CPAP Basics - 1

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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SleepWellCPAP
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CPAP Basics - 1

Post by SleepWellCPAP » Sun Mar 24, 2013 1:14 pm

Hello All! Hope you doing well!

In this post my goal will be to concisely assemble everyone's collective knowledge on the basics of CPAP usage. I'll post a question along with what I believe to be the answer, and invite all comments, feedback, or replys. Next Sunday, I'll come back and post another calling it CPAP Basics - 2, etc. etc. I hope all will find this an easy way to get a good start if they are new, or for the veteran users, maybe they will find something they have not yet discovered. This blog is without a doubt a wealth of information and I'm very interested in how you'll answer these questions.

What should be the number one concern for a new CPAP patient?

My answer: By far and away, initial mask fit and cleanliness of both the cushion/pillows and skin. Your mask needs to be the right one and the right size to keep the air in your circuit and you comfortable for at least 6 hours. Our skin produces oils and acids that cause the mask to shift, in addition to discomfort. Night creams and moisturizers need to be avoided in the area where the mask contacts your skin. Also, a quick fitting tip. If you get leaks from any part other than the air entrainment port, push down on the mask with your hand and see if the leak goes away. If it doesn't you either have a fold in the cushion or the mask just isn't the right one for you. Push the mask away from your face far enough for the cushion to clear your skin and let it settle back. Try not to get emotionally attached to any certain mask, I have had people try a dozen before we found one that worked.
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Todzo
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Re: CPAP Basics - 1

Post by Todzo » Sun Mar 24, 2013 2:07 pm

To establish nightly gathering and several times a week use of the PAP flow data to modify lifestyle and deal quickly with any problems that will crop up as the therapy is used.
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Re: CPAP Basics - 1

Post by LinkC » Sun Mar 24, 2013 2:36 pm

Todzo wrote:To establish nightly gathering and several times a week use of the PAP flow data to modify lifestyle and deal quickly with any problems that will crop up as the therapy is used.
I disagree. Cart before the horse. Efficacy data gathered while there is significant leakage (or other variance) is practically meaningless. That's a basic tenet of any process control.

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Todzo
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Re: CPAP Basics - 1

Post by Todzo » Sun Mar 24, 2013 2:41 pm

LinkC wrote:
Todzo wrote:To establish nightly gathering and several times a week use of the PAP flow data to modify lifestyle and deal quickly with any problems that will crop up as the therapy is used.
I disagree. Cart before the horse. Efficacy data gathered while there is significant leakage (or other variance) is practically meaningless. That's a basic tenet of any process control.
The flow data would show the leak, the problem would be quickly seen for what it is, a direction for solution would be quickly taken.

I very strongly disagree with you on this.

Last time I checked only 20% of those medically commended to PAP treatment are able to use it for more than four hours per night at the one year mark. I think your attitude is the largest contributing factor in that horrible truth.

Please change your mind!

Todzo
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Re: CPAP Basics - 1

Post by quietmorning » Sun Mar 24, 2013 2:55 pm

I'll answer, then I'll go above and read what everyone else has put so that my answer is true.

Number one concern? Understand Sleep Apnea. Understand YOUR Sleep Apnea - and what the numbers mean. Understand what not following through with treatment means, and understand what the benefits of treatment are. THEN - begin to negotiate your way to getting there.

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Re: CPAP Basics - 1

Post by ChicagoGranny » Sun Mar 24, 2013 3:05 pm

the air entrainment port
If this is about basics, not one out of one hundred will know what this means.

Todzo wrote:To establish nightly gathering and several times a week use of the PAP flow data to modify lifestyle and deal quickly with any problems that will crop up as the therapy is used.
I agree in the sense that you must understand before the first visit to the DME that you will only accept a full-data machine. Take anything less home and you are stuck.
"It's not the number of breaths we take, it's the number of moments that take our breath away."

Cuando cuentes cuentos, cuenta cuántas cuentos cuentas.

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Re: CPAP Basics - 1

Post by chunkyfrog » Sun Mar 24, 2013 3:10 pm

And you need to be able to pick out a mask by trying them on-one after another
-under therapy pressure-(like in a shoe store-but with beds.)
If the mask don't fit the patient will quit.

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Re: CPAP Basics - 1

Post by LinkC » Sun Mar 24, 2013 3:27 pm

Todzo wrote:The flow data would show the leak
As would the awful hiss from a beginner's mal-fitted mask.

Of course leak detection/control is always important, and data is vital when you sleep thru leaks.

But the question was "the number one concern for a new CPAP patient?" You don't need "data" to tell you that your new mask is constantly hissing because doesn't fit right. Fixing that is job one.

I believe you have misinterpreted my "attitude" along with the original question...

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Re: CPAP Basics - 1

Post by StuUnderPressure » Sun Mar 24, 2013 3:48 pm

SleepWellCPAP wrote:What should be the number one concern for a new CPAP patient?

My answer: By far and away, initial mask fit and cleanliness of both the cushion/pillows and skin.
I would start a step before that.

A new CPAP patient should make sure he is getting the proper machine he needs.

