General Question

Caravanfan's avatar

Any suggestions on getting accustomed to a CPAP machine?

Asked by Caravanfan (10839points) 1 week ago

I have very mild sleep apnea but my doctor and I decided to give CPAP a try. I have one with nasal pillows. I got it working and fitted properly but I’m a little leery on giving it a go tonight as I have a busy clinic schedule tomorrow. Thursday morning I’m off so I’m going to try it tomorrow night.

But any veteran tips on how to get accustomed to it?

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10 Answers

JeSuisRickSpringfield's avatar

In my opinion, nasal pillows were the right choice. I tried a nasal mask first, and it rubbed the bridge of my nose raw. My recommendation would be to give yourself an extra 15 minutes to get used to the airflow and to start out sleeping on your back. If that’s not your normal position, you can shift as you’re about to drift off or just let it happen while you sleep. Honestly, a lot of the adjustment was learning to trust that the mask wasn’t going to fall off of my face if I moved around.

Also, don’t be too paranoid about the mask fit. Sometimes the machines can be oversensitive when judging the seal. If you think it’s secure but the machine disagrees, wiggle it around a bit instead of tightening it further. My doctor said that more problems come from excessive tightening than from inadequate tightening. The former causes pain and abrasions, while the latter just means the machine has to work a little harder to get you enough air.

If you have a machine with a humidifier, experiment with the setting even if you think the default setting is fine. I use one above the default, and the difference was immediately noticeable. Also, even a nasal pillow may eventually irritate the area around your nostrils. Using Vaseline or Neosporin or something as a barrier at the first sign of irritation has always helped me. Just make sure to rinse the nasal pillow every few days (which you’re supposed to do anyway, but most people don’t).

This is the stuff I wish I had known when I started, so I hope it helps.

Blackwater_Park's avatar

I also have very light sleep apnea and a CPAP with the nasal pillows is the way to go. It took me two days to get used to it and now I refuse to sleep without it. My wife won’t let me sleep with out it either. I have been lucky that my mouth tends to stay closed when I sleep by default.
The headgear is important and I like the Phillips Respironics dreamwear. Make sure the nose piece is the correct size for your schnozzle and don’t over tighten the fit. In the first few days you don’t have to wear it the whole time. You can work up to wearing it the whole time. Mine has an app that connects and gives you a synopsis of your night. If you end up being a hard sleeper with it those numbers will be important in determining if your fit stays good throughout the night.

product's avatar

I just rebooted my treatment for apnea, so I’m following this thread!

Here are a couple of things that have helped a little so far:

1. Try wearing it with the CPAP machine on for a bit while you are not in bed trying to sleep the first few days. Wear it while watching tv in the living room. Just get used to having it on and breathing with the pressure.

2. My machine Autosense 11 Autoset has auto humidity levels. I found that manually adjusting them worked better. Auto was too dry, and I would get rainout when it was too humid.

3. Stick with the nasal pillows even if you feel that you might want the opportunity to breathe with your mouth occasionally. Nasal passages that are congested will often open when forced to. Nose breathing > mouth breathing. (I have the Airfit P10, and they’re pretty comfortable.)

4. If your mouth falls open, it will feel awful and it won’t be effective. If you can’t keep your mouth closed during the night, look into a chin strap.

5. Look into mouth-taping if the chin strap doesn’t work for you or you get air escaping out of your mouth. I have been experimenting with this for about a week, and it has really improved my results.

6. Make sure you have a heated tube if you’re getting condensation.

elbanditoroso's avatar

Agreed with the others. Mine is a Swift LT mask, with pillows.

It took two nights to get used to it. Now I sleep wonderfully.

Several important points:

1) you will want a humidifier attachment. otherwise your nose will get dry and cause other issues.

2) change your pillows regularly (once/month) and keep them clean

3) keep the straps tight. Not horrendouisly tight, but snug. Otherwise air escapes.

Caravanfan's avatar

These are great everybody, thanks!
Yesterday I put it together while I was sitting up and practiced. Last night was awkward and made more difficult as my nose got stuffy. I tried it on and off during the night. So it was a bit rough, but it’s only one day.

kneesox's avatar

@Caravanfan what happens with it when your nose gets stuffy? or do you think the CPAP caused the stuffiness?

I would probably be a candidate for one of those things, but I worry about allergy season and also have a horror of having my mouth clamped shut or anything else that feels like it threatens asphyxiation. Also I worry if I sleep too soundly, what if I don’t wake up in the night when I, er, need to?

So I will be watching for your experience as a new user. Please update us.

@product, what’s rainout?

product's avatar

@kneesox: “what’s rainout?”

Condensation in the tube and/or mask. It can cause a very loud noise.

Caravanfan's avatar

Hi all. First night was rough. Last night I managed to keep it on all night although I found myself fiddling a lot with the fit. Wife said no snoring though, which is a bonus. I adjusted the humidity up one notch and that helped.

@kneesox My nose is always stuffy. I’ve had 5 sinus surgeries and I’ve spent the last 20 years of my life in constant battle with them. If it’s completely blocked up the CPAP wouldn’t work unless I use a decongestant like Afrin (which I hate doing). But currently my nasal passages are open enough that the machine can deliver air.

product's avatar

@Caravanfan – I feel your pain re:stuffy nose. I too have always had issues breathing through my nose. I had septoplasty in 2013 to fix it, but honestly it just made things a bit better. I still get congestion, and almost year-round allergies don’t help.

My first struggles with CPAP back in 2012/2013 were brutal. I went through around 11 masks (had to pay out-of-pocket), and ended up with damage to my skin on my nose and persistent leaking and pain. I finally gave up and have been untreated for years.

My current attempt has been to just go all-in on nasal pillows. Last night was pretty rough, because there was some congestion. But I’ve been surprised at how some of the congestion I feel pre-mask has been alleviated by putting on the mask with humidity and giving it some time.

I’ve been at this for about 3 weeks now, and the longest stretch I have worn the mask at night has been just under 4 hours. Mostly, I make it about 2–2.5 hours. But I’m attempting to keep at it in hopes that I can teach my body to tolerate it for longer and longer periods.

The mouth-taping seems to have improved things in the past week. My overall time with the mask on has improved slightly, and I’m more comfortable (surprisingly). The chin strap wasn’t doing its job, and I was getting lots of air sneaking out of my mouth.

Note: Masks are tough to fit because they don’t always work for people. But if you give the nasal pillows a chance and still find that you’re struggling with pure nose breathing, there are masks that blend the nasal pillows with a mask section for the mouth. If you can get something that fits your face comfortably without leaking, it might be the way to go.

Good luck! (And keep us/me posted.)

Caravanfan's avatar

@product Thanks. I have a whole routine regarding my sinuses (my wife calls it my beauty routine). I have to do sinus irrigation twice a day as well as steroids twice a day. I found two days ago that I can’t do the sinus irrigation right before bed becuase I get congested with the CPAP, so I did it earlier in the evening. That seemed to work okay last night. I managed to keep the CPAP on all night but I was up a lot.

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