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FAQ:

CPAP and Sleep Apnea Basics

What is Obstructive Sleep Apnea?

What is CPAP therapy?

I suspect I have Sleep Apnea, what should I do?

I have been diagnosed with Sleep Apnea, what should I do?


What is Obstructive Sleep Apnea?

 

 

Obstructive Sleep Apnea (OSA) is a condition in which a patient’s airway seals during sleep, causing the patient to stop breathing. So, the body responds to this lack of oxygen by arousing, or waking from sleep. This cycle will leads to the patient being unable to get the needed quantity of restful sleep and results in:

 

  • Constant Fatigue
  • Difficulty Focusing
  • Irritability

Untreated Sleep Apnea is potentially fatal and frequently results in the following serious health problems:

 

  • Heart Attacks
  • Strokes
  • High Blood Pressure
  • Diabetes

The main symptoms for obstructive apnea are:

 

  • Excessive daytime sleepiness (not explained by other factors)
  • Snoring, choking, gasping or pauses in breathing during sleep
  • Recurrent awakening from sleep
  • Unrefreshing sleep
  • Daytime fatigue
  • Trouble concentrating

 

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What is CPAP therapy?

CPAP stands for Continuous Positive Airway Pressure. CPAP therapy provides a constant airflow/air pressure which holds the airway open so that uninterrupted breathing is maintained during sleep. This eliminates Obstructive Apneas and allows the patient to get a restful sleep. CPAP therapy is traditionally provided through a nasal mask that seals around the nose. However, more innovative, comfortable and better sealing options are now available for apnea patients.

 

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I suspect I have Sleep Apnea, what should I do?

Sleep Apnea is a serious and potentially fatal medical condition. If you or a love one suspect you have it, you should be tested as soon as possible. You can consider doing:

 

  • Sleep Questionaire This is a simple test you can fill out and bring with you to a physicians visit that evaluates you for the most common symptoms of sleep apnea.
  • Sleep Study A Polysomnogram, or Sleep Study, measures many key metrics while you sleep. These metrics are used to determine if you have Sleep Apnea or a number of other sleep related conditions such as central sleep apnea or restless leg syndrome

 

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I have been diagnosed with Sleep Apnea, what should I do?

  • Get The Best Equipment. For effective treatment, you must wear your CPAP every night. Due to this, it is a good idea to get the most comfortable equipment for you. Respironics is a good choice for you to have a comfortable therapy treatment when you sleep at night.
  • Replace Disposable Equipment Regularly. CPAP Filters should be replaced every 2-3 months. CPAP Masks should be replaced every six to nine months. Sinus infections and nasal congestion often result from the failure to replace disposable equipment regularly.

 



 

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Machines

What maintenance is required on machines?

What comes with my machine?

What is C-Flex?

What is a CPAP Machine?

What is an APAP Machine?

What is the difference between BiPAP and BiPAP ST?


What maintenance is required on machines?

The only maintenance for the machines require is that you clean or change the filters in the back of the machines to keep the internal parts from accumulating dust. You can send your CPAP machine to us for the servicing once a year.


 

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What comes with my machine?

Machine comes with a six foot hose, filters, manuals, smart card, power cord and a carrying case. They do not come with a CPAP Mask. CPAP Masks must be purchased separately and depend on your needs on CPAP mask.


 

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What is C-Flex?

C-Flex is a feature that makes breathing out against CPAP pressure easier to do. Independent studies conducted by leading universities indicate that patient comfort, and therefore, patient CPAP compliance, is higher with machines that use C-Flex. C-Flex is a technology invented by Respironics, is proprietary, and is not available on other brands of CPAP Machines.


 

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What is a CPAP Machine?

A CPAP machine blows only one constant pressure. Your ideal pressure was determined during your sleep study at hospital. However, many factors can affect your ideal pressure over time, like weight fluctuations and even sleeping positions.

 



 

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What is an APAP Machine?

An APAP machine automatically adjusts on a breath by breath basis to blow the minimum pressure needed to keep your airway open during sleep. This allows your machine to provide you with your ideal pressure nightly.

APAPs tend to be more advanced, more feature rich and more expensive than CPAP machines.

 

 

 



 

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What is the difference between BiPAP and BiPAP ST?

A BiPAP alternates blowing two set pressures, a higher pressure for inhalation and a lower pressure for exhalation.

A BiPAP ST Machine is a non-invasive ventilator. ST stands for Spontaneous Timed.

A BiPAP has two set pressures but some patients require a back up timed response in which the BiPAP will initiate a breath if a breath is not taken within the set timed parameters.

For example, a BiPAP ST might be set with an inhale pressure of 10 and an exhale pressure of 5 with a BPM (BPM=Breath Per Minute) of 12. A BiPAP ST will not breathe for you but will initiate a breath if you do not inhale 12 times a minute.