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Re: CPAP Basics - 1

Post by DoriC » Sun Mar 24, 2013 5:24 pm

SleepWell, thanks for starting this thread, I think it will be helpful to newbies and veterans alike. There's always something to learn or review again.

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Re: CPAP Basics - 1

Post by zoocrewphoto » Sun Mar 24, 2013 6:05 pm

StuUnderPressure wrote:
SleepWellCPAP wrote:What should be the number one concern for a new CPAP patient?

My answer: By far and away, initial mask fit and cleanliness of both the cushion/pillows and skin.
I would start a step before that.

A new CPAP patient should make sure he is getting the proper machine he needs.
I'm with you. We can always keep trying masks. But unless somebody can afford to buy their own machine, they are usually stuck with the first one they get. It sure is hard to improve therapy without any data.

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Re: CPAP Basics - 1

Post by Jimster » Sun Mar 24, 2013 6:10 pm

":?: What should be the number one concern for a new CPAP patient? Great Post, SleepWellCPAP

SleepWell I hope you are doing well.

Believe this or not SleepWell, but I was thinking along the same lines as you when it comes to "What’s the Most Important?", but I was thinking more on the lines of "Data".

I certainly went after acquiring CPAP Device Data "Right Off the Bat", to the dismay of my DME, and I got it, but then only to come to realize I didn't have a clue at what I was looking at whatsoever.

“AHI”, what's that?...
“Blue Ball” with an H in it, What's That?....
“Leak Graph”, What is it and How do you Fix it?...
“Basal Level”? What's That.... etc.?????

Not having a Clue may be an understatement on my part; that’s sort of like me telling myself that "My Cat" is not the Boss.

I have enjoyed reading everyone's replies to your post and certainly agree with everything that has been posted.

I also, strongly agree with your assessment as to the Face Mask being at the top of the list. Like you I also think that when one puts their mask on their face for the first time, that's where the "Rubber Meets the Road".

To back that up a little, anyone that is going to stay in this business has to accept the fact that forevermore they are going to be a “Non-Free Sleeper” the rest of their life. In other words there will be no more just running and jumping freely and un-tethered in their beds for a night’s sleep, without first looking like they’re going to Fly a Jet.

With all the above being noted, most of us very quickly learn that the most important connection in, and to our CPAP World is Pugsy.

Jim

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Re: CPAP Basics - 1

Post by NotLazyJustTired » Sun Mar 24, 2013 6:11 pm

The number one concern for a new CPAP patient has nothing to do with equipment. As newly diagnosed, I can tell you the number one concern is more psychological than anything. IMHO, going from sleeping "freely" to having an alien strapped to your head is more a battle of the mind than anything. I spent the entire first week of treatment reading the sticky thread, "Success stories". It helped me more than anything else I have read on this forum. Hearing all those stories and just knowing this can work and what issues I would likely face really helped me deal with it mentally. All newbies should take time to read at least part of that thread. I read all 28 pages because I found it immensely inspirational.

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Re: CPAP Basics - 1

Post by Todzo » Sun Mar 24, 2013 7:11 pm

quietmorning wrote:I'll answer, then I'll go above and read what everyone else has put so that my answer is true.

Number one concern? Understand Sleep Apnea. Understand YOUR Sleep Apnea - and what the numbers mean. Understand what not following through with treatment means, and understand what the benefits of treatment are. THEN - begin to negotiate your way to getting there.
Hi quietmorning!

I think you have the best answer so far!

Certainly I have learned through the years that my flow data is essential to guide the use and management of xPAP therapy but as NotLazyJustTired points out not knowing what to expect and how to respond to it makes for more stress and stress is a key enemy of effective xPAP therapy.

We really should have "xPAP College" as part of xPAP therapy.

Have a great week!

Todzo
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Re: CPAP Basics - 1

Post by Drowsy Dancer » Sun Mar 24, 2013 8:07 pm

NotLazyJustTired wrote:The number one concern for a new CPAP patient has nothing to do with equipment. As newly diagnosed, I can tell you the number one concern is more psychological than anything. IMHO, going from sleeping "freely" to having an alien strapped to your head is more a battle of the mind than anything. I spent the entire first week of treatment reading the sticky thread, "Success stories". It helped me more than anything else I have read on this forum. Hearing all those stories and just knowing this can work and what issues I would likely face really helped me deal with it mentally. All newbies should take time to read at least part of that thread. I read all 28 pages because I found it immensely inspirational.
This is a wonderful response.

I'm having a hard time deciding what the very first, number one, concern of a new xPAP patient should be.

There's no doubt that you need the best mask fit possible.

There's no doubt that a data-capable machine will enable you to take charge of your treatment in a way that no brick ever can.

But there's also no doubt that wrapping your head around what's to come is critical too.

One of my favorite sayings is, "You can only have one first priority," which sounds simplistic until you try to apply it. And I'm having trouble here <weebles>.

Maybe the first concern is, having as accurate a titration as possible? I'd say have the most carefully-done PSG possible but (1) not everyone has a PSG and (2) even now I wouldn't know myself how to ensure that my PSG was well-done.

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