospital.

  2. When treating with CPAP machines continuously, is there any chance that it will disappear or get better like a normal person?

    1. If you just keep using the CPAP machine without changing other lifestyle behaviors The symptoms are still the same. compared to wearing eyeglasses If you don't wear it, you won't be able to see clearly as usual. CPAP is the same. If you don't use it every night, it will return to snoring as before. We will have to modify other lifestyles as well, such as exercising regularly. Lose weight to keep your body mass index within the normal range. Refrain from drinking alcohol or smoking before bedtime. Refrain from using sleeping pills these etc. Therefore, there will be a chance to recover or get better like a normal person.

  3. If we make other changes and lose weight
    Exercise, adjust bedtime, stop smoking. Do we have to use CPAP all the time? Is there a % that will go away? because we are young but already have this disease I'm worried that it will affect my studies and work. Thank you.

    1. If such behavior is adjusted, then there is a chance that it can be cured. I have patients who exercise and lose weight until they can stop using CPAP altogether.

  4. Hi teacher, I'm 15 years old. I just started using cpap for a week. By the doctor who ordered it to use. The first day was no problem. But on the 5-6th day, a little bit of a kiss. So I sprayed my nose normally. I feel better. cpap works fine. much fresher but will feel difficult to speak Opening your mouth is not the same as before. It's like having wind in your neck all the time. feel that the neck is round and wide Is this normal for people who have just used it? thank you teacher

    1. Normally, people who use CPAP machines will not have side effects as mentioned. Some people just started using it for the first time. It may just be a dry throat, nasal congestion, or bloating when you wake up. Which these symptoms will disappear after 2-3 hours, but the symptoms you have mentioned must consult a doctor who treats any cause. Or the symptoms may disappear after using the machine for a while.

  5. My mom has been using a CPAP machine for about 8 years. Clean the filters and tubes every month. change the water every day But this month, I just noticed that there is black mold on the rubber joints connected to the machine and the filter, using a cotton swab moistened with Dettol solution, there are still stains. In this case, should 1) change the machine 2) buy the Ozone machine. Clean or 3) send to wash at the company. Thank you.

    1. As I understand it, black mold is occurring in the air duct section. After washing, there are still stubborn stains. I recommend as follows.
      – Send the device to the company We will bake ozone to kill germs inside the machine and air ducts. (If it is a device purchased with us, there is no charge)
      - Replace the new air duct. Click to view product details and prices.
      – (Option) If you want, you can buy an ozone dryer to clean later by yourself. Or if you don't buy it, you can always send the machine to be cleaned at the company. Recommended at least once a year (if it is a device purchased with us, there is no charge)

      If you want to ask for details before sending the machine in Please contact the number 02-462-6441-2, 082-2233-710 or Line: @nksleepcare Thank you.

  6. Thank you very much for your doctor's advice. I am interested in buying an ozone dryer. air duct and send the machine to be washed at the company as well And would like to ask more questions as follows: 1) What is the difference between washing at the company and buying the machine to wash by yourself? 2) The time taken by the company to wash the machine and 3) Should I take my mother to be tested for lung infection? yes

    1. I would like to ask the following questions:
      1) Washing the machine at the company and buying the machine to be washed by myself, everything is the same.
      2) It takes 30 minutes to wash the machine.
      3) You should take your mother to check for lung infections as well.

  7. I have already ordered an ozone dryer and an air duct. Received the next day from the day of ordering. I'm very impressed with the service. I clean the CPAP machine with an ozone dryer every day, 2 times a day (now I can wash it 6 times), but I haven't let my mother use it because I have questions to ask the doctor as follows.
    1) In the case that the machine has not been washed (Ozone oven) for a long time, the more times to wash before the next use, the better, right?
    2) Can the ozone sterilizer reach the filter? Or must be brought out to dry separately after washing off the dust.
    3) In the mask section (It's gel + silicone) If you wash and dry it. put in a sealed box with an ozone generator inside Take the machine as normal Will it help to get rid of the infection more effectively?
    4) Which parts of the CPAP machine will be damaged by ozone?
    Thank you very much

    1. Hello, I would like to ask the following questions.
      1) In the case that the machine has not been washed (Ozone oven) for a long time, the more times to wash before the next use, the better, right?
      – Not necessary In the case that the machine has been used for a long time and has never been sterilized before, it is enough to steam twice before using the next time. If you bake too much, there will be a lot of residual smell. But if it's already done, it's okay. After baking, you should turn on the appliance and leave it for about 1 hour to drain the smell.

      2) Can the ozone sterilizer reach the filter? Or must be brought out to dry separately after washing off the dust.
      – Yes, take out the filter and wash off the dust first. then put it back into the machine as before Then bake ozone.

      3) In the mask section (It's gel + silicone) If you wash and dry it. put in a sealed box with an ozone generator inside Take the machine as normal Will it help to get rid of the infection more effectively?
      – That's right, the company bakes masks in the same way.

      4) Which parts of the CPAP machine will be damaged by ozone?
      - do not have

      Additional advice: Ozone is an odorous gas and decomposes relatively quickly. But often the smell remains in the machine, especially the sponge lining inside the machine After baking, leave the appliance turned on for about 1 hour to release the smell.

      1. Ask the professor.
        filter
        _When should I change it?
        _How often should I change it?
        _Can you clean it?
        _ Grandma's stuff has to be changed every week (90 baht per sheet) 2-3 days, it's starting to turn gray.
        _of the butler's room next to Grandma's room Used for about 1 month, starting to turn grey.

        1. Please answer Khun Sompong's questions as follows:

          filter
          _When should I change it?
          _How often should I change it?
          _Can you clean it?
          There are 2 types of CPAP machine filters. If it is a fine type (can't be washed), it should be replaced every 1-2 months, or maybe sooner if it is found to be dark gray to black. If it is a rough type (washable), it should be washed every 2 weeks and change a new sheet every 6 months.

