Keys to Success with your CPAP or BiLevel Machine

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What is CPAP? Continuous positive airway pressure or CPAP

therapy is a prescribed treatment delivered to

the upper airway to keep it open during the

night.

The pressure is delivered through tubing

attached to a mask and held in place by a

headgear

Bi-Level Bi-level therapy is similar to CPAP but it uses two

pressures

Inspiratory pressure

Expiratory pressure

With Bi-Level therapy, inspiratory pressure is higher than the expiratory, making it easier to

exhale because the pressure is decreased

• Why is Bi-Level Therapy used?

Therapeutic or Treatment? Humidification

Active humidification monitoring

Heated Circuits

Electronic pressure relief

Use & Compliance Data

Event detection monitoring

Compliance

Wireless

Issues With Their Mask

What is the number one cause

of people failing PAP Therapy?

• Masks must fit properly

• People stop using PAP when they have mask related problems

• Early (first week) problem solving improves PAP compliance

• Variety of masks on the market

• 30 day mask guarantee

• New masks available

• Shop before you buy

• Replace early or every three months

Mask Fit: Keys to Success

Common mask related problems

Pressure points where mask meets skin

Blisters Most common on the bridge of the nose

Blisters may break open and become infected

Leaks – air blowing around ‘seal’ of mask

Most machines will compensate for a small leak

Eye leaks

Beards/moustaches

Worn Mask

Dryness

Signs of a worn mask Ask patient to bring with them to lab

Increased leaks

Tears or rips

Change in texture of the mask

Gel masks

become soft

lose shape

Silicone masks

Develop ‘dry rot’ and crack

Stretching

Replacing Supplies General rule of thumb (most insurance

providers)

Replace filters monthly

Replace mask every three months

Replace headgear every six months

Replace tubing two to three times per year

* Contact your home care company for details on your coverage

Prevention of Pressure Sores Do not over tighten your mask

Have your mask as loose as possible without having a leak

Wash your mask daily with warm, soapy water

If you do get pressure sores: Don’t Wait!

Contact your home medical equipment provider, you may need a different mask

You cannot keep using the same mask as it will cause the sore to open

Neosporin, Moleskin or other OTC remedies

Care and Cleaning Tubing should be cleaned weekly

Submerse tube in warm solution, rinse well, hang to dry

Headgear should be cleaned weekly Wash in warm solution, rinse well, hang to dry

Clean more regularly in warm weather or when

you have a cold or respiratory infection

Adjust the straps and headgear on your mask to obtain a better fit.

If you have had your mask for a while, check to

make sure that it is not worn or torn.

You may need to try a different size mask.

A different type of mask may work better for

you. Either a full face mask or nasal pillows may eliminate the air leaks.

Talk to your PAP supplier if you continue to have

problems with air leaks.

Care and Cleaning (continued)

Distilled + Distilled = Success Distilled water in humidification chamber

More likely to be sterile

No dissolved solids

Fluoride, calcium, phosphorus

Distilled white vinegar for cleaning

50/50 Solution

Inexpensive and safe

No perfumes or moisturizers

Inexpensive and replenishable

Five Common Problems

Problem #1: User seems to have more

nasal congestion after using PAP. This is the most common side effect of PAP therapy. User may

also have a runny, dry nose or nosebleeds. Nasal congestion often goes away after your first month of use.

Suggest that the patient talks to their doctor if their congestion

is severe or if they are experiencing nasal, sinus or ear pain.

These tips can also help reduce nasal problems:

• Try using a saline nasal spray. Apply a few sprays in

each nostril before using PAP therapy.

• Try a nasal decongestant. Some types require that

the patient has a prescription from their doctor.

• Try using/adjusting Heated Humidifier.

Problem #2: The patient is having trouble

breathing with so much air coming in

through the mask. This problem is common if the OSA is severe and the

patient need a high level of air pressure to keep the

airway open, there is also an acclimation period for

most users.

Try these tips: Begin using PAP for short periods of time during the day

TV

Reading

This can help the body begin to adjust to the air pressure

One may need to start by using it for only a few minutes at a time

Gradually increase the length of the sessions. Focus on breathing at a

nice, slow pace

Use the unit's ‘ramp’ setting

Problem #3: The patient is experiencing a

dry or sore throat after using PAP.

Anyone who breathes through his or her mouth during sleep may have this problem.

These tips may help relieve throat irritation

caused by PAP: Try a chin-strap, available through a home-care company.

Heated humidity is a feature on many machines that

requires adjustment. If available, turn the humidity up one

night at a time.

In some cases, a full face or different style of mask will help.

Problem #4: The patient has red eyes, continues snoring or stops breathing

during sleep.• These problems are all signs that air may be

leaking out of the mask.

• These tips can help correct the problem:• Loosen the straps slightly so that they are not too tight.

Make sure the mask is still snug enough to prevent air leaks, but not so tight that it hurts the facial skin.

