This guide covers every aspect about PAP devices. For your convenience, we have provided you with a table of contents that allows you to skip to the specific section(s) you wish to see. There is an arrow on the right side of the screen that you can click to return back up the top at anytime so you can select another section from the table of contents.
- 1 About This CPAP Guide
- 2 Types of Positive Airway Pressure (PAP) Devices
- 3 Special CPAP Machine Features
- 4 Choosing The Right CPAP Mask For You
- 5 PAP Pressure Adjustment
- 6 What Should CPAP Feel Like?
- 7 How Long Does It Take To Get Used To CPAP?
- 8 Solutions To CPAP Side Effects & Other Issues
- 8.1 Difficulty Tolerating Forced Air
- 8.2 Annoyed By The Noise Of The Machine
- 8.3 Dry Mouth and Tongue
- 8.4 Fixing And Preventing Mask Leaking For Full Face Masks
- 8.5 Can’t Talk With My CPAP On
- 8.6 Pressure Sore On The Bridge Of The Nose From CPAP Mask
- 8.7 Your Teeth Hurt
- 8.8 Gas in Stomach (Aerophagia)
- 8.9 Clean Your Mask: Avoid CPAP Respiratory Infections And Degradation Of Your CPAP Equipment
- 8.10 Nasal Congestion Using CPAP
- 8.11 Condensation In CPAP Tubing
- 8.12 Power Source Issues
- 8.13 Air Intake Issues
- 8.14 Pet Problems
About This CPAP Guide
This all-inclusive guide will provide you with all of the necessary information to help you gain a complete understanding about the various PAP devices and masks, how to make sure you get the right equipment for your need, and solutions to all the common CPAP side effects and problems. So whether you have just been diagnosed with sleep apnea and prescribed CPAP treatment or you have been using CPAP treatment for years, you have come the right place, as this guide has all the answers to your questions regarding CPAP. And of course, if you don’t find the answer your looking for in this guide, just shoot us a question in the comment box at the bottom of the articles and we will be sure to get back to you promptly with the answer.
We also have a comprehensive guide on Sleep Apnea that I highly recommend you check out as well. It will provide you with extensive and relevant information about sleep apnea including the causes of sleep apnea and the array of treatments options available.
If you do determine a PAP device is your best course of treatment for sleep apnea, be sure to check out our ultimate buying guides on the best CPAP machine 2016 reviews, best BiPAP machine reviews, and best CPAP mask reviews so you are sure to get the right equipment for your particular needs and preferences.
Types of Positive Airway Pressure (PAP) Devices
There is a variety of PAP devices that range in different shape, sizes, and weight. You will work with your physician to determine which machine type will meet your clinical and lifestyle needs. The following are the 3 primary types:
CPAP (Continuous Positive Airway Pressure)
CPAPs as the name suggests, simply provides a constant level of pressure during both inhalation and exhalation. This is the most commonly used PAP device.
Bilevel PAP (BiPAP)
This machine is prescribed to individuals who require two different pressures during each breath. The greater pressure is provided during inhalation and the lesser during exhalation. For some patients, the prescribed pressure required to keep the airway open is high which can make exhalation difficult. The adjustment to a lesser pressure by the BiPAP machine during exhalation can make breathing much easier under such conditions.
Auto PAP (APAP)
Instead of manually adjusting the pressure to a single level as determined by a sleep study, these auto-adjusting devices are capable of adjusting the necessary pressure in real time throughout the night as the minimum level of required pressure to keep the airway open can change from night to night and even throughout the night. This can make APAP devices more effective and comfortable to use than standard CPAP machines.
Special CPAP Machine Features
The various PAP devices differentiate themselves in a variety of ways. The following are a couple of the special features that set some PAP devices apart from the rest:
This feature provides a gradual increase in pressure to the specified level when the device is first activated. This makes the adjustment to breathing with CPAP much more comfortable and allows you to transition to sleep easily. This is especially helpful for people who have a particularly high level of prescribed pressure.
Similar to how a BiPAP makes it more comfortable to breathe due to the lesser pressure applied during exhalation, this feature that some CPAPs have provide a relief of pressure momentarily during the beginning of exhalation.
