CPAP

Unlike APAP, which adjusts the pressure based on your inhalation, CPAP delivers one rate of pressure while you sleep.

While the continuous rate of pressure can help, this method can lead to breathing discomfort. Still, CPAP is used most often because it’s the simplest and most extensively studied treatment for sleep apnea.

Sometimes the pressure may still be delivered while you’re trying to exhale, making you feel like you’re choking. One way to remedy this is to turn down the pressure rate. If this still doesn’t help, your doctor may recommend either an APAP or BiPAP machine.

 

Different types of CPAP machines

How does a CPAP machine work?

A CPAP machine takes in room air, then filters and pressurizes it before delivering it through a tube and into your mask. The continuous flow of air gently keeps your tongue, uvula and soft palate from shifting too far into your airway. This stabilizes your breathing and improves your overall sleep quality.

A CPAP machine is just one type of PAP (positive airway pressure) device. While CPAP is the most common among these machines, there are other types as well. These include:

Bi-level PAP.

This machine uses two different pressures — one during inhalation and one during exhalation.

Auto CPAP.

This device self-regulates, using a range of pressures to keep airways open.

Adaptive servo-ventilation (ASV).

Reserved for people with central sleep apnea, ASV keeps your airway open by delivering a mandatory breath when necessary.

Different types of CPAP masks

There are a few different types of masks available. The kind that’s best for you depends on your comfort level, breathing habits and the type of sleep apnea you have. CPAP mask types include:

Nasal mask.

This option covers your nose. A nasal mask is often recommended for people who move around a lot when they sleep.

Nasal pillow mask.

Rather than covering your entire nose, a nasal pillow mask only covers your nostril area. Some options also have prongs that fit into your nostrils. People who wear nasal pillow masks can wear their glasses comfortably.

Full mask.

This triangular mask fits over your nose and mouth. A full mask is best for people who breathe through their mouth during sleep. Your healthcare provider may also recommend this type of mask if you suffer from a nasal blockage.

How to clean a CPAP machine?

Keeping your CPAP machine clean helps you avoid bacteria and mold exposure. For optimal hygiene, you should clean your tubing, mask and water chamber daily. If this isn’t possible, make an effort to clean your CPAP machine at least once a week.

You should always follow the manufacturer’s recommendations for cleaning your CPAP machine, but here are some general guidelines:

Disassemble your CPAP machine
Unplug the device.
Remove your mask and headgear from the tubing.
Remove the tubing from the CPAP machine.
Remove the water chamber from the CPAP machine.
Soak the parts of your CPAP machine
Fill a basin with warm water and a small amount of dish soap.
Submerge your tubing, mask and headgear.
Allow the parts to soak for at least 30 minutes, then rinse.
Allow the CPAP parts to air dry.
Clean the external surface
Dampen a soft cloth and wipe down the external surfaces of your CPAP machine.
Reassemble your CPAP machine
Once the parts are completely dry, reassemble your CPAP machine.
Turn the device on temporarily to ensure that everything is working properly.
Clean the humidifier once every week
Use hot water and mild soap.
Allow the humidifier to air dry.
You should only use distilled water when running your humidifier.
Note: Don’t use external cleaning devices that aren’t included in the manufacturer’s instructions, as many of these products haven’t been approved by the U.S. Food and Drug Administration (FDA).

What are the advantages of a CPAP machine?

CPAP machines prevent breathing interruptions caused by sleep apnea. These devices also eliminate harmful sleep apnea side effects. Notable CPAP machine benefits include:

Improved sleep quality.
A lower risk of heart attack and stroke.
A reduction in daytime sleepiness.
Possible improved sugar control in people with diabetes.
Are there any CPAP machine side effects?
It may take time for you to become accustomed to your CPAP machine. Some people find them cumbersome or uncomfortable.

Drawbacks include:

Difficulty falling asleep (insomnia).
Nasal congestion.
Dry mouth.
Feeling claustrophobic.
Nosebleeds.
Feeling bloated.
Skin irritation.
As you get used to your CPAP machine, most of these side effects will diminish. If your device feels uncomfortable, ask your healthcare provider about different mask or equipment options.

Are there alternatives to CPAP machines?

While CPAP machines are the most common sleep apnea treatment, there are other alternatives. These include:

Oral appliance therapy. Specific dentists can make a custom oral appliance that fits over your teeth. This device opens the airway by placing the jaw in a more favorable position. Oral appliances work best in mild or moderate cases of sleep apnea.
Positional therapy. People who sleep on their backs are more prone to apneic episodes. There are devices that encourage you to sleep on your side or stomach, reducing your risk for sleep apnea.
Weight control. Obesity is one of the leading causes of obstructive sleep apnea. Many people can reduce their risk for the condition by losing weight.
Surgery. In some instances, sleep apnea is caused by skeletal abnormalities. Surgery may be required in these cases. Common options include soft tissue removal, jaw repositioning or an implantable nerve stimulator.