          _ Grandma's stuff has to be changed every week (90 baht per sheet) 2-3 days, it's starting to turn gray.
          _of the butler's room next to Grandma's room Used for about 1 month, starting to turn grey.
          Normally, it will start to gray about 1 month and will be dark gray to black in about 2 months, which should be replaced with a new sheet. (or wash with water if it's a washable type filter) 2-3 days it starts to turn gray and then indicates that there is a lot of dust in the room. or lay on the floor or placed in a musty place poorly ventilated It is recommended that the CPAP machine be placed on a table, not on the floor. And recommend cleaning the bedroom to reduce the amount of dust less.

  8. Hello doctor, I bought a CPAP machine. from the doctor through Chulalongkorn Hospital..I have a problem with reimbursement for this machine..so I would like to ask the doctor's opinion as follows..CPAC machine.. Classified as Vekhaphan (a device used to treat the symptoms of the disease) or classified as a prosthetic device used to treat disease..

    1. CPAP machines are classified as therapeutic devices. by both therapeutic equipment and prosthetic organs They are all in the same document called “Notification of the Ministry of Finance on Types and Rates of Prosthetic Organs and Devices for Treatment”. The latest is year 2013 which I have attached. The document will have many pages. I have cut only the page that has a list of CPAP machines and masks, which Mr. Prutsamart can use this document for reference in reimbursement. If you still have problems, please call 02-462-6441, 02-462-6442, 082-2233-710 or LINE: @nksleepcare Contact Khun Thanradee (Khun Kob)

      Civil service_cpap&mask_2013.pdf

  9. Thank you very much.. at work, I have never let anyone withdraw this device Employees can reimburse medical supplies for treatment of diseases..except prosthetic organs and miscellaneous equipment..with this message, the company refuses to reimburse them..because Chula Hospital receipts are divided into 2 topics, namely 1. organ costs Prosthetics and therapeutic equipment 2. The cost of medical supplies that are not used as medicines…I therefore ask for clarification in my suspicion as knowledge and clarification to the company…that the CPAP machine should be medical supplies or artificial organs

    1. dear thursday This issue probably needs to be discussed with the agency to understand. because according to the announcement of the Ministry of Finance Both prosthetic organs and therapeutic devices are included in the same set of ministry announcements. Finally, you may try to go back to consult Hospital again what to do or is there any additional document to certify or not

  10. hello doctor
    Now I have a lot of snoring and when I wake up, I feel dull and lethargic throughout the day. My father is currently using a CPAP machine and suggested that I try it out.
    1. To use a CPAP machine, do I need to do a sleep test or not?
    2. If using the APAP instead of the automatic system, can it be used right away or is it necessary to do a sleep test first?
    3. I already have allergies and crooked nasal passages, will there be any side effects from using CPAP/APAP?
    4. Should I consider CPAP/APAP as a last resort? By trying to exercise more and adjusting the daily living schedule first or the doctor saw that the machine could be used along with adjusting the way of life at the same time?
    Does it bother you doctor? thank you very much

    1. hello glorious I would like to ask the following questions:

      1. To use a CPAP machine, do I need to do a sleep test or not?

      Actually I recommend you to do it. because they will know what level our true symptoms are Are there any other side effects? And will know the pressure for treatment in case of having to treat with a CPAP machine, etc. This method must first see a doctor. Your doctor will then order a sleep test, and then you'll need to see your doctor again to hear the results. But if you don't want to see the doctor many times, there are other options as follows: you can do a hoem sleep test at home and then take the results to see a doctor at once. It will save a lot of time.

      2. If using the APAP instead of the automatic system, can it be used right away or is it necessary to do a sleep test first?

      If it's really inconvenient to do a sleep test, you can buy an APAP (Auto CPAP) machine to use. By contacting us to request an Auto CPAP machine to try for about 1 week before then bring it back to us to download the results. which the machine will calculate the sleep apnea index (AHI) while using the machine If it is found to be less than 5 times an hour, the treatment is considered effective. or we may notice ourselves that snoring And the symptoms of waking up are not bright and have symptoms of lethargy throughout the day. whether those symptoms have disappeared or not If the symptoms improve, you can continue to use the CPAP machine. However, we will always have a team to give advice. which type of machine should be used and how should I adjust the settings?

      3. I already have allergies and crooked nasal passages, will there be any side effects from using CPAP/APAP?

      You should see a doctor to treat allergies and crooked nasal passages to get better first. Because the nasal cavity is swollen, the air from the device cannot pass through or is inconvenient. cause more irritation And most importantly, especially the APAP machine will cause possible distortion. because when the air flows through it is not convenient The machine will mistakenly believe that there is a blockage in the throat. The higher the pressure, the higher the pressure will be to open the opening. (This is the working principle of APAP) will make us even more uncomfortable.

      4. Should I consider CPAP/APAP as a last resort? By trying to exercise more and adjusting the daily living schedule first or the doctor saw that the machine could be used along with adjusting the way of life at the same time?
      Disturb your doctor. thank you very much

      This depends on how much the symptoms are. Which, if not doing a sleep test first, must be evaluated from our physical and physiological conditions, such as body mass index (weight vs. height), throat, snoring, etc. If the symptoms are not very severe, we can use exercise methods and adjust the schedule. daily life before But if the symptoms are very severe (excessive snoring, obesity, high AHI, excessive daytime sleepiness) or have congenital diseases such as high blood pressure, heart disease), it is recommended to use the APAP machine in conjunction with exercising and changing daily behavior.

  11. Why use a cpap machine. and dry throat Is there a way to fix it?

    1. no problem But it's better to use. because it makes the nasal cavity and throat not dry

  12. Disturb the doctor to help advise. Hospital or clinic that has a sleep test for me. Thank you very much

  13. Ask. Father, have you ever gone to check sleep? As a result, sleep apnea + symptoms of Parkinson's disease are associated with sleepwalking.

    Cpap machines help with deep sleep. and can reduce negligence?

    thank you

    1. Dear Ms. Jiranai
      I'm asking for the opinion of a neurologist. Wait, if I get advice on how to reply via email again.

  14. Hello, my husband usually wears a watch that can record his sleep every night. from the observation that “Nights without a CPAP machine have longer, deeper sleeps. Nights using the CPAP machine “sleep effect example
    - Nights without CPAP machines, 1 hour deep sleep.
    – Nights when using the CPAP machine, sleep deeply for 30 minutes.