Many CPAPs, BiPAPs, and APAP machines allow for the option to attach a humidifier to the device. The added moisture to the air prevents the drying of the airways from the movement of a lot of air throughout the night. Such drying of the airways not only creates discomfort but can actually cause additional inflammation that can result in a change in air pressure requirements. There are both cool and heated pass-over humidifiers. As you may assume from the names, the cool humidifier passes the air over a room temperature chamber of water while the heated humidifier passes the air over a heated chamber of water causing the air to become even more saturated with water.
Other special features of various PAP machine models include internal downloadable memory which can output data including documentation of nightly respiratory events (software required), automatic altitude compensation, and a capability to be battery operated.
Choosing The Right CPAP Mask For You
Types of CPAP Masks
There is vast array of available CPAP masks on the market today with varying features and designs to make the mask as comfortable and effective as possible. The variations in the these different types of masks are designed to help accommodate the many different needs of people with sleep apnea including their face type, whether they breathe through their nose or their mouth, and the person’s desired sleeping position (e.g. side sleeper).
Even though all of these masks are unique, they can be categorized into 3 types of masks:
Nasal Pillow Mask
This type of mask only delivers air through the nose. For this type of mask to be effective, the person’s mouth must be shut while sleeping or the air will simply go up through the nose and out through the mouth, thus never creating the necessary pressure within the airway to keep it from collapsing. If your mouth tends to open while you are sleeping, you may want to consider using some form of a chinstrap or mouthguard to keep it closed. If you primarily breathe through your mouth while sleeping this type of mask is probably not the right one for you.
The nasal pillows (also referred to as prongs) are actually inserted into your nostrils which creates a seal. This is the most minimalistic type of face mask as it is the least invasive due to the small size and minimal coverage/contact with the face. This type of mask is great for people who may get claustrophobic due to the minimal coverage/contact with the face as well as the fact that most nasal pillow masks do not impede your vision (i.e. mask is not in the line of sight). This type of mask is also good for side sleepers as it allows you to sleep on your side comfortably without causing the mask to move or have sealant issues.
As the pillows make contact in and around your nose, which can be sensitive, you may experience chaffing or chapping in that area. One way to prevent this is to apply some water based lubricant where the pillows make contact every night before applying the mask. Another potential issue is that the air that flows into the nostrils is so direct that it can tend to dry out the inside of the nose and increase the likelihood of bloody noses. A common solution to alleviating such effect is the use of a heated humidifier.
Nasal Cup Mask
Like the nasal pillows, this type of CPAP mask only delivers air through the nose, but unlike the nasal pillows, instead of creating a seal within the nose, this mask is a chamber that sits over the nose. These masks are very effective as they usually provide a very good seal due to the nature of the design and will not cause any irritation within or around the nostrils as is sometimes the case with nasal pillows. Like the nasal pillow, this type of mask is also good for side sleepers as well.
Full Face Mask
The full face mask creates a sealed chamber that covers both the nose and mouth. This allows you to freely breathe through either without having air pressure issues. This mask is good for people who have had deviated septum or any other sinus problems, as well as for people who just naturally prefer to breathe through their mouth while sleeping. It is common for people who use one of the nasal masks regularly to also have a full face mask on hand as a secondary backup for when they have unusual congestion due to a cold, flu, or allergies.
The downsides to these types of masks is they commonly will leak when you are lying on your side and they can be quite cumbersome and intrusive on your face.
What Type Of Mask Should You Use?
As you can see there are pros and cons for each type of CPAP mask. It really comes down to finding the type of mask that addresses your specific needs and sleeping habits best. The results of the “titration” portion of your sleep lab test will usually help direct you to what type of mask with be best for you but at the end of the day, you simply will have to try out different masks and find out through personal experience.
Everybody’s face is unique, so finding a mask that fits you best is essential in effectively treating your sleep apnea in the most comfortable and non-obtrusive manner. CPAP or other forms of PAPs are 95% – 100% effective, but that is only if the patient puts the mask on and uses it. The more reasons that discourage you from using the CPAP mask the more likely you will not want to use the treatment.
Full Face Mask: A full face mask is the preferred face mask for many CPAP users. These kinds of masks are commonly used by people who breathe through their mouths when they sleep. This is the case as the nasal type masks will not properly maintain the necessary prescribed pressure if the air is allowed to leak through your mouth. Many people have a full face mask as a backup for when they are experiencing congestion due to a cold or allergies and need to breathe through their mouths.
