YOUR QUESTIONS ANSWERED...
Continuous Positive Airway Pressure (CPAP) is the most recommended and the most effective treatment for sleep disorders such as Obstructive Sleep Apnoea (OSA).
CPAP: A CPAP machine provides air at a constant pressure through a tube and out of a CPAP mask during sleep. CPAP therapy provides constant airflow which holds the airway open so that uninterrupted breathing is maintained during sleep. This eliminates sleep apnoea events and allows the user to get a restful sleep. The pressure of the air is determined by a sleep study and set by your equipment provider. Treatment pressure varies from person to person and needs to be established during diagnosis.
CPAP Auto (APAP): Automatic Positive Airway Pressure machines adjust in a breath-by-breath basis to your ideal pressure. The machine will establish the pressure on its own (but still needs some guidance by your healthcare professional!). APAP is highly recommended if your prescribed pressure is above 10cmH2O, you have a busy lifestyle, you consume alcohol on a regular basis, you are younger than 40.
CPAP Bi-Level (BiPAP): These devices haves two different adjustable pressure levels. A higher level for inspiration and a lower level for expiration. These machines are recommended for morbid obese patients, patients with a treatment pressure above 17cmH2O that cannot cope on normal CPAP pressure, patients with neuro-muscular disease, patients with central sleep apnoea. respiratory insufficiency, like COPD (Chronic Obstructive Pulmonary Disease), etc.
Portable APAP Machine: Some machines are small, compact and lightweight ideal for those who enjoy camping or traveling. Some machines will have battery pack for times where mains power is unavailable. It’s made smaller and lighter, but it is usually much louder.
It is important to keep your equipment clean. Remember that you are breathing whatever might be growing inside
If you have been sick recently, clean your equipment more often
Remember to always follow the advice of your medical and equipment providers as well as the manufacturer’s instructions for cleaning your CPAP
Never use any perfumes or cleaning solutions other than gentle soap on your equipment. These can irritate your lungs and make you sick. The humidifier must only contain distilled water
It is not advisable to clean your equipment in a dishwasher or washing machine
Submerge the mask, headgear, tubing, and connectors in the warm soapy water. Allow it to soak for a short period of time (about 10 -15 minutes). Alternatively, wipe out the mask with a soft cloth and warm water, and swish soapy water through the tubing. Allow everything to air dry on a towel. These items should ideally be cleaned every day
The humidifier should be cleaned with hot water and mild soap. It should also be allowed to air dry. Remember to only put distilled water in the humidifier. If you do not, there is an increased risk of illness as well as the probability that hard minerals will build up on your equipment. The humidifier should ideally be cleaned weekly. (To disinfect hoses, and humidifier water chambers, use one part vinegar, to three parts water)
Some CPAP machines have filters in place. It will be important to review your manufacturer’s instructions or ask your equipment provider about how these should be maintained. Some can be rinsed but others must be replaced, and the timing of this will vary depending on the environment you use the machine in
If you find that your sleep apnea symptoms have returned or you feel like your machine isn’t working right, bring it in to your equipment provider and have things checked out
Getting used to your CPAP machine is different for everyone. Some people adjust right away while others need more time to get comfortable. Here are some important tips for adjusting to CPAP when you sleep:
Practice breathing against the pressure. Breathing against the pressure of your CPAP machine may feel unusual at first, but if you practice before you’re ready for sleep, you’ll adjust to it faster.
Try listening to music, reading or watching TV in bed with your mask on. Don’t give up! It may take a week or longer to get comfortable with your mask, so don’t give up.
Give yourself as much time as you need to feel comfortable, awake and refreshed in the morning. Be sure to use it every night!
Try a different mask You have options – explore them if you continue struggling with therapy If you’re feeling claustrophobic, consider a nasal or pillows mask. If your nasal pillows are bothering you, try a nasal mask If you’re waking up with a dry mouth or find you’re opening your mouth during sleep, a full face mask might be necessary.
Pull and re-adjust the mask while it is still on your face. If the upper straps are pulled too tightly, it may cause irritation to the bridge of the nose.
Adjusting the straps to pull the mask tighter more than often causes more leaking.