 



 

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Masks

What is a nasal mask?

What is a full face mask?

What is a nose cushion mask?

What is a nasal pillow device?

What is a total face mask?

How often should I replace my mask?

How do I care for my mask?


What is a nasal mask?

A nasal masks seals around the entire nose and is held in place with straps, or headgear. This is a good device for first-time CPAP users.

 



 

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What is a full face mask?

A full face mask seals around both the nose and mouth and is held in place with straps, or headgear.

Full face masks are good alternative for 'mouth breathers'. For some people the mouth tends to open unknowingly during sleep. This allows the treatment pressure blowing through the nose via a traditional nasal mask to escape. If this happens, it renders CPAP therapy ineffective as the pressure intended to hold a patient's airway open instead flows out of the patient's mouth. The full face mask equalizes pressure between the nose and mouth allowing the patient to receive the proper treatment pressure at all times.

Sometimes nasal blockages like a common cold or those who have nasal congestion due to illness or allergies might also need a full face for consistent treatment.



 

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What is a nose cushion mask?

A nose cushion mask seals over both nostrils, similar to a nasal mask, but it fits under the nose instead of around the entire nose. The cushion does not fit over the tip of the nose or rest on the bridge. These devices include different sized cushions for ease of fit.



 

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What is a nasal pillow device?

A nasal pillow device seals against the outside edge of each nostril rather than around the entire nose. The pillows open into the nostril but are not inserted inside to seal. This device is helpful for people who sleep on their side or stomach, or for those with facial hair. It is sold with different pillow sizes for ease of fit.



 

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What is a total face mask?

A total face mask seals over the entire face, at the forehead, down the sides and under the chin. It can only be used when sleeping on the back and is somewhat of a last resort.

There are special circumstances or needs for this mask, like patients who leak air out of the corner of their eyes. This mask is like a Full Face mask in that it equalizes pressures for an even treatment, but this mask encompasses every opening on the face where air might escape like the eyes.



 

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How often should I replace my mask?

Medicare allows for mask cushion replacement every three months and complete mask system replacement every six months. CPAP manufacturers and vendors suggest these replacement schedules as well.

In our experience, most mask cushions begin to deteriorate after about six months of use. The silicone eventually becomes too soft to hold a seal and headgear straps must be tightened more and more to get the same quality seal.

We strongly suggest replacing cushions and pillows as soon as they start to soften. Air leaks may reduce the effectiveness of CPAP therapy and headgear that is too tight may cause facial sores at pressure points.



 

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How do I care for my mask?

Masks should be washed daily in warm water with baby shampoo and left to air dry or washed daily in warm water only.



 

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Humidifier

What is Humidification?

What is a heated humidifier?

What is a Passover humidifier?


What is Humidification?

Humidification adds moisture to the CPAP air, reducing irritation to the nasal passages caused by the increased airflow.

CPAP air is an irritant - to one degree or another - to everyone. In some cases the irritation dries out the nasal passages and may cause bleeding. It may also cause swelling, excess mucous, congestion or sneezing. The irritation also creates a very fertile ground for infections to begin. The irritation may be cumulative, building up over time. The only way to reduce the irritation is to add moisture.

Humidification is therefore a critical part of CPAP Therapy.



 

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What is a heated humidifier?

A heated humidifier uses heat to produce moisture. The heat is adjustable for more or less moisture, and the chamber is much smaller than a Passover humidifier.

Patients who use heated humidifiers have a much higher rate of therapy effectiveness to CPAP therapy.



 

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What is a Passover humidifier?

A Passover humidifier is a chamber of water added to the CPAP to help moisten the airflow and reduce irritation to the nasal passages.

Air flows from the CPAP, through a short hose to the humidifier, then into the six foot hose to the mask. The air picks up whatever moisture it can as it "passes over" the water in the chamber.

Passover humidifiers may provide sufficient moisture with CPAPs set at lower-end pressures, but if not, there is no way to increase the amount of moisture produced. Furthermore, in cold climates, the water temperature in the chamber will drop, causing the CPAP air to become very cold and reduce the amount of moisture.



 

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Filters

How often should I clean my filters?

How often should I replace my filters?

In what order do I insert the filters?

What are reusable foam filters?

What are disposable ultrafine filters?


How often should I clean my filters?

Washable pollen filters should be cleaned as soon as they become discolored. Depending on your environment, that may mean weekly cleaning.

Ultrafine filters should not be cleaned, just disposed of.



 

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How often should I replace my filters?

Reusable pollen filters should be replaced when they deteriorate and begin to fall apart, much as a sponge does.

Disposable ultrafine filters should be discarded as soon as they become discolored, or at least every 30 days to 60 days.


 

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In what order do I insert the filters?

