CPAP concerns

[HHCgal#1]

I have 2 patients that pull their masks off and/or turn off their machines in the middle of the night without realizing they are doing this. Does anyone have the same problem? And does anyone have any suggestions to prevent this from happening?

[Pugsy]

That's actually fairly common.

We usually suggest that the users take some regular tape and tape the straps to the cheeks in a couple of areas so the minor discomfort associated with the tape pulling on the skin will wake a person up enough to hopefully make them realize that they are doing something unwanted and stop.

Some people have resorted to wearing mittens at night to make it more difficult to fiddle with the mask to remove things but some masks are so easy to get off that mittens aren't much of a problem to bypass.

[49er]

I have 2 patients that pull their masks off and/or turn off their machines in the middle of the night without realizing they are doing this. Does anyone have the same problem? And does anyone have any suggestions to prevent this from happening?

It depends.

Do they have data capable machines and know how to access their data so the two of you can see if anything is going on that may be causing this such as a cluster of apneas or flow limits which might necessitate a pressure increase?

How is their nasal congestion as I have found through personal experience that I did this alot with full face masks due to most of them pressing on the nasal area and causing more congestion? Or I would do it if I went to bed congested and hadn't taken the time to address my nasal issues.

Or there might not be a specific reason but they are uncomfortable with the mask and need to find another one.

The immediate area around the machine or the filters may be dirty causing congestion which leads to feeling uncomfortable with the mask.

I assume you are in the healthcare profession. I am curious, what do you do?

Anyway, in a nutshell, you need to start with looking at the issues I have mentioned and do some detective work to figure out what is going on.

49er

[RicaLynn]

If I had to wager, I'd say HHCgal does what I do: in-home health care.

HHCgal, can you talk with your patients and find out what is bugging them about their mask or their therapy? If they've had their machines for a while, are they doing routine maintenance like washing hoses/masks and replacing filters, topping off humidifiers, etc? I've worked with several clients whose CPAPs are gathering dust on the nightstand because they just got tired of the hassle, but no one has tried to educate them on the necessity, or the proper care, of their therapy. At least your patients are trying to comply with therapy, they may just need some tweaking to their system to get better sleep. Good for you for working to advocate for them!

[RicaLynn]

I can't begin to tell you how many clients I've had that know or do little to no routine maintenance to their machines. I've seen bone dry reservoirs, filters CAKED with dust, hoses with holes in them, masks that smell like sour milk --- and replacement parts stockpiled in a nearby closet! If your patients are agreeable, try a thorough cleaning of all parts and a check of the mask fit first, and see if that helps.

[Wulfman...]

I have 2 patients that pull their masks off and/or turn off their machines in the middle of the night without realizing they are doing this. Does anyone have the same problem? And does anyone have any suggestions to prevent this from happening?

A very large percentage of the new users have that problem in the first few months of beginning their therapy. The trick is to stop doing it. There may be a number of things that cause this, like a pressure that is too low or humidity settings too high, an itchy nose or cheek or many other things. Sleeping with a mask strapped to the face is not "normal" and their subconscious is telling the user to remove it.
If you're a DME employee, make sure ALL of your customers/patients/users have fully data-capable machines......nothing less than a ResMed Elite or PR S1 Pro.


Den

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[library lady]

When I started on cpap therapy nearly 6 months ago, I knew nothing about something called "mask liners" - I struggled with my mask and noisy face farts from mask leaks, etc. in addition to the stranger on my face, "the mask." We've spent years sleeping without that stranger, and we need to teach our brains that it's OK to have this stranger on our faces. One way to do this is to spend some time each day with the mask and blower on while watching TV or reading. This is way of getting used to the mask as well as breathing with the mask and machine.

I came to this forum after about 4 days, and after I'd been reading for a while I learned about mask liners. I immediately googled and searched for them, and once I had them my game had changed. These days I rarely have large leaks, and even more rarely do I wake up from them. It's been a long time since I took my mask off in my sleep. Two sources for liners: http://www.padacheek.com, and http://www.cap.com. Many DMEs carry the RemZzzzs brand of liners.

[archangle]

When people wake up or partially wake up, do something, and then go right back to sleep, they tend to forget that they did it and even that they woke up. I think some of these people wake up, decide to take the mask off "just for a minute," then fall back asleep.

Try stressing to the patients to never take the mask off, not even for just a second without getting up out of bed first. Maybe that will help, maybe not, but it's worth a try.

We need some sort of gadget that attaches to the CPAP hose, and sets off a loud alarm if you turn the machine off for more than a "potty break" time interval. You'd need some sort of "drunk test" function to turn it off. i.e. you have to enter in a number sequence, or maybe push a button on a remote control that you can keep in the bathroom so that you have to get out of bed to turn it off.