The task of the nurse is to guide and aid the person who has been diagnosed with sleep apnea at the beginning of the treatment. After a doctor’s diagnosis, the patient will meet a nurse. The most important thing of the nurse is to motivate the patient to care of the sleep disorder, along with sharing information. People are different. Others want to definitely get the equipment, and it is easier for them to adjust. Others are opposed to the idea of a whole sleep apnea, and it may be very difficult for them to start treatment and commit to it. If the person diagnosed with sleep apnea has adapted to the idea of having a treatment-demanding syndrome, it is easier for him / her to be motivated to use the device and get help.
Getting used to the device takes a lot of time for others, while others get used to the device overnight. Some of the troublesome symptoms may be scary and some are reluctant to start treatment if the symptoms are mild. The feeling of being sick with sleep apnea is an interesting thing; Fatigue or other symptoms may not be thought of in the same way as other diseases, such as pain.
Sleep is important for everyone’s quality of life and well-being and we must try to treat sleep disorders as well as possible. The main purpose of CPAP device management is to improve sleep quality and daytime alertness, and to prevent other disorders caused by sleep apnea. Poor sleep quality is a risk to your body’s functioning. Repeatedly interrupting sleep easily increases weight, resulting in poor quality of sleep and this easily turns into a vicious cycle. Overweight is an important background factor for sleep apnea, and if poor sleep continues to exacerbate the weight situation, the vicious cycle may be tricky to break with your own.
The nurse must look for a common base with which the treatment can be built. If the patient does not understand the importance of treatment, it is difficult to get started.
“Finding that understanding is our common task. Often, the nurse will carefully inquire about the patient’s symptoms. It is important that the patient tells them themselves, and the nurse just does not read them from the doctor’s epicrisis. Through the description of the symptoms, it is attempted to justify why this particular patient should at least try device therapy. For example, if he has to go to the toilet often at night, it may be one of the symptoms of sleep apnea. The kidneys do not get into hibernation due to the poor quality of sleep and this causes a need for nocturnal urination. The patient may be motivated by the fact that, in the case of successful device treatment, night-time toilet visits will definitely be at least scarce and a change in the state of alertness would be possible for this reason too,” the nurse says.
The CPAP device is effective in treating sleep apnea. Sometimes, however, expectations may be oversized. For some, the device brings a sense of new, refreshing life. However, the CPAP does not prevent other sleep problems, so the person suffering from insomnia can still be tired. When starting treatment, the person should be patient and allow the body time to get used to it. For some, getting full benefits and getting used to the device can take several months, even a year.
The main purpose of CPAP therapy is to improve the quality of sleep and daytime alertness and to prevent other disorders caused by sleep apnea.
Getting used to the CPAP device
“It’s a good idea to become familiar with your own CPAP device. It doesn’t go broken in normal use. Many are concerned, that they might break the device or mess up its settings. It is needless to worry about that. The user can be confident that he cannot accidentally erase any important information. The device registers comprehensively its use. The extent to which each user of the device wants to view this information himself varies. Someone wants to check out the sleeping hours and mask leaks every night and that’s enough. Someone, for example, wants more information on the AHI number, breathing breaks and respiratory depression, automatic pressure level, or other more detailed information. The thing is a bit like driving a car – it’s worth checking the amount of fuel, but you don’t have to understand exactly how the engine is working. Also, it is not necessary to monitor the AHI indices precisely. Every night is not the same, small variations are entirely possible without the patient’s symptoms changing. The need for information is individual. The patient is entitled to his own information and the research proves that the more interested and conscious the patient is about his care, the more motivated he is to take care of himself.”
The nurse helps the patient to find the most appropriate mask, as it is the most important thing to do with the convenience of CPAP. An ill-fitting mask that squeezes or leaks is the most common reason for giving up CPAP device therapy. This is why you should invest in finding the right mask. There are plenty of mask options, so usually everyone can find a well-functioning mask.
Humidification is another important issue in the convenience of CPAP, and some users need a device with a humidifier. In the latest devices, it is fixed and for the old ones it’s available separately. Humidifiers help to relieve the symptoms of dry mucous membranes. Pressure treatment often dries mucous membranes of the nose and throat as it overcomes the humidification system of the nose. The blown air dries out mucous membranes. The nose gets clogged when the expanding blood vessels of the mucous membrane are trying to intensify nasal humidification.
Nasal mucous membranes can be treated with oil-based moisturizing nasal sprays, saltwater washes, vitamin A drops or nasal lavage. Some people suffer from a runny nose in the mornings, and usually transient epistaxis can occur at the beginning of the use of the CPAP device. Nasal and mucosal symptoms are quite common in sleep apnea patients and are often the reason for discontinuation of treatment. Most of them are alleviated gradually with use, some worsen. For this reason, it is important to tell the person about humidification of his nose and the possibility of connecting a humidifier to the device right from the start. Especially at the beginning, the runny nose that occurs in the morning may be a problem.
No one-size-fits-all mask has been developed and people’s preferences are also different. An exact comparison with another sleep apnea patient and his choices may not lead to the best mask solution. Ask your nurse or doctor for advice and ask for other mask alternatives if needed. However, you should first take a good look at using the selected mask type first.
Arranging and experimenting usually helps to find comfortable mask for each, with which sleeping usually goes well after getting used to. Alternatives include a nasal mask, nasal pillow mask, nasal cradle mask and full face masks. Mask straps should not be too tight, nor should they be too loose. Leakage may occur at both extremes.
