Troubleshooting CPAP problems
Most people with sleep
apnea don’t like CPAP the very first time they use it, although some
do. However, with time and some
minor modifications, most people can improve their tolerance of the
CPAP. If you are having trouble
tolerating CPAP when you first start using it, you are not alone. Many people take several weeks to
months until they are comfortable using the CPAP.
First off, these
suggestions should be used in conjunction with the advice of your
physician. These are some
helpful hints that can improve your ability to tolerate the CPAP.
Many tolerance problems are
related to the interface. For
many people, the interface they are given does not fit well. Only by trying on multiple different
interfaces can you find the one which fits you best. Is the interface comfortable? Is there excessive air leaking
around the mask? Do you have to
fit your mask too tightly to your face in order to control the air
leak? If these are problems you
are having, your interface may not be the right one for you or it may need
better adjusting in order to fit properly.
Do you trouble with
claustrophobia? Most people do
not like having the mask strapped to their face. If this is a significant problem for
you, you may find that nasal pillows are less intrusive and better
tolerated than the nasal or full facemask.
Do you have a lot of
leaking through your mouth?
(Not around the mask).
This is common with higher pressures that some people require in
order to adequately control the sleep apnea. If this is the problem, there are 2
possible fixes for you. If you
are using a nasal mask or nasal pillows, a chinstrap can be used. The chinstrap helps keep your mouth
closed in order to reduce the mouth leak. Another option is a full face mask. This fits over your nose and mouth
and therefore the air cannot leak back out of your mouth.
Do you have a dry mouth
when you wake up after using the CPAP?
If so, this may be a sign of a large air leak. In addition, if you don’t have
humidification as part of the CPAP setup, you may benefit from this as part
of your treatment.
Is nasal congestion a
problem for you? Often this is
related to drying out of the inside of your nose. This can be related to using dry air
instead of humidification, or may be related to a large air leak through
your mouth. Sometimes the nasal
congestion persists despite fixing these problems. Often medications to decrease the
congestion are helpful.
Another problem can be
related to the pressure being too high or too low for all or part of the
night. If the pressure feels
too high and interferes with your ability to fall asleep or stay asleep, it
may be too high. If you develop
snoring or your bed partner tells you still stop breathing while using the
CPAP, the pressure may be too low.
This often follows a change in weight .
Some people have sleep
apnea that is worse during different stages of sleep, or in different body
positions. For many people, the
sleep apnea is at its worst when you are in rapid eye movement (REM) sleep
and while you are laying flat on your back. Many times, this means the CPAP
pressure requirement is higher in these positions than at other times. An automatic PAP machine can help
when the pressure requirement changes throughout the night.
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