Try to be gentle with your mask fitting.
The mask should only be tight enough to “hover” on your face.
If you turn at night, the anatomy of your face changes as well. Just wiggle the mask to form a seal again.
Sometimes the problem is the mask itself. You may choose to try on other masks that may be more comfortable.
On the front of all vented masks, you’ll find small vent holes that have been designed to release exhaled carbon dioxide You should only be concerned with mask leaks that occur when your mask pulls away from your skin
If the mask moves on the face, it can cause irritation to the skin. The mask should be securely on the face to prevent movement. Also, ensure that the mask is kept clean (wash it everyday) to prevent build-up of oils. This can contribute to facial blemishes and sores (especially on the bridge of the nose). It is important to wash your face with mild cleanser before bedtime, as the oil on the skin and the silicone on the mask may cause an allergic action. Never use oil-based creams (Vaseline/petroleum jelly) because they break down the silicone material of the mask.
Pressure ulcers or injuries are wounds that can develop where the CPAP masks come in contact with the bony areas of the nose, mouth, or face. They indicate that the mask isn’t fitting properly.
No air should be directed up into the eye area with a properly sized and fitted mask. This might indicate leak in the top area of your mask; gently tighten the top mask straps taking care not to over tighten. This leak might also indicate a worn mask cushion that needs replacement.
Consider fitment of a different model mask to get a better seal. Nasal masks are often less prone to irritate the eyes.
Some people naturally sleep with their eyes partially open which can cause dryness or irritation; they benefit from wearing a simple fabric eye mask.
Eyedrops or ointment designed for dry eyes may bring relief.
If swelling or irritation is chronic or persistent, consult with your physician.
Dry nose: Using a humidifier to reduce the amount of air resistance through the nose can make CPAP treatment easier to tolerate. For those who use nasal masks, the positive airway pressure can dry up the nose and cause irritation – you may want to switch to a full-face mask.
Congestion: Similar to dry nose, starting CPAP therapy may cause congestion in the nose, which can make it difficult for air to pass through. Certain medications or switching to a full-face mask may be helpful to address this problem.
Blow your nose before bed. If you are congested, discuss using a nasal decongestant with your doctor. However, it should only be used on occasion, since overuse can cause a rebound effect.
If the problem persists because of a more significant blockage, it should be investigated.
The air coming from the CPAP machine is the same temperature and humidity as the air that is in the room. Because the air from your machine is travelling much faster to hold your airways open, this air can cause a cool and drying effect on the air passages.
An option is to use a CPAP humidifier. The heated humidifier humidifies the fast-moving air to make it much more comfortable to breathe.
Alternatively, a heater in the bedroom at night may also be effective.
You may want to invest in a heated pipe that has a coil inside to heat the air while passing through the hose.
All masks have exhalation ports to allow the escape of CO2 (carbon dioxide). The higher the machine pressure setting, the harsher this escape flow will be.
Check with your partner to discuss a resolution. Some patients resolve by side sleeping with their backs turned to their bed partner to avoid a distracting air flow.
Mounting a bulky head pillow between you and your partner may just do the trick!
Some masks have better air diffusion features than others.
Water in CPAP tubing
- Excess condensation can form in the CPAP tubing when the temperature of your bedroom is cooler than the air coming from your machine.
- Insulating your hose or popping it under the blankets should resolve this common problem.
- Heating your bedroom is a good idea (unless there’s load shedding or course).
- White, grey or pink film in humidifier water chamber
- Bacteria can quickly develop in the water chamber of a CPAP humidifier.
- Manufacturers recommend the use of distilled water.
- Purified water is fine, but do not top up - empty any leftover water, rinse chamber and let air dry.
- To remove film, fill chamber with 1/3 white distilled vinegar to 2/3 purified water solution. Let soak for one hour.
- Water spill
- Always remove water chamber unit from machine before filling with distilled water.
- Empty and dry the water chamber prior to transporting the machine.
- Spilling water in to the machine may compromise the interior circuits, damage the machine and void the warranty.
If you have an infection of the upper respiratory tract, middle ear or sinus, you should consult your doctor about using your CPAP machine.