Many people with sleep apnea and who are snoring are accustomed to breath through the mouth and it may take some time to get used to nasal breathing. Air inhaled through the mouth interferes with the effectiveness of the nasal masks, but the situation usually gets easier with the use. If this doesn’t happen, the patient can get help with a “full face mask” that covers both the nose and mouth.
Getting used to sleeping with a mask is individual. Many tell us how the first night slept with CPAP went great. Some people need more time to get used to the device, even months.
The CPAP device will not help unless it is in use. It is the same as medication – only the medication that is taken helps, that is, only the inhaled overpressure helps.
CPAP treatment goes smoothly when
- The mask fits well and does not leak
- The nasal mucous membranes remain intact. If necessary, vitamin A sprays or nasal rinse can be used
- Maintenance and cleaning of the CPAP mask
- Use a moisturizer to support the treatment if necessary
- Give time to getting used to the treatment
Sometimes getting started and getting used to a CPAP does not seem like a success. This can happen in a situation where a person has too many other stress factors in his life – challenges of personal life or other illnesses. Then it may be wise to take extra time to resolve these other issues and try CPAP treatment only in a better situation.
The routine follow-ups of CPAP therapy has been significantly reduced in many places, and many clinics now use remote monitoring of the device. Remote monitoring or telemonitoring enables remote support for the user. Generally, people are positive about this remote monitoring. It provides security and the feeling that someone will help in difficult situations if needed. Remote monitoring is also used by some device manufacturers to give technical support to their users. The device user can register as a user of these support services and receive personalized help from their online support center. The service can be logged on in the Internet if the care unit has activated the device for remote monitoring. After registration, the user will receive personalized messages and instructions into his e-mail from the device manufacturer’s service when the tracking detects some problems such as mask leaks or long outages.
Due to improved diagnostics, the number of sleep apnea patients who are receiving treatment has increased significantly in recent years, however, the number of staff in clinics has not increased in the same proportion, so remote monitoring makes sense for that reason too. For example, when all sleep apnea patients no longer meet routinely, for example every year, more staff resources are available to help those with acute problems. However, when leaving the hospital or clinic, everyone must have phone numbers to call and get help and answers if needed. If there are problems with the treatment, you should always contact the treatment unit.
CPAP equipment maintenance and care
It is best to maintain your CPAP, masks and humidifiers properly. The life of the mask and hoses is about a year. Because routine monitoring in clinics is often reduced in many places, it is often the practice that the device manufacturer sends the mask and hoses once a year to the user at home, or they can be picked up from a distribution point.
Basic CPAP device maintenance
Basic maintenance for the mask and air hose after every use:
- Remove the air hose and store it in a clean, dry place.
- Wash the mask pillow with mild soap and rinse well.
- Dry the mask, but do not leave it in direct sunlight.
- Remove the humidifier and its container.
- Empty the tank. Rinse and dry thoroughly to prevent bacteria from accumulating in the container
Bleaching agents or products with chlorine must not be used for cleaning masks and hoses. Also, aromatic, moisturizing and antibacterial soap solutions are not suitable for cleaning the mask, air hose or device. These substances can harden or brittle the plastic and thus shorten the life of the product.
CPAP weekly cleaning
- Remove the mask parts according to the manufacturer’s instructions. Also wash the mask straps with a mild soap solution.
- Wash the air hose with a mild detergent solution or soapy water and rinse well.
- Put the air hose to air dry, for example, on a clothesline.
- Remove the humidifier and its container and empty the tank. Disassemble the container according to the manufacturer’s instructions. Wash with mild detergent solution. In the humidifier instruction manual you can check if the tank can be washed in the dishwasher. Dry the tank, but do not leave it in direct sunlight.
Thorough CPAP service once a month
- Check the condition of the mask and air hose and see if there are any signs of wear or tear.
- Check the condition of the humidifier tank. If there are cracks in the container, it should be replaced. Take care of the tank, and if there are white lime and mineral deposits in the water inside the humidifier, place the vinegar / water mixture (1 part vinegar, 10 parts water) in the container and let it soak for 10 minutes. Rinse the tank thoroughly. The tank should be replaced every couple of years.
- Wipe the surface of the CPAP with a dust cloth or a damp cloth.
- Check the condition of the filter on the back of the device and make sure it is not blocked. Replace the disposable filter at least once every six months and if necessary. If your home has pets or plenty of dust, replace the filter more often.
- The actual CPAP device works for years without maintenance, as long as you change the filter at regular intervals. If you notice something abnormal in your CPAP device, contact your care unit or supplier.
Traveling with a CPAP machine
CPAP becomes a permanent travel companion for both short and long night trips outside the home.
Your own CPAP device will also be taken to the hospital if the treatment requires an overnight stay. It is used both in the recovery room and in the ward before and after surgery.
You should not stop treatment even for one night. A user accustomed to the device says that for one night sleeping without the device, feels like a bad condition right away. Someone likes to to take a break in using the device, but usually it’s not recommended.
The CPAP device can also be used with a battery in non-electric conditions, even in a cottage, boat or tent. For airport security checks, it is advisable to request a treatment document from the treatment unit. In most cases, CPAP devices have already become familiar with airport security checks, and there is no problem with the machine. It is a medical device that can be taken into the cabin as extra hand luggage. If you plan to sleep on a flight with CPAP, you should inform the airline in advance, for example, by filling out a form on the web, which will also reserve a suitable seat. A humidifier cannot be used on the flight. Some manufacturers also have small devices designed for travel.