Sleep Study Mask vs. Home-use Mask

[thecpapguy!]

http://cpapguy.blogspot.com/2016/09/sle ... -mask.html


There are many shortcomings in the positive pressure industry. Whether these failings source back to physicians, sleep study centers, or durable medical equipment providers can become a very diverse and opinionated subject. As positive pressure therapy (CPAP) use is moving forward into the future, I truly hope that some of these shortcomings can be solved. In solving them, it may be possible that more quality service could be provided. Whether that is a lofty goal or not, we can always have hope.

An area of concern that I feel should be addressed is the goal of the CPAP mask used during the sleep study titration and the mask intended for long-term home use. The approaches from the respiratory therapist, sleep technologist, or technician will (or should be) very different. However, the communication about this difference in approach is often not addressed by these healthcare professionals (we all understand that some of them are not professionals). It is yet another failure to communicate crucial information.

To address the issue from my perspective when communicating with patients before the study begins is the goal of this article. I cannot speak for the industry as a whole and its approach. It seems that nearly every technologist I have encountered has a very different "method" to mask fitting and information dispensed.

I have a portion before the sleep study begins that I label “orientation." In the orientation, I take between twenty and thirty minutes to review what should be expected throughout the night. If the study is a titration sleep study or a split-night sleep study, then I always make a focus on reviewing positive pressure therapy and mask expectations. Not only to ease anxiety but to also help clarify the process as a whole. In this portion of the orientation, I may take 5-15 minutes reviewing and answering questions. From my experience, it seems that the extra time took at this point truly does help ease concerns.

When explaining positive pressure, I start with the process of when the therapy will be provided and quickly move to what mask is recommended. In addressing what mask to use I first question the patient if they have a preference or a recommendation to what mask that he/she prefers. If there is a specific mask, I briefly talk about why the mask could be a good option and the potential problems that could arise. For example; if the patient requests to use a nasal pillow style of mask I like to talk about the possible risks that are associated with that style. Such as if the patient struggles with severe sinus congestion and an irritated nasal passage; we may discuss a different style of nasal mask to accommodate better.

Once that is addressed, or the patient does not have a recommendation, then I move into the mask preference that I have. I discuss facial structure, nasal congestion/pain, mouth breathing, claustrophobia, and humidification. As I address each specific point, a better understanding of why I may recommend a Resmed Mirage FX nasal mask compared to Fisher and Paykel Eson nasal mask is clearly explained. The difference between suggesting a nasal style of mask over a full face style; or vice-versa can also arise. While on that point, I typically always try to use a nasal style over a full face mask when starting therapy to help with patient comfort (as long as the patient is comfortable). As my mask recommendation is given, we discuss any problems that may arise and the solutions to help fix them during the study if needed.

With the style and type of mask to be utilized found I briefly explain the difference between the mask that will be used in the study versus the mask provided for home use. Although the goal of the mask is very much the same, the fitting and utilization of the mask is very different. The optimum pressure for the patient is not known. Without knowing what the exact pressure may be the mask chosen must take into account additional factors that may not be required for home use and the tension on the headgear straps may need to be increased. A mask that offers additional support may need to be utilized if it is stated during orientation that movement during sleep is a factor. These unknown circumstances must be taken into account. The mask that will be utilized for long term home-use has specific pressures already found and observations made by a technologist, and physician, on sleep position. With some observations made during the sleep study a mask to better meet specific needs can be fitted.

As you can see, I have a lengthy bit of information to give to patients to aid in their experience not only with the sleep study but also as they move forward into home treatment. The goal is to bridge better the gap between sleep study and home therapy as the mask used in each have different goals, and this is where the “shortcomings” I mentioned before come into play. I know a great many of technologists that lean greatly towards full face masks for the simple reason that it makes their jobs easier throughout the studies they perform. I understand that a full face mask can be very much needed by some patients (and there is nothing wrong with that), but for a great many they are utilized improperly (in my opinion). There are many different instances where patients are given very poor information and fitted even more poorly to masks that likely do not remotely meet their needs. If technologists were better trained and a focus on mask fitting was more specific by the American Academy of Sleep Medicine and the Board of Registered Polysomnographic Technologists, I feel that the compliance by patients would be much more assured. However, that is a much longer blog for a different time.