Nasal Cup Mask: A nasal cup mask is a good type of mask to attempt to start out with. Nasal masks are great as there is nothing that gets in front of the eyes so you can easily slip on your glasses and watch TV even with the mask strapped on your face.
Nasal Pillow Mask: These masks are really easy to get on and they are really easy to get off but that can be a bad thing. You may slip off the mask while your sleep and not even realize it.
For both nasal pillow and nasal cup masks, you need to keep your mouth closed or all the air will leak out your mouth and the treatment will no longer be effective. There are chin straps and mouth guards to assist you with this. You can either use one of these solutions or consider using a full face mask
Hybrid Mask: There is also hybrid masks that cover the mouth but use pillows to create a seal within the nose. These types of mask are used to address specific issues such as having problems with chaffing or irritation on the bridge of the nose or inner cheek.
I like to compare picking a mask to dating. There are a lot of masks out there but there are probably only a couple that are really right for you. Just don’t be afraid and put in the time to try different types of masks. Most masks have a 30 day money back guarantee. That will give you more than enough time to determine if the mask is right for you.
What Size Mask Is Right For You?
The following are instructions on how to check to see if the mask if the appropriate fit:
Full Face Mask: First you need to identify you Nasion (the low point between your brow and your nose) which is where you want the top of the face mask to seat itself. Then have your mouth slightly open such as when you space out watching TV. With the top of the mask sitting on your nasion and your mouth slightly open, you want the inside of the cushion of the bottom of the mask to fit a ¼’’ – ½’’ below your bottom lip.
Nasal Cup Mask: These types of mask are much easier to fit. You just want to make sure that you have enough room around and below your nostrils. You need to make sure the mask is not pinching your nostrils or is not clearing the bottom of your nostrils so that the inside of the cushioning on the bottom of the mask is blocking your nasal passages. Both of these conditions will inhibit your breathing. The top of the mask does not have to sit on your nasion like the full face mask. It can really sit anywhere on your nose as long as you get a good seal.
Nasal Pillow Mask: To maximize comfort and airflow you want to have the opening of the pillows to be just smaller than the size of your nostrils. This will also minimize the amount of chaffing you experience.
PAP Pressure Adjustment
It is common that during your overnight sleep study, once there is a potential positive diagnosis of sleep apnea, a PAP device will be administered for the remainder of your nights rest in the lab. During this time, the sleep tech will manually adjust the pressure administered by the PAP device to determine the minimum amount of pressure necessary to keep the airway open. This process is commonly referred to as “titration”.
There are also Auto PAP devices in which the device itself will automatically adjust the pressure to the necessary level, but this type of automatic calibration is not appropriate for all cases. Such a determination will be made by your physician.
What Should CPAP Feel Like?
It’s important to know your breathing will not be the same. You are literally inflating your upper airway. Now breathing in is going to feel fairly normal to lot of people as many don’t mind the pressure, but the problem comes in when you exhale. People want to exhale completely where they feel there lungs fully deflate, etc, but with the CPAP, you won’t experience that same sensation. You will feel more of a leaking out of air. Some people try to counteract this by really forcing out the air as they exhale which can commonly get someone into a hyperventalative state and consequently cause them to be unable to relax and go to sleep. You just need to relax and let your lungs exhale on their own. Simply let the air leak out on its own. It will take some time to get used to but just be patient and try to relax.
How Long Does It Take To Get Used To CPAP?
This answers differs from person to person but in general you should get used to it fairly quickly. The learning curve or adjustment period is very short for this type of treatment. But as you haven’t been using a CPAP or other PAP device for your entire life up until your diagnosis, you can’t expect for you to fully adjust the first night. It is a different way of breathing and now you have some form of a mask strapped to your face that is connected to a machine next to your bed.
A lot of the time, not everything is perfectly correct in terms of the prescription (pressure), etc. Even though you had a titration study performed at the sleep lab or you are starting on an auto titration PAP device (APAP), you may definitely be on the incorrect pressure setting. Just a centimeter of water pressure too high or too low and you could experience unusual respiratory arousal, central sleep apnea, general discomfort, etc.
