CPAP FAQs
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In case you are looking for them, here are the Wiki FAQs which discuss how to use the CPAPtalk.com CPAP Wiki.
This is a list of CPAP FAQs. It is a great place to get started, especially if you are a new CPAP user. You are free to add common questions and answers here, regarding the use of an xPAP machine, or Obstructive Sleep Apnea. Answers should preferably be short in nature and link to more detailed articles in the CPAPtalk.com CPAP Wiki, if necessary.
Contents
Selecting Equipment
Insurance
What are the insurance billing codes for my CPAP equipment?
Where can I learn about software?
Visit the page on software.
Common CPAP Side Effects
Why is air leaking from my mouth?
Air leaks from the mouth whenever the mouth is opened during CPAP therapy. This occurs for many reasons, but a very common one is due to nasal irritation from the CPAP airflow.
The correlation to a lack of humidification and mouth leaks is a topic being heavily researched. Studies are now being conducted on the hypothesis that a large amount of mouth leakage is caused by the following cycle:
1. CPAP therapy is used with ineffective or no humidification. 2. The nasal membranes are unable to adequately condition the increased airflow and after a few minutes the airway and nasal passages become dry. 3. To remedy the dryness and obtain moisture, the body uses the mouth to breathe. 4. CPAP air follows the path of least resistance and leaks out of the open mouth. 5. The air leaking through the mouth causes more dryness. 6. Patient wakes up feeling tired with significant dryness in mouth and dry, swollen nasal passages.
The answer to this cycle is humidification. If the mouth continues to open during sleep, a chinstrap may be needed to hold the jaw up so that the mouth can close. If mouth breathing continues, a Full Face Mask that covers the nose and mouth is indicated.
How do I stop these leaks?
Wet your skin== Mask leaks (IPAP = 19) solved by wetting skin and mask seal just before donning; makes it seal better (Leak = 0). - rogelah
Mouth Leaks
When using nasal masks; e.g. Swift For Her, Airfit P10, ......
Some nasal mask users need a seal over the mouth. The reason for this is that during sleep, everyone's body naturally enters sleep paralysis which causes one's skeletal muscles, including facial muscles, to completely relax. It's not possible for anyone to physically press their lips closed after sleep commences due the normal effects of sleep paralysis. When a nasal mask or nasal pillow user wakes with a very dry mouth, even with a humidified CPAP, the most likely cause is "puffing" where air is flowing into nasal passages from the mask and then flows right back out through the mouth uncontrollably. A CPAP machine will typically begin pumping a much larger volume of air during this time to compensate for the air leaking past the CPAP user's lips. By taping over one's lips while using a nasal CPAP mask, it's entirely possible to achieve zero air leaks the entire night as reported by data collected by modern CPAP machines and also eliminate the terrible dry mouth feeling. Chin straps are often recommended to solve this "puffing" issue, but they are only effective in keeping one's jaw from opening during sleep paralysis. Chin straps have no direct ability to keep lips sealed, so air will still flow out ones mouth. Taping over lips will not keep one's jaw from dropping down, but typically this is not a problem since the important thing is just having one's lips sealed to prevent "puffing". A chin strap is likely not necessary when taping lips closed, but could be helpful for some if the tape is not holding up all night.
There is now a product called the "DeepSleep" made by Goldstream CPAP which can also help prevent airflow out the mouth. It is placed in front of the teeth and behind the lips at bedtime and forms a gasket against the inside of the lips. Many find that it can work when a chin strap does not.
One form of seal is 3M Blue painter's 2" tape, or a better choice may be 2 inch 3M Micropore medical hypoallergenic tape. For the 3M Micropore tape, search for item number 1530-2 (white) or 1533-2 (tan) on your favorite online shopping site or ask for it at your local drugstore. (The tan may cost a bit more; the only real difference is that it looks a bit less scary than the white tape does to other household members.) Micropore tape also comes in 3 inch wide which may be needed at higher CPAP pressures to keep a good mouth seal all night long, 2 inch should be adequate for most.
Rip off a piece of tape about 3 1/2" to 4" long, fold over a small amount of all 4 corners of the tape at about a 45 degree angle, sticky side to sticky side (so that you can grab any tape edge easily after application in case you feel the need to quickly remove the tape) and place over mouth. Apply your favorite lip balm to lips prior to applying the tape so that the tape does not stick directly to your sensitive lip skin for easier removal. If 3M tape is not staying stuck on skin, if tape user is waking up in the middle of the night with the tape loose and wet, it may be air puffing out between lips (blowfishing) causing warm air condensation under the tape or drooling.
To prevent this tape becoming loose potential issue, in addition to the tape, there are numerous options; some of them are: Purse, pucker or fold lips under the tape, place Poligrip Strips between lips, use a chin strap in conjunction with the tape, or ....... It also could be due to oily facial skin, so washing and drying one's face before applying the tape may help the tape stay put better all night.
To use the Poligrip Strips, bend each one so it fits the curve of the lip line, place each strip onto wet bottom lip. Then, wet the top of the strip and top lips, close lips. EASY to take off with a tissue in the a.m. There is no taste to the Poligrip Strips due to the fact that they sit on lips and do not ooze into mouth or touch tongue like polident paste would.
Supplies
Teflon tape
Moleskin
Additional Problems
Bruxism, Aerophagia, Rainout Oh My!
Mask Fit Problems
Pain on the Bridge of the Nose
For the complete list of CPAP side effects see CPAP.com List of CPAP Side Effects
Common Equipment Problems
Which masks work with beards?
