CPAP Troubleshooting Guide
Contents
1. Increase humidity with a heated hose or ClimateLine hose Rule out mouth opening issues Often the cause Ask your therapist about being switched to a BiPAP machine Skin Breakdown Allergic reaction If mask is new soak in warm soapy water to remove any manufacturing residue Never clean with harsh cleaners Ensure mask is not too tight e Considera mask from a different vendor manufacturer as the design and cushion materials may be different e Considera nasal pillows mask as there is less contact with the skin e Ifyou experience nasal bridge breakdown consider a nasal gel pad or barrier such as a Band aid Moleskin or a Breath Rite e Considera SleepWeaver fabric nasal mask e Replace masks and nasal pillows on a regular basis Old masks breakdown and become colonized with fungus and bacteria e Considera cotton liner to go over the mask as a skin barrier e Considera ointment for skin breakdown ex Secaris or Roezit Insomnia Difficulty falling asleep with CPAP e Wear CPAP while awake ie while watching TV or reading e Follow sleep hygiene recommendations e Ask your respiratory therapist to explain the ramp feature on your CPAP machine or if you have a Fixed CPAP consider talking to your therapist about an Auto CPAP COLD of Sinus Infection e Continue using CPAP only if tolerated e Ifyou use a nasal mask and are unable to breathe through your nose discontinue CPAP use e Considera full face2. mask as a back up if you frequently get colds e _ Increase the CPAP humidity Swollen eyes Irritated eyes e Rule out issues with mask leaks e Change mask e Trya mask with a different exhalation port direction Still snoring on CPAP e You may need to increase the pressure on your CPAP ask your therapist about this e Ifyou have a bed partner ask them if you are mouth breathing or the mask is leaking while you are snoring Headaches or Ear pressure e Thisis usually caused by sinus congestion e Ruleout pre existing cold sinus issues or allergies May need to put CPAP on hold until this resolves e Consideran ENT Doctor referral for frequent and chronic problems Unable to use CPAP Trial Stopped e Consideran Oral Appliance for patients that cannot tolerate CPAP Ask your Respiratory Therapist about your options e Usually indicated for patients with snoring or mild apnea only approximately 60 effective although compliance is higher e Maybe contraindicated for patients with TMJ issues
3. CPAP Troubleshooting Guide Problem Solution Difficulty Tolerating e Askyour Respiratory Therapist about increasing the amount of time CPAP Pressure from your baseline pressure to the prescribed pressure During the initial start up period itis not un common for a patient to find the prescribed CPAP pressure hard to tolerate Please remember that an adjustment period is necessary Practice patience and persistence will pay off e Consider using Auto CPAP over a Fixed CPAP as the pressure will onlyincrease when the user is asleep e Ruleout nasal obstruction deviated septum nasal congestion or nasal dryness e Consider wearing the CPAP device while awake or while watching TN e Returnto a sleep clinic for review Consider a lower or higher start pressure Sometimes a higher pressure will open up the nasal passages and make it easier to breathe e Tryadifferent CPAP mask Nasal Congestion Dryness or Post Nasal Drip Nasal congestion is probably one of the biggest impediments to using CPAP Using a heated humidifier allows the air to retain more moisture A heated hose will also retainthis moisture as the air flows from the humidifier to the user e Use saline sprays Nasomist or a nasal moisturizer Nasogel before and after using your CPAP e Ruleout Post nasal drip or allergic rhinitis Consider inhaled nasal corticosteroids Flonase or Nasonex Consider nasal or oral antihistamines Ask your resp
4. During the daytime you don t need CPAP because your muscles are stimulated and your throat is open so all of the CPAP air is going to your lungs and it will feel different This isn t bad and it WON T hurt you If your feel stressed calmly and gently lift the mask or pillows off your face Then calmly try again Day 2 Repeat Now try opening your mouth and talking with the CPAP on Note how hard itis to do If you feel stressed calmly and gently lift the mask or pillows off your face Then calmly try again Day 3 5 Repeat as much as necessary until the CPAP can be worn for 15 minutes Now try to wear it at night Don t worry if you re not successful Try a bit more each night Unintentional Removal of mask pillows during sleep Common during first e Often more common with nasal pillows over nasal mask as the nasal masks are more secure e Ensure mask leak issues are corrected as this could be the root cause three months of CPAP Ensure optimal nasal humidification Follow advice for nasal use congestion Dry mouth e Increase CPAP humidity Consider a heated hose or climate line e Rule out mouth opening Consider a chin strap if this is occurring e Consider the use of OTC glycerin bases saliva agents such as MoiStir paste used at night prior to CPAP to help protect the oral cavity from drying Ask your respiratory therapist about your options Swallowing Air Gastric Insufflation Limit pressure on CPAP
5. iratory therapist about these options e You may be breathing in through your nose and out through your mouth causing the nose to become dry Ask your respiratory therapist aboutyour options e Considera full face mask or a hybrid oral nasal mask e Consider using an OTC nasal decongestant for example Otrivan for no longer than 3 nights Use longer than 3 nights can cause rebound congestion Ask your respiratory therapist about your options Mouth Leaks Mouth Breathing e Symptoms may improve with time as patients become accustomed to wearing nasal CPAP Ensure optimal humidity Consider a heated humidifier and hose Considera chin strap Consider a full face mask Mask Leaks Ensure straps are tight enough This is the most common problem Poorly fitting mask Usually nasal masks seal better than nasal pillows and long term compliance is usually better e Consider another CPAP mask may be fitting poorly or try another type of mask ie nasal pillow nasal or full face mask e _Ifyour mask is old consider a replacement or a new cushion Claustrophobic e Wear your CPAP while you are awake watching ty or reading e Considera different mask ask your respiratory therapist if a different type of mask will work for you like a nasal pillow mask Try this Claustrophobia plan Day 1 Wear CPAP for 10 15 minutes Note that you ll feel as if you re getting too much air and that it s hard to exhale all of the air
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