If both the pollen and ultrafine filters are used, the ultrafine filter is inserted first with the smooth side against the machine and the hard side facing out. The tab is folded out for easy removal. The pollen filter is placed on the outside to remove the larger dirt particles first.


 

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What are reusable foam filters?

Pollen filters are designed to collect larger dirt particles and animal fur. If two filters are used in a machine, the foam filter should be on the outside.


 

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What are disposable ultrafine filters?

Ultra fine filters collect much smaller particles and are useful for those with allergies or sinus issues. These filters are not meant to be cleaned, but discarded when dirty.


 

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Tubing

What is CPAP tubing/CPAP hose?

How often should I replace my CPAP hose?


What is CPAP tubing/CPAP hose?

CPAP tubing and CPAP hose can be interchangeable terms, however, we usually refer to the larger diameter connection that delivers the CPAP air to a mask or humidifier as a Hose, and any other similar item as a Tube or Tubing.


 

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How often should I replace my CPAP hose?

CPAP hoses can last a long time, sometimes up to a year if taken care of properly.

Signs of wear are dry, cracked places on the inside lining or on the rubber ends; "stretch marks" near the rubber ends; and minerals deposits or mold from water left inside the hose.

Your CPAP hose will last longer if you detach it every morning and hang it to air dry. It should be removed by grasping it on the rubber ends, rather than on the hose itself.

Drying the hose each morning will also prevent bacteria from growing in the damp interior and help reduce the possibility of colds and other health issues.

If you are not drying the hose daily, then be sure to replace the hose very frequently as negative health issues will result!


 

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Chinstrap

What is the purpose of a chinstrap?


What is the purpose of a chinstrap?

Nasal delivery devices are the preferred mode of delivering CPAP air. They are smaller, lighter and usually more comfortable, with many styles and sizes to choose from.

When using a nasal device with a CPAP, it is imperative that the mouth remain closed for the pressure to be maintained and the therapy to be effective. Most people will automatically keep their mouth closed while on CPAP, but some are unable to do so, at least in the beginning of the therapy.

Use of a chinstrap is the first response to opening the mouth during sleep. It is worn in addition to the CPAP mask to hold the jaw up and help keep the mouth closed.

Even with the use of a chinstrap, some people are still able to breathe through their teeth and lips. If so, a full face mask is an option worth considering.


 

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Common CPAP side effects

Why is air leaking from my mouth?

Why am I congested from CPAP use?

Why do I wake up with dry eyes?

Why is my face breaking out around my nose?

Why is air leaking from my mask?

Why do I have a headache when I wake up?

Why do I wake up to find my mask is off?

Why is my mouth dry in the morning?

Why do I wake up with air in my stomach and intestines?

Why am I getting sores inside my nose?

Why is my nose so dried out?


Why is air leaking from my mouth?

Air leaks from the mouth whenever the mouth is opened during CPAP therapy. This occurs for many reasons, but a very common one is due to nasal irritation from the CPAP airflow.

The correlation to a lack of humidification and mouth leaks is a topic being heavily researched. Studies are now being conducted on the hypothesis that a large amount of mouth leakage is caused by the following cycle:

 

 

    1. CPAP therapy is used with ineffective or no humidification.
    2. The nasal membranes are unable to adequately condition the increased airflow and after a few minutes the airway and nasal passages become dry.
    3. To remedy the dryness and obtain moisture, the body uses the mouth to breathe.
    4. CPAP air follows the path of least resistance and leaks out of the open mouth.
    5. The air leaking through the mouth causes more dryness.
    6. Patient wakes up feeling tired with significant dryness in mouth and dry, swollen nasal passages.

The answer to this cycle is humidification. If the mouth continues to open during sleep, a chinstrap may be needed to hold the jaw up so that the mouth can close. If mouth breathing continues, a full face mask that covers the nose and mouth is indicated.



 

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Why am I congested from CPAP use?

The primary reason why congestion sometimes develops from CPAP use is lack of adequate humidification.

CPAP air is an irritant - to one degree or another - to everyone. The irritation may cause the nasal passages to dry out and bleed, or the mucous membranes may try to protect the nasal passages by producing excess mucous and so congestion results. And the irritation can be cumulative; the problem may develop over time.

Add a heated humidifier to add moisture to the CPAP air and reduce or eliminate the irritation. A passover humidifier may not offer enough moisture. If you are already using a heated humidifier, try turning it up to a higher setting. If that produces condensation in the six foot hose, you should try an insulating cover for the hose.


 

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Why do I wake up with dry eyes?

Air leaking from the mask at the bridge of the nose and over the eyes during sleep will cause the eyes to dry out. The most common reason for air leaking at the nose bridge is that the mask is too big or too long for the nose.

