Positive airway pressure (PAP) treatment uses a machine to pump air under pressure into the airways of the lungs. This helps keep the windpipe open during sleep. Forced air that is insufflated by CPAP (continuous positive airway pressure) prevents episodes of airway collapse that block breathing in people with obstructive sleep apnea and other respiratory problems.
Who should use the CPAP Machine
PAP can be an effective treatment for most people with obstructive sleep apnea. It is safe and works well for people of all ages, including children. If you only have mild sleep apnea and do not feel very sleepy during the day, you may not need it.
After using PAP regularly, you may notice:
- Better concentration and memory
- I am feeling more awake and less sleepy during the day.
- Improving your bed partner’s sleep
- Improvement in labor productivity
- Less anxiety and depression, and better mood
- Normal sleep patterns
- Lower blood pressure (in people with high blood pressure)
Your health care provider will tell you the type of PAP machine that treats your problem:
- Continuous positive airway pressure (CPAP) provides a light and stable pressure of air in the airways to keep them open.
- Self-adjusting positive airway pressure (APAP) changes pressure throughout the night, based on breathing patterns.
- Two-level positive airway pressure (BiPAP or BIPAP) has higher stress when you breathe in and lower anxiety when you breathe out.
BiPAP is useful for children and adults who have:
- The respiratory tract that collapses while asleep, which makes it difficult for them to breathe freely
- Decreased air exchange in the lung
- Muscle weakness that hinders breathing, due to conditions such as muscular dystrophy
PAP or BiPAP can also be used by people who have:
- Respiratory insufficiency
- Central sleep apnea
- Heart failure
How to use the CPAP machine
• Clean and dry your face for a good seal of the mask.
• Place your CPAP device on a lower level surface than the bed, either at the head of the bed or on the side.
• Place hairstyles on the head and mask on the nose or mouth and tighten until blockage. Do not over-tighten, as this could lead to bruising and pain.
• Attach the hose and swivel tube to the elbow connection on the mask, if necessary.
• Turn on your machine. Airflow must be continuous. If there are no leaks around the mask, you may need to tighten your harness straps.
• Wash your mask the next day with warm water and mild soap. Dry with a clean towel.
Tips and Warnings
- The mask can be uncomfortable at first, so wear it for short periods at a time until you get used to it. Check your filter once a month and replace it or wash it if the filter is dirty. Wash the tubes weekly and hang to dry wash tubes daily if you are sick with a cold.
- Side effects include a dry or clogged nose, skin irritation, and headaches. Stomach discomfort is not an average side effect, and your CPAP will need to be readjusted.
When using a PAP configuration:
- You put a mask on your nose or nose and mouth while you sleep.
- The mask is connected using a hose to a small machine that stays next to your bed.
- The machine pumps air under pressure through the hose and the mask into the airways while you sleep. This helps keep the airway open.
You can start using PAP while in a medical center for nighttime sleep.
- Your provider will help you choose the mask that suits you best.
- They will adjust the configuration of the machine while you are asleep.
- The settings will be adjusted based on the severity of sleep apnea.
If your symptoms do not improve after receiving PAP treatment, the machine settings may need to be changed. Your provider can show you how to adjust the scenes at home. Or you may need to go to the sleep center to have your adjustments made.
Accustoming the machine
It may take time to get used to the use of the PAP configuration. The first nights are often the most difficult, and you may not sleep well.
If you are having problems, you may be tempted not to use the machine overnight. But, you will get used to this more quickly if you use the device the entire night.
When using the configuration for the first time, you can submit:
- A feeling of being enclosed (claustrophobia)
- Muscle discomfort in the chest, which often goes away after a while
- Eye irritation
- Redness and ulcers on the bridge of the nose
- Secretion or nasal congestion
- Dry mouth or pain
- Infections of the upper respiratory tract
Many of these problems can be alleviated or prevented.
- Ask the provider about using a mask that is lightweight and padded. Some masks are only used around or inside the nostrils.
- Make sure that the mask fits correctly so that no air escapes. It should not be too tight or too loose.
- Try nasal sprays with salt water for a stuffy nose.
- Use a humidifier to relieve dryness of the skin or nasal passages.
- Keep your equipment clean.
- Place your machine under the bed to reduce noise.
- Most machines are silent, but if you notice noises that do not let you sleep, tell the provider.
Tips to avoid common problem while using the CPAP machine
Continuous complimentary respiratory pressure therapy ( CPAP ) is a standard treatment for obstructive sleep apnea. It includes a small machine that supplies a constant and stable air pressure, a tube and a face mask or a nasal CPAP mask. Common problems with CPAP include leakage of masks, problems falling asleep, and dryness in the mouth or nose.
The good news is that if a mask or CPAP device does not work for you, you have other options. And most CPAP masks are adjustable to help you be more comfortable. Here are ten common CPAP problems and what you can do about it.
The wrong size or style of the CPAP mask
It would help if you worked closely with your doctor and CPAP provider to make sure you have a CPAP mask that fits your needs and you. Each person has different needs and face shapes, so the style and size of another person’s mask may not work.
