Problem

• Sore or Dry Eyes
• Redness on the face where the mask touches the skin
• Dryness or burning sensation in the throat or nose
• Nasal, sinus, or ear pain
• The pressure being delivered feels different
• The air flow from the CPAP seems warm
• The air flow from the CPAP seems cold
• The noise level of the CPAP has changed
• The CPAP unit will not turn on
• The CPAP unit had hours on the time meter when it was delivered
• Snoring has returned
• Patient has a feeling of "claustrophobia" or "air-hunger"
• Does CPAP have to worn all the time?
• Aching around sternum or "pressure" upon awakening
• Taking the mask off at night
• Not all symptoms are going away soon after starting therapy
• Developing "insomnia"
• Sneezing and runny nose
• Nasal Congestion
• Mouth opens at night

Solutions

Sore or Dry Eyes

1. Readjust headgear.
2. Contact CST about being fitted for another mask.

Redness on the face where the mask touches the skin

1. Loosen the straps on the headgear.
2. Check the mask's spacer to make sure that it is fitted properly and in good condition.
3. Use a skin barrier between the skin and the mask, such as 3M's Microfoam™ tape, Squibb's Duoderm™ or Hollister's Restore™.
4. Review mask cleaning instructions and make changes where needed.
5. Contact CST to be fitted with a different mask style or size.

Dryness or burning sensation in the throat or nose

1. Consider using a chinstrap to keep the mouth closed during the night.
2. Consider using a humidifier.

Nasal, sinus, or ear pain

1. You may have developed a sinus or ear infection.
2. If symptoms continue, consult your doctor.

The pressure being delivered feels different

1. It is normal after 2-4 weeks of good compliance the pressure will feel different to you than it did when you first started on therapy.
2. Check to make sure that the elevation setting is set to the correct elevation.

The air flow from the CPAP seems warm

1. Replace or clean the filter.
2. Make sure that the CPAP is away from bedding or curtains that could block the flow of air around the unit.
3. Make sure the CPAP is away from heating equipment.

The air flow from the CPAP seems cold

1. Consider using a chinstrap to keep the mouth closed during the night.
2. Consider using a warm air humidifier on the CPAP unit.
3. Make sure that the mask is fitting securely.

The noise level of the CPAP has changed

1. It is normal for some brands of CPAP units to make a humming sound when the power is turned on or off.
2. If the sound is significantly louder than usual, contact CST for directions on having the CPAP unit serviced.

The CPAP unit will not turn on

1. Make sure that it is plugged into a working outlet.
2. Change the fuses if the CPAP unit has them.
3. Verify that the correct voltage has been selected.
4. Contact CST for directions on having the CPAP unit serviced.

The CPAP unit had hours on the time meter when it was delivered

1. CPAP units are tested at the factory prior to shipment.
2. It is normal to have up to 200 hours of testing time recorded on the CPAP unit.

Snoring has returned

1. Consider using a chinstrap to keep the mouth closed during the night.
2. If a bed partner is available, find out if it is a snoring sound from breathing in or a "puffing" sound when you exhale. Snoring may require a pressure change, while the expiratory sound may require a chinstrap.
3. Contact CST for directions on having the pressure checked on the CPAP unit.

Patient has a feeling of "claustrophobia" or "air-hunger"

1. This sensation is normal when patients are beginning therapy for the first time.
1. Take a few slow deep breaths. You'll begin to feel that you have control over your breathing and start to relax.
2. The ramp button is available for you to use if the pressure seems to be too much.
3. This sensation will decrease as your breathing muscles get "warmed-up".
4. This sensation will decrease significantly after an adaptation period has elapsed.
2. This sensation may reappear if you develop a "cold" or has seasonal allergies and nasal congestion becomes a problem.
3. Recommend the Desensitization Procedure and ongoing desensitization at home.

Does CPAP have to worn all the time?

1. CPAP does not cure the underlying conditions that cause snoring and sleep apnea.
2. CPAP should be worn all night and every night if possible.
3. Until there is a cure, CPAP is the most effective treatment for snoring and sleep apnea.
4. We consider adequate compliance to be at least 4.5 hours per night about 70% of the time.
5. Some patients will use a combination of different therapies (medical management, airway dilators, surgery) to treat sleep apnea.

Aching around sternum or "pressure" upon awakening

1. This is not unusual the first few mornings after starting CPAP therapy.
2. This occurs because the breathing muscles in that area get a "work-out" from CPAP therapy.
3. These muscles become stronger after a short period of time and the sensation will subside.

Taking the mask off at night

1. It is not unusual during the adjustment period for you to take the mask off while sleeping and have no memory of it in the morning.
2. This is just a temporary situation that will correct itself as the patient becomes adjusted to CPAP therapy.
3. If this situation persists a chinstrap may need to be added to the headgear to keep it in place at night.
4. You should not become discouraged; this situation may occur over six times during the first month of therapy.

Not all symptoms are going away soon after starting therapy

1. Some of the symptoms of sleep apnea will be corrected as soon as the first night of therapy is completed.
2. One of the first symptoms to be corrected is snoring. You may even wake up feeling very "refreshed" for the first time in a long time.
3. Some of the other symptoms of sleep apnea may take months to correct.
4. The sequence of the disappearance of symptoms varies from person to person.

Developing "insomnia"

1. Sleep should be deeper and more restful than before starting CPAP
2. You may notice a decrease in the number of hours of sleep that are required to feel rested in the morning.
3. It is likely that your sleep has become more efficient and requires less time in bed.
4. If the problem persists, the CPAP therapy may not be working properly; please consult CST.

Sneezing and runny nose

1. This is common during the first week of therapy.
2. Sneezing and runny nose are generally temporary and will clear up within a couple of weeks.
3. If the problem persists there are several things that can be done.

Nasal Congestion

1. There are several situations that can result in nasal congestion:

1. Increased airflow
2. Infection
3. Allergies
4. Low humidity

2. You may benefit from use of a chinstrap if the problem is due to increased airflow from the mouth opening at night.
3. If low humidity is the problem, moisture can be added directly to the nasal passages by using saline nasal spray at bedtime. Nasal saline is available at the drugstore and no prescription is needed.
4. The next option for low humidity is to add a humidifier to the CPAP device. There are the pass-over type and the heated-types. The pass-over type is less expensive and is usually effective in treating nasal dryness and nasal congestion. The heated-type is more expensive and very effective in delivering humidification to the airway.
5. If a cold or allergies develop it will be hard for the CPAP therapy to be effective. In the event that one of these conditions develops a doctor can prescribe antihistamines or nasal decongestants to help through these situations.
6. External nasal dilators are another method for decreasing airway resistance from a deviated septum or nasal congestion.

Mouth opens at night

1. While using a CPAP device it is important that mouth remain closed so that continuous positive airway pressure can be maintained.
2. During the first few weeks of therapy you will find that your sleep is much deeper and more relaxed than usual. The muscles in the jaw become so relaxed that the mouth can drop open. The pressure from the CPAP device then rushes out of the mouth rather than keeping the airway pressurized and open.
3. This is usually a temporary situation that occurs as the body becomes adjusted to better sleep. If your bed partner notices that you have an open mouth while you sleep, or if your mouth feels very dry at night or when waking up, you may require a chinstrap.