Help Adjusting Into PAP (for new members)

Some of the information I'm going to post below is probably common sense and old school for many forum readers. However, many of these items have helped me attain compliance.

(1) Getting used to your new equipment can be a big obstacle. Try to set aside at least 20 minutes each night when the lights are still on to experiment with your new therapy. I have been doing 30-40 minutes before "lights out" sometimes longer.

During my follow up tritration study my respiratory therapist really helped me a lot setting my mind at ease about settings going above the common 10-12 range(s) I had read a lot about up to 16-18-20 cm H2O (foreseen by my doctor). Instead of having me put on the equipment, turn out the lights and go to bed, she had me just turn on the machine and periodically hold it up to my face a few inches away and then finally against my face (not strapped in), to get used to the pressure.

Try this while watching the TV with the lights still turned up. I've been lying on the bed, holding the mask to my face for several nights sometimes using my ramp feature and sometimes not. My goal has been to just "relax" and ease into the therapy. I know this sounds trivial but it's helped me volumes more then anything else I've tried. In as little as a few weeks I have been able during late night outings to just turn off the lights without a ramp and go right to sleep but I attribute that success to taking the time in the weeks before to easing into the therapy when it was new.

(2) Try to set a common "bed time" each night. My lifestyle was probably the second hardest obstacle to overcome as I had not really noticed some nights I'm still up at 2AM while other times I'm in bed by 11AM. My wake up schedule was just as bad ranging from 5AM to 8AM (longer on some weekends). I have been working very hard at keeping both sleep and wake times more consistent and I feel it's paying off well. I managed 10.5 hours of therapy this past Friday night (personal best!), but I'm shooting for 10:30 PM-11:00 PM sleep with a 6AM wake time. Most insurance companies will want 4 or more hours for compliance each night so make sure you work towards that standard unless you want to lose the equipment or pay out pocket to buy your own.

(3) Experiment with your humidifier settings (hopefully you have one). If my setting is too low, (0-1) I have dry nostrils and a feeling that I need to scratch at or pick at my nose to get relief. I also have experience minor nosebleeds from the dryness. If I turn my humidifier up too high (usually past 3 for me), I tend to get "rainout--water build up on your hose or mask" and the air blowing through my mask tends to be too warm for my personal taste. My respiratory therapist suggested I might try some distilled water ice cubes to help with higher settings and that "too hot" feeling, but a setting of 2 works pretty well for me without having to perform any "magic" tricks.

(4) Place your mask on your face first until it's comfortable and then start putting the straps into place with a free hand. If you have a significant other, get them to help you if needed. I used to always just put on the mask and then start pulling on the straps to get things into balance. By the time I had the right fit, it was time to remove the mask again to blow my nose or I needed to play with the velcro to make adjustments that always tended to create more leaks!

(5) Your doctor, HME, sleep lab, etc. should be working with you to ensure compliance. During my 1999 diagnosis/therapy, I visited a doctor that seemed to be much more interested in collecting checks from office visits, the sleep lab, etc. then helping me be compliant. My sleep study took place in an old apartment building where kids next door were beating on the walls all night and to this day I think my mixed study (half with therapy and half without) produced an inaccurate assessment of my polysomnogram that lead to an 8 cm H2O setting where my wife could here me snoring loudly a few days later while using the therapy. My HME had very old equipment (no digital readouts) that required shop visits to "adjust" or "maintain" equipment. I could NEVER get a filter replacement for my machine through my HME--they were always out of stock. As you can see experiences may very. My latest assessment/study/therapy was FANTASTIC and it's made all the difference in my compliance.

Keep a positive attitude and don't give up!