PAP THERAPY OVERVIEW

CPAP/BIPAP Overview

What it is: A CPAP or BIPAP machine delivers air pressure through a mask while a patient sleeps. CPAP is pressure to help your airways stay inflated during sleep. BIPAP also has an additional pressure when you breathe in that makes it more comfortable to breathe. It is most commonly prescribed for patients with Sleep Apnea. The sleep study you had helped the doctor to know how much pressure to prescribe. CPAP/BIPAP helps people get a good night’s rest and avoid daytime fatigue and drowsiness. You will have more energy to do the things you like to do, wake up feeling more refreshed, and possibly help avoid having a heart attack, stroke, or having high blood pressure.

How to Use It:

  1. Gather the equipment.
  2. Attach the tubing to the CPAP/BIPAP machine at one end and to the mask/pillows at the other end.
  3. Fill the humidifier to the correct level as described in the owner’s manual. Distilled water is preferred but, you may also use bottled or reverse osmosis water. Empty remaining water every 1‐2 days and let air dry so it doesn’t grow any bacteria.
  4. Put on the headgear and mask or nasal pillows and adjust for comfort.
  5. Make sure the mask/pillows are snug around your nose but not too tight.
  6. Turn the machine on, press the ramp button if it has one and breathe normally through your nose. (slow deep breaths)
  7. Lie down and adjust the tubing so it is free to move if you turn in your sleep. Adjust the mask and headgear/pillows until you have a comfortable fit and there are no airflow leaks into your eyes. If air is blowing in your eyes, readjust the headgear straps.
  8. Turn the machine off in the morning after you awaken. Take off your mask/pillows

Cleaning Instructions

Always use Distilled, bottled or R.O. water in your humidifier chamber! Every day (preferred) or every other day:

Wipe off or wash Mask or Pillows (the part that touches your face). This removes the oily residue from your skin that can cause your mask to leak. You should wash your face every night before putting on your cpap mask. Empty Humidifier Chamber and refill with Fresh Water.

Every Week:

Disconnect the tubing, humidifier, mask (or pillows) and foam filter if applicable and gently wash in a solution of hot water and mild dish detergent (without scent or antibacterial like Dove, Ivory or baby shampoo. Other soaps have a chemical that can leave a film on the plastic. As an alternative to soap you may use vinegar water. 3 parts water to 1 part white vinegar and soak for at least 20 minutes. Rinse thoroughly and air dry or attach to the CPAP/BIPAP unit and turn it on to “Blow Dry” your hose. Then shake out excess water and hang hose up to drip dry. If your machine has a white paper filter, this does NOT get washed. After it’s dry place the mask or pillows in a zip‐lock bag to keep dust away from it after cleaning.

Helpful Hints

  1. Make sure bedding, curtains, or other things are not blocking the filter or vents of your machine.
  2. Wash your face before putting on your mask. Normal oils in your skin can shorten the life of the mask and lead to more leaks.
  3. Keep your bedroom quiet, dark, and cool.
  4. If your machine has a pressure delay (ramp), this can make it easier to fall asleep with your CPAP/BIPAP. Your Respiratory Therapist can show you how this works. As you get adjusted to the CPAP, you may prefer to start at full pressure instead of using the ramp.
  5. If your doctor has ordered a Heated Humidifier, it will automatically turn on and off when you turn on and off your CPAP/BIPAP machine (the exception is Puritan Bennett machines with heated humidifier). A Heated Humidifier can offer more humidity for those who have a

problem with nasal dryness, runny nose, stuffy nose or nosebleeds.

  1. When traveling by commercial airline, the carrying case is for carry‐on ONLY. It will not protect the system if put through checked baggage.
  2. For security stations, there is a note at the bottom of the machine identifying it as a medical device. It might be helpful to bring the owner’s manual along with you for airport security

personnel. Your PAP device is a prescribed medical device and must be allowed on the plane with you as a carry on item. However, the airline cannot count it as a carry on item.

  1. Replace your foam filter every 6 months, white pollen filter or disposable air filter ( if you have one) every month, hose every 3‐6 months, mask or pillow system every 3 months and headgear every 6 months Your water chamber can be replaced every 6 months, depending on your insurance plan allowed schedule and your needs. If needed, most insurance plans will allow for a new nasal pillow or mask seal every month if it isn’t time to replace the whole mask. If you are experiencing new leaks and it has not yet been 3 months since your last new mask, you may want to consider this.
  2. If the nasal pillows irritate your nose, put some K‐Y Jelly around your nostrils before putting the pillows to your nostrils. This will lubricate the mask and keep it from irritating your nose. DO NOT USE VASOLINE or any other product with oil in it as it will break down the seal. Frequently asked questions about CPAP/BIPAP therapy for sleep apnea

What are CPAP and BIPAP?

CPAP is Continuous Positive Airway Pressure. CPAP provides for an increased minimum pressure in your airways at all times. BIPAP is Bi‐level Positive Airway Pressure. Bi‐level Positive Airway Pressure provides two levels of airway pressure. One level during the time you inhale and another when you exhale.

What does BIPAP do that CPAP doesn’t?

Bi‐level helps in more severe cases of respiratory failure by assisting the person during their inhalation and maintaining a minimum airway pressure during exhalation. Bi‐level may also use a timed backup rate that will provide an assisted inhalation if the person does not take a breath within a specified period of time.

What is the difference between BIPAP and Bi‐level?

