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  CPAP therapy is the “gold standard” for treating obstructive sleep apnea, also called OSA.  For some of the people who use CPAP it is very difficult to use every night.  There are many reasons for this, but the biggest is a lack of education.  With this in mind there are five things that you can try that may help you being more successful with your CPAP.

 

  1. You can start using it little by little.  For the first couple of days try wearing you CPAP while watching the evening news.  Make sure you are in a comfortable position such as sitting in your recliner.  The reason for this is because it is less intimidating then lying in a dark room telling yourself you must fall asleep with this strange machine attached to you.  Once you have been able to sit for 30 minutes increase it to an hour.  Usually if you can use the machine for an hour you can move to the bed and all asleep with it. 
  2. Clean the mask properly.  Many people are not taught how to properly clean their mask.  Using the improper technique can lead to your skin breaking down, red marks on your face or a rash where the mask and headgear sit on your face.  You should wash the part of the mask that sits on your face every day with a gentle soap like ivory, rinse it very well then air dry it.  Your headgear, hose, humidifier chamber and the full mask is washed once a week.  Again you should use a gentle soap, rinse well and then disinfect it.  Many companies sell a product you can use or you can use the old fashion method.  Use 1 part white distilled vinegar and three parts water, soak for 20 minutes, rinse well then air dry.  Just make sure you rinse the equipment well enough or you will smell the vinegar all week.
  3. Humidification is essential to reduce swelling and congestion in the nose.  Many people do not use or underuse their humidifier because of rain out or water in the tubing.  If you create a sleeve for the tube using flannel and some fabric glue you can help to reduce the rain out. 
  4. Leaking masks do not help anyone sleep better.  Many people will put their mask on before turning on the machine.  They then tighten the mask down too tight.  This actually increases the leak rather then decreases it.  Most of the new masks are designed to create an air seal against the skin.  If the CPAP is not on this pocket does not inflate.  If you over tighten the mask it will crush this pocket keeping it from keeping it from sealing properly. 
  5. Ask for help.  You have a team that is supporting you.  Take advantage of that team especially if you are having problems.  Talk to your DME provider, your sleep lab or your sleep specialist.  They are there to help you be successful.  If you need a new mask or have questions they are there for you.  They can get you a new mask if you need one.  They may also be able to look at other therapy for you including BILEVEL therapy or oral appliances.  Find support websites and local support groups.  These will allow you to talk to someone who is outside your care group and will also allow you to find other patients who may be able to share what they did to overcome your problem. 
 

CPAP therapy is designed to help you live a healthier life.  It is long term care for the person who is using it and for the person who sleeps with him or her.  It reduces snoring, apnea, and airway resistance.  It does take some getting used to but in the end the energy and better health you experience from using your CPAP on a regular basis will be worth it. 


 
 
Technology has come a long was and studying sleep is no exception.  We are now able to perform sleep studies in the home as well as the sleep lab.  This is a great thing because it allows more people to be tested for sleep disorders then every before.  The drawback is that there are limitations to what can be done in the home versus the lab.

In home sleep studies are generally modified unsupervised sleep studies.  This means that the equipment is delivered to the patient and then they are responsible for applying it and taking it off.  In some areas a technician will come out in the evening to apply the equipment and you will wear it the rest of the night, then you may have to take it off or the technician will come back in the morning and remove it.  Generally these types of studies are limited in nature and only monitors certain parameters, oxygen level, heart rate, breathing, and whether you are awake or sleep and position.  Because the study is limited it is designed strictly to diagnoses sleep apnea.  Other conditions a person may have will not be diagnosed, such a periodic limb movement disorder and teeth grinding.  This type of testing is also not good for patient with significant health issues such as congestive heart failure or COPD.  

In lab testing has several differences.  The first one is there is a technician there with you if any problems should arise.  If one of the wires become dislodged it can be fixed right away.  You do not need to have another study performed.  The technician is also there to answer questions should you have any during the nights.  The most important role of the technician, however, is that they can intervene if there is a significant health issue during the night.  They can also do a special type of study called a split night, or combination study, which allows you to be diagnosed and treated for your sleep apnea on the same night.  This way if you have severe sleep apnea you can be treated right away instead of waiting.  You also are able to be evaluated for other conditions you may not know you had.  

Treating sleep apnea after the home sleep study can occur in two different ways as well.  You can be brought into the sleep lab for a titration study.  During this test the technician finds a mask that works for you, educates you about CPAP and how it works and then finds the right pressure to eliminate most of the apneas and snoring.  This test also allows the doctor to look for the other disorders such as periodic limb movements.  

The  an auto-titrating CPAP.  This machine is set to allow a range in pressure that adjusts as you have events during the night.  The technician will fit you for a mask and then leave the machine for you to use.  The drawback is that there is no one there during that first night to assist you if there is an issue.  The other issue is that unless you call your doctor or the company that delivered the machine they may not be able to correct any problems that happen until they download the information in the CPAP memory. 

Overall home sleep studies do have a place in the diagnosis and treatment of sleep apnea.  They are very good for diagnosing the straight forward sleep apnea patient.  If, however, there is any issues that need to be addressed right away or if a person needs some assistance this may not be the best choice.  A full sleep study allows for the possibility for quicker treatment and intervention.  There is also the ability to diagnose other conditions that might go unnoticed in the home setting.  That and the personal care involved in testing help to create a successful long term care situation.other option for treatment is to have a homecare company deliver