WHEN TO CALL THE DOCTOR
When should I see my healthcare provider?
People with sleep apnea may not realize they have the condition because so many symptoms occur during slumber. However, your partner may hear you snoring or gasping for air during your sleep cycle. You may also notice tiredness, morning headaches, insomnia, dry mouth or irritability. If you experience any of these symptoms, schedule a consultation with your healthcare provider. They can help determine if a CPAP machine is right for you.

Questions & answers about CPAP

Do you need a prescription to buy a CPAP machine? Yes. Though CPAP machines are safe and pose little risk for abuse, a formal prescription from your healthcare provider is necessary for purchase.

How long does a CPAP machine last?
Overall, CPAP machines last approximately five years. However, masks will need to be replaced several times a year. Additionally, your headgear, tubing, filters, humidifier chamber should be checked routinely and replaced when necessary.

Are CPAP machines loud?
While older CPAP models were noisy, newer ones are especially quiet. In fact, the average CPAP noise output is rated at 30dB (decibel) — which is about as loud as raindrops or a whisper.

Do CPAP machines really help?
Research shows that CPAP machines are incredibly effective in the treatment of sleep apnea. CPAP is often the first line of defense against the condition because it yields excellent results.

Can CPAP damage your lungs?
There is no indication that CPAP can damage your lungs. Some people report a burning sensation in their lungs following CPAP use. However, this is usually the result of inhaling cold, dry air. To correct this problem, use warm humidified air instead.

What’s the difference between a CPAP machine and a ventilator?
CPAP machines and ventilators both help people breathe better. However, these two devices cannot be used interchangeably. Unlike a CPAP machine, a ventilator is used to treat people who are in intensive care situations. Ventilators push air in and out of the lungs through a tube, which is inserted in the mouth or nose.

The air pressure
You will not be able to adjust the air pressure once the clinic has set it. Some machines have a ‘ramp’ feature that gradually increases pressure until it reaches your pre-set pressure over the first few minutes. The ramp feature may help you get used to it the pressure.

It’s normal to feel it’s harder to breathe out. Once you’re asleep, your body will get used to this, but it may take time.

The mask
CPAP masks come in many shapes and sizes:

masks that fit over your nose
masks that fit over your nose and mouth. These work if you breathe through your mouth when you sleep, have nasal blockage or still snore with a nasal mask
masks that cover your whole face
nasal pillows, which fit against your nostrils.
Your clinic should be able to help you find the best mask for you.

Getting a good air seal
The mask has a soft, flexible cushion that rests against your face. Getting this cushion in the right place is important so that it is comfortable, won’t hurt you and makes a good seal with no air leaks. If the mask is too loose or too tight, the seal won’t be effective.

The tubing
The flexible tubing carries air from the machine to your mask. It may be more comfortable if you run the tubing above and behind your head. Changing the position of the machine can also help you to find a comfortable place for the tubing.

Humidifiers
Some people find their CPAP more comfortable if it has a humidifier to moisten and warm the air from the machine. Some clinics issue humidifiers as standard, but others issue them only if you find the air uncomfortably cold and dry.

How to use it & Looking after your CPAP machine

Your CPAP machine should come with instructions about how to use it, keeping the components clean, and washing or changing the filters. Always follow the manufacturer’s instructions.
Before you leave the clinic with your CPAP machine, it’s important to get clear instructions on how to fit the mask, use the machine and keep the equipment clean. It’s vital you use the CPAP properly or the treatment won’t be effective

Getting used to CPAP
Some people wake up the first morning after CPAP and feel much better immediately, while others find it takes longer.

CPAP can feel odd to start with especially if you aren’t used to sleeping on your back, and you may be tempted to stop using it. But people who stick with it soon find their symptoms improve significantly – within a week of using it consistently. About a third of people we asked said it had taken over six months to get used to it. But almost everyone said it was the best treatment for them.

Research indicates that the longer you use it each night – the more you benefit. Try to use it every night, especially at the beginning of the night, when we tend to sleep most deeply. If you’re having problems, ask your sleep clinic for help.

You should have an initial consultation within 1 month of starting your CPAP treatment, to check how it’s going, the effectiveness of the treatment and to see if you need any support. Many people now have telemonitoring with their CPAP device so that the effectiveness of CPAP can be checked, and the pressure changed remotely if needed. The telemonitoring sends data to your sleep centre on breathing pauses, leaks from the mask and your use of the CPAP device each night. Once your CPAP treatment is optimised, you should have an annual review.

CPAP problems and solutions

If you’re having trouble with your CPAP, here are some solutions to try.