Yes, you do. If you are having surgery, it is very important to tell both the surgeon and the anaesthetist that you are using CPAP. Remember that the CPAP machine treats your OSA, and when you are not using it, the OSA is not being treated.
OSA is a long-term condition. The CPAP does not cure the problem; it only corrects the problem while it is being used. As a result, it will need to be used possibly for the rest of your life.
Some people, with time, stop doing this.
However, sometimes doing this is an indication of discomfort. If your pressure is too low or feels very high, or if there is discomfort due to dryness, some people will react in their sleep by removing the mask.
You may need to use a humidifier to increase comfort.
If the pressure is a problem, you should discuss it with your doctor.
This is usually the result of excess air being swallowed from the flow of the machine.
Using a delay timer or ramp when falling asleep with the machine may solve it.
Sometimes slow deep breathing exercises with the machine on will help you to become used to the flow and not swallow the air.
If symptoms persist, contact your doctor.
If your CPAP pressure feels overwhelming at the beginning of the night, your machine may have a feature called ramp which can be set to start your pressure at a lower setting and “ramp up” over a period of time.
Practice makes perfect. To help get used to treatment during sleep, practice wearing it during the day while sitting in a chair watching television or reading.
Your CPAP pressure may be temporary reduced and gradually increased as you adjust to treatment on a standard CPAP machine.
Patients who experience claustrophobia usually find that a smaller size nasal mask or nasal pillow masks are more tolerable.
There is an adjustment period for most patients as they get used to sleeping with any mask on the face.
While your goal is to be able to sleep all night on CPAP, using it as long as you can tolerate it each night is better than nothing. Try to increase usage over time until you reach your goal.
Practice makes perfect. To help get used to treatment during sleep, practice wearing it during the day while sitting in a chair watching television or reading.
- A full face mask is typically recommended for mouth breathers, deviated septum or other nasal issues. A full face mask offers several advantages to mouth breathers including:
- - Useful for CPAP users with high treatment pressure
- - Decreased nasal passage strain especially during cold season
- - A good choice for people who sleep on their side
If you’re using a nasal or nasal pillow mask and predominantly breathe through your mouth during sleep, CPAP therapy may not work as well as expected. Air may flow in through your nose and released out through your mouth. Switching to a full face mask might provide immediate improvement to your CPAP treatment.
As you start therapy, you’ll probably hear the word “compliance” a lot. As a patient, compliance means staying on therapy on a consistent basis. It’s a personal goal for your long-term health
Compliance is a technical term. It’s required that the data your CPAP machine logs shows that you’re using your CPAP equipment a specified number of hours per night and days per month
Some people need a bit longer than 30 days to sleep more than 4 hours while on therapy Start CPAP therapy on the first night and continue using it for all the subsequent hours you sleep at night (not just the minimum four hours required). This will help you become compliant within the first 45 days and get the most out of therapy
You should take your CPAP therapy with you when you travel. Thankfully, if you’re traveling by air, some airlines won’t even count your CPAP bag as an additional carry-on. ResMed also offers AirMini™, the world’s smallest travel CPAP. Now you can easily pack and go wherever your next adventure takes you and get the restful sleep you need to get the most out of your trip.
Pack a power extension cord. The nearest electrical outlet may not always be near your bed.
Bring the appropriate electrical adapter when traveling outside the country. Your CPAP machine will automatically convert to the appropriate voltage of the electrical outlet you are plugging into, but you will need to bring the right outlet adapter with you.
Use bottled water in your humidifier if you can’t find distilled water Remember to switch back when you get home and avoid using tap water. Check the label for mineral content. It should be as low as possible.
- If you experience any of the following symptoms during the course of your CPAP treatment, consult your doctor.
- - Headache
- - Middle ear or sinus discomfort
- - Chest pain
- - Persistent bloated feeling
- - Nose, mouth or throat irritation or dryness
- - Air leaking out of the mouth while sleeping
- - Old symptoms of OSA returning even with regular use of your CPAP
Do not stop your CPAP treatment without the approval of your doctor. You should consult your doctor if you expect to be in a situation where you cannot use your CPAP system overnight.
