# 2506 Don’t Hold Your Breath

Q. Can one use on Shabbos the new CPAP (continuous positive airway pressure) automatic apnea respirator machines that produce a soft, steady jet of air with enough pressure to keep the airway open?
A. On question 1744, we wrote: “Horav Shlomo Miller’s Shlit”a opinion is that when there is a compelling need for operating the apnea machine on Shabbos, as when the user cannot fall asleep without it (even if his life is not presently in danger), it can be used if it is connected to a timer that automatically turns it on. It should also be the type of machine that does not have a sensor that turns it on and off, responding to the breathing and also adjusts accordingly the pressure needed in real time, (APAP or Auto Positive Airway Pressure system) but rather the simpler continuous air stream machine.
A trial should be done before Shabbos to see if the timer set up works properly.”
You use a CPAP, or Continuous Positive Airway Pressure, which is a form of positive airway pressure ventilator, that applies mild air pressure on a continuous basis to keep the airways continuously open in people who are able to breathe spontaneously on their own.
Horav Shlomo Miller Shlit’a suggested to have them add to the machine an optional switch that can override the sensors and monitoring devices for Shabbos use.”
Recently we were informed that when acquiring a CPAP machine. one can request whether it should be set on the automatic mode or not. If that is correct, one should indeed instruct at that time, to make the necessary changes for permitting the use of the respirator on Shabbos.
If the above is not an option, the Rov permits in need using the machine when it is turned on by a timer set before Shabbos named SmartStart. The reason being, since the air flow changes that occur automatically by the sensors responding to the breathing of the user, are considered only as “missassek,” or totally done without any conscious intention and awareness, and therefore permitted.
Rabbi A. Bartfeld as revised by Horav Shlomo Miller Shlit’a

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