    Please ask. Is this normal sleep effect and is using a CPAP machine should help me get deeper sleep?

    1. Dear Yuranan
      Normally, using a CPAP machine should help you get more deep sleep. But if it's not like that, you have to look at what causes it, such as the wind pressure being too strong. or the leakage of the mask disturb sleep or not
      I will have the staff contact me to download the results of using the machine to analyze it in detail. Thank you.

    2. ค่า total hypopneas คือ ค่า อะไรครับ

      1. ขออภัยที่ตอบกลับช้าครับ Hypopnea คือภาวะหายใจแผ่ว เกิดจากการที่ช่องทางเดินหายส่วนต้นเกิดการอุดกั้นแต่ไม่ถึงกับปิดสนิท ยังมีอากาศเข้าได้อยู่ประมาณ 30-70% ครับ ค่า Total Hypopnea ก็คือจำนวนครั้งที่เกิดภาวะหายใจแผ่วที่เกิดขึ้นทั้งหมดใน 1 คืน ซึ่งถ้าเรามาหารด้วยจำนวนชั่วโมงการนอนก็จะได้ค่าดัชนีภาวะหายใจแผ่ว (hypopnea index) มีหน่วยเป็นจำนวนครั้งต่อชั่วโมงครับ

  15. In case of using Cpap and humidifier model Dreamstation Auto from phillip, there is a lot of steam in the mask and I have to wake up before the time, how to fix it?

    1. To fix it, follow the steps below.

      1) In the case of using a heated tube, check the heat level of the hot tube. This should be 1-2 levels higher than the heat level of the humidifier. For example, if you set the heat level of the humidifier to 3, the heat level of the hot pipe should be set to 4-5, etc. If there is still steam. a lot of water or use it as a normal pipe, proceed to item 2

      2) Try lowering the heat level of your humidifier. There will be levels from 1-5, try to decrease by 1 level and try to see if the steam decreases or not, for example, if currently set to 3, reduce to 2.

      *See here for how to set the heat level for humidifiers and hot pipes. https://www.nksleepcare.com/help/dreamstation-adjust-heat-level/

      3) If doing both methods above, there is still a lot of steam problem. This may be caused by setting the air pressure too low. Causing the breath not to be released from the mask in time, causing steam This is a very rare case. Please contact the salesperson who takes care of you or the after-sales service department at number 091-003-0209 for the staff to help check and adjust the air pressure settings.

  16. Hello doctor, I need some advice, which model should I use? I did a sleep test and the results came out. I stopped breathing according to the test results. And after the sleep test results came out, the doctor told me to use a CPAP machine. I informed the doctor that I had an appointment with a pacemaker. After I had my pacemaker inserted. And the hospital gave the machine to try. It will be a CPAP mask to cover the nose and mouth. Ever since I used the CPAP machine on April 9, 2021, I had a lot of stomach ache and distension, after drinking a little water or eating food, my stomach continued to harden. Even before the sleep test, I had no symptoms like this. Until now, April 19, '64, I felt very tormented.

    1. In most cases, if using a full face mask, there will always be flatulence due to the fact that air can pass through the mouth into the stomach. Another possible cause is that the set air pressure is too high. I recommend consulting your doctor to see if the type of mask can be changed or not. Or can you reduce the pressure level to be lower during the period when you start to adjust to using the machine or not?

  17. give me some advice
    I've been using a Phillips CPAP machine for about 3 years. Just printed out the graph and found that most of the AHI is below 5, but there are days when the value is between 5-10. How do I adjust the machine or not?

    1. If most of the time the AHI is below 5, it works fine. Some days, it may be more than 5 due to the physical condition that day, such as exhaustion from exercise or work. taking drowsy drugs, etc., but if the number of days exceeds 5 consecutive days May need to adjust the pressure at the beginning (Ramp pressure) and / or the maximum pressure (Max. pressure) to be higher. I'll have the staff call me to give advice again.

  18. I bought an Auto CPAP machine from NK and have been using it for about 3 weeks now.
    and know that the AHI value It should normally be between 0 and 5 times in the AHI subset. It will be subdivided into 1.Total Clear Aiway Apneas 2.Total Obstructive Apneas I would like to know what criteria are good and normal. What should be the ratio between these 2 numbers, doctor? is the overall AHI value. When I use a CPAP machine It's between 1-5, but notice that some return subnumbers (1) and (2) have some of these. The other one is less than alternately. /thank you very much

    1. Hello, first of all, I would like to explain these 2 sub-values first. The difference will be at the cause of the symptoms as follows.

      1) Total Clear Airway Apneas (CA) is the number of episodes of sleep apnea. “Because of the midbrain,” this condition is sometimes referred to as Central Apneas. This condition can happen to anyone. It's not something to worry about.

      2) Total Obstructive Apneas (OA) is the number of episodes of sleep apnea. “Due to the obstruction of the upper respiratory tract.”

      People with sleep apnea can have 3 forms:

      1) There is only OA.
      2) There is only CA.
      3) There is a mixture of OA and CA.

      CPAP machines can only treat OA, where two values may be greater than one. Depending on the physical condition each night, but if these 2 sub-values are combined, the AHI can be calculated at no more than 5 times per hour. Medically, the treatment is considered to be effective (AHI value less than 5 does not affect our physical health).

      In short, you don't have to worry about which value is greater, but let the AHI not exceed 5, it's okay.

      1. Thank you doctor for giving more knowledge. It's an explanation that I have heard and no more questions. / Thank you :)

  19. hello doctor Now I have been using the Philips Auto CPAP machine for almost 2 months now. I have some questions that I would like to ask the doctor as follows:
    – I have tried to download the App: Philips Dream Mapper onto the smartphone device. and from the observation that The value indicating sleep hours in the AHI app is sometimes the same as what the system displays on the LCD screen of the CPAP machine. But there were 4-5 times. At the value specified on the CPAP machine, the AHI jumped very high, about 5-10, but when looking at the AHI results in the app on the smartphone, the AHI was between 1-5. is less than what is displayed on the LCD screen. of the machine so I wonder why And which value should I believe more? In fact, it should be the same for both devices. Oh, note that the AHI value jumps about 5-10 shown on the LCD screen. of the CPAP machine That would be when I slept for more than two hours. Then the mask slipped unconsciously. Then when I realized it, I put it on again (I'm currently using a Philips CPAP mask like Dreamware Nasal Mask).

