Continuous Positive Airway Pressure (CPAP)

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1 Patient Information Continuous Positive Airway Pressure (CPAP) Author: Pulmonary physiology, sleep and ventilation Produced and designed by the Communications Team Issue date July 2017 Expiry date July 2020 Version 3 Ref no. PILCOM1519

2 Continuous Positive Airway Pressure (CPAP) Obstructive Sleep Apnoea / Hypopnoea Syndrome Obstructive Sleep Apnoea (OSA) affects 4% adult men and 2% women in the U.K. People with OSA stop breathing repeatedly during sleep because the airway collapses. Airway collapse may be due to many factors such as a large tongue, extra tissue in the airway, or decreased muscle tone holding the airway open. The breathing muscles continue to move the chest but, because of the blockage, air will not be able to move in and out of the lungs as easily. This is often accompanied by loud snoring. The blockage may cause a reduction in breathing (hypopnoea) or completely stop breathing (apnoea). The lack of air going into the lungs reduces the delivery of oxygen to the body. The brain senses this shortage of oxygen and rouses the patient. These pauses in breathing can happen many times through the night resulting in unrefreshing sleep. Patients are often unaware of their symptoms. The patient s partner may also end up with disturbed sleep. When sleep is interrupted in this way, it can affect a number of medical conditions such as hypertension (high blood pressure), stroke, heart attack and diabetes. Due to increased sleepiness and tiredness, patients have an increased risk of driving or workrelated accidents. 2

3 Key symptoms include: Excessive daytime sleepiness Loud and irregular snoring Gasping or choking during sleep Grogginess and morning headaches Frequent urination at night Headaches on waking Difficulty concentrating Depression and irritability Memory loss What is CPAP therapy? CPAP therapy provides a constant flow of pressurised air through a mask into the air passages. This prevents the collapse of the airway during sleep. Once the air passage is held open by the use of CPAP, both breathing and sleep usually return to normal. CPAP treatment is long-term. What is the treatment for OSA? Many patients with OSA are overweight or obese. Losing weight may help the problem. Continuous Positive Airway Pressure (CPAP) is the recommended treatment for people who have been diagnosed with moderate to severe OSA. Rarely surgery and mandibular devices can also be used when CPAP does not work. What are the benefits of regular treatment? Regular use of CPAP treatment has a number of benefits including: Increased energy and attentiveness during the day Increased effectiveness at home or at work Restoration of restful sleep Reduced driving accidents or at the workplace. Beneficial effect on blood pressure, stroke and heart attacks 3

The CPAP System The CPAP system consists of: 1. machine 2. tubing 3.

The machine consists of a pump that sucks air from the room through a filter, and blows it out at a pre-set pressure.

Flexible tubing The flexible tubing connects to the machine and the mask. It allows the flow of air between the machine and the mask.

4 The CPAP System The CPAP system consists of: 1. machine 2. tubing 3. mask with headgear The CPAP machine There are different brands of CPAP machine but they work in similar ways. The machine consists of a pump that sucks air from the room through a filter, and blows it out at a pre-set pressure. The pressure varies according to individual needs and will be prescribed specifically for you by the Sleep Team. Flexible tubing The flexible tubing connects to the machine and the mask. It allows the flow of air between the machine and the mask. The Mask and Headgear There are several types of masks available. Nasal masks cover the nose. Face masks cover the nose and mouth, and are used if you tend to breathe through your mouth or if you have problems with air leaking from your mouth. There are various sizes and style and the Sleep Team will assist in finding the right one for you. 4

5 The masks are made of soft, flexible, cushioned material which fits comfortably around the nose if you have a nasal mask or around the nose and mouth if you have a face mask. A good seal and a comfort fit are important. Small leaks around the mask, as long as they are not into the eyes, are acceptable. All CPAP masks have an opening to allow exhaled air (breathing out) to escape. It is important that this opening is not blocked in any way to release the carbon dioxide you breathe out. The headgear is attached to the mask to keep it in position while you are asleep. The straps on the headgear are attached loosely to the mask before positioning over the nose for nasal masks, and mouth and nose on face masks. Once the mask is positioned, the straps can be adjusted to make a good, comfortable seal. Once the CPAP machine is turned on, the straps can be adjusted until a comfortable fit without any air leak is achieved. You may otherwise experience discomfort from a tightly fitting mask. You will need to contact the Sleep Team. Humidifier A humidifier can be added to the CPAP system for people who experience severe nose and mouth dryness when using the machine. If required, the Sleep Team will issue you with one. If you are using the humidifier, the device should be kept lower than the level of the bed. You must used distilled water or cooled previously boiled water. Change the water on a daily basis. Keys to effective treatment for OSA During the initial weeks of therapy, you may encounter problems adjusting to the therapy. The Sleep Team will be available to help and the problems may be easy to correct. You have a choice of mask selection to suit you. Be patient and persistent while you adjust to therapy. It may take time to adjust but the Sleep Team will always be there for support. Please Note: CPAP treatment is not a cure for the problem, but will control the condition as long as the system is used during sleep. 5

