Ongoing Desensitization Program

Even after the initial equipment installation process, you may continue to have difficulty adapting to the therapy. In these cases you should continue with the Ongoing Desensitization Program.

Step 1:  Wear the nasal mask at home, while awake in the evening and when performing normal evening activities, for about one hour daily. When this can be done for five consecutive days, then go to Step 2.

Step 2:  Connect the tubing to the CPAP unit and turn the CPAP unit on. Put the mask on, and breathe through it at home while at rest, for one hour daily. When you can do this without anxiety or concern for five consecutive days, then go to Step 3.

Step 3: Wear the CPAP apparatus, with the unit turned on, for a scheduled one-hour nap. When you can do this without anxiety or concern for five consecutive days, go to Step 4.

Step 4: Wear the CPAP unit, with the power turned on, for 4-5 hours of sleep each night. When you can do this without anxiety or concern for five consecutive days, go to Step 5.

Step 5:  Wear the CPAP unit throughout the night. If you have a setback, go back to the previous step that was completed successfully and begin again. Keep this up until you can sleep with the mask and CPAP machine on all night, every night.

Because PAP does not cure the underlying conditions that cause snoring and sleep apnea, PAP therapy should be used all night and every night. Until there is a cure, research shows that PAP therapy is the most effective treatment for these conditions.

After the first few nights of using PAP therapy you may detect some aching around your sternum (breast bone) when you wake up in the morning. Sore muscles in your rib cage probably cause this and it responds very well to over-the-counter analgesics. This occurs because these muscles are getting a "work-out" from the PAP therapy. These muscles will become stronger over a period of a few weeks and the aching will subside.

During the first few weeks of therapy you may find that when you wake up in the morning you are no longer wearing the mask even though you put it on before you went to bed. It is not unusual during the adjustment period to take the mask off while you are sleeping and have no memory of it in the morning. Do not become discouraged! This is just a temporary situation that will correct itself as you become adjusted to PAP therapy. If this situation persists we may need to temporarily add a chinstrap to the headgear to keep it in place at night.

As your body becomes used to the PAP therapy you will find that the pressure becomes more comfortable to breathe with. In fact, it may become so comfortable that you may have the feeling that you are not getting enough therapeutic pressure. This adaptation usually happens during the first three or four weeks of therapy. If you feel that you are not getting enough pressure please let us know so that we can check your device with a pressure gauge.

PAP therapy is very effective in treating sleep apnea and snoring. Some of the symptoms of sleep apnea will be corrected as soon as the first night of therapy is completed. 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. Some of the other symptoms of sleep apnea may take months to correct. The sequence of the disappearance of symptoms varies from person to person.

Since your sleep is now deeper and more restful than before, you may notice a decrease in the number of hours of sleep that you require to feel rested in the morning. You may also feel that you have developed insomnia because you require less sleep. It is more likely that your sleep has become more efficient and you require less time in bed.

For good sleep hygiene it is recommended that you go to bed and get out of bed at about the same time each day . This will help "strengthen" your sleep cycle and make it easier for your body to get refreshed when you are sleeping. You may, however, choose one day of the week (Sunday morning for instance) when you want to sleep-in. A regular sleep cycle will help you feel rested in the morning.

During the first week of therapy you may experience some sneezing and perhaps the sensation of nasal congestion when using the device. You may also experience a runny nose in the morning when you wake up. This situation is generally temporary and will clear up within a couple of weeks. If the problem persists there are several things that can be done.

Moisture can be added directly to your nasal passages by using saline nasal spray at bedtime. Nasal saline is available at the drugstore and you do not need a prescription.

The next option is to add a humidifier to your PAP 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. It is very important that humidifiers be kept clean and that the water be changed frequently because of the potential for bacterial growth which is aided by standing water.

PAP devices require patent and open nasal passages to work properly . In the event that you develop a cold or allergies it will be hard for the PAP therapy to be effective. In the event that one of these conditions develops your doctor can prescribe antihistamines or nasal decongestants to help you through these periods if you feel that it is necessary.

There are also external nasal dilators (Breathe Right nasal strips) that are a good non-pharmacological method for decreasing airway resistance due to nasal congestion or a deviated septum. They can also be purchased at a pharmacy without a prescription.

While using a PAP device it is very important that you sleep with your mouth closed. During the first few weeks of therapy you will find that your sleep is much deeper and more relaxed than usual. The muscles in your jaw become so relaxed that your mouth can drop open. The pressure from the PAP device then rushes out of your mouth rather than keeping your airway pressurized and open. This is usually a temporary situation that occurs as your body becomes adjusted to better sleep. If your bed partner notices that you open your mouth while you sleep, or if you start to notice that your mouth feels very dry at night or when you wake up, please let us know. You may require a chinstrap that is made by the company that manufactures your machine. If you experience this problem please contact us and we will provide a strap for you and teach you how to use it.

In a very few cases, the use of PAP can decrease the amount of urine that you produce with a consequent increase in water retention and body weight. For the first two weeks that you use PAP make sure that you weigh yourself every day when you wake up, or shortly after that. If you notice a sudden increase in weight (more than 3 or 4 pounds in one day), please contact your physician or us. This can be especially important if you have a heart condition.

If you are taking medication(s) to reduce your blood pressure because you suffer from hypertension, please try to have your blood pressure checked frequently (once a week) when you start PAP therapy . By treating sleep apnea you can sometimes improve your high blood pressure. If this occurs, you will no longer need to take the same amount of diuretics (water pills) or antihypertensives (blood pressure pills). Your doctor could start reducing them gradual and carefully.

If the noise of the machine is bothersome to your bed partner, you can explore the possibility of placing the device inside a closet or in a room adjacent to your bedroom . You can purchase additional tubing. You should not make this tubing excessively long because the pressure may drop and the device will become ineffective. 

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