Starting Sleep Therapy

Introduction

If you've just started using positive airway pressure (PAP) therapy, congratulations. You have taken an important step toward improving your health for the years to come. Consistent therapy is the best way to improve your quality of life and reduce the health risks  associated with sleep-disordered breathing (SDB).

PAP therapy is the safest and most effective treatment available for SDB, and the most important steps are usually the first:

• the proper treatment pressure
• a comfortable system—continuous positive airway pressure (CPAP), automatic positive airway pressure (APAP), or bilevel device and mask system
• good education (understanding both your condition and your treatment).

These three things can mean the difference between success and failure for many PAP users. The most successful PAP users address these things immediately. Of course, these initial steps can be revisited periodically, and probably should be. For instance, you may need to change your treatment pressure if you are not using an APAP device. You may find a more comfortable mask system. And you may find that continuing to learn about SDB and its treatment keeps you motivated.

Benefits of PAP Therapy

Success means sleeping better and getting more enjoyment out of waking hours, and it can also mean lowering blood pressure and treating the symptoms associated with obstructive sleep apnea (OSA). Successful positive airway pressure (PAP) users report feeling improvements in

• energy and motivation
• job performance
• mood
• alertness while driving
• sexual drive and performance
• quality of life.

However, a failure to use PAP therapy will cause symptoms to return and may increase your risk for conditions linked to untreated SDB, including

• hypertension (high blood pressure)
• stroke
• congestive heart failure.

Common Questions

How long will I have to use this therapy?

You will probably have to use positive airway pressure (PAP) therapy for the rest of your life. Most people don't want to hear that, but it is important to understand. One night without treatment usually causes an immediate return of the same symptoms that motivated you to get help in the first place.

In the next few days and weeks, think about what you will need to make your treatment successful. Your long-term use of PAP therapy may simply require an individual commitment, and it may require support from your partner or family. You may also benefit from a support group such as A.W.A.K.E. (Alert, Well, And Keeping Energetic)—ask your sleep lab, medical equipment dealer, or sleep specialist for information about the groups in your area. If you decide to communicate with other PAP users, you will discover a large community with lots of information and valuable suggestions.

How many hours do I need to use my PAP device each night?

You should use your PAP device whenever you sleep. Sleeping without your PAP device poses health risks and will probably reduce your quality of life by increasing your sleepiness and other symptoms associated with SDB.

Where should I put my PAP device?

A nightstand provides the best spot for a PAP device. Some people like to put them on the floor or under their bed so that they stay out of sight, but this can be hard on the device. Floors tend to have more dust than night tables, and increased dust will shorten the life of the air filter in your PAP device.

Do I have to replace any of parts on my PAP device?

You will need to replace the air filter on your PAP device periodically. Check your user manual to see how often. Most devices require you to replace your air filter every six months, but some as often as every two weeks. All ResMed PAP devices should get a new air filter every six months in regular conditions. If you live in a dusty environment, you may need to replace the air filter more often.

How often should I replace my mask?

Mask systems wear differently according to how well they are cared for and the skin type of the person wearing them. People with oily skin tend to need mask replacements more often. It's a good idea to check with your insurance company and equipment provider to see how often you are eligible for a new mask system. We can help you determine your eligibility for mask and other equipment replacement. T get started, simply create a patient account or contact us for more information.

Will I ever need to replace my PAP device?

Yes. Eventually your device will need to be replaced. Medicare will pay for a new device every five years, and most insurance carriers follow this schedule. If you need a new device, contact your insurance carrier for details.

Are there times when I shouldn't use my PAP therapy?

Yes. Most doctors will recommend that you not use therapy when you have a sinus cold or sinus congestion. The air pressure can cause sinus and ear discomfort. Some doctors also worry that if you have prolonged sinus congestion, the pressure of the device may prevent your sinuses from draining effectively, increasing the risk of sinus infection.

Getting Familiar with Your Equipment

As soon as possible, take an hour or so to read the user manuals for your equipment: your positive airway pressure (PAP) device, mask system, and humidifier if you have one. Do not wait until five minutes before going to bed to turn it on for the first time.

Getting familiar with your PAP device

Walk through each of the features available on your PAP device. Make a spot for it on your night table and attach your air tubing, mask, and humidifier if you have one. Learn how to replace the air filter. If the device has user menus that give you information, get comfortable with those, but be careful not to change your settings.

Getting familiar with your mask system

Before you use your mask system, it's a good idea to wash it (follow the cleaning instructions in the user manual). The cleaning instructions for ResMed nasal masks and full face masks are available on this site. Cleaning the mask will give you a chance to disassemble and reassemble it. It's important to get comfortable with cleaning and assembling your mask because you will need to do it regularly.

Adjusting to Positive Airway Pressure (PAP) Therapy

PAP users have very different experiences adjusting to therapy. For some people, it's an instant success. Once they use their devices, they never sleep without them. For other people, adjusting to the mask and presence of air pressure requires time and effort, or they may just feel unattractive wearing the mask.

Getting used to the mask and air pressure

If you have feelings of claustrophobia or difficulty wearing your mask for the whole night, try to increase the time you use your system each night. For instance, you might try using therapy while watching television or listening to the radio. Get used to the sensation and let yourself focus on the television or radio. If you are able to distract your attention from the mask and air pressure, you will take your first step toward relaxing into your therapy at bed time.

Feeling unattractive

Many people worry about their appearance while using PAP therapy, and this makes perfect sense. The bedroom is where we are supposed to be our most sensual and attractive, but that is difficult when you're wearing a plastic mask with an air tube.

The best way to approach these feelings of insecurity is to involve your partner in your therapy. This involvement might mean asking your partner to learn about sleep-disordered breathing (SDB) and the importance of treatment. It might even mean asking your partner to attend support groups with you. At the very least, your partner needs to understand the importance of PAP therapy to your health and the feelings you have about wearing the mask.

Side Effects

While positive airway pressure (PAP) therapy remains the safest and most effective treatment for sleep-disordered breathing, some people experience nasal irritation from the increased airflow created by the PAP device and pressure sores from a poorly fit mask. If you have any problems with your therapy, take a look at our Improving Therapy section.

Copyright © ResMed 2005, Used with Permission