There is no difference between the two. Bi‐level is a term we use as well as BIPAP. What kind of therapy do I need if my doctor says I have sleep apnea?

Both devices explained above can be helpful with the treatment of Obstructive Sleep Apnea. CPAP is 100% effective for 90% of the patients prescribed.

How does CPAP help people with sleep apnea?

CPAP works by making an air splint, holding the airway open in order to allow breathing throughout the night.

What are my alternatives to CPAP?

There are alternatives to PAP for sleep apnea including surgery and oral appliances, however, please consult with your Sleep Disorder Specialist or physician for a discussion of these options as they apply to you.

Is CPAP or BIPAP portable?

CPAP is portable and you can carry the equipment in one bag. The flow generator can be operated on 110 volt, 240 volts or even a 12‐volt system depending on the machine. The humidifier can be operated with either 110 volts or 240 volts. The Humidifier should not be used with 12 volt. The heat should be turned off. To make sure your machine is compatible outside the US on the bottom it will say 100‐240V. If it doesn’t and you need to take a trip call us and we can provide a loaner.

What about traveling on airlines with CPAP therapy?

Traveling with your CPAP equipment is easy and all airlines allow you to take your equipment as a carry‐on in addition to your personal carry‐on luggage. It is actually a federal law that they have to let it on the plane.

Do I have to wear it (CPAP or BIPAP) for the rest of my life?

Yes, you will need to wear it until you no longer have sleep apnea. Most patients need CPAP treatment for a lifetime. Your sleep provider will discuss re‐evaluation and discontinuing your PAP therapy.

What is a nasal mask?

A nasal mask is made of plastic and soft molded silicone that is placed over the person’s nose and connected to the PAP machine. The person using a nasal mask should have a fitting performed by a respiratory care practitioner experienced in PAP devices.

What if I get home and I think my mask is too small or too big? Is there a better mask?

Fitting of masks is a special and sometimes very time‐consuming process. There are multiple manufacturers of masks and many sizes. A mask fitting is geared toward patient comfort and the seal around the mask. Patients should consult with a respiratory care practitioner (RCP) who has experience in this area of therapy. The staff has many years of experience fitting masks and other interfaces for patients with sleep apnea.

Keep in mind that your insurance company will usually only pay for one mask every 90 days. If the mask needs to be changed before those 90 days there may be a charge to you if your insurance company does not cover it.

What if my mask leaks?

Mask leaks are very common and may be caused form various causes. Mask problems are the most common complaint from PAP users. First make sure the mask is properly

assembled. After cleaning, the mask may not be put back together and will leak or not seal to your face properly.

Is the cushion torn?

Replace the cushion especially if it is over 3 months old. Has the headgear worn and lost its elasticity?

Replace the headgear especially if it is more than 6 months old. Is your face clean before using your mask?

Sometimes natural oils or soiled skin may affect the ability to seal the mask to your skin. Has the headgear worn and lost its elasticity?

Replace the headgear especially if it is more than 6 months old. Has the headgear worn and lost its elasticity?

Replace the headgear especially if it is more than 6 months old.

Is your mask adjusted properly?

Remember to adjust the headgear with the PAP unit on

at pressure to adjust your mask then use the ramp feature. Did you adjust your headgear sitting up or lying down?

You should adjust your mask while lying down as your face changes shape in different positions.

My CPAP/BIPAP machine is not working properly. Who do I go to for assistance? If the equipment is under warranty it may be repaired for the cost of shipping and handling.

What will I use for therapy if my machine needs to be sent to the factory for repair?

You should not go without your therapy while your equipment is being repaired. Make arrangements with your home care provider for a replacement machine while yours is being serviced.

What if I have allergies?

Some CPAP machines filters air through both HEPA and pollen filters. Therefore, air you will be breathing will be cleaner and will most likely not have an allergenic effect.

What can be done about sore/dry throat or stuffy nose?

1 Are you using a heated humidifier with your PAP therapy? A heated humidifier can address comfort regarding dry throat or stuffy nose.

1 Is your mouth opening during the night? If your mouth still opens, a chinstrap (elastic band) or Full Face mask may be used to close your mouth. In severe cases your physician may prescribe a decongestant.

What if I’m a mouth breather?

A chinstrap or Full Face Mask can be used to help keep your mouth closed. Much of the time you will cease to be a mouth breather with the use of the CPAP. Many patients have found that PAP therapy allows them easier breathing through their nose eliminating the need for mouth breathing.

How do I get rid of water in my tubes? What can I do to prevent it?

Water in tubes is due to condensation. The difference in temperature between the humidifier on your PAP unit and the cool air in your bedroom surrounding the tubing causes water to collect in your tubing and mask.

Try insulating the tubing during the cooler months. Warm up the room temperature or turn down the heated humidifier. Place the equipment and especially the humidifier lower than the head of your bed to allow the condensed water to roll back into the humidifier canister.

What if the power goes off?

The CPAP units used in the home do not have battery back‐ups. Remove your mask when power goes off. You will open your mouth and breathe easily. You will not be able to continue with your therapy until the power returns. Some people in rural areas with frequent power outages use generators or a battery backup system.

Is there a battery pack for the CPAP?

There are battery packs available for almost all of the cpap machines. However, at this time no insurance covers the battery and the cost is between $250‐450 depending on the cpap. All of them can be adapted for use with a 12 volt car battery via an adapter for

about $50. The cigarette lighter or similar adapter is used in most cases. You can also use an inverter of your

choice.