CPAPtalk.com Forum Members weigh in:
1. Full Face Masks
'I too have a full beard and although I normally use a nasal pillows mask, this past weekend I got a great seal using the Liberty. I think using a chin strap to keep the lower FF mask strap from pulling the lower jaw open helps a lot ... Try Sleep Guy's PAP-Cap.' - Fuzzy Guest
'Full beard, ResMed Mirage Quattro.' - Bigburd Two fully bearded CPAP users participated in the Product Challenge 11 FullLife Full Face Mask vs. Mirage Quattro Mask. Both chose the ResMed Mirage Quattro. Their reveiws can be read here: PC11
Lanolin tip A bit of lanolin in the beard where the seal contacts it and my leak line goes flat. It washes out easily with soap and water in the morning. - Silver Pelt
2. Nasal Pillow Mask
'When I went for my sleep study I had a full beard. The tech, who was great, started with a nasal pillow, but I hated it. We then spent hours trying to get a nasal or full mask to provide a good seal. Nada. He then said give the nasal pillow another chance. I did and fell asleep. I hated it during the first two weeks of use, but sometime during the third week I realized that it didn't bother me any longer. You might want to try a naal pillow and see if you can adjust to it. For me, it was that or shaving.'- norm
'Contemplate the Nasal Aire II and a chinstrap. I've got a few friends with beards who are getting good results with it. Just had a satisfied customer leave my house in fact. Cute little beard and mustache, very happy with his NAII and PAP-CAP from http://www.pur-sleep.com.
4. Profile Lite
'I have a full, bushy beard and moustache and get a good seal using the Respironics Profile Lite mask.' -Ladd
Replacement
How often should I replace my mask?
- Many masks have replaceable cushions, pillows, or other parts. Replace the individual parts as needed, when they don't perform well any more.
Do not replace things on the schedule from your DME, they are selling you things more often than needed, simply because Medicare and the insurance companies have said "We won't pay for this more often than xxx" and the DMEs said "well, we'll tell everybody to buy new stuff every xxx". It's wasteful, and unnecessary.
Have a spare, and replace things when needed.
How often should I replace my headgear?
- It depends. Sure signs your headgear needs to be replaced are leaks, having to over tighten the headgear, elasticity is gone, etc.
When should I change the filters on my xPAP machine?
- Fine Filters should be replaced approximately every 30 days, or as necessary. If you can visibly see some dirt or dust on the fine filter then it is time to change it.
Cleaning
How do I clean my mask and hose?
- There are many methods available. Most manufacturers of CPAP Masks include cleaning instructions in the package with the mask. Baby shampoo or ivory bar soap is often used.
How do I clean my humidifier?
Use distilled water to clean your humidifier. Only use tap water if you intend to clean it daily. This avoids mineral deposits.
CPAPtalk member Bluebonnet_Gal says: Have you tried soaking it in water that has a little bleach mixed in. Bleach should kill any mold. My DME recommends cleaning my mask and hose in bleach water. I personally don't think it's a good idea to use bleach on something that I strap to my face every night, so I use vinegar to disinfect, but on a one time basis, I don't think it will do any harm. Be sure to rinse well, repeatedly, after soaking in bleach.
How Do I dry CPAP Hoses after cleaning?
Cleaning Tubes or Hoses requires warm soapy water. To dry hoses, try these techniques:
1. Spin Dry
tatooyu says: I spin the tube gently, a la Mick Dundee in Crocodile Dundee II when he was making his aboriginal "phone call" using a bullroarer. That way, the centripetal force pulls the water to the outside of the tube. Seems to work pretty well.
2. "Pipe Cleaners"
6ptstar says: I use a nylon string with a fishing weight tied to it to drop it through the hose. Put a loop on the other end and put a couple of strips of fake camos I bought to clean my car windshield and pull it through. Gets it almost dry so in a couple of hours it finishes drying. I would thing you could use strips of a paper towel or pieces of a regular towel and it would work as well.
3. Hair Dryer
6ptstar says: One time I did duck tape a hose connector to my wife's old hair dryer and hooked the hose up to the connector and turned the hair dryer on low. It dried it in no time. The string thing just seems easier but I don't wash it that often.
4. Let it Be
Catnapper says: NEVER use paper towels. You want to be careful not to leave lint in the hose. You don't want lint in your lungs, right?
Unless there is lots of water, just leave it alone. You are going to send moist air through the hose anyway.
5. Rotate Hoses
Fishhead says: bought a second hose so i could rotate them each day, doubling my drying time.
5. Place the hose in a freezer for a couple of hours. The droplets will freeze and fall off the hose surface when you flex it from the outside. If you want to wash your hose... the best is to have a spare hose that can be used while waiting for the other to dry. In fact, having a spare hose is a good idea anyways.
If I lose weight can I get off the CPAP?
Everyone is different and has a different take on this question. It is almost always true that an improved diet and level of activity is beneficial to your health.
Read Diet and excercise tips on the [Sleep Tips] page. Also explore other's experiences on relevant CPAPtalk posts here:
Are surgeries for Obstructive Sleep Apnea effective?
Do dental devices for snoring or Sleep Apnea actually work?
Miscellaneous Questions
Alcohol & CPAP: Bad idea?
CPAPtalk.com member Mars says:
Generally speaking, alcohol is a dangerous drug, and if it had just appeared in the last 20-30 years it would very likely be made illegal.
If you want to be on the safe side, I would suggest no drinking whilst you are awake, and so you will avoid all problems concerning alcohol, except those caused by others. :) :(
Otherwise, work out what a safe blood alcohol level would be for you, get an instrument for measuring blood alcohol, and keep below your safe level.
A safe level is where you metabolize the alcohol before it reaches the brain.
Alternatively, go a week with your normal drinking, and a week with no drinking, and compare the results.
Having both - an alcohol damaged brain and a sleep apnea damaged brain - I personally would tend to give what is left up there every chance of recovery.
Good luck.
PS An interesting moral/ political/ scientific arguement is currently going on in the UK