• Consider buying pads that slip over the straps. Made of

fleece or other soft material, they keep the straps from

rubbing against the skin.

• Talk to the CPAP supplier if the mask continues to irritate skin or cause soreness.

Problem #5: Air delivered through the mask is cold and disrupts sleep.

The environmental elements may affect the use of PAP

therapy. Room temperature, humidity and bed location

can all affect the air flowing from the machine through

the mask. The following suggestions may help:

Try heating the room

Placing the tubing under the bedclothes

Obtaining a Snuggle Hose

Heated humidification

Frequently Asked Questions

How long will it take to get used to CPAP?

Most people adjust to CPAP in one to two weeks

but it may take up to a month or more to adjust.

Many factors affect adjustment period:

Severity of Apnea

Pressure

Mask

Humidity

Bed Partner

Patient Education

How soon after the patient begins using

treatment that they may notice

improvement? Many patients notice an immediate improvement, some

people may take a little longer to recognize

improvement.

Several health conditions are affected by sleep apnea

including:

Hypertenstion

Cardiovascular Disease

Type II Diabeties

Depression

More

How often will the patient need to use their treatment?

The patient will need to attempt to use their equipment each time they sleep. If they do

not, they will return to the previous level of snoring, sleep apnea, and daytime tiredness.

Will the pressure on the device ever need

changing?

• It may. There are a few things that affect the need for a

pressure change, and it’s important to keep in

communication with the ordering physician about the

treatment of apnea. Some items that may affect the

amount of pressure required are:

Weight loss/gain

Snoring returns

Daytime sleepiness returns

Changes in your overall health

Will the patients’ blood pressure improve after

starting treatment?

One of the positive effects of PAP compliance is the

possibility of lowering blood pressure. The patient needs

to discuss this further with their physician before making

any medication changes.

The ordering doctor should review blood pressure

regularly even if the patients mediation does not change initially.

Is it easier to lose weight when using PAP therapy?

It may be. One should find that his or her energy levels

will increase. It is also likely to notice more motivation to

take part in many activities that previous sleepiness has

prevented.

Permanent weight loss requires long-term lifestyle changes to diet and exercise.

The patients nose gets blocked

regularly, so he or she has to breathe through their mouth.

The nose is often the point of entry when using PAP

therapy.

Nasal Decongestant

Please note that overuse of nasal decongestants can also

cause a blocked nose over time and are really only a

temporary solution.

Full Face Mask

A full face mask covers both the nose and mouth so that

the patient can continue to receive effective therapy, even if they are breathing through their mouth.

The patient feels air leaking out of his or her mouth as they fall asleep.

The mouth needs to be closed while sleeping to

prevent any air escaping from the mask.

A full face mask that covers the nose and mouth

will ensure that the patient will continue to

receive effective therapy as he or she falls asleep.

A chin strap, obtained through a medical

supplier, can help to keep the patients mouth closed.

Can the patient use PAP treatment if he or she has a cold?

If the patient is experiencing an infection of the upper

respiratory tract, middle ear, or sinus, he or she should

consult your physician before continuing treatment.

One may be advised to discontinue until the infection has

cleared.

If the patient continues with treatment during infection, it is

advisable to wash the mask and tubing more often.

A full face mask may be good alternative at this time, as it

covers both the nose and mouth so the patient can continue to receive effective therapy.

Should the patient take his or her device to

the hospital with them, if hospitalization is ever

needed for any reason?

Yes.

If the patient is having surgery, it is very

important that they tell both the surgeon and

the anesthetist that they wear a PAP device. Do this before the date of the surgery, if possible.

One should also inform the physician treating

the patient for sleep apnea that he or she is going to be in the hospital.

Will the patient ever be able to stop

treatment? Will he or she ever be cured of

snoring and sleep apnea?

OSA is a long-term condition for which there is

presently no known cure.

The good news, however, is that PAP therapy

will effectively control sleep apnea-as long as

the patient continues to use it.

Technology continues to improve, making PAP more effective and comfortable.

The patient often takes the mask off in their

sleep. How can the patient avoid this?

It may indicate that the treatment pressure is not enough to completely control sleep apnea and

a slight increase in pressure may solve the

problem.

Speak with the ordering physician about this issue. Often it can be corrected quite easily –

but it is important that the doctor is aware of this

problem.

Mask alarms available on some PAP machines

Why is the patient having difficulty breathing

out during CPAP?

When first using CPAP, most people find they

experience a need to push against the airflow when they breathe out. It may take a little time

to get used to breathing out against the

pressure.

Practicing sessions in the daytime while relaxing or listening to music may help overcome this

feeling. However, breathing out against the flow

of air will happen automatically when the

patient is asleep.

Don’t forget about Ramp.

Can the patient use their machine in other

countries?

Most devices have a switch mode power supply.

Please note that the patient will still need to use

the correct adaptor for the type of power outlet

in the country he or she is visiting.

Contact the patients home care company or

Sleep Solutions Home Medical Equipment for equipment options before the trip.

Questions