One way to check if you do have the correct pressure is to use the SleepHead software which collects the necessary information when you are using the device to determine if your pressure is too high or too low. You can download the software for free here at sourceforge.net. It will list which kinds of machines the software supports. There is a number of new machines it does not support yet, but hopefully there will be update in the near future that will support these newer machines.
Be sure to start using a heated humidifier right from the beginning. Don’t wait to see if your nose starts drying out or experiencing inflammation to start considering integrating the heated humidifier into your treatment. It will definitely make the transition much more comfortable.
Another thing that may not be correct right out of the gate is the mask you first start with. Is the mask fitting properly? Is the mask comfortable? If your using one of the nasal masks, are you having mouth leaking? Adjustments to the mask can be made as well as other possible strategies to solve such issues (see below), but sometimes you just need to try another mask. As referred to in the above section, there are a lot of masks out there and there are probably only a couple that are truly right for you, so expecting that you’ll get the right mask the first time is a little overly optimistic. Not to say you can’t find that match made in heaven the first go around, but is fairly unlikely. The faster you get these issues resolved the faster you are going to adjust to the CPAP treatment.
You should also know that is not uncommon to have a little honeymoon period with your new CPAP treatment and then start to have issues sleeping with the CPAP. I believe this is due to the fact that when you first start using the treatment you are very sleep deprived and thus you are able to sleep soundly throughout the night. Once you obtain the necessary restorative sleep and are no longer seriously sleep deprived, little discomforts of the CPAP can start to annoy you and wake you up at night. This is when you are really beginning that period of getting used to sleeping with CPAP or other PAP treatment. The most important tip I can give you is to just give it time and be patient. For a large majority of people this period will pass and the use of the treatment will become second nature.
Solutions To CPAP Side Effects & Other Issues
Difficulty Tolerating Forced Air
Many people, especially when you are first starting out with your treatment with a PAP device or you have a high prescribed pressure prescription, you may have trouble falling asleep with the pressure applied by the PAP.
- One way to counter this issue is to use the “ramp” feature which many CPAPs and other PAP devices have. This allows you to begin at a lower pressure and then have the machine gradually increase the pressure automatically to the prescribed pressure as you fall asleep.
- If this does not solve the problem, you may want to consider using a BiPAP that has two different types of pressure, one when you are breathing in and a lower pressure when you are breathing out.
Annoyed By The Noise Of The Machine
Some people can find the noise of the PAP devices to be annoying and prevent them from falling asleep. Most of the new models are practically silent but if you find the machine is making noise that is bothersome there is a couple things you can do.
- First, check to see if the air filter is blocked or not clean as this can cause the machine to make noise.
- The machine could also not be working properly and you should have it checked out my your PAP device supplier or your doctor.
- After you have confirmed the machine is working as it should but the noise is still bothering you I would recommend either using earplugs or purchasing a sound machine that will help mask the noise of the PAP machine.
Dry Mouth and Tongue
If you are using a nasal cup or nasal pillow mask and are waking up with a dry tongue/mouth this may be due to excessive mouth leaking. This is where you are opening your mouth during the night and the pressurized air is going through your nasal passages and right out your mouth. This kind of leaking can be detrimental to your CPAP therapy as this may mean an insufficient amount of air pressure is not being maintained to keep your airway open. Thus, you are still experiencing apnea throughout the night.
The variety of possible solutions to prevent this from occurring include using a chinstrap, a soft surgical collar around your neck, a basic boil and bite mouthguard, or possibly you should consider switching to a full face mask.
Fixing And Preventing Mask Leaking For Full Face Masks
A common problem with full face masks is that they tend to get a lot of leaks as the seal around the mask expands around a lot of surface area. Obviously leaks can be caused by simply having the mask be too loose on your face which will allow the seal to break once the air pressure of the CPAP is applied. But other causes of leaks include the creation of creases within the seal which stem from moving in your sleep or the mask actually being on too tight.
If leaking does occur due to the formation of a crease, the easiest way to resolve this is to move the mask away from your face to allow the creases to flatten out and then allow the mask to fall back on your face creating a new leak free seal. Once the mask is back resting on your face, you may have to slightly move it around a bit to allow the silicon to re-seat itself on your skin. You may have to do this a couple of times to achieve the desired seal. Be sure to do this when the air pressure is off or the seals of the mask will simply fold out preventing the mask from fitting on your face properly.
