CPAP FAQ

How long will it take to get used to CPAP?
Most people adjust to CPAP in one to two weeks. Occasionally it may take a little longer if, for example, you are very sensitive to noise or the feel of the mask on your face.

How soon after starting treatment will it be before I notice an improvement?
You should notice an immediate improvement when you start treatment though some people may take a little longer.

Will the pressure on my device ever need changing?
If you are using CPAP or bi-level (VPAP) therapy, the pressure will remain set at levels that suit your requirements. Sometimes, however, there is a need for fine-tuning or adjustment to pressure levels, for example if you lose or gain weight, if you find your pressure difficult to tolerate, it may may be dropped slightly for a short time at the beginning of therapy at the discretion of your doctor or sleep physician.

Will my blood pressure improve after I start treatment?
Yes, it can, but please do not alter your medication without consulting a doctor. Your doctor should review your blood pressure regularly.

Is it easier to lose weight when using treatment?
It may be. You should find that your energy levels increase and you are likely to feel motivated to take part in many activities that your previous sleepiness has prevented you from doing. However, permanent weight loss requires long-term lifestyle changes to diet and exercise.

What do I do if I find my device a bit noisy?
You can try placing your device on the floor next to your bed until the noise no longer bothers you. Another option is to place the device under the bed.

I've just started treatment and it's irritating my nose.
The cool dry air of treatment can cause a runny nose and sneezing in some people, but it usually settles down within a few days to a week. If it does not settle down, you should consider using a heated humidifier.

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 the effectiveness of CPAP therapy and headgear that is too tight may cause facial sores at pressure points.

How do I care for my mask, headgear, and tubing?

Masks, headgear, and tubing should be washed daily or at a minimum, weekly, in warm water with a mild detergent and left to air dry.

How often should I clean my filters?

Washable foam filters should be cleaned in water only as soon as they become discolored. They can then be left to air dry. Depending on your environment, that may mean weekly cleaning. Paper filters should not be cleaned, just disposed of.

How do I clean my water chamber?

The heated humidity water chamber should also be cleaned weekly to prevent the growth of bacteria. If you have a ResMed CPAP unit, use the yellow tray to measure the white vinegar and pour that into the water chamber. Then cap the chamber with the yellow tray and shake the chamber. You can then rinse it. If you have a Respironics Machine, you can clean the mask and hose in warm, soapy water as long as you do not have hard water. If that is the case, it is recommended that you use bottled water to clean your water chamber.

Common CPAP Side Effects

Why is air leaking from my mouth?

Air leaks fromt he 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.

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.

Why am I congested from CPAP use?

The primary reason why congestion sometimes develops from CPAP use is the 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. The irritation can be cumulative; the problem may develop over time.

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

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 either too big or too long for the nose.

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 too much to eliminate the air leak. Pressure from a mask that is too tight will cause bruises and even open sores if applied long enough.

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. 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 purchased 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.

Why is the bridge of my nose sore?

Sores at the bridge of the nose or below the nose are usually due to tightening the headgear straps too much. The pressure will create soreness, then a bruise, and may eventually create an open sore if left untreated.

Headgear is usually tightened too much to reduce or eliminate air leaks. A small degree of this may be necessary, but too much is an indication that the mask is too large, too old or just the wrong style.

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 my be too big or too old. 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 tht your pressure could be adjusted. You should speak to your doctor if you think your pressure may need to be adjusted.

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 a 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 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 mask.

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 both your nose and your mouth.

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

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

Bloating is a sign that you are swallowing the CPAP air. There is no real medical solution, but we have found that sleeping position may be a factor. Try sleeping as flat as possible first, even without a pillow. If that position doesn't help, try sleeping on your side or elevated, whichever postion you do not sleep in now.

If changing your position doesn't resolve the problem, talk to your doctor about the possibility of lowering your pressure a bit. It may let a few apneas through, but the trade-off might be worth it.

What is rainout?

Rainout is the accumulation of water in a CPAP tube due to warm, moist air cooling on its way from your CPAP machine to your CPAP mask. Solutions to rainout include raising the temperature of your bedroom or insulating your tubin with a insulating cover.

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