    1. First of all, I have to ask. Are we looking at both values at the same time?

      If not at the same time / different time will not be correct The hours of sleep are different, the AHI will be different. For example, if you sleep for 2 hours and look at the results on the LCD screen, you will get a certain AHI value, which will be higher than normal. because he had just slept and the treatment had just begun And another reason is the number of hours is less. The higher the AHI, the higher the number of hours of sleep.

      And continue to sleep until morning to see the report on the mobile app, the AHI value will be reduced because the treatment pressure level has been properly implemented. and have more hours of sleep

      But if we compare the data in the same period and find that the AHI value on the App and on the device screen are not equal Let's stick to the numbers from the screen of the machine. Because the data from the App will store less details than on the device so as not to waste data when sending to the server, which may cause the value to fluctuate. We focus on looking at trends over a long period (Long term).

      Also, it's best to view it on an SD card by loading it through a program on your computer. To be able to believe the most And we also see other information, such as what kind of abnormal breathing is there. Or is there an unusual amount of air leaking? (Large leak) etc.

      If you want us to help you download the data and teach reading reports You can inform us at Line: @nksleepcare.

      1. Thank you very much Dr. for explaining the factors for reading the results. I understand more now.

  20. Currently using a device purchased from another company for many years..if wanting to buy a new device from the company What should I do? Jor.. knows that the current name has been changed.

  21. I bought a CPAP to use myself. It can be used for about 2 weeks, but the AHI value is still very high, mostly around the late 20s, some days as high as 34.12, and other values I don't understand, such as P90, P95, Flat, TV, etc. I want to learn. I consulted with my doctor what I should do to lower my AHI and I would like to know the details of what the values are. I'm having trouble consulting your doctor.

    1. The P90 and P95 pressure values used to treat sleep apnea, which the machine processes from our pressure and condition from past use of CPAP machines, may simply be translated as the pressure value of 90%. or 95%, which causes sleep apnea to less than 5 per hour. which each brand of machine is not the same Some brands calculate P95, some brands calculate P90. This value, if it is an Auto machine, will be used to see if the treatment trend is getting better or worse, for example, normally P90 is at 8 cmH2O. If it later comes up to 12 cmH2O, it means that our symptoms are getting worse. or in another case, it is used as a pressure value for setting pressure in a constant pressure type machine (manual cpap).

      As for Flat and TV values, I have never seen them in the brands that we sell so we cannot answer them. The TV value may refer to the Tidal Volume value, which is the volume of air that we inhale in 1 cycle, which is the value available in the type of machine. 2 levels of pressure (BiPAP)

      In general, AHI values while using a CPAP machine should not exceed 5 times per hour. If the value is higher than that Must look in detail which type of machine and which model to use so that you can give advice correctly, for example, it may be caused by improper pressure setting, resulting in insufficient pressure for treatment. Or use a machine model that is not suitable for our condition, such as having a high central apnea (cessation of breathing from the brain), which must be used as a machine that can treat this condition, etc.

      Try sending details of the brand, model name, settings, sleep test results and results reports downloaded from the device to service@nksleepcare.com I will try to get the staff to help me see it.

      1. dear doctor
        I have sent all available information to the doctor for consideration.
        I sent it by e-mail today.

        Thank you very much to the doctor and the team.
        district

        1. received the information Give me some time to check and I'll contact you back.

  22. hello doctor I had a sleep test and the AHI was 50. I used CPAP for about 2 weeks and used about 8 hours a day. The machine showed the average AHI of 1.2, but the symptoms did not improve. Haven't been drowsy during the day. Waking up not refreshed, dizzy, what is the cause? Or do I have to use CPAP for a longer time before the symptoms get better?

    thank you

    1. In fact, if your AHI falls below 5 beats per hour, your symptoms should improve. Or at least in the first few nights, you should be able to feel the difference. But if not I assume as follows.
      1. You may not be used to using the machine yet. or uncomfortable with wearing a mask causing insomnia, such as falling asleep, waking up or not sleeping deeply This one, try to use it for longer than this, about 1 month and see if the symptoms improve or not.
      2. The machine is set to too high pressure, making it uncomfortable or there is air leaking from the mask. causing poor sleep This one must ask the staff who set up the machine for me.

  23. I used to request to try CPAP from many institutions, both Auto and Manual, found that it made my sleep worse than not using it. Because I can't sleep at all. At first it might be because I'm not used to the mask. But in the end, I found that I actually felt harder to exhale than usual. Because you have to breathe against the air pressure. I would like to ask the doctor if

    1. If we adjust the CPAP well, will it be enough to help with this?
    2. Or if we skip to use the BiPAP device, would it be better?

    1. Here are the answers:
      1) It can help. Adjustment requires expertise and experience of staff to reduce discomfort while using, for example, having set the minimum-maximum pressure (min-max pressure) to fit the Ramp function is used to Let the pressure release machine start at a low level. first to make it easy to fall asleep And most importantly, according to the aforementioned symptoms, the machine must have an exhalation pressure relief function, which in each model Each brand has a different name, for example in a philips machine called flex or in a Transcend machine called EZEX, which the operator must enable this function and set it at the highest level. (mainly at level 3)
      2) If our sustaining pressure is very high, e.g. more than 15 cmH2O, the exhalation pressure reducing setting may not be sufficient. In this case, you need to change to a BiPAP machine. I recommend you to look at the settings of the CPAP machine as mentioned in the first point first. If adjusted well but still feel compressed I would consider it a BiPAP device.

  24. I tried using a cpap machine and the results
    AHI=2.8
    sni=11
    leak3.5 lpm
    If the sni value is high like this, does it mean that this model is not suitable for me? or can be adjusted

    1. The SNI value is the snoring index. This value should not exceed 5 if a cpap machine is in use, but a high value may be due to slight opening of the mouth at certain times. or depending on the posture of sleeping at that time or our bodies
      The snoring index is not as important as the AHI, which is the sleep apnea index. (Apnea-Hypopnea Index), which should not exceed 5 times per hour. In the case of Khun Kitipat, the value is only 2.8, it is considered that the machine works well. The machine can treat sleep apnea well. which is the main purpose of using the cpap machine. I recommend you to check the SNI on other days. It may be high for some days only.