6 Common Problems When Using CPAP Occasionally CPAP treatment can irritate the lining of the nose, which results in sneezing and a runny nose like hay fever. This may settle down on its own, but if persists, please consult your GP who may prescribe a nasal spray. Alternatively, you may contact the Sleep Team for further advice. Some people may experience a continuing dryness of the nose and throat in which case a humidifier may be helpful. Contact the Sleep Team for further advice. Discomfort with Airway Pressure comfort settings, such as a ramp or flex on the machine may help you adapt to the pressure. These are on the machine and the Sleep Team will tell you how to use them. If your nose becomes blocked during the night then it will be difficult to use the CPAP system. Continue the use of nasal decongestants if you were taking them before as prescribed by your GP. If you have a cold, consult the Sleep Team if problems persist as we will decide whether to temporarily stop the treatment until you recover. Travelling Advice Most of the machines are dual voltage and will work abroad. Take your CPAP machine with you when you are away from home for two or more days. You must carry the machine as hand luggage when travelling abroad. Most flights accept CPAP machines. However, please contact them in advance. You may also wish to take a long extension lead in case the mains socket is not close to the bed in your accommodation. Looking after your CPAP machine It is important to keep your CPAP equipment in good working condition. 1. The headgear must be washed in warm soapy water (example washing up liquid), rinse and leave to air dry. This should be done every two weeks. 2. The mask should be washed in the same way using a soft toothbrush if necessary. Do not use any other cleaning agents especially ones containing bleach as this will damage the rubber parts. 6

7 3. Do not put the mask or tubing in a dishwasher. 4. The CPAP machine should be disconnected from the mains (electricity) and wiped using a damp cloth to clean the outside. 5. You will need to check the filter monthly and will be shown how to clean it when the machine is first issued to you. What to do if there is a fault The CPAP system is a very reliable. However, occasionally faults can develop. If you do have difficulty with your system, please check the following before calling the Sleep Team: 1. Check that the mains lead is attached to the unit firmly and switched on. 2. Check that the tubes are tightly and correctly fitted. 3. Check that there is no split or hole in the tubing. If there is a split or hole, a replacement is urgently required and you have to contact the Sleep Team. 5. Ensure the filter is not obstructed by bed linen for example or by placing it close to the wall. Do not smoke near the machine as this will affect the filter in the machine. Caution The humidifier must be switched off for half an hour to let the plate cool down before removing it for cleaning. If there is a problem with your CPAP machine, please ring the Sleep team on the contact number given below. We will be happy to answer any queries. After working hours, please leave a message on the answering machine, and you will be contacted the next working day. Basildon and Thurrock University Hospitals operate a no smoking policy. Contact The Sleep Team for advice on stopping smoking. 4. Check that your mask and headgear fits well and is in good condition. 7

8 Not to be photocopied Contact Details The Sleep Team Pulmonary Physiology & Sleep Department Basildon University Hospital The Essex Cardiothoracic Centre (CTC) Nethermayne Basildon SS16 5NL Telephone: ext Basildon University Hospital Nethermayne Basildon Essex SS16 5NL ( / Minicom ( Patient Advice and Liaison Service (PALS) ( E pals@btuh.nhs.uk W The Trust will not tolerate aggression, intimidation or violence directed towards its staff. This is a smokefree Trust. Smoking is not allowed in any of our hospital buildings or grounds. This information can be provided in a different language or format (for example, large print or audio cassette) on request.

Helping You to Breathe Better, Sleep Easy & Live Well

Helping You to Breathe Better, Sleep Easy & Live Well Your Guide to CPAP Therapy info@cansleep.ca Vancouver Island Lower Mainland Fraser Valley Sleep Apnea & Symptoms Obstructive Sleep Apnea (OSA) occurs