I have a nasal mask and air comes out of my mouth at night.

Try altering your sleeping position or the number and position of your pillows.

If that doesn’t work, ask your sleep clinic for:

a humidifier to moisten your airway or
a chin strap to help keep your mouth closed or
a full-face mask to cover your nose and mouth

I or my partner find the machine noisy

Check if the noise is coming from the mask – it may need re-fitting or re-assembling
Put the machine in a box or cupboard – this is fine as long as there is room for air to circulate
Try wearing earplugs

CPAP treatment is causing a runny nose, blocked nose or sneezing

Go to your sleep clinic or your GP to see if there is a medical reason
CPAP’s cool air can irritate your nasal lining and give you a runny nose or make you sneeze. This usually settles down after a week or so. If not, try a nasal spray or ask your sleep clinic. Heated humidification may help if problems persist.

I take my mask off in my sleep

You might be waking up slightly, which may indicate your pressure is not quite high enough. Ask your sleep clinic
I wake up feeling uncomfortable with the pressure of the machine
Try switching it off and removing the mask for a few minutes. Clear your nose if you need to before putting the mask back and switching on the machine
Try using CPAP during the day for short periods while you are relaxing to help your body adjust
Use the ramp setting to increase the air pressure gradually

I find the air too cold and it disrupts my sleep

This can make your nose, mouth or throat feel dry. You could:

ask your sleep clinic for a heated humidifier
try heating the room
try adding moisture to the room by placing a tray of water above your radiator
try keeping the tube warm

I am finding it difficult to get a good seal

Remember to adjust the mask with the machine turned off. Lift the mask off your face, let it settle again and make sure the cushion is not distorted
Try adjusting the straps
Make sure your mask and cushion are not worn or torn – the cushion may need replacing every three – six months
Your mask may not be the right size for you, or you may need a different type – ask your sleep clinic
There is air leaking out of the mask, which irritates my eyes
The mask may be too tight -if so, the cushion won’t work as well as it should
The mask may be too small or too large
The cushion may need replacing – ask your sleep clinic
The mask may not be fitted correctly – check it’s not upside down

I am getting sores where the mask is rubbing

A bit of tenderness on the bridge of your nose is common when you first start on CPAP
Your mask may be too tight, so try loosening the straps.
This could be because the cushion is no longer working and needs replacing, or it could be because the mask is too big for you
Use a cream to ease soreness
Ask your sleep clinic for advice if the soreness remains or gets worse, or if you loosen the straps and get a leak

I have a cold or other infection of my upper airway

Ask your GP if you should continue your treatment
If you do continue, wash everything more often
You may need a full-face mask to help you breathe more easily
Don’t worry if you need to stop using CPAP for a night or two. But try to avoid stopping CPAP for more than a few nights

My throat feels dry or sore

Ask your sleep clinic for a chin strap or a humidifier
You may find a full-face mask more comfortable

I need to go into hospital for an operation

Tell the surgeon and the anaesthetist you have OSA
Take your treatment with you

I find it hard to breathe

You might take time to get used to breathing out while pressurised air is being pushed in. Once you’re asleep, this will happen automatically. Try:

practising with the machine on during the day while you relax or listen to music
using the ramp feature
using a full-face mask instead of a nasal mask

I am still snoring and stopping breathing in my sleep

Maybe air is leaking out of the mask – follow our tips on how to get a good seal
The pressure might need adjusting – ask your clinic

I feel bloated or I have wind

You might take time to adjust to using a CPAP machine – keep trying.

You may be swallowing air in response to the pressure – using a ramp feature can help
Ask your sleep clinic for advice – the pressure may need adjusting
Drink peppermint tea at bedtime and when you get up
Relax by lying still and breathing calmly or listening to music
Raise your head higher with an extra pillow

I feel claustrophobic wearing the mask

Try to keep the mask on for a few hours every night and gradually increase the length of time you wear it
If you’re using a full-face mask, you may be able to switch to a nasal mask (not if you breathe through your mouth when asleep or if your nose is blocked)
Check you’ve adjusted the mask correctly so there are no leaks and remember to breathe through your nose if you have a nasal mask – sometimes, air rushing out of your mouth can make you panic
Try taking a few deep breaths in and out of your nose.

Sleep Better
• People with lung disease often have a hard time sleeping or don’t get very
restful sleep.
• There are many reasons for this, but one is that people with lung disease
lose oxygen in their blood overnight, especially during REM sleep.
• Using oxygen therapy at night allows your body to get more oxygen into
the bloodstream so that you may get a better night’s sleep.
• Your doctor may recommend you do a sleep study to determine whether
supplemental oxygen at night is right for you.

CPAP machines were developed primarily for use at home.

Advances in CPAP technology now make it possible for patients with sleep apnea to use their CPAP devices during long-duration flights that span normal sleeping hours.