      1. Doctor, my sni is high every day, always over 10. Will there be a problem? How should I fix it?

        1. Normally there is no problem. Because snoring alone is harmless, only annoying noise. An AHI value lower than 5 is considered a good treatment. An SNI value higher than 5 may be caused by:
          1) The mask leaks a little without our knowledge. This makes it possible to detect air flutter and wind pressure. to understand that it is snoring or
          2) The device in use does not have a pressure adjustment system or an algorithm that can only focus on solving snoring symptoms. (not related to sleep apnea)
          I don't know what brand of equipment to use. Which version is it? And what kind of mask do you use?

          1. The machine that was tested was a brand bmc g2s a20. The mask is a nose cover only.

          2. Must try to ask the staff of the company that brought the machine to try that this model has an algorithm that can treat snoring (Not related to sleep apnea) as well or not, and ask the question about the SNI value.
            As for the mask, if there is a leak, have his staff download the results of use to see if there is a Leak or not. If there is, see if the time of the leak is consistent with the time of snoring Officers should be able to answer these questions.

  25. The machine that was tried belonged to a relative. because he temporarily traveled to work abroad So I borrowed it to try.

    1. You may have to ask your relatives which company they bought from. or look under the device whether there is a sticker attached or not But from my experience, the SNI value is nothing to worry about. Or maybe try to see a snoring doctor specifically to discuss this matter.

  26. I tried an auto cpap machine, set to 8-17, average 8 hours was 13.5.

    The Ahi effect is still in the range of 10-20 times.
    The sleettest result before use is 80 times.

    In this case, which part should I try to adjust further?

    thank you

    1. 1) Look at the pressure graph whether there is a range that goes up to touch 17 or not. If there is enough, it is recommended to set Max Pressure more than 17, but try to adjust it by 0.5 and see if the AHI value decreases. or not
      2) You may have central cerebral apnea (CA), which CPAP machines only treat obstructive apnea (OA) if you have CA. too much, it will make the AHI value too high because the AHI value will include both CA and OA. Let's see from the results of using the machine. (If the device you use has a detection function) or see from the sleep test results whether you have a high CA value or not.

  27. ask the doctor
    I have done the sleep test AHI 41
    skin test and not allergic
    and Doctor Rajavithi diagnosed that
    I have non-allergic rhinitis. At night, I sprayed dymista illiadin by the doctor. Appointment for turbinate tube surgery in August 2022.
    But now I can hardly sleep. like I can't breathe I'm lying still, I can't breathe, can I use CPAP?

    1. If the nasal cavity is constricted for whatever reason It is recommended that you should not use CPAP because it will cause the machine to detect obstruction of the airway erroneously. Also, using CPAP when the nasal passages are inflamed and blocked can increase the inflammation and swelling. And it will feel very uncomfortable because of the pressure of compressed air in the nasal cavity.

  28. Can I put my cpap machine on when I wake up in the middle of the night?

    1. It can be put in. In fact, if it can be worn every time we sleep, it's even better. Whether it's a short sleep or long sleep

  29. Ask. I've done a sleep test and the air pressure value is constant. I'm wondering if I should buy an auto unit just in case. Or should I buy a fixed price?

    1. From our past experience If the pressure to maintain is not very high, for example, not more than 8 cmH2O, most of them can use a constant pressure machine. Because the pressure is not very high, it will not feel uncomfortable. But if you need to use pressure in the range of 9-15 cmH2O, it is recommended to use it as a device that adjusts the pressure automatically (auto), because the device will only give a high pressure in the necessary range. This will help reduce discomfort during sleep. But if a treatment pressure of more than 15 cmH2O or more is required, this group is recommended to be used as a 2-level pressure-adjusting device (Bi-level).

  30. What is the cause of the bipap machine when patients can't sleep? Why does it look like a patient who uses it and looks so cruel?
    The patient is suffering from a genetic type of muscle weakness.

    1. The bipap or ventilator in this type of patient is primarily intended to help the patient breathe. Selection of the type and model (specification) of the bipap apparatus, and setting the apparatus to suit the patient's breathing condition and pattern. will make the patient less suffering or uncomfortable And will have the effect that the body is not tired and able to sleep well. Consult your attending physician. Have your doctor advise you to use the appropriate version. Or do you have to adjust the device settings to be more suitable or not?

  31. Right now the machine company is out of stock, right? must be pre-order I would like to know directly from the company as well.

    1. Yes, now the products that are not in stock must be pre-ordered.

  32. Hello doctor, I have been using Auto CPAC for a long time. Pressure P95. At about 11 h2o, sometimes when exhaling, it feels uncomfortable because the flex system can only be set to 3
    I bought a Bipap machine, set everything up like an old CPAP machine but with pressure support I set it to 4.5 exhaling was more comfortable but woke up in the morning my chest felt tight unlike when using cpap. My question is 1) If I don't have any serious illnesses, can I use a bipap device to make my breathing easier?
    2) Why does my chest feel tight in the morning? I just tried it for 7 days.
    My AHI is usually around 2 to 2.5 thank you.

    1. In fact, P95 pressure at 11 is not considered high. You should be able to use a CPAP machine with Flex at 3. If you want to change to a 2-level pressure type machine or bipap, you should consult your doctor first because bipap machines have Many types if for people with OSA and need to use high pressure Doctors usually recommend an auto bipap or a basic version, i.e. with only spontaneous mode. Other types of bipaps are often used for patients with respiratory problems such as chronic obstructive pulmonary disease, emphysema. etc.

  33. Hello, I've been using a cpap machine for over two years. It's very good to wake up refreshed. during two years But recently, someone close to me said As if I came back to sleep like I didn't put on the cpap machine. I slept like I was in torture and struggled all the time, so I wanted to know Should I have to bring the device to the hospital staff after finishing it? I wondered if the reason might be because I was overweight. then have to do sleep Is it a new test again?

