"There are naive questions, tedious questions, ill-phrased questions, questions put after inadequate self-criticism. But every question is a cry to understand the world. There is no such thing as a dumb question." – Carl Sagan.
When it comes to proper treatment for any health condition, patient education is often the most crucial aspect in compliance with therapy. Patients that are uninformed about their disorder and treatment options are among the first to quickly abandon therapy. It's sad to see patients go through the process of exploring their symptoms, seeking diagnosis, and getting set-up with treatment, only to discontinue treatment after a short time. And one of the biggest factors for patients quitting treatment is a lack of quality education from medical professionals about the necessity of continued therapy.
At The Alaska Sleep Clinic we strongly believe that well-informed patients will be most likely to succeed in successful treatment. That's why we constantly listen to our patients' questions and concerns, and strive to provide the best answers and resources possible for them.
Here we have compiled a short list of some of the common questions we get asked about CPAP therapy.
I’ve been told I may have sleep apnea and need a CPAP machine. How do I get one?
You should begin by talking with your primary care physician about your symptoms. Let your doctor know if you snore during sleep, stop breathing during sleep, wake with headaches, feel excessively sleepy during the day, have memory or cognitive troubles, and any other symptoms you may be experiencing.
Based on your answers and a physical check-up your doctor may recommend you have a sleep test performed.
If you do not have a primary care physician or would rather speak with a sleep specialist directly, you can always contact a sleep clinic to schedule a consultation with a sleep specialist.
If your examination or consultation reveals that sleep apnea is likely causing your symptoms, you will advised to have a sleep study. Click here to learn more about sleep studies.
The results of your test will be reviewed by a sleep physician who will determine the diagnosis of your test and recommend the best therapy.
If a CPAP machine is found to be the best treatment for your sleep apnea, you may be asked to return to the clinic to have a second sleep study, called a CPAP titration, in which you will be required to wear a CPAP mask during the night so the specialist can find the best pressure settings to keep you breathing regularly throughout the night.
Afterwards you will be prescribed a machine with specified settings to treat your condition. You will be shown an array of masks so that you can find one that fits comfortably enough to wear each night.
How often do I need to get supplies for my CPAP?
Regularly cleaning and replacing your mask, mask cushions, filters, and other CPAP equipment is vital in maintaining compliance. Various parts and pieces are scheduled to be replaced every so often as the materials in the equipment breakdown over time.
Most DME vendors will notify you when your equipment is due to be replaced. If you're unsure of your replacement schedule or how often your insurance allows replacements, contact your DME provider and they will gladly check with your insurance company for you, so you don't get any surprise bills in the mail.
Here is a general guideline for replacement parts:
- Nasal interface – One every 3 months
- Full face mask – One every 3 months
- Nasal pillows – One per month
- Nasal cushion – One per month
- Full face cushion – one per month
- Headgear – One every 6 months
- Tubing – One every 3 months
- Filter, disposable – Two per month
- Filter, non-disposable – One every 6 months
- Chinstrap – One every 6 months
- Humidifier chamber – One every 6 months
If I can't tolerate CPAP therapy, what are my other options?
CPAP therapy is the gold standard in treating moderate to severe sleep apnea. However there are alternatives to CPAP use that patients should be aware of.
First off, CPAP is often used as an umbrella term for all positive airway pressure (PAP) devices including automatic positive airway pressure (APAP) and BiPAP (Bilevel positive airway pressure) therapy. Many of the alternatives operate the same way, but with slight differences to make positive airway pressure therapy more tolerable for patients.
Before searching for an alternative to CPAP therapy, make sure you are giving treatment an honest effort, as it is often the best treatment for your condition. If it's the mask causing you trouble, talk with your DME provider about finding another mask that offers a better fit and comfort for your needs. If it's the pressure, inquire about getting a CPAP machine with a ramp feature that allows the pressure to slowly build to your prescribed settings, so that you're not immediately discomforted by the full pressure as soon as you turn on the machine for the night.
If you have mild to moderate sleep apnea, you may qualify for a dental device. Make sure that you visit a dentist to get a specially fitted dental appliance opposed to an over-the-counter device. Over-the-counter devices often don't work properly as they're not specifically fitted to your individual needs.
Depending on the cause and severity of your symptoms, various types of surgeries may help reduce or eliminate your sleep apnea symptoms. Surgeries for sleep apnea can include adenoteonsillectomies, nasal surgery, maxillomandibular advancement surgeries, and tracheostomies. To learn more about these surgeries and other forms of alternative treatments, click here.
