Adapting to a PAP: The Best Way?

 

Today’s post is about adapting to a PAP unit. We will break down the phases of getting used to the unit and troubleshoot each recomendation as fully as possible. While not all experiences can be summed up in this singular article, a great deal of effort will be spent covering what it takes to virtually assure success on a PAP device.

Decide where you will sleep and make your sleeping area as welcoming and comfortable as possible.

This may mean:

  • Fresh bed sheets, pillow cases.
  • Special pillows, such as the CPAPpillow
  • Lighting that can be dimmed.
  • A source of white noise and/or music.
  • Comfort items that only you have and add to your sense of relaxation.
  • An outlet closest to the bed and/or extension cord kept away from your walking path.
  • Overhead fan on or off, as desired.
  • Open or closed window(s), as desired.
  • Open or closed door(s), as desired.

 

Now let’s take a look at your PAP system. A complete PAP system is typically:

Once you have taken inventory of your new PAP, it’s rather important to take a quick look through the owner’s manual.

After doing this, let’s gain a proper introduction to the experience.

 

Step One

What you’ll need:

  • a mirror large enough to see your face
  • you
  • your mask
  • a comfortable chair or your sleeping area

 

What to do:

1) While in front of the mirror, place your mask on your head as instructed by youtube or your DME/Vendor specialist.

Things to watch out for with your mask fit:

  • Not too tight
  • Not too loose
  • Any forehead pad should hold just enough to keep the mask from falling. Very few masks, if any, require a tight fit on the forehead (unsightly marks don’t go over too well with anyone on a PAP device.).
  • Remain standing as you do this. Why? This will assure a basic fit. As you sit or lay down, gravity will add more pressure to the fit and you can adjust the mask again, aiming for a happy medium between tight and loose.

2) Attach your mask to the tubing as it is attached to the PAP device.

3) Turn your PAP “on.” You should hear and feel a gentle “thump” inside the mask.

(Note: this probably won’t happen with a nasal pillows mask. Instead, feel around your nostrils for air leaks to check the fit.)

4) At this point, lay back, and find your best sleeping position, relax as you can, and acclimate your breathing, but…don’t go to sleep. The idea here is to simply be aware of the system running and the mask doing its work.

5) Watch TV or read (if the mask isn’t too big) for about fifteen (15) minutes.*After fifteen minutes, remove the mask and shut off your PAP device.

OPTIONAL: Repeat this as you desire on a per day basis so ultimately falling asleep with the PAP unit feels “natural.”

*The incremental approach to the amount of time on the PAP can be more than fifteen minutes. Some have done this for the duration of a movie, i.e. around two hours. The reasoning behind this approach is the same.

 

Step Two

What you’ll need:

  • you
  • your mask
  • your sleeping area

What to do:

(This step is nearly identical to the first step, with a few differences.)

1) Place your mask on your head as instructed by youtube or your DME/Vendor specialist.

Things to watch out for with your mask fit:

  • Not too tight
  • Not too loose
  • Any forehead pad should hold just enough to keep the mask from falling. Very few masks, if any, require a tight fit on the forehead (unsightly marks don’t go over too well with anyone on a PAP device.).
  • Remain standing as you do this. Why? This will assure a basic fit. As you sit or lay down, gravity will add more pressure to the fit and you can adjust the mask again, aiming for a happy medium between tight and loose.

2) Attach your mask to the tubing as it is attached to the PAP device.

3) Turn your PAP “on.” You should hear and feel a gentle “thump” inside the mask.

(Note: this probably won’t happen with a nasal pillows mask. Instead, feel around your nostrils for air leaks to check the fit.)

4) At this point, lay back, and find your best sleeping position, relax as you can, and acclimate your breathing. This time, you will go to sleep.

5) But here’s the difference, sleep for about two hours OR until the mask falls off unconsciously (which is normal for a beginner) or whatever comes first.

The idea here is to place a small demand on your sleep time, per night.

Repeat this as you desire on a per night basis so ultimately falling asleep with the PAP unit feels “natural.” Note: you may get more or less than two hours per night, but the incremental approach is the same.

When a few hours of successful sleep is steady, you are now ready for longer sleep time.

Hints and tips to make this work:

  • Set a timer so music plays to wake you up gently to remove the mask and shut off the PAP.
  • If your PAP has an automatic on/off feature, enable it so you won’t have to wake up to shut everything down.
  • If you have a basic PAP, purchase a separate A/C timer to shut the PAP off at a particular time.

Progress like this until you have something close to a full night’s rest.

If sleeping at night like this is too disruptive, attempt daytime naps instead. And aim for naps starting with twenty minute duration.

