Millions of Americans have been diagnosed with obstructive sleep apnea (OSA) a serious disorder of interrupted breathing during sleep. For people with OSA, repeated pauses in breath occur when the airway at the back of the throat becomes blocked during sleep.
The first-line treatment for OSA in adults is with a continuous positive airway pressure (CPAP) device. CPAP machines work by pressurizing air that is delivered through a hose and mask into the airway during sleep. The steady flow of air keeps the airway open, improving respiration and sleep quality.
In order to get the benefits of a CPAP, it’s important to set it up properly. Knowing the right steps can ensure that it’s working correctly and help you get used to sleeping with a CPAP.
If you’ve been given a prescription for a CPAP machine, it’s normal to have questions about how to set it up and use it in the right way. The process is straightforward and follows a series of steps.
A first step is deciding where you’re going to put the CPAP. A good space for your device meets these characteristics:
For most people, the optimal spot is on a nightstand or small table next to their bed.
The CPAP machine comes with a replaceable filter, but the exact type of filter depends on your device. There is usually a small compartment in which the filter fits snugly. Written instructions or instructions from your sleep technician should provide specific details about the filter in your CPAP machine.
The machine has a special connector for the hose. The hose should attach and stay in place without exerting considerable force or effort.
The other end of the hose plugs into the mask and should create a tight connection, sometimes by clicking into place.
Many CPAP machines have an attached humidifier to moisturize the air so that it’s less likely to dry out your mouth and throat over the course of the night.
If your CPAP has a humidifier, fill it with distilled water only. Using distilled water prevents mineral buildup or any impurity issues that can come from using tap water.
The humidifier reservoir should have a clear “MAX” fill line. Be careful not to exceed that level, which can cause water to enter the hose.
Make sure that the power cord is properly attached to the CPAP device, and then plug the device into an electrical outlet.
There are several types of masks that can be used with a CPAP. Full-face masks go over your nose and mouth. Other masks go over the nose or just underneath it. Your doctor or sleep specialist will recommend a mask based on several factors including how you breathe, the pressure you need, and your sleeping position.
Regardless of the type of mask you use, it will be held in place using one or more straps that go around the top and/or back of your head.
Start by positioning the mask on your face, and then attach or pull the straps to secure it. The mask should form a seal against your face, but it should not pinch or press deeply into your skin. Adjust the length of the straps to find a comfortable fit.
Once you have the mask in place, you can turn on your CPAP machine. The pressure settings will have already been set by your health care team, so you should be able to plug-and-play.
When the machine is on, you will notice pressurized air coming through the mask. If you hear air escaping from the mask, it’s a sign that you need to adjust it for a tighter seal. Some CPAP machines have a function to test whether the mask has a good seal.
When the device is turned on, you can decide whether to use the Ramp function. This starts with lower pressure that gradually increases before reaching your prescribed pressure for the night. Some people like to ease into their sleep with the Ramp function while others like to have full pressure from the start.
Test out a few sleeping positions to find those that are comfortable for your body, don’t interfere with your ability to wear the mask, and don’t pinch or block the hose.
Most people find it difficult to get started with a CPAP. The mask may be uncomfortable, the sensation of the pressurized air can be unsettling, and on some machines, noise from the device can be bothersome.
It’s normal for there to be an adjustment period before you are accustomed to and sleeping comfortably while using a CPAP. Several tips can help you get used to your CPAP.
Another part of getting used to the CPAP is remembering to communicate with your doctor or sleep technician. If your mask isn’t comfortable, there is often another option to try that has a different size, shape, or type of cushioning. Similarly, if the pressure doesn’t seem right, your health care team can determine whether any adjustments are needed.
When you first open your CPAP, write down the brand, model, and serial number. Keep that information with the owner’s manual. In the same place, jot down the phone number for your sleep technician, the CPAP manufacturer, and, if applicable, the local service provider who delivered your machine. These steps will simplify the process if you have any technical problems in the future.
In order to keep your CPAP working in top shape, you’ll want to keep your mask, hose, and humidifier clean. Establishing a routine for frequent cleaning allows you to avoid buildup of dirt, bacteria, or other contaminants.
Another tip is to think in advance about using your CPAP when traveling and to plan out the logistics of bringing the device with you.
The setup and use of bi-level positive airway pressure (BiPAP) or auto-titrating positive airway pressure (APAP) devices is virtually the same as with a CPAP. While these machines provide variable levels of pressure, their basic design is similar, and you can follow the same steps to use and get used to them.
While a CPAP dramatically improves sleep in most people with sleep apnea, there can be complications from using them. In most cases, these issues arise primarily in the first few nights, but some may persist over time.
If you experience these issues, contact your doctor or sleep technician. Changes in settings or other steps can usually resolve these side effects of CPAP therapy and make it easier for you to sleep well while using the device.