Such simple thoughts according to great many of CPAP veterans. Those who have been through the process and understand much. However, this information can be crucial to a patient that is not unaware of how the mask is utilized. A CPAP mask can be a very intimidating factor to using this therapy as a great many have quickly forgotten or even never experienced.

I hope that the way I approach this particular issue has “shed some light” on the subject for you and helps you better understand the process of receiving a mask from sleep study to home use!

[avi123]

Who is Viggi?

[palerider]

I hope that the way I approach this particular issue has “shed some light” on the subject for you and helps you better understand the process of receiving a mask from sleep study to home us!

clear as mud, as usual, with your disjointed ramblings.

if in person you are anything at all like you are here, then I feel so very sorry for your victims.

who knows, maybe you're able to adequately communicate in person.

[chunkyfrog]

Some publishers pay by word count, not by communication.

[palerider]

Some publishers pay by word count, not by communication.

yeah, I'd almost consider posts by mr thug life as a rambling stream of unconsciousness.

[thecpapguy!]

I'm from Oklahoma City Palerider. I think you are from Dallas, is that correct? I am sure that we could arrange a time to meet face to face.

[chunkyfrog]

Whoever you are writing for; I doubt anyone EVER gets past the second PONDEROUS line.
I have skimmed much of your rant, and find little worthy of the paper or bandwidth you are wasting.

[palerider]

I'm from Oklahoma City Palerider. I think you are from Dallas, is that correct? I am sure that we could arrange a time to meet face to face.

now, there's a threat.

it'd be a lot better if you'd just find someone willing to edit your random thoughts into something readable... then you might have a chance at helping someone.

[palerider]

I mean, seriously?

An area of concern that I feel should be addressed with new users, and veteran patients alike, is the goal of the positive pressure therapy mask used during the sleep study titration and the mask intended for long-term home use.

I can almost guess what that means...

"Patients should understand that the needs of a home mask and titration study mask may be different."

[Julie]

I just don't understand what it is you think you can offer to patients (or potential Cpap users) that either their doctors, DME's or this forum hasn't already addressed many times... seriously. I'm not aware that you were invited to use the forum for your blogs and because your writing style is confusing, could mislead newbies into thinking it 'comes with' the forum... however I've also noticed that your stuff is NOT in the list at the top of the home page here, has not been adopted as major info. that forum owners think is needed (and therefore gets put on that list), so ... don't you have real work to do?

[chunkyfrog]

My advice: hire an editor.
And take a pill, because if they are any good, there will be many deletions.

[palerider]

"positive pressure" was "taboo"?

did I miss a memo?

[Matthew77]

CPAPGUY - I'd just leave this place. Your writing isn't nearly as confusing as these folks are claiming. It also reads as though you are relatively new to this forum. I think you've stumbled into the lair of a handful of people who like to think of themselves as the only authority to speak on this forum.

I found this location searching about Lysol spray disinfectant. The thread seemed reasonable...and then I read the next thread about this being the most negative forum. I haven't gone to the blog in question, but if there are no advertisements on it, then this forum's clan is completely out of line.

[49er]

Interesting that this post got deleted when it wasn't spam:

""CPAPGUY - I'd just leave this place. Your writing isn't nearly as confusing as these folks are claiming. It also reads as though you are relatively new to this forum. I think you've stumbled into the lair of a handful of people who like to think of themselves as the only authority to speak on this forum.

I found this location searching about Lysol spray disinfectant. The thread seemed reasonable...and then I read the next thread about this being the most negative forum. I haven't gone to the blog in question, but if there are no advertisements on it, then this forum's clan is completely out of line.""

So much for being able to say what you want in this forum without censorship.

49er

[palerider]

So much for being able to say what you want in this forum without censorship.

LookitMe!

puhlease, if there were active censorship on this form, your drivel would never be seen.

you probably deleted it yourself, so you could make another of your attention seeking posts.