    1. It is possible that our physical condition has changed from two years ago, such as increasing weight. making it possible to use more pressure It is recommended to bring the device to the staff at the hospital or doctor to set it up. You may not need to do a new sleep test.

  34. Ask for permission to ask for self-assessment from the AHI value. We got from inserting the CPAP machine and having the machine read the value directly, right, doctor? We can evaluate the AHI value to see the severity of the disease. Is there any other way or not? Thank you, doctor.

    1. If we read the AHI from the CPAP machine, it will be the value obtained "after" treatment with the CPAP machine, not the AHI from our normal sleep. The machine will get the correct value. As for the method of measuring the AHI, if accuracy is desired, it must be the value obtained from the sleep test (sleep test), which may be examined at the hospital or at home and has both detailed and limited results. But either way, the AHI is the same. There are also AHI calculations from smart watches. (May be called AHI differently) such as Apple Watch, Garmin, FitBit, but the values obtained from these devices are not as accurate as the values obtained from the sleep test.

  35. Ask about philips sound dampening foam.
    Changing the foam will be safer, right? Does it need to be changed every year? Does Resmed's need to be changed? If you change, do you have to change every year as well?

    1. The new foam won't have the same problem anymore. It doesn't have to be changed every year, but the machine should be brought to the center every 1 year so that the technician can check the overall condition. Resmed's does not need to change the foam. Because I haven't encountered problems like Philips's. If you have any further questions, you can ask the after-sales department at 091-003-0209 or 092-962-9885. Thank you.

  36. In case of difficulty falling asleep and insomnia Waking up often in the middle of the night can a CPAP machine help?

    1. CPAP machines cannot help in cases of difficulty falling asleep or staying asleep. It is advisable to see a neurologist and sleep specialist. Because the cause can be caused by many reasons such as stress, anxiety, depression, insomnia, etc., which must be thoroughly tested and diagnosed by a doctor. Should not be left because it will destroy our health in the long run. Recommended doctor: Dr. Thapanee Somboon, Prasat Neurological Institute, Tel. One of them may be caused by sleep apnea, because lack of air during sleep can cause us to wake up frequently. If your doctor diagnoses your frequent nighttime awakenings as being caused by sleep apnea, your doctor may recommend treatment with a CPAP machine.

  37. There is carbon dioxide I have to wear the BiPap device every day. (At normal times, sometimes there is a panic attack too.)

    1. This requires consulting the doctor who treats you. because it depends on the level of symptoms of each person

      1. Please allow me to ask the doctor. I have been using a cpap machine for 1 year now, the ahi sleep test is 15.1 (light breathing), the max pressure is set to 15, the ahi and cai are below 5. Every time I use it, I used to have only 0.1. I wake up every morning and I still feel dizzy every morning. Used to use an oring2 ring to measure oxygen in the blood, some nights it was as low as 86,%, even using a cpap machine, ahi 0.4, but still dizzy. I have angina. I don't know if angina can make it hard for me to breathe or if it doesn't allow my lungs to expand fully.

        1. must try to send a report using the device to see details first If you look at the report and see that your CPAP machine is set up and working normally. It may be a result of the aforementioned heart conditions because the oxygen in the blood is lower than normal.

  38. Hello, I would like to ask High blood pressure, unable to breathe due to stress I would like to inquire if wearing a respirator while still unable to breathe will it have any effect?

    1. It is not recommended to use a CPAP ventilator during this condition. because the cause is not caused by an obstructed airway It is advisable to consult a doctor on how to treat it when symptoms occur.

  39. สวัสดีค่ะ ขอรบกวนถามนะคะ ดิฉันได้ตรวจ sleep test และคุณหมอแนะนำให้ใช้เครื่อง CPAP ที่ความดัน 6 และได้ทดลองใช้เครื่อง resmed ของ รพ. เครื่องที่ทดลองใช้เป็นรุ่น for her ทาง จนท.แจ้งว่าเป็นเครื่อง Auto แต่ set แรงลมไว้ที่ 6 ไม่ได้ set แบบ Auto ไว้ หลังทดลอง ค่า AHI =3 อยากเรียนถามว่า 1.ควรใช้เครื่องแบบ manual หรือ Auto ดีคะ จาท.แนะนำว่าใช้แบบ manual ก็พอ เพราะใช้แรงลมน้อย ไม่จำป็นต้องใช้แบบ Auto 2. ทดลองใช้ mask แบบครอบจมูก แต่แพ้ ซิลิโคนค่ะ คันมากบริเวณที่สัมผัสกับหน้า โดยเฉพาะ บริเวณระหว่างจมูกกับปาก อยากทราบว่าจะใช้ mask รุ่นไหนได้คะ จากการทดลองใช้ก็ชอบ resmed ค่ะ ไม่อึดอัด มีปัญหาตรงแพ้ mask นี่ล่ะค่ะ ขอบคุณค่ะ

    1. สวัสดีครับ ขอตอบคำถามดังนี้
      1. เนื่องจากใช้แรงดันลมไม่สูง (6) และผลลัพธ์คือได้ค่า AHI=3 แปลว่าการรักษาได้ผลดี ดังนั้นใช้เครื่องแบบ manual (แรงดันคงที่) ก็เพียงพอครับ
      2. แนะนำให้ลองใช้หน้ากากแบบสอดจมูก (nasal pillow mask) ดูครับ จะไม่มีส่วนที่สัมผัสกับผิวหน้าบริเวณรอบจมูกครับ

  40. ปรึกษาคุณหมครับ ใช้เครื่อง cpap resmed มา 1 ปีแล้ว แต่รู้สึกทุกครั้งที่ตื่นนอนจะไม่สดชื่นเลย ทั้งที่หน้ากากก็ไม่รั่ว ค่าที่มาจากเครื่องก็โอเคทุกอย่าง แต่ตื่นมาแล้วมีอาการเพลียไม่สดชื่น หน้ากากที่ผมใส่เป็นแบบคลอบแต่จมูก ส่วนตัวผมมีอาการภูมิแพ้ ตอนกลางคืนในโพรงจมูกจะโต

