Our veteran clinicians share their tips for success for CPAP therapy
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Today's Clinician
Amy Aucott
Amy has been a Registered Respiratory Therapist for 8 years, helping patients with sleep apnea and respiratory issues in the Wilmington, Delaware area. In her spare time, Amy likes to spend time with her dog, cat, and horse. She also enjoys gardening and photography.
CPAP
Q. I have a small leak in between my hose and my mask attachment, is that normal? How would I fix that?
A. This is a very common question, and the good news is that this is completely normal. Each CPAP mask has a small exhalation port that will have a small stream of air coming from it when the CPAP is on; so the small leak you're referring to is there intentionally. Most masks will have this port on the elbow between the tubing and the mask, although some can have them on the mask frame. Allowing air to be expired from this port prevents pressure and carbon dioxide buildup in the mask. It is very important to keep the port open and uncovered from any blockages like blankets or pillows.
Q. What can I do about not waking up in the morning with dents in my face from my mask?
A. If you're waking up with marks or indents on your face from your mask, it usually means it's not fitted properly. Ideally, the mask should be tight enough to create a good seal, but not so tight that it's causing marks. I always encourage patients to put their mask on in front of a mirror when starting CPAP so they can see exactly where the straps and cushion should sit.
Typically, CPAP mask headgear is one size fits all, so switching to a smaller cushion can help if the straps are pulled quite tight. If you are a side or belly sleeper, using a low profile mask, meaning it sits closer to your face and isn't as bulky as some other masks are, would be a good option for you as well.
For more information: Get the best CPAP mask seal.
Q. How do I know when the pressure in my CPAP needs to be adjusted (i.e. when is it too low)?
A. There are a few different factors that we can look at to see if someone's CPAP pressure needs to be adjusted. If a patient is feeling increased daytime sleepiness, has audible snoring, or has an increasing AHI, this tells us that the CPAP pressure is ineffective, meaning too low.
AHI stands for “apnea-hypopnea index,” which measures the average number of times per hour that breathing slows or pauses. A good rule of thumb is for this number to be less than 10 on a CPAP report. It's important that patients monitor their symptoms, and report any of these symptoms to their doctor.
Conversely, headaches, ear pressure, and bloating are signs that the CPAP pressure may be too high.
Q. When I first started CPAP therapy I would sleep through the night but now I’m waking up several times each night again, what would be causing this?
A. Waking during CPAP therapy can be indicative of a CPAP pressure that is too low. When the pressure is too low, it cannot support the airway from snoring, which in turn causes patients to wake themselves up. CPAP pressures may need to be adjusted every now and then, especially if a patient has major health changes, a gain or loss of weight, or sinus/mouth surgeries.
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