The Continuous Positive Airway Pressure (CPAP) machine consists of a pump that sucks air from the room through a filter and blows it out at a pre-determined or variable pressure during the night. The pressure varies according to the patient's needs.
Some people find it harder to get to sleep when their CPAP machine is blowing pressurised air. For this reason, some machines have the option to build up pressure over a period of time while the patient sleeps.
If the patient is not tolerant of fixed CPAP therapy, a bi-level device is available that will provide two levels of pressure: a higher pressure on inspiration and a lower pressure on exhalation.
Bi-Level therapy may be used by those patients who require increased support of their airway during the night.
The mask The mask is made of soft flexible cushioned material and fits snugly around the nose. There are several types of masks available with varying designs, but they all share a number of common features.
The nasal maskThe standard mask fits over the nose leaving the mouth free. A good seal around the nose is important to minimise leaks of air.
The full face mask Full face masks cover the nose and mouth. They are usually recommended if the patient has problems with air leaking from their mouth or if they tend to breathe through their mouth generally. A good seal and comfortable fit is important. Small leaks around the mask, as long as they are not into the eyes, are acceptable. The masks are made of soft, flexible cushioned material that fit snugly on the face. There are various sizes and styles available.
The headgear The headgear is provided to keep the mask in position while the patient is asleep. It may consist of thin straps or a full cap to be worn on the head.
The straps are attached loosely to the mask before positioning over the nose. Once the mask is positioned, the straps can be adjusted so that the bottom straps are below the ears and the top centre strap passes over the top centre of your head.
Once the PAP machine is turned on, the straps can be adjusted until a comfortable fit is achieved to minimise air leaks from the mask. Your Air Products
The patient should be advised to position their CPAP/Bi Level machine and tubing to suit their preferred sleeping position. Some people prefer to bring the tubing over the top of their headboard, whilst others prefer to run it over their shoulder. The patient should be advised to choose whichever is the more comfortable to them .
When using the nasal CPAP/Bi Level machine for the first time the patient will notice an unusual sense of pressure when breathing. It is normal to feel some resistance to breathing out as the patient is breathing out against the incoming airflow .
The patient should be advised that it is better for them to keep their mouth closed when wearing the mask. If the mouth is open, air will leak out and this may feel uncomfortable and restrictive .
If the patient wakes in the night and feels uncomfortable with the pressure of the airflow, they should be advised to switch off the machine and remove the facemask for a few minutes. When the patient is ready to replace the mask, they should make sure it is comfortable before restarting the machine and breathe slowly with their mouth closed.
Some CPAP/Bi Level devices feature a ‘ramp’ comfort feature which may assist the patient when starting/restarting their therapy. Further advice on this is given by the Air Products technician on installation.
Common nasal problems
Occasionally, the CPAP treatment can irritate the nasal lining, which results in sneezing and a runny nose, similar to hay fever. The patient may find that this settles down on its own but if it doesn’t, then it would be wise for them to consult their doctor or respiratory specialist.
Some people may experience a continuing dryness of the nose and throat in which case it may be helpful to be prescribed a heated humidifier to be used in conjunction with the CPAP device .
If the patient has a cold and it becomes difficult for the CPAP system to be used, then they should consult their doctor or respiratory specialist who will decide whether treatment should be temporarily stopped.
A patient may find that if the fitting of the mask is too tight, then it may mark their face. Repeated over tightening can cause further skin problems and may require revision of the mask type and/or fit.
The patient should be advised to clean and wash their masks and tubing in accordance with the manufacturer’s instructions.
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