If I lose weight will I be able to get off CPAP therapy?
While weight and neck circumference are strong contributors to sleep apnea, they are not the only cause. Many people falsely believe that weight and neck size are the only causes of sleep apnea because they are the most obvious to point out.
Weight contributes to sleep apnea because of gravity and excessive tissues. When you sleep, the muscles of the body relax; this includes the muscles of the throat and mouth that work to keep your airway open during waking hours. People that are overweight often have larger necks and more soft fatty tissues in the throat. A narrower opening due to a thicker neck coupled with excess fatty tissue in the throat makes it easier for these tissues to fall back in the airway and restrict airflow.
However, many people that are not overweight also have sleep apnea for a variety of reasons. Some of these causes are:
- Age- As people age their muscles begin to lose muscle tone. This is also true of the muscles in the throat. As throat muscles lose definition, they become weaker and more likely to collapse into the airways during sleep.
- Enlarged tonsils or adenoids are the leading cause of obstructive sleep apnea in children but can also affect adults who never had a tonsillectomy when they were younger.
- Natural causes- Some people can be genetically predisposed to having a narrower throat or may have an enlarged tongue that falls back into their airway. If your family has a history of OSA you are more likely to have it yourself.
- Frequent alcohol use- Alcohol relaxes the muscles in the body, and this includes the throat muscles as well which may relax to the point of blocking the airway during sleep.
- Smoking- Smoke is an irritant to the lungs, throat, and esophagus. It can cause inflammation and fluid retention in the upper airways that can impede airflow.
Also, you may lose enough to put yourself in the mild to moderate group and qualify for a dental appliance as opposed to CPAP therapy.
My CPAP machine is making me bloated/gassy. Why?
Patients that wake feeling bloated, gassy, or feel like burping are most likely swallowing air, a symptom called aerophagia, which literally translates as "swallowing air." This can be fairly common in first time patients in their first few weeks of therapy.
CPAP therapy works by blowing pressurized air into the airway to splint them open and reduce apnea events as the air makes its way to the trachea and lungs. Right near the trachea is an opening to the esophagus and stomach. Sometimes the air gets misdirected to the wrong place and air accumulates in the stomach leading to the patient feeling bloated, and the need to burp or pass gas.
While it may feel uncomfortable and distressing, it rarely leads to any type of permanent damage and is often relieved in the first hour of waking.
However, there are certain steps one can take to alleviate symptoms of aerophagia:
- Reduced pressure settings. High-pressure settings can contribute to air flowing into the esophagus more readily. Ask your sleep specialist if it's possible to reduce your pressure settings. You can also ask about being put on an APAP device that has a high-pressure setting and a low-pressure setting that the device fluctuates between on a breath-by-breath algorithm so that your pressure isn't continually set high.
- Change sleep positions. While it may not entirely relieve bloating, it can help provide tolerable relief by sleeping with a wedge pillow that inclines the body slightly. If you can afford it, you may consider purchasing an adjustable bed.
- Treating gastro-esophageal reflux disease (GERD). Patients suffering from GERD often have a weakened lower esophageal sphincter causing it to not be able to close all the way. Patients with GERD often have stomach acids flow up into, and burn, the esophagus's delicate lining. Patients with both GERD and using a CPAP device may also experience bloating and gassiness as the pressurized air more readily flows past the lower esophageal sphincter and into the stomach.
Do I need my CPAP while traveling or camping?
You should be using your CPAP every time you sleep (including naps) to help keep all of your symptoms at bay. Even one day off of CPAP therapy you may notice a return of some of the very symptoms that brought you to seek treatment in the first place: a headache in the morning, poor/fragmented sleep at night, and feel excessively sleepy the next day.
Fortunately, there are CPAP devices made specifically for travel and even camping remotely.
These devices are smaller, lighter, and much easier to pack along. One such device you may want to check out is the Transcend Travel CPAP machine. The device itself is slightly larger than a can of coke, comes with a variety of plug-ins including a DC converter so you can connect your device in a car, international plugs, so you can take it overseas, and even batteries and a solar charger to charge the batteries if you plan on going off the grid. And while these devices aren’t recommended for everyday use, they are a great machine to have for the frequent traveler.
If you want great tips for traveling with a CPAP machine, check out this detailed article.
If you have any further questions about CPAP therapy, sleep studies, sleep apnea, or any other sleep troubles you're having, feel free to contact The Alaska Sleep Clinic. We welcome any and all questions, and will do our best to answer them in a timely manner.
The only stupid questions are the ones that were never asked. We look forward to hearing from you.