  41. สอบถามครับ ผมใส่เครื่อง resmed cpap มา 1 ปี รู้สึกว่าใส่แล้วก็ง่วงนอนเหมือนเดิม
    เหมือนกับตอนไม่ได้ใส่เลย ตัววัดค่าที่เครื่องก็ออกมาดี อากาศรั่วนิดหน่อย แต่ตื่นมาแล้วเพลีย ตาบวม เจ็บคอ

    -ผมมีอากาศภูมิแพ้ตอนกลางคืน จมูกจะชอบตัน เพราะด้านในบวม แต่ลองไม่เปิดแอร์เปิดแต่พัดลม ใส่เครื่อง cpap แล้วก็ยังเป็นแบบเดิมครับ

    1. ขออภัยที่ตอบกลับช้านะครับ ปกติแล้วอาการภูมิแพ้จมูกตันมักจะเป็นอุปสรรคต่อการใช้งานเครื่อง cpap ที่ใช้หน้ากากผ่านทางจมูก ทำให้เครื่องไม่มีประสิทธิภาพในการรักษาเท่าที่ควร การที่โพรงจมูกตันขณะใช้งานเครื่องทำจะให้เกิดผลดังนี้ 1) แรงดันอากาศไม่สามารถส่งไปถึงช่องคอได้เต็มที่ ทำให้ไปลดความสามารถในการรักษาภาวะหยุดหายใจขณะหลับที่เป็นสาเหตุของการง่วงนอนตอนกลางวันได้ 2) ถ้าเป็นเครื่อง Auto CPAP เครื่องจะเข้าใจผิดว่าเกิดการอุดกั้นในช่องคอ ทำให้เกิดการเพิ่มแรงดันขึ้นเพื่อพยายามรักษาการอุดกั้นนั้นๆ ส่งผลให้ปล่อยลมแรงขึ้นและทำให้ผู้ใช้งานอึดอัด หรือนอนหลับไม่สนิทได้ 3) ถ้าใช้หน้ากากครอบเฉพาะจมูก จะทำให้เรานอนอ้าปากหายใจอัตโนมัติ ทำให้แรงดันลมรั่วออกทางปาก

      แนะนำให้ปรึกษาแพทย์เพื่อรักษาอาการจมูกตันให้หายก่อน แล้วค่อยกลับมาใช้งานเครื่องครับ

      1. พ่อเป็นข้าราชสามารถเบิกค่า เครื่องCPAP ได้ไหมคะ หรือมีเครื่อง CPAP ที่ราคาไม่แพงไหมคะ พอดีอายุยังน้อยแล้วกำลังซื้อไม่ถึงค่ะ

        1. 1. คุณพ่อสามารถใช้สิทธิ์กรมบัญชีกลางเบิกเครื่องได้ จำนวนสูงสุดไม่เกิน 20,000 บาท

          2. พ่อสามารถใช้สิทธิ์เบิกเครื่องให้ลูกได้ แต่ลูกจะต้องอายุต่ำกว่า 20 ปี

          3. ราคาเครื่องตอนนี้มีโปรโมชั่นเริ่มต้นที่ 35,000 บาท และหากมีบัตรเครดิต SCB KTC กรุงศรีฯ กรุงเทพ สามารถผ่อน 0% 10 เดือนได้ครับ

  42. สอบถามคุณหมอครับ ผมใส่เครื่อง cpap แล้ว ตื่นมามีอาการหูอื้อครับ เปนประจำคับแต่ไม่บ่อยมาก มีวิธีแก้ไหมครับ ขอบคุณมากครับคุณหมอ

    1. บางท่านใช้เครื่อง cpap แล้วอาจมีอาการหูอื้อได้เป็นเรื่องปกติครับ เนื่องจากเครื่องมีการอัดแรงดันอากาศเข้ามาในช่องทางเดินหายใจของเรา วิธีแก้ไขคือให้ปรึกษาแพทย์หรือตัวแทนที่ดูแลท่านเพื่อทดลองลดค่าแรงดันลมลง เช่น แรงดันเริ่มต้น (ramp pressure) หรือแรงดันสูงสุด (max. pressure) โดยการลดแรงดันนี้ต้องไม่กระทบกับการรักษาโดยรวม ดังนั้นจึงไม่ควรทำด้วยตนเองครับ

  43. คุณพ่อเพิ่งลองใช้เครื่อง CPAP มาได้ประมาณ 1 เดือนค่ะ เคยใช้เมื่อเกือบ 10 ปีที่แล้ว แต่ใช้ไม่รอด เลิกใช้ไป เพิ่งกลับมาลองใช้ใหม่ เพราะผลการทดสอบการนอนออกมาว่า หยุดหายใจ 30 ครั้งต่อชั่วโมง ระดับออกซิเจนต่ำสุด 87% ระดับความดันจะสูงตอนกลางคืน หลับเมื่อไหร่ ความดันเริ่มไต่ขึ้น ตอนเช้าบางครั้งความดันขึ้นไป 200 และเริ่มมีอาการสับสน จากการที่สภาพเส้นเลือดฝอยไม่ดี เลือดไปเลี้ยงสมองไม่พอ ใช้ยาลดความดันแรงไม่ได้ เพราะความดันตัวล่างไม่ค่อยสูงและระดับการเต้นหัวใจค่อนข้างต่ำ (ไม่ถึง 50) หมอให้พยายามใช้ CPAP ให้ได้ค่ะ

    ตอนนี้ทดลองใช้เครื่องของ Resmed AirSense 10 for Her หน้ากากแบบ Nasal (ลองทั้ง Full Face และ Pillow แล้วด้วยค่ะ) คุณพ่อยังตื่นมาไม่สดชื่น ง่วงนอน ความดันก็ยังค่อนข้างสูง และบ่นอึดอัด หายใจไม่สะดวกเวลาใส่เครื่อง คุณพ่อนอนอ้าปาก ใส่ที่รัดคางไม่ได้เพราะแพ้ และยิ่งอึดอัดค่ะ ความดันเครื่องตั้งอยู่ที่ระดับ 6-12 แรงดันเฉลี่ยตลอดคืนไม่เคยใช้แรงลมเกิน 8 ไม่ทราบว่าจะต้องตั้งเครื่องหรือใช้วิธียังไงให้คุณพ่อใช้เครื่องได้สบายขึ้นคะ