Sometimes people have a more systemic problem with leaking of their full face mask. The mask is properly fitted with the right amount of tightness and thus a great seal is created. Unfortunately, this is only the case when you are awake/falling asleep as you have enough muscle tone to push against the mask that creates such a good seal. Once you start falling into a deeper sleep your muscles begin to relax, specifically the muscles supporting your mandible jaw bone. The mandible is your lower jaw bone which is free floating, so once your muscles begin to relax, the mandible begins to move back. As the jaw moves back, the seal of the face mask is broken thus dissappating the necessary pressure required to keep your airway open. It is not uncommon this will cause you to wake up. You will then attempt to address the problem by tightening the mask. You most likely will overtighten the mask which can either cause you discomfort that possibly prevents you from getting back to sleep or cause the silicone to fold over on itself causing more leaking, etc.
A great simple and economical solution to this problem is to use a boil and bite mouthguard that has a spacing between the two guards so you can breathe through it. The mouthguard connects the mandible (lower jaw) with the upper jaw which then prevents the mandible from sliding back as you sleep, thus preventing your face from changing shape which is causing the persistent leaking issue.
The mouthguard I have found to work well is Adam’s USA Boil-n-Bite mouthguard, but really any should work fine. Just make sure the mouthguard has that gap that allows you to breathe through your mouth with it in. Additionally, just for clarification, a “boil and bite” mouthguard is a mouthguard that you simply place in boiling water for a short duration to soften the plastic and then bite down on it so it properly molds to your jaw/teeth. That way, it will fit comfortably in your mouth and you will be able to sleep peacefully.
Can’t Talk With My CPAP On
If you have your nasal mask on and you attempt to talk, the air pressure within your nose will flow out your mouth, causing your speech to sound practically incoherent. This is more so the case, the higher your prescribed pressure is.
The way to solve this is by internally plugging your nose. Just as you would do when you are going under water and don’t want water to go up your nose, you internally plug your nose before you begin speaking. Just give it a try. If you are unable to perform this, but you have the right nasal mask, you can simply pinch your nose with your fingers. If either of these options are not possible, unfortunately you are out of luck and will probably have to just remove your mask to speak.
Pressure Sore On The Bridge Of The Nose From CPAP Mask
One of the very common CPAP side effects for people who are new to CPAP is finding that happy medium regarding the tightness of your mask. If you have it too loose, it will cause all kinds of leaks, but if you have it too tight, this will cause leaks as well. Additionally, having your mask on too tight will cause pressure sores as well. Sometimes, pressure sores will occur even if you have the correct tightness.
- Try to loosen the top of the mask to where it remains leak free to prevent such sores from occurring.
- If you already have the pressure sore, the cheapest and easiest way to solve the problem is to simply apply a bandaid over the sore. This will provide a barrier between you and the mask which hopefully provides sufficient cushioning to allow the sore to heal. It will also prevent any further chaffing/irritation as well as eliminate your skin’s contact with the silicone which you may be having a reaction to.
- There are also products you can use as well such as the Gecko pad. It’s not very expensive and many people live by it.
- Another option is to use a backup mask while you allow the sore to heal. This is an especially good option if you are using a nasal cup mask. You can simply switch to a nasal pillow mask which does not have contact with the bridge of your nose. Use the nasal pillow mask for a couple days until the sore is healed and then you can return to your normal mask.
- In line with the last option, having a couple of different mask and cycling through them throughout the week will help prevent any sores from forming in the first place. It gives various parts of your face a break from pressure points of the different masks. As referred to above, you can switch between a nasal cup mask and a nasal pillow mask. If you use a full face mask, you can switch between a traditional full face mask and one of the hybrids that don’t come in contact with the bridge of your nose (e.g. Amara View, Innomed Hybrid, Resmed Mirage Liberty).
Your Teeth Hurt
Teeth pain is another of the potential CPAP side effects you many experience. This is most commonly caused by nasal cup masks in which the bottom of the mask is pressing too hard on the upper lip.
- To solve this problem, incrementally loosen the bottom of the mask with the straps until you have it as loose as possible without any leaking.
