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Using CPAP

Tips for dealing with common concerns

Continuous positive airway pressure (CPAP) is the most common treatment of Obstructive Sleep Apnea. The treatment uses a small machine that supplies constant flow of air through a hose into a mask that a patient wears during sleep.

Most common problems that CPAP users experience include trouble falling asleep with the mask, dry mouth and nose, and leaky masks. These problems can usually be easily overcome to make CPAP therapy comfortable and effective for most patients. Below are some common problems with using a CPAP machine and some tips for overcoming them.

Trouble getting used to wearing the CPAP mask

On average, it takes three weeks to get used to wearing the CPAP mask during bedtime. To get accustomed to the feeling, it is helpful to wear the mask during the daytime with the air pressure on. Try wearing the mask for some time while watching television or reading. Once you get used to the feeling, get in habit of using the device every time you take a nap and when you go to sleep at night. Persistence and good habits will make getting used to the CPAP therapy easier and faster.

Difficulty falling asleep

This is a very common problem experienced by many CPAP users at the beginning of the therapy. It will take some time before you are fully accustomed to the feeling of wearing the mask in bed. Practice wearing the mask during the daytime to get used to it. Using a ramp feature on your machine may also help, which will start supplying the air at low pressure and gradually increase it to the prescribed level as you fall asleep. Finally, get into good sleeping habits: exercise regularly but not immediately before going to bed, avoid alcohol and caffeine at night-time, go to bed at regular time and not before you are tired.

Claustrophobia

Some people experience anxiety and feelings of claustrophobia while wearing the CPAP mask for the first time. This can be overcome by gradually getting accustomed to the mask. First, practice holding the mask to your face by hand. Then, practice holding the mask to your face with the hose attached to the machine running at a low pressure setting. Then, try using the CPAP machine wearing the mask and the headgear while awake. Once you get comfortable with that, try falling asleep with the mask. If you are not able to overcome the feeling of claustrophobia, talk to your doctor or the CPAP equipment supplier. Changing the style of the mask to nasal pillows may help with overcoming the problem.

Wrong style or size of a CPAP mask

Choosing the right mask for your CPAP therapy is a key step for successful treatment of Sleep Apnea. Make sure you work closely with your doctor and CPAP equipment supplier when choosing the mask. Everyone has different requirements and face shapes, so something that works for other people may not necessarily work for you. There is a variety of mask styles available; discuss the benefits of each one with your CPAP supplier. Do not simply settle on the first mask that the CPAP supplier suggests! Try on multiple styles and sizes of masks and find the one that best suits your needs. Pay attention to the size of the mask and find one that best fits you. Ask the CPAP supplier to show you how to adjust the mask and the headgear to get the best fit. Also keep in mind that, just because you feel comfortable in a particular size of one mask, this does not necessarily mean the same size is best for you with a different mask.

Difficulty getting used to forced air

This problem may simply be overcome by using the ramp feature on your CPAP machine. This feature allows starting the CPAP machine at a low pressure and gradually increasing it to the prescribed pressure over time. This setting can be adjusted by your doctor or a sleep technician. If this doesn't solve the problem, you may want to switch to a different device type, such as bi-level positive airway pressure (BiPAP) or variable positive airway pressure (VPAP) machines. These devices automatically reduce the air pressure as you exhale, making it easier to breathe with the mask on.

Stuffy or dry nose, dry mouth

Use a CPAP machine with a heated humidifier and increase the level of humidification if you experience dry or stuffy nose. You may also want to use a nasal saline spray before bedtime to cope with this problem. A leaky mask can cause a dry nose, so make sure your mask fits well. If the problem persists, your therapist may prescribe a nasal steroid spray.

CPAP users who breathe through their mouth at night may wake up with a dry mouth. Using a chin strap that helps to keep the mouth closed can help in this case, if you are using a nasal mask. Switching to a mask that covers both the nose and the mouth will prevent the mouth from drying out.

Skin or eye irritation due to a leaky mask

A leaky mask can lead to skin irritation. If the air is leaking towards your eyes, it can cause them to become dry or teary. Moreover, if your mask is leaky, you are not getting the full air pressure you need for your CPAP therapy to be successful. Sometimes a simple repositioning of the mask to get a better fit can solve the problem. Make sure the mask does not sit too high on the bridge of your nose, as this can cause the air to be directed into your eyes. In some cases, you may need to adjust the straps on your headgear to stop the leak. If you cannot fix the leak by these adjustments, you may need to ask your CPAP supplier for a different size or style of a mask, such as a nasal pillow or a mask with an inflatable cushion.

Pressure sores

A proper-fitting mask should not leave marks on your skin that last for longer than an hour. However, some masks can cause pressure sores, especially on the bridge of the nose. Make sure your straps are not too tight. You may try adding extra padding or using a Band-Aid over problem spots. If you cannot solve the problem by simple adjustments of the mask and headgear, you may need to get a different mask that better fits you. Masks with soft silicone padding are available and should prevent the development of pressure sores.

Noise

Most modern CPAP machines and masks are designed to be almost completely silent. If your device is noisy, check that is it set up correctly, the filter is clean and the machine air intake is unobstructed. You may want your doctor or CPAP equipment supplier to check that your machine is working properly. In case there are no problems with your equipment but the noise is bothersome, try wearing earplugs or masking the sound of the machine with relaxing ambient noise.

Removing the mask at night

Sometimes you may wake up and realize that you are no longer wearing the mask. You may have removed it by accident while moving in your sleep. In this case, using a chin-strap to secure the mask can help keep it on your face throughout the night. Switching to a full-face mask can also help overcome this problem.

In other cases, you may be removing the mask in your sleep due to a stuffy nose. Make sure your mask fits properly and use a CPAP machine with a heated humidifier to prevent this problem. If you still find yourself consistently removing the mask during the night, you may consider setting an alarm clock for some time during the night to make sure you put the mask on in case you removed it.

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