    1. สวัสดีครับ เบื้องต้นผมอยากให้ปรึกษากับบริษัทที่ให้เครื่องมาทดลองใช้ก่อน เพราะเค้าสามารถดาวน์โหลดผลมาดูแบบละเอียดได้ และสามารถปรับค่าเครื่องบางอย่างเพื่อช่วยให้เรานอนหลับได้ง่ายขึ้นได้ครับ นอกจากนี้ เนื่องจากเพิ่งทดลองใช้ไม่กี่คืน อาจต้องให้เวลาปรับตัวอีกซักระยะด้วย เพราะช่วงแรกอาจยังไม่ชินและทำให้นอนหลับไม่สนิทได้ครับ

      แต่ถ้าใช้เครื่องไปมากกว่า 2-3 เดือนแล้วและยังตื่นมาไม่สดชื่น ต้องปรึกษาเจ้าหน้าที่บริษัทที่ซื้อเครื่องอีกที โดยทั่วไปมักแนะนำให้ปรับระบบลดแรงต้าน (EPR) ให้ลดลง (เท่าที่ยังไม่อึดอัดมากและหลับได้) ถ้ายังไม่ดีขึ้นก็จะให้ปรึกษาแพทย์เพื่อปรับค่าแรงดันให้ต่ำลง หรือปรับระบบจาก auto เป็นแบบแรงดันคงที่ ทั้งนี้ต้องดาวน์โหลดผลการใช้เครื่องอย่างละเอียดมาดูประกอบด้วยครับ

      การใช้เครื่อง cpap ต้องใช้เวลาให้เกิดความเคยชิน ให้สามารถอยู่กับเครื่อง ได้อย่างน้อย 4 ชั่วโมงต่อคืนครับ

  44. ถ้าคนใช้บอกว่า เวลาใช้เครื่องหายใจไม่สะดวก เหมือนหายใจได้ไม่เต็มปอด แสดงว่า แรงดันเริ่มต้นต่ำไปหรือสูงไปคะ

    1. เวลาใช้เครื่องหายใจไม่สะดวกเหมือนหายใจได้ไม่เต็มปอด แสดงว่าตั้งค่าแรงดันต่ำไปครับ ถ้าเป็นช่วงแรกๆที่เริ่มเปิดเครื่องก็แปลว่าตั้งค่าแรงดันเริ่มต้น (Innitial/ramp pressure) ต่ำไป แต่ถ้ามีอาการตลอดเวลาแปลว่าตั้งค่าแรงดันรักษา (therapy pressure) ต่ำไปครับ

  45. ผมซื้อเครื่องจาก nk รุ่น resmed 10 ผมรบกวนสอบถามครับ เครื่อง cpap รู้ได้อย่างไรว่า เราหยุดหายใจ ในเมื่อเครื่องมันเป่าอากาศเข้ามาตลอด

    thank you

    1. ในตัวเครื่องจะมีเซ็นเซอร์วัดอัตราการไหลของอากาศและแรงดันอากาศอยู่ครับ (Flow sensor & Pressure sensor) โดยลมที่เป่าออกมาจะมีการเปลี่ยนแปลงรูปแบบทั้ง flow และ pressure ตามการหายใจของเราตลอดเวลา ซึ่งเครื่องจะบันทึกรูปแบบการหายใจของเรา (pattern) ในช่วงปกติไว้ เพื่อเปรียบเทียบกับ pattern การหายใจในช่วงที่ผิดปกติ ทำให้สามารถทราบได้ช่วงไหนมีการหยุดหายใจและนานแค่ไหนครับ

  46. อยากทราบวิธีอ่านผลCPAP
    ค่า P90 และ P95 ขึ้นอยู่ในระหว่า 7-10 ถือว่ายังปกติอยู่มั้ยคะ
    และค่าApnea ควรอยู่ที่เท่าไหร่คะ

    1. ค่า P90 (หรือ P95) ในเครื่อง CPAP คือค่าแรงดันที่ที่เครื่องคำนวณออกมาเพื่อใช้ในการรักษาภาวะหยุดหายใจขณะหลับ (therapy pressure) ดังนั้น ค่า P90/P95 อยู่ที่ 7-10 แปลว่าค่าแรงดันรักษาอยู่ระหว่าง 7-10 cmH2O จัดว่าอยู่ในระดับปานกลาง (หากคนที่มีภาวะหยุดหายใจขณะหลับขั้นรุนแรง ตัวเลข P90/P95 จะสูงกว่านี้) โดยหากมีการตั้งค่าเครื่องได้เหมาะสมและใส่หน้ากากได้ถูกต้อง ค่าดัชนีการหยุดหายใจ (Apnea-Hypopnea Index; AHI) ขณะใช้งานเครื่องควรอยู่ในระดับต่ำกว่า 5 ครั้งต่อชั่วโมงครับ

  47. ใช้เครื่อง CPAP (แบบไม่ได้เติมน้ำ) จะนอนสบายในช่วง 2 ชม แรก หลังจากนั้น คอจะแห้ง และแสบจมูกมาก จนต้องลุกขึ้นมาขับเสมหะออก จะมีเสลดข้นเหนียว พยายามใส่แล้วนอนต่อ แต่ก็ไม่สบายเลย บางคืน ต้องดึงออกทันที เพราะรู้สึกว่ามันทรมานค่ะ ลักษณะแบบนี้ต้องแก้ไขอย่างไรคะ

    1. ถ้าจะให้ดีที่สุดก็คือแนะนำให้เพิ่มตัวทำความชื้นแบบอุ่นน้ำ (heated humidifier) เพราะจะช่วยทำให้คอไม่แห้ง ลดอาการแสบจมูก และทำให้เสมหะไม่เหนียว แต่ถ้าไม่สะดวกก็ให้ลองปรึกษาแพทย์เพื่อลองปรับลดแรงดันอากาศลง ก็อาจช่วยลดเรื่องคอแห้งกับแสบจมูกได้ แต่เสมหะอาจไม่ช่วยเท่าไหร่ครับ

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