CPAP troubleshooting


μάσκα cpapCPAP Machines: 10 tips for avoiding common problems

The use of the CPAP device is an important treatment for the syndrome of obstructive sleep apnea, but unfortunately it is often problematic.

Continuous positive airway pressure (CPAP – Continuous Positive Airway Pressure) is the treatment of choice for obstructive sleep apnea syndrome. It includes a small machine that feeds a continuous pressure of air through a tube and a mask that the person wears. The most common problems when using the CPAP device include air leaks from the mask, problems while sleeping, dry mouth, and dry nose.

The good news is that if a mask or CPAP device is not working for you, you have other options. Most masks are adjustable to be as comfortable as possible. Below are described the 10 most frequent problems of CPAP use and what you can do for them.

1. The wrong size or style of your CPAP mask

You must contact your physician or your appliance supplier to make sure you have a mask that fits your needs. Every patient has a different face shape, so a mask that suits someone else, may not be at all convenient and practical for you.

Many different types of masks are available. For example, some manufacturers have masks covering both the mouth and nose with straps that extend around the forehead and cheeks. These may make some people feel claustrophobic, but they work well in providing constant pressure especially in people who change positions and postures frequently during sleep. Other masks are exclusively nasal or they even have nasal pillows placed under your nostrils and carry straps that cover less surface area of your face. With this type, the patient usually feels less cumbersome. Furthermore, if you wear glasses or want to read while wearing the mask, nasal pillows are more suitable because they impede vision less than the full face masks. However, it may not work for you if you change position frequently during your sleep.

Pay attention to size. Most masks come in different sizes. The same size, however, may vary from manufacturer to manufacturer. Ask your doctor or your provider to show you how to adjust your mask to get the best fit and therefore the best treatment results.

2. Trouble to get used to wearing the mask with your CPAP device.

It may help if you start wearing the mask only for a short time while you are awake, for example, while watching TV. Then, try to wear the mask connected with the tube and the CPAP device, during the day, while you are awake. Once you get used to the feeling, you can use it while sleeping – in the evening and during the afternoon sleep.

3. Difficulty to tolerate air pressure.

You can overcome this by using a simple trick that is available in several CPAP machines. This is activating an adjustment that increases gradually and not abruptly the pressure of the machine, until you fall asleep. This feature allows you to start with low air pressure, followed by an automatic, gradual increase in pressure. This setting can be done by your doctor.

If this does not help, talk to your doctor because you may be prescribed a different kind of device that automatically adjusts the pressure while you sleep and is called (BiPAP). This provides more pressure when you inhale and less when you exhale, so it helps to overcome intolerance to high pressures.

4. Dry, stuffy nose

Quite simply, your doctor may prescribe a CPAP device that features a heated humidifier. The humidification level is adjustable. Furthermore, using a nasal saline spray at bedtime may also help you. Your doctor may prescribe you a nasal steroid spray if dryness does not respond to heated humidity. It is also important that your mask fits well in your face. An air leak from the mask can easily cause dryness in your nose.

5. Feeling claustrophobic

If you’re awake, start wearing the mask on your face without any of the other parts (belts, tube, CPAP device). Once you feel comfortable, try to wear your mask with straps. Then, try to keep the mask and hose, without the straps and connect the hose to the CPAP machine at a low pressure setting. And finally, wear the mask with the straps and tube attached to the CPAP machine at normal pressure level while you are awake. Once you are comfortable with this, try to sleep using your device.

Relaxation exercises such as progressive muscle relaxation, can also help reduce your anxiety. If you still feel claustrophobia, talk with your doctor. He can help you to choose a different mask size or a different mask type, such as the one with nasal pillows.

6. Air leakage from the mask, skin irritation or sores due to pressure from the mask

A leak from ill-fitting mask means that you will not get the required level of air pressure you need, and it can also irritate your skin. You may also feel air into your eyes, drying them or causing them irritation and tearing. Try adjusting the straps and pads setting. If the mask fits over your nose, make sure that it does not sit too high on the bridge of your nose, which can direct air into your eyes.

You may need to ask your supplier to help you find a different mask, particularly if your weight has changed recentrly significantly, or try a mask from a different manufacturer. If you develop skin lesions or sores, eg on your nose, inform your doctor immediately.

7. Difficulty getting to sleep

This is a normal, temporary problem. Wearing the mask alone for some time during the day can help you to get used to. Using the trick described in section 3, with the gradual increase in air pressure until you fall asleep, it can also help you. Follow the rules of good sleep hygiene, avoid caffeine and alcohol before bed, and try to relax. For example, take a warm bath before bedtime.

8.Dry mouth

If you breathe through your mouth during sleep, certain CPAP devices can aggravate dry mouth. A belt that is placed on the chin can help you keep your mouth closed and reduce air leakage in case you wear a nasal mask. A full face mask that covers the mouth and nose, can work positively, too. Also, using a heated humidifier attached to the CPAP machine can help.

9. Inadvertent removal of CPAP mask during the night

It’s normal to sometimes wake up and discover that you have removed the mask during your sleep. If you move a lot during your sleep, a full face mask is most likely better for you. If you remove the mask because your nose is stuffy, a heated humidifier can help you.

10. Disturbed by noise

Most new models of CPAP devices are almost noiseless, but if you still consider annoying the noise of your device, make sure the air filter is clean. If this is not the case, contact your supplier to check the device and make sure it works properly. If the device is working properly and the noise still bothers you, try wearing earplugs.
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