Positive Airway Pressure Therepy - download
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-Positive airway pressure machines, which keep your respiratory
tract open when you sleep, can be very effective in treating your
sleep apnea. This information is designed to help people who use
PAP find solutions to the problems often encountered when beginning
PAP treatment. If you have obstructive sleep apnea, your upper
airway collapses again and again as you sleep. Positive airway
pressure (PAP) devices give you just the right amount of pressurized
air needed to prevent this collapse. Properly set and used whenever
you sleep, PAP machines can eliminate your apnea and snoring so
that you get a good night's sleep.
-Various PAP machines and masks are available, allowing each
person to find the combination of equipment that works best. The
pressurized air comes through a mask, which fits securely over
your nose. Some patients will find PAP works best for them using
a mask that fits over the nose and mouth or in the nostrils. Most
people first try PAP machines that deliver a continuous fixed
amount of pressurized air called continuous positive airway pressure
(CPAP). Some people prefer two-level PAP machines, which deliver
more pressurized air with breathing in and less with breathing
out. Self-adjustable PAP will raise pressurized air levels only
when apnea occurs.
-Your PAP machine needs to be carefully adjusted to provide just
the proper amount of pressurized air you need in all body positions,
no matter how deeply you sleep. To determine the amount of air
pressure right for you, your sleep is monitored in a sleep center
while you use a PAP device, and the pressure of air is raised
in small amounts until your apnea is eliminated. You may need
higher pressure during some sleep stages and in some sleeping
positions. The sleep center technologist is experienced in helping
people get used to sleeping with PAP.
-Obstructive sleep apnea can usually be completely controlled
with PAP, but you must use it whenever you sleep. Getting used
to sleeping with a PAP machine takes time. While at first you
may find it inconvenient or troublesome, you shouldn't abandon
it without a good try. It can really help you.
Nasal stuffiness or congestion is the most common side effect
of PAP therapy, and is often a nasal reaction to airflow from
the PAP device. More than half of patients experience some increased
nasal stuffiness when they first begin PAP treatment. These symptoms
often disappear within a month.
Dryness and pain in the throat may be caused by PAP devices. Often
the discomfort is caused by air blowing through an open mouth.
A chin strap to keep the mouth closed or a mask that covers the
nose and mouth can eliminate this complaint. Humidifiers for PAP
machines can also help control mouth discomforts.
Mask air leaks
Symptoms of mask air leak are red eyes, loss of beneficial effects
of PAP, and return to snoring or apnea. Air leaks are most often
the result of a poorly fitted mask. Sometimes a different mask
or a mask of a different size is needed. If you continue to experience
significant air leaks despite using a chin strap, consider a mask
designed to fit inside your nostrils, or one that covers your
nose and mouth. A custom mask can be made for you if necessary.
Noise of the machine
Newer PAP machines are much quieter than older models, but all
make some sound. Placing the machine under the bed or on the floor
usually solves the problem.
Sore, dry, or red eyes
These problems can result from an air leak from your mask. Try
reapplying the mask and readjusting the headgear. If the problem
continues, contact your PAP supplier to determine whether you
need to try a different mask size, nasal pillows, or a different
Redness on the face where the mask contacts the skin
If you develop reddened areas or sores on or above the bridge
of your nose or on your forehead, first check to see whether your
mask is pressed too tightly to your face. Your mask needs to be
fitted and adjusted to eliminate air leaks without undue pressure
on the skin. Sometimes spacers and air cushions can help ease
the pressure points. If you need to loosen your mask so much that
leaks develop, ask your PAP supplier whether your mask is the
right type and size and is properly adjusted.
Too much air
Especially when first using PAP, some people complain that the
pressure of air through the nose seems too high. If this sensation
makes it difficult for you to fall asleep, try using a pressure
ramp. Most PAP machines have ramp capability. The ramp starts
the machine at a very low pressure and gradually raises it to
the right amount over a period of minutes. Most PAP machines will
allow you to adjust your ramp time.
Should I try a two-level PAP?
If you have trouble breathing out against the continuous air pressure
of CPAP, a two-level PAP machine may help you. These machines
sense when you breathe in and out, and deliver one pressure of
air when you breathe in, and (usually) a lower pressure when you
breathe out. If you were not tested in a sleep laboratory on a
two-level PAP device, you will probably need another study to
determine the correct air pressure for you.
Should I try self-adjustable PAP?
PAP devices that raise air pressure only when they sense problems
with breathing were approved for use in America in 1996. By increasing
air pressure intermittently, it is believed that PAP treatment
of sleep apnea may be made more comfortable and effective. If
air pressure-related complaints limit your use of CPAP or two-level
PAP, you should consider asking your doctor about self-adjustable
Cleaning PAP devices
Regular cleaning is essential to assure proper function and safety
of PAP devices. The method and schedule for cleaning hoses and
masks and for changing filters may be different for each PAP device,
so you should refer to the manufacture's instruction. Improper
care of PAP devices, filters, mask and hoses can lead to nasal
and sinus problems (congestion, infection, etc.).
Can I travel with this machine?
Most PAP machines available today come equipped with transformers
which allow them to be used with international (220v) voltages
when you travel to foreigh countries. Current PAP models are lightweight
and portable. A travel case for the device and accessories often
comes with the machine, or can be purchased from the manufacturer.
A battery power option is available for those who camp. High altitudes
can affect the performance of your PAP machine.
The air cools as it moves through the PAP hose tubing. To reduce
heat loss, try repositioning the tubing so that it runs under
your bed or bed coverings.
Should I wear my dentures?
Some people with dentures find that if they sleep without their
upper dentures, the PAP mask does not fit properly and air leaks
develop. Try sleeping with your upper dentures to eliminate this
infrequent but difficult problem. If you have no upper teeth,
consider trying a mask that fits inside or just under your nose.
Can I use it when I have a cold?
You may find your PAP machine more difficult to use when you have
a cold. You may need more humidity, or a decongestant. Contact
your healthcare provider for recommendations if you find you cannot
sleep with your PAP when you have a cold. If you develop nasal,
sinus, or ear pain when using your machine, this could be a sigh
of developing infection.
Some people experience feelings of claustrophobia, difficult breathing,
choking, or suffocation when first using PAP. Let your doctor,
sleep technologist, or PAP machine supplier know about these felling.
Spend some time practicing with your PAP machine during the day
while awake. You may need to start by wearing the PAP device for
only a few minutes at a time and gradually increase the time you
spend breathing with it until you feel comfortable.