- If this is does not work, purchase an upper mouthguard. This will lock all your teeth in place so your back molars are supporting your front teeth. Instead of your two front teeth working alone against the pressure of the mask, you have all your teeth backing them up so the pressure is dispersed. You can get one of these simple boil and bite mouthguards at any CVS, Rite Aid, Walgreens, etc.
Gas in Stomach (Aerophagia)
A common CPAP side effect is the swallowing of air into your stomach due to the pressured air being pushed down your throat. The technical term for this issue is Aerophagia. The primary symptom of this condition is waking up with a painful bloated gassy feeling.
- The best moat sure fire solution to this problem is to start using a bi-level device (BiPAP). Unlike CPAPs that provides only one consistent pressure, BiPAPs provide an inspiratory pressure (pressure applied by the machine when you are breathing in) and an expiratory pressure (pressure applied by the machine when you are breathing out). A lower pressure is applied when you are breathing out which makes it easier to exhale and helps prevent you from swallowing air as you breath out. The only downside to this solution is it can be expensive. BiPAPs are more expensive than their CPAP counterparts.
- A more economical solution that many have found to work is to sleep on a wedge or make your own wedge with a bunch of pillows. Basically you want to be sleeping with your upper body in an elevated position (around a 45 degree angle). This has been found to help prevent air from entering your stomach.
- Another possible solution is to tuck your chin towards your chest as this will prevent you from swallowing. Just try tucking your chin in towards your chest and you will find it is much harder to swallow. You can accomplish this by setting up some pillows so that your head is pushed forward. Obviously, if you try this method and it hurts your neck, stop immediately!
- Also be sure to inform your doctor of this issue as he/she may have other solutions to solve this problem. Your physician may also perform a scope to look at your throat to determine if there is anything wrong that may be causing the problem. It is possible that your upper esophageal sphincter may be damaged or you may have gastroesophageal reflux disease (GERD).
- For some reason many people have found that simply switching to a full face mask from a nasal mask has helped to alleviate this symptom as well.
- The reason a small percentage of the people who experience Aerophagia is simply due to the fact that they have the incorrect prescribed pressure. If your pressure is too low, you may be experiencing apnea or hypoapneas causing you to gasp for air and resulting in you swallowing air into your stomach. So make sure you have the correct pressure prescribed and programmed into your device.
Clean Your Mask: Avoid CPAP Respiratory Infections And Degradation Of Your CPAP Equipment
This problem is a little unique as I will be providing more of a preventative solution as to avoid any of these problems from occurring in the first place. When we sleep, we perspire sweat which contains oils, these oils come in contact with your CPAP equipment, especially with your mask. Overtime, these oils will breakdown the materials of your mask which cause the mask to not seal as well or possibly fit as comfortably. A dirty mask can also cause skin irritation.
You also need to make sure you clean and replace the water in your humidifier after every use or you will have issues in getting upper respiratory tract infections.
To avoid these problems referred to above you simply need to clean your including your mask, tube, and humidifier on a daily basis. To clean your mask the old fashioned way, simply fill your sink with some warm water while applying a few squirts of liquid dishwashing soap. Once the sink is sufficiently full, simply dip your mask into the water and scrub with your hands. Specifically focus on the seals of the mask that come in contact with your face. Then wash off the mask and place on a drying rack or towel just as you would if you were drying dishes. Just be sure to not have the mask or any of your equipment dry or sit in direct sunlight. This will damage your mask. Also be sure to not use any petroleum products or alcohol on your equipment as well.
As your humidifier has been sitting in a dark, warm, moist environment, this creates prime conditions for bacteria to grow. Thus, it is very important to dump out the reservoir water from the night before and submerge it into the warm soapy water. After that, simply wash it off with some fresh water and place it on a towel to dry.
Finally, you need to clean the hose. Dunk the hose into the soapy water until it fills up a bit, then cap both ends and move the two ends of the hose up and down in opposite directions so that the water moves throughout the entirety of the inside of the hose. Then put one end of the up against the sink and let cool fresh water flow through the hose and out the other end. To dry, I would suggest hanging the hose on a towel rack or something similar so that the hose can drain out both ends and be sufficiently dry for that night.
Just as you wash your face everyday, this cleaning process should be performed everyday. I know it seems like a big hassle, but it really only takes 2 – 3 minutes to complete once you establish a routine.