Keys to success

  • a supportive pillow for your head and shoulders
  • supportive pillows for your low back, if required.
  • aromatherapy to offer a pleasing scent, if you prefer this
  • light music that encourages relaxation and/or meditation
  • a soft accessory for your mask headgear to cradle your cheeks in silky comfort

When napping with a PAP and mask is successful, then you can attempt sleeping with it for a partial night and ease into a full night over time.**

**Please re-read this article from the start to refresh your knowledgeable approach.

 —

Step Three

As much as the above is near sure to work, Inevitably there are pitfalls.

Let’s take a look at each one:

 

Wrong style or size and claustrophobia

This refers to the mask and its size. Some services do not take the time to
fit a mask on someone properly, which is unfortunate. That can invite claustrophobia as well.

The solutions include masks that come with all sizes in the package, which makes your sleep time successful after a few nights of “testing.”

For other masks like full face masks, medium tends to fit most if you are presented with a choice when shopping for PAP gear.

Otherwise, the best approach is to trial a mask before you buy it. Some online sources will allow it as well as some local vendors. A few minutes of research can save you countless nights using the wrong size or style of PAP mask.

 

Acclimation

Review this article from its beginning.

 

 

Difficulty tolerating forced air

On some PAP devices, the Ramp time (the time it takes for your PAP air speed to get to your prescribed pressure) can be changed to something longer. Most models are featured on YouTube showing you how to change Ramp time fast.

Pressure relief is another setting on recent PAP units that can be changed. Again, some YouTube videos show this. Or simply call your vendor or DME to help you.

If your setting is the trouble, some doctors want to see statistical proof before authorizing a pressure change. Consult your sleep doctor about the policy to decide pressure changes.

 

Dry Stuffy Nose

The addition of water to your PAP water container can alleviate a dry stuffy nose. Additional changes can mean changing the heat and humidity on the PAP. Check your PAP user manual for proper instruction.

The use of a heated tubing is also an option, if your PAP is a recent design. Or a tubing cover can work just as much if your PAP doesn’t allow for heated tubing.

Humidifier attachments to your home furnace can help. The same can be said for in-room humidifiers.

Closing windows, doors and slowing down overhead fans can help.

 

 

Leaky mask, skin irritation and pressure nose sores 

Much of this is caused by ill-fitting masks OR oily skin OR headgear that needs regular washing.

Call around to vendors who allow mask trials OR consider washing your mask more often or both.

 

 

Difficulty falling asleep and unintentionally removing the mask (during sleep)

The beginning of this article addresses a full effort to address comfort for sleep so falling asleep is inevitable. For those who can’t fall asleep despite best efforts, this may be a case between you and your doctor.

 

Noise

If your PAP device is noisy, here is a quick guide to determine where the noise originates:

1) Is it the mask?

If the soft part of the mask is too soft, it will create leaks and noise during use. Consider replacing this part if this is the case.

If the front exhaust of the mask (a requirement on all masks) is partially blocked by soap or water, it will whistle or make a similar noise. Consider a thorough rinse and air dry.

 

2) Is it the tubing?

Check where it bends (at the connection point to the PAP and to the mask). Is it lazy or stretched? Does it look like there might be small holes?

If none of the above apply, block the end of the tubing (where the mask would go) and glide your hand along the tubing (while the PAP is running) and check for leaks.

 

3) Is it the machine?

Here’s a short video to see if the problem is the machine:

 

 

4) Is it the humidifier?

Here’s a short video to see if the problem is the humidifier:

 

 

5) Or are the PAP settings causing noise?

 

Final Notes:

For machines more than five years old (you might be borrowing one or acquired one in place of a PAP purchase), here are some general indicators that suggest your PAP device might stop working altogether.

Here’s what to watch out for:

a) Warm or hot air blows from the unit and the humidifier is NOT hooked up

b) A grinding or whining sound as it blows.

c) Any crackling, snapping noise from the inside of the PAP as it blows.

 

What if we missed something obvious?

d) Could it be that water got into the tubing, causing that annoying gurgling sound?

Here’s what to do:

  • Dry all wet components out.
  • Turn down the heat or humidity.
  • Use less water
  • Enable the system again

 

 

Conclusion

Today we have covered a considerable amount of troubleshooting centered around getting used to a PAP unit. It is the intent of this article to save you time and money from lengthy and repeated visits to your vendor, sleep lab retesting, etc.. Hopefully we have covered enough ground to improve your PAP experience and success.

Information we have covered today:

  • Getting used to a PAP unit.
  • Troubleshoot for the most common usage issues.
  • Identify PAP sounds you might hear and silence them.
  • Learned good information to make using your PAP unit easier and better.

If you have further questions, 1.877.430.2727 (CPAP)

If this post was helpful, please leave a comment!

Questions?

Call 1.877.430.2727 for help.

Written and Edited by Bill Bistak B Sc.,SEO/SEM Spc, CRT

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