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. 

  More people and their physicians are looking at sleep habits and problems that might be contributing to problems such as hypertension, difficult to control diabetes and congestive heart failure.  They are also looking beyond medications to take care of issues like chronic fatigue.  Snoring is looked at as something more significant then an annoyance.  To find out the source of the problem a sleep study has been scheduled.  Unfortunately not much is explained before the study and it is hard to figure out what is expected by talking to friends and family.  There are a few tips to make the experience more pleasant and get a good night sleep

 

1. Take a tour of lab.  If the doctor owns the lab you can probably take the tour the day the appointment is scheduled.  However, if you are going to an independent or hospital based lab then taking the time to visit the facility to will give you and idea of what to expect and if you feel you can not sleep in that facility it gives you a chance to call another center or discuss other options with your physician
2. Make sure your sleep clothes are comfortable.  Many facilities keep the rooms cool to prevent sweating.  If you know that you will be cold bring socks and warmer clothes.  If you tend to be hot during the night shorts and a t-shirt may be all you need.
3. Bring your pillow or blanket.  Bring something with you that will make you feel like you are sleeping at home.  Many people prefer their own pillow or blanket.  Other may bring their child’s teddy bear or an object that belongs to their spouse. 
4. Read all the paperwork and instructions carefully.  Different facilities have different requirements for preparation.  Some basics will be to have your hair washed with no products in it, no lotion on your face and legs, and to avoid caffeine the day of the study. Make sure all paperwork is filled out and a list of all medications you are on is attached. Some labs will want you off or on certain medications. 
5. Talk to your doctor if you feel you can not fall asleep.  Some labs will prescribe a sleep aid for you to take if you try to fall asleep and are unable to.  If you know you have anxiety issues or you have a history of first night effect, the inability to fall asleep in a strange bed the first night, having some medication as a back up might prevent you from having to come back for a second study.  This is also useful if you need a titration study.  Adjusting to CPAP can take some times.  If you have a sleep aide or anti anxiety medication it might make the adjustment to the CPAP go a little more smoothly.

 

Having a sleep study can be very stressful if you do not prepare for it.  But these steps will help to make you more comfortable and allow your sleep through the night.  The closer your sleep is to sleep at home the more likely the lab will be able to find a problem you might be having. 

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  An article was released about teens and the effects of caffeine and technology is having an effect of teens and their sleep.  I know I live this issue daily.  I have a teen son and a daughter who is just in her 20s.  The problem is that we have not created a culture that supports teens and their needs.

 

This article was timely as this week my son took his yearly standardized tests.  He has to get up at 6am to get ready for school so he can arrive just before 7am.  He will then sit in the testing room he is assigned to and will take a test that will determine his future.  Of course what they are not thinking about as these students enter the school is that more then half of the students walk on campus with an energy drink, diet soda or Starbucks in their hand.  They are all yawning, dragging their feet and look like they could use two more hours of sleep.  When they normally attend class at least 3-4 of the students will want to put their head down during at the very least 1 period.  These are not fresh, excited students.  These are sleep deprived people that our culture is trying to get to fit into a cheapest easiest way to give them an education.  We have not created an education that is designed for them to become successful educated individuals that can perform at their optimum. 

 

Add to this early more education some new parts to our culture.  Their diets include processed food, chemical substances, and stimulants like caffeine.  They are exposed to light 24 hours a day and their brains are stimulated from the time they wake up until the time they go to bed.  They are in the computer, playing video games or watching television.  They have 2-3 hours of homework they need to do when they come home.  They also have outside activities.  Things like my son’s Boy Scout meeting will last from 7-10:30 at night.  We have not set them up for optimal sleep we have set them up to be sleep deprived. 

 

It is difficult to tell a 5’10” boy that it is bed time at 9 or 10 pm.  The world has not stopped or even slowed down by then.  He still has homework he wants to tweak, friends to chat with or challenge on a game, or just wants to watch a show he knows everyone will be talking about at school the next day.  He gets tired around 11-12pm and is sound asleep no later then 1am.  On the weekend he sleeps until 11am and sometimes a little longer.  His friends are the same way. 


I believe that we have to look at what our children need, how to create a healthy environment for them and then nurture that.  Is sending our children to school at 7am really in their best interest?  One of the local school districts changed the time for the high school children from 7 to 9.  Next year they are changing it back because it interferes with after school work and activities.  Did they even bother to look at the student’s attendance, grades or test results?  They did not. 

 

So what is the result of sleep deprivation with our teens?  It is multifold, sleep deprivation can increase the incidence of depression, increase the symptoms of ADD, increase the chances of obesity.  It interferes with learning and storing information into long term memory. 

 

Now we need to explain to our teens why a sleep routine, turning off all electronics and going to bed early I so important.  We need to overcome peer pressure so that our children understand that this is the norm.  We need to be examples for them.  We need a very strong sleep routine that includes turning off the computer and the television.  We need to make time for the family to sit and eat together and read together.  These changes will help them during the tough teen years.  We need to help them reach their true potential.

Your wife or husband tell you they need to go to bed before you or they will never sleep.  You know if you are going on a trip you can not share a room with anyone else  because they will complain.  Do you know when a snore is something you need help for or just annoying?

The fact is that no matter what a snore is not normal.  If you snore there is something in your anatomy that says you need to have it evaluated.  It may be just that you have a large uvula that vibrates when you breath at night.  It could also mean you have sleep apnea, a condition where you stop breathing or breathing is partially obstructed and your oxygen levels in your blood drop. 

If you have plain snoring this can be treated with several medical treatments including medications, surgery, or an oral appliance.  You might also benefit from positional therapy.  This is where you avoid sleeping on your back.  You can use a special pillow or other device.  My personal favorite is to take a t-shirt sew or glue a pocket down the center of the back of the shirt and place 3 tennis balls into the pocket then close it.  Every time the person rolls onto their back they become uncomfortable and roll to their side.

If you are not sure if you might have sleep apnea take the Sleep Quiz.  If you have a score of 9 or greater then it is time to speak with your physician.  Sleep apnea is important to treat because sleep apnea can contribute to many health issues including depression, high blood pressure and diabetes. 

If your child is a snorer you should take the time to talk to his or her pediatrician.  Sleep disorders can very easily be disguised as irritability,  short attention span and can lead to other health problems.  It can be caused by enlarged tonsils and adenoids.  It can also be caused by a small airway.  The current research is discussion new medication treatments to help children. 

No matter who in the family is snoring it is something that is not normal.  It is something that should be evaluated by a professional.  If they can sleep quieter then everyone will get a better night sleep.