I also recommend that you give your equipment a good deep clean once every week or every other week. This consists of filling up your sink with some white vinegar that is highly diluted with water and then soaking the equipment in it for 5 to 10 minutes.
It is very important to keep your PAP device equipment clean including your mask, humidifier, and your tubing. There are a variety of products available to help you, including mask wipes as well as complete CPAP Cleaner and Sanatizer systems such as the SoClean. These products can definitely make it easier to clean your equipment, but if you don’t want to spend the money, you can get your equipment just as clean and sanitized using mild dish soap and some elbow grease.
Nasal Congestion Using CPAP
One of the most common problems in patients using CPAPs with a nasal mask, whether that be a nasal pillow mask or nasal cup mask, is nasal congestion. Consistent nasal congestion is a common condition many patients already have before even starting CPAP treatment for sleep apnea so it is important to address this problem right from the beginning.
- The best way to resolve this issue is the use of a humidifier. As discussed above, a humidifier is one of the special features that most CPAP and other PAP devices have the capability to attach. But you should know that using a humidifier is not always as easy as simply attaching the humidifier to your PAP device. It is important to understand the different humidification settings, when to change them (e.g. winter vs summer), and how to change them. It is a good general guideline to re-evaluate your humidification settings at least 4 times a year. It should be highest in the winter, lowest in the summer, and somewhere in between for Spring and Fall. When you get a cold and you have congestion, it’s important to increase your humidification setting as you require greater external moisture to help eliminate the production of the internal moisture.
- If this does not eliminate the problem fully, you may want to consider a steroidal nasal spray to help clear the congestion. This kind of spray requires a prescription, but I highly recommend you use such a spray instead of the over the counter Afrin nasal sprays. Using these types of over the counter nasal sprays for more than three days in a row can actually cause the problem to get worse.
- As a last resort, if these potential solutions don’t work, then you will want to see an Ear, Nose, and Throat doctor to help you resolve this issue.
Condensation In CPAP Tubing
Unfortunately, it is not uncommon when a patient increases the humidification during the winter or when one has congestion, condensation builds up in the hose. This condensation can create gurgling noises which can be mistaken for snoring or other respiratory issues. It can also hinder your breathing or even cause you to inhale the water.
- One of the easiest ways to solve this issue and is actually just a general best practice for setting up your CPAP, is to have the CPAP device below the top of your bed so any condensation that forms within the hose will simply run back down into the humidifier reservoir. But I would not recommend putting your CPAP on the floor as there is usually a lot of dust on the floor which will be sucked up by the CPAP and clog the filter, causing the machine to not operate appropriately.
- An alternative to having the machine below your mattress level is to have the tube hang up above you whether that be by hanging it over your headboard or creating/buying a hanger. This will allow any condensation that forms in the tube to drain back into the reservoir as well . This method also takes weight off of the end of the tube where the mask is attached. This allows you to move more freely without the weight of the tube impeding your movements.
- Another solution that you can try alone or in conjunction with the suggestions above is to place the hose under your covers of your bed. This helps keep the hose warm and minimize the amount condensation. There are also hose “cozys” that are available such as the SnuggleHose. These are essentially pieces of cloth that go over the hose and have the same effect as putting the hose under your covers as it keeps it warm and thus reducing the condensation.
Power Source Issues
Obviously you need to have a power source nearby to plug in your machine, but there are a lot of places that have constant power outages due to storms, etc.
Under these conditions you may want to consider obtaining an uninterrupted power supply (UPS) unit that will keep the machine running even if the power goes out
Air Intake Issues
Most PAP devices take in air from the back of the machine. If the air intake is impeded for any reason, it can cause the machine to malfunction.
To assure your machine is receiving optimum air intake, make sure to have the back of the machine at least 4’’ from the wall or other surface. Also be sure to avoid having the machine near places in which there can be significant dust accumulation such as the floor, as this will clog the filter and cause air intake issues.
The hose of the CPAP machine can be a very alluring toy for cats and dogs. It is not uncommon that cats will attack the tubing and put little holes in it with their claws or teeth.
If you have pets, I would recommend either covering up the tubing with some kind of fabric or storing the tubing in a place that is not reachable by your pets.
Written by Dr. Gilmore. Cara is an expert in getting a good nights sleep.