Like Portable Oxygen Concnetrators, CPAP machines are classified as medical assist devices. They are, therefore, permitted on most domestic and international flights.

Remember that an external power source may not be available during your flight.

Check with your airline ahead of time to make arrangements for any electrical power you will need.

Portability has become an important consideration with the design of these machines. Over time, the machines have become lighter and more compact, with multi-voltage power supplies for international use. Having a portable CPAP machine also opens endless travel options.

With advances in modern technology and the introduction of specifically designed travel CPAP machines, leaving home with your CPAP therapy has never been easier. Whether it’s for work or pleasure, domestic or international, your CPAP treatment can travel with you also. Apart from being smaller and more convenient to travel with, travel CPAP machines have other important features including:

Cigarette lighter compatibility
DC Cable Converter compatibility
Portable extended battery compatibility

Travel with a CPAP machine

Before Air travel with a CPAP machine

Make Sure Your CPAP Equipment Is Dry Before You Pack.
Empty your humidifier water chamber and make sure your CPAP device and supplies are completely dry before packing them to prevent mold and mildew.
Pack Backup CPAP Supplies.
Even for a short trip, make sure to pack extra supplies like mask cushions, headgear, and filters. These supplies have a way of breaking when you need them most, and nobody wants to play MacGyver just to get a good night’s sleep.
Keep A Copy of Your Prescription With You.
You probably won’t need it, but if you had to replace your CPAP mask or machine while on vacation you’d be glad to have it!
Bottled Water Is Your Friend.
Even if you’re headed to a five-star hotel, it’s a good idea to bring some bottled water, because you don’t know when or where you’ll find distilled water. It’s important to only use distilled water in your CPAP, because tap water (and even spring water) contains minerals that can build up in your machine and cause it to break down in time.
This is especially important if you’re traveling to a location where you’re advised to not drink the local water. If the tap water isn’t safe to drink, you probably shouldn’t inhale it either.

Stock Up On CPAP Wipes.
You don’t want to waste your bottled water on cleaning your CPAP supplies. CPAP wipes are a fast and easy way to make sure your mask and machine stay clean. Plus, the alcohol-free formula is good for more than just CPAP equipment!
Make Sure You Have the Right Power Supply
If you’ll be traveling internationally, you may find that your power cord isn’t compatible with the local power outlets. Most modern CPAPs will automatically correct for the difference in voltage (110v in America vs 220v in most of Europe), but you’ll likely need an adapter to fit the outlet.
Get A Second Battery Pack.
Even if you’re heading to a location with ample power, you never know what might happen along the way. Maybe your flight gets delayed. Maybe your campsite doesn’t have an outlet. Maybe your hotel experiences a power outage. No matter what, having a battery or two can help protect your sleep health from unforeseen problems.
Invest in a DC Converter.
A DC converter is an inexpensive way to multiply your power supply options. DC adaptors allow you to power your CPAP (or charge your battery) from solar panels, USB ports, cigarette lighter style outlets, and even car batteries.
Extra tips
Pick a seat that has access to power if you need to use your CPAP machine on a long flight. Also, bring your airline’s phone number and website with you to check their assisted device policy. The airline has the final approval for in-flight usage.
FAA Compliance Letter: Download and keep with your CPAP machine.
Transportation Security Administration (TSA): Review the airport security page for medical conditions to confirm the process for CPAP machines.
Review airline policies for using CPAP machine for in-flight use and restrictions for carry ons.
Review a checklist of documents to take with you.

Make sure your CPAP isn’t damaged in transit. If it is your holiday may be difficult and unhappy. Even if you won’t use your CPAP on the flight, take it on board as part of your hand baggage. Make sure that it is in a sturdy, protective bag. Airlines are used to people with medical equipment. Explain things to them. They will probably let you have this as another piece of cabin baggage. To be even safer, you might want to get a letter explaining things. It is best if this is from a specialist doctor. You can use this if you run into any problems with customs or airlines. A lot of countries use languages other than English. If you are going to one of these, you should get these translated.

Some manufacturers supply batteries made specifically for their machines. These batteries are sealed Lithium-ion batteries and are certified for use on planes. These batteries usually last an average 12-13 hours on CPAP only, about 6 hrs using CPAP and humidifier and about 3-4 hrs using CPAP, humidifier, and heated tubing. The battery will be used up quicker at higher pressures or if the mask leaks. Mask leaks result in the machine working harder as it tries to compensate for the leak.

The batteries are charged from mains power and take around 4 hrs to be charged from completely flat to fully charged.

Use of CPAP with other than normal mains voltage may pose special problems or risks. It may void your warranty. The supplier of your CPAP machine should always be consulted before using non-mains power supplies unless an approved battery and inverter.