NASAL CPAP / BiPAP
OPERATING SAFETY INSTRUCTIONS
- Gather Equipment:
- Flow Generator
- Mask or Nasal Pillows
- Humidifier (if prescribed)
- Place flow generator on a flat level surface on a nightstand next to the bed. DO NOT PLACE ON FLOOR.
- Fill the humidifier (if so equipped) with distilled water.
- Attach tubing to flow generator and mask or pillows.
- Plug flow generator power cord into an appropriate electrical outlet(UNGROUNDED outlets may require GROUNDING ADAPTER).
- Turn on flow generator to inflate mask or nasal pillows cushion.
- Fit mask or nasal pillows to face and adjust headgear.
- Position patient in a comfortable sleeping position and readjust headgear, if necessary.
- Breathe in and out through nose. Try not to exhale through mouth.
- If leaks develop during the night, attempt to correct the leak by:
- First, gently pulling mask or nasal pillows away from face to allow cushion to re-inflate.
- If necessary, re-adjust headgear. Try to avoid over-tightening the mask or nasal pillows, which could distort the cushion and cause a leak.
- If it is necessary to get up during the night, do not remove the mask or nasal pillows from the face. Turn off the flow generator and disconnect tubing from flow generator before getting up. Upon returning to bed, reconnect the tubing to the flow generator and turn on the power switch.
- Upon rising in the morning:
- a. Turn off power switch.
- b. Remove mask/pillows and headgear.
- Clean CPAP circuit as directed in the Cleaning Instructions provided to you.
Call your servicing location if you have problems or questions
Your doctor has prescribed Continuous Positive Airway Pressure or CPAP therapy for you. When used appropriately, CPAP therapy is nearly 100% effective in managing obstructive sleep apnea. It is important for you to understand why you are using the therapy and the benefits you may expect from using it. In order to better explain CPAP and its use, let’s look at some of the most common questions patients may have about its use.
Why am I using CPAP?
Most people using CPAP have a condition known as obstructive sleep apnea or OSA. During sleep, the muscles in the back of the throat relax causing the upper airway to become smaller. This is especially true during the deepest stages of sleep (called Rapid Eye Movement or REM sleep). In some individuals, the upper airway can actually collapse, causing a blockage of air movement into the lungs. When airflow is stopped for at least 10 seconds, it is referred to as apnea. These apneas can occur many times each hour and hundreds of times each night.
Why is this bad?
Apneas can cause several problems. Oxygen levels in the blood can drop to dangerous levels causing irregular heartbeats and increased blood pressure within the lungs. This stresses the heart and over time can result in damage to the heart. Obstructive sleep apnea is associated with increased blood pressure, heart disease, and even stroke. During apneas, an arousal (i.e. moving to “shallower” sleep) may occur, affecting the patient’s ability to maintain deeper stages of restful sleep. It is because of this that sleep apnea patients are frequently very sleepy during the day. Other symptoms that may be associated with sleep apnea include severe snoring, waking up gasping or short of breath, morning headaches, impaired thinking, attention deficit, poor memory, mood changes, depression, and impotence.
How does CPAP therapy help?
Continuous Positive Airway Pressure or CPAP therapy works by creating positive air pressure within the back of the throat, preventing airway collapse, and apnea. This positive pressure pushes out on the walls of the throat, creating an “air splint” within the airway in much the same way that water pressure within a garden hose pushes out on the walls of the hose preventing it from collapsing. Positive pressure is delivered by the CPAP machine to the airway by a mask that is worn over the nose (called a nasal mask) or over the nose and mouth (called a full face mask). There are many other interfaces that can be used that vary based on the need of the patient.
Consequences of Obstructive Sleep
Consequences of Obstructive Sleep Apnea
Consequences of Obstructive Sleep
- Ischemic Heart Disease
- Reduced Drive to Breathe
- Excessive Daytime Sleepiness
- Attention Deficit
- Chest Pain at Night
- Right and/or Left Heart Enlargement
- Insulin Resistance
- Learning/Memory Deficit
- Decrease in Intellectual Capacity
What is Bilevel Positive Airway Pressure or BiPAP® therapy?
Bilevel Positive Airway Pressure delivers two different pressures to the airway; one during inhalation, and a lower pressure during exhalation. Some patients find this to be more comfortable than a single continuous pressure.
Are there problems with CPAP or BiPAP® therapy?
Most patients are able to use CPAP without significant problems after a period of acclimating to the mask and pressure. Don’t be surprised if it takes a period of time to get used to. Other problems can be soreness around the nose and mouth, irritation to the eyes, problems tolerating the pressure, claustrophobia, dry nose or mouth, difficulty sleeping, or nasal congestion. If any of these occur, contact your equipment provider and they will be able to offer possible solutions. If problems persist, talk with your doctor about other alternatives.
Intolerance of CPAP and Potential Solutions
Problem Possible Solution Mask-Related
- Soreness Around Nose and/or Mask Leak
- Mouth Leak
- Refit Mask
- Adjust Straps
- Different Mask Type
- Chin Strap
- Full Face Mask
- “Nasal Pillow” Device
- Slow Acclimation
- Difficulty Exhaling
- Nasal Congestion/Runny Nose
- Nasal Dryness
- Lower Pressure
- Ramp Settings
- Bilevel PAP
- Nasal Decongestant
- Nasal Saline Wash
- Nasal Saline Wash
- Room Humidifier
- Continuing Symptoms (eg, sleepy, headaches, etc.)
- Air Temperature
- CPAP Machine Too Loud Can’t Sleep
- Adjust Settings
- Different Therapy
- Increase Room
- Heated Humidifier
- Tubing Under Blanket
- Quieter (Newer) Device
- Move Further from Bed
- Ramp Feature
- Time to Acclimate