One of the first issues I hear when a person comes into a sleep lab to be introduced to a CPAP is that they have claustrophobia; that you cannot stand to have anything on your face. There is always an excuse for not tolerating therapy. Most of the reason has to do with feeling out of control. There are so many ways that can create a successful experience.
Let’s start with the mask. It is probably the most important piece of equipment you will use and the easiest to change. If you are unable to use the mask during the night of your study tell your tech, however, what usually happens is that they use the mask for 1-3 days at home and find that it is not the best mask for them. It may move too much causing leaks, it might cause your skin to mark or breakdown, it might make your eyes dry; all these issues can be handles with a change of mask. It is also common for people who are claustrophobic to be much more successful with a full face mask due to the ability to breathe through both the nose and mouth which will make anyone more comfortable. Your insurance will pay for replacement mask during the first thirty days of the therapy. After the first thirty days a new mask must be ordered. At many centers they will allow you to trial or borrow masks to find one that will work for you.
Knowing how to perform relaxation techniques will allow you to be successful when you are trying to fall asleep the first few days. It can also help on days where your stress level is high. The two techniques I have found that help are progressive relaxation. This is easy to learn and allows you to focus on relaxing as well as helping you to focus your thinking.
1. Start at your feet and tighten them as tight as you can, hold for the count of ten and then allow them to relax and go limp
2. Progressively move up the body focusing on one muscle group at a time.
3. To reach the top of your head should be having spent about 10 minutes on deep breathing and your muscles may be relaxed. This centered concentration helps increase oxygen levels and allows the mind to camp down preparing it for bed.
Diaphragmatic breathing is another exercise that will allow you to relax and breathe deeply with a technique that takes focus. Lie flat on your back with your hand on your stomach just below your ribs. As you take a slow deep breath in push your hand out; when you exhale draw in your abdominal muscles so you are pulling your hand in. I usually like to hold the breath 3-5 second between peak inhalation and exhalation. Having to concentrate allows the mind to calm and it increases the oxygen level from doing nice slow inhalations.
If relaxation techniques do not work for you medication or working with a councilor that practices Cognitive Behavioral Therapy. Your physical can help you to find assistance that will work for you. It is not unusual for someone to need a little extra support, this is long term therapy and sometimes it takes a little time to become compliant with it.
Some accessories can help you with some of the small issues. Chin Up strips can help a mouth breather minimize the leak. A Gecko will help with sores on the nose and leaks into the eyes. A heated hose might help with mouth drying.
Overall working with a patient technologist or physician is the best way to be successful when using PAP. The more you communicate about your issues the sooner a solution to help you be successful on your machine, and sleeping a healthy sleep.
If you wear a CPAP you might notice that this time of year you have more side effects. The cold dry weather and the increased time indoors can cause many side effects such a drying of the mouth and nose, congestion, sinus infections, and illness. It is important that if you are using your CPAP that you are comfortable all year so you have to consider the time of the year and make the changes you need.
The first problem is the dry air that occurs during the winter. This is true even if you have a humidifier in the house. Your humidifier is the best defense for this. Most humidifiers on CPAP machines have settings of 1 to 5 and are usually set to 1 or 2. The reason for the low setting is due to water accumulating in the tubing and mask. This problem can be reduced by making a sleeve for your tube. A nice piece of flannel and some seam glue is all you need. You want to turn it up high enough to make your airway comfortable.
One of the side effects of an overly dried airway is congestion. This is one of the easiest ways to tell if you need to increase the humidifier setting. If you are experiencing congestion you might also want to use a nasal saline spray before going to bed and then again when you wake up to help rehydrate your airway.
The other issue that really causes problems during the winter is colds and flu. Illnesses makes wearing your CPAP challenging. This is where owning two masks can come in handy. It helps to have a full face mask if you usually wear a nasal mask or nasal pillows. It is essential that you keep your mask, tubing and humidifier clean. Warm damp places are a great place for viruses and bacteria to grow. The best way to keep your equipment clean is to wash it with soap and water and then you can disinfect it with one part white vinegar and 3 parts water. Just soak them for 20 minutes then rinse very well so your equipment does not smell like salad dressing then allow your equipment to air dry.
If you try some of these ideas and they do not help you then go back to your doctor, sleep lab or DME company and ask for some help. Everyone wants you to succeed with your CPAP and they will be happy to help.