There are many styles of mask available. There is a range of CPAP masks available. For example, some have full masks that cover the mouth and nose, with straps that extend across the forehead and cheeks. These can make some people feel claustrophobic, but they work well by offering a stable fit if you move a lot while you sleep. Other masks have nasal pads that are placed under the nose and that have straps that cover less part of your face. These masks can make you feel more comfortable. They can also work well if you wear glasses or if you have or want to read with the mask on since some systems obstruct the impaired vision. However, it is possible that this type of mask does not work for you if you move a lot at night or if you sleep on your side.
Pay attention to the size. Most masks come in different sizes. The CPAP masks are adjustable. Ask your doctor or CPAP provider to show you how to adjust your mask to get the best fit. The product manufacturer’s instructions can also help you show how to do this.
Get used to using the CPAP device.
It may be useful for you to start using your CPAP mask for short periods while you are awake, for example, while watching TV. Once you are used to this, try the mask and tube with the air pressure during the day while you are awake. Once you get used to what you feel, start using the CPAP device every time you sleep, at night, and during a nap. Getting used to the mask can be challenging.
Difficulty tolerating forced air
You may be able to overcome this by using a “ramp” function of the machine. This feature allows you to start with low air pressure, followed by an automatic and gradual increase in force for the prescribed setting while you sleep. Your doctor can adjust the rate of this ramp function.
If this does not help, talk to your doctor about switching to another type of device that can automatically adjust while you are sleeping. For example, units that provide positive two-level pressure ( BiPAP ) or tools that have variable pressure contours. These provide more pressure when you inhale and less when you exhale.
Dryness and nasal congestion
A CPAP device that has a thermal humidifier, which is connected to the air pressure machine, can help you with this problem. The level of humidification is adjustable. The use of a saline nasal spray before bedtime can also help. The doctor may prescribe a nasal spray with steroids if your dryness does not respond to hot moisture. It is also essential that the mask fits well. A leaky mask can dry your nose.
Sensation of claustrophobia
While you are awake, but only the mask on your face, without putting any more part. Once you feel comfortable with that, try using the mask with the straps. Next, try to keep the mask and the tube, without the straps, with the tube connected to the CPAP machine at low pressure (disables the ramp function). And, finally, use the mask with the straps and with the air pressure machine on while you are awake. After you feel comfortable with that, try to sleep with her on.
Relaxation exercises, such as progressive muscle relaxation, can also help you reduce anxiety. If you still feel claustrophobic, talk to your doctor or CPAP provider. They can help you get a different sized mask or try a different style, like the one that uses nasal pads.
The mask causes irritation or sores on the skin.
A leaky or poorly fitting mask means that you are not receiving the full pressure of the air you need, and that can cause skin irritation. It can also release air in your eyes, making you dry or cry. Try using the pads and adjustable straps to get a better fit. If the device is placed on the nose, make sure that the air does not go to your eyes.
You may have to ask your provider to help you find a mask of a different size, especially if your weight changes dramatically, or you can also try a device of a different style, such as a nasal pillow or an inflatable mask that adapts to Your face. If your skin deteriorates or skin sores appear, inform your doctor immediately.
Difficulty getting to sleep.
This is a temporary and regular problem. Wearing the mask for some time during the day can help you get used to the mask. The use of the ramp function, which provides an automatic and gradual increase in air pressure, can reach your prescribed pressure setting while you sleep. Have good sleep habits in general, such as exercising regularly, avoid caffeine and alcohol before going to bed, and try to relax. For example, take a warm bath before going to bed. Avoid going to bed until you are tired.
If you breathe through your mouth at night or sleep with your mouth open, some of these devices can worsen the dryness of your mouth. A chin strap can help keep your mouth closed and reduce air leakage if you use a CPAP nasal mask. A full-face mask device that covers the mouth and nose can also work well for you. An air-conditioned CPAP humidifier connected to the air pressure machine can also help you.
It was unintentionally removing the CPAP device during the night.
It is expected that sometimes when you wake up, you realize that you have removed the mask during the night. If you move a lot when you sleep, a face mask will be the most appropriate for you. You can remove the mask if your nose is congested. If so, ensuring a good fit of the mask and adding a CPAP humidifier can help. A chin strap can also help you keep the device on your face. If this is a constant problem, you can consider setting the alarm for some time at night to verify that you are wearing the device. You can also progressively delay the time of the notice if you keep the device for longer.
The noise bothers you.
Most new models of CPAP equipment are very quiet, but if you find the device noise very annoying, first verify that the air filter of the equipment is clean and not blocked. Something obstructed may be contributing to the noise. If this does not help, ask your doctor or CPAP provider to check the device to make sure it is working correctly. If the device is working correctly and noise still bothers you, put on earplugs.
Time and patience is the key to success. The use of a CPAP device can be frustrating as you get used to it, but you mustn’t give up. Treatment is essential to avoid complications related to obstructive sleep apnea, such as heart problems and fatigue during the day. Work with your doctor and CPAP provider to ensure the best fit and best device for you and try to make adjustments if you are experiencing some of the common CPAP problems. It can take you several months to find the right configuration for your case and to adapt to the mask. With time and patience, CPAP can positively influence your quality of life and health.