We would suggest you try our measurements for sizing your mask to be sure you have the best size. A mask that has an adjustment at the bridge may also be helpful in getting a good fit. Nasal pillow or nose cushion devices which do not rest on the nose are also an option.

It is not advisable to tighten the headgear to eliminate the air leak. Pressure from a mask that is too tight will cause bruises and even open sores if applied long enough.


 

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Why is my face breaking out around my nose?


An allergic reaction to the mask usually appears as redness or a rash all around the nose and on the forehead.

Most masks are made of silicone, which is an inert substance. But silicone is manufactured in chemicals to which some people are allergic. The chemicals normally degrade and disperse over time, but may cause a reaction when first used. The solution is to remove the chemicals and gasses before using the mask.

Washing the mask will reduce or eliminate the problem. This process can be accelerated by long soaks in warm soapy water. This is true with all masks and other types of nasal prongs and cushions.

Replacement items should be bought well before they are needed, washed and soaked at once and stored. This process may reduce the life of the silicone.

Allergic reactions are often confused with the pressure bruises, bumps and open sores that can result from tightening headgear straps too tightly. If the problems are only at the bridge of the nose or beneath the nose, it is probably a pressure issue and a new size or new mask is needed.


 

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Why is air leaking from my mask?


Air leaks are caused by masks that are too big or too old or just the wrong style.

Air leaking into the eyes is usually an indication that the mask is too big (long) as are leaks at the base of the nose.

Leaks may also occur under the nose due to facial hair. As the silicone in the mask cushion ages, it deteriorates and becomes too soft to hold a seal. You may be able to tighten it enough to stop the leaking when you go to sleep, but during the night it will loosen and leak.



 

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Why do I have a headache when I wake up?


CPAP is does not normally cause headaches unless there is a sinus related problem or some pressure from the machine acting where it should not be.

Sinus systems are extensive, even going behind your ears. When a CPAP is used and part of the sinus cavities are blocked, a situation is created where there is a pressure differential between the sinus cavities affected. These pressure differences can sometimes be felt as sinus headaches or just plain headaches, even though they are caused by sinus blockages. These can be treated using over the counter medications to open the sinus. CPAP heated humidifiers can also open and maintain sinus systems. If you do not use a heated humidifier, we strongly suggest to use one. If this does not correct the problem, visit your ENT.



 

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Why do I wake up to find my mask is off?


People remove their mask during sleep because they are not getting enough air.

The CPAP pressure may be reduced if your mask is leaking. Your mask may be too big or too old. Take our mask sizing measurements to see if you have the best size. If your mask fits you but is six to nine months old, it should be replaced. In time, the silicone cushion deteriorates and becomes too soft to hold a seal.

If the CPAP air is being delivered effectively, it may be that it is set too low. Pressure settings may require change due to weight gain or loss. The type of sleep study you had and the duration of sleep may indicate that your pressure could be adjusted. You should speak to your doctor if you think your pressure may need to be adjusted.



 

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Why is my mouth dry in the morning?


Dry mouth is a sign that you are opening your mouth while you sleep. If you use nasal mask, breathing through your mouth bypasses any humidification you may be using so increasing the heat will not be effective. Breathing through your mouth while using a nasal mask also reduces the benefit of the CPAP therapy.

First be sure the mask is not leaking. If it is six to nine months old and leaking, try replacing it. If it is new and leaking, we can help you get a better size.

If your mask is new and NOT leaking, try a chinstrap to keep your jaw up and mouth closed. If a chinstrap doesn't solve the problem, try a full face mask that covers your nose and mouth.

If you use a full face mask and have a dry mouth, try adding a heated humidifier to add moisture.


 

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Why do I wake up with air in my stomach and intestines?


Bloating is a sign that you are swallowing the CPAP air. You can try to use a Bipap machine to help you to draw the CPAP air out from your mouth or stomach. This can improve the comfort level and reduce the bloated ness in your stomach.


 

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Why am I getting sores inside my nose?


Sores inside the nose may be caused by nasal pillow or nasal prong devices that are too big or the wrong shape for your nose.

If you use nasal pillows, try the smallest size available that seals around your nasal.


 

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Why is my nose so dried out?


The primary reason why nasal passages sometimes dry out from CPAP use is lack of adequate humidification.

CPAP air is an irritant - to one degree or another - to everyone. The irritation may cause the nasal passages to dry out and bleed, or the mucous membranes may try to protect the nasal passages by producing excess mucous and so congestion results. And the irritation can be cumulative; the problem may develop over time. Furthermore, dry, cracked or bleeding nasal passages are a breeding ground for infection.

Add a heated humidifier to add moisture to the CPAP air and reduce or eliminate the irritation. A passover humidifier may not offer enough moisture. If you are already using a heated humidifier, try turning it up to a higher setting. If that produces condensation in the six foot hose, you should try an insulating cover for the hose.

 

 


 

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