Why is the bridge of my nose (area between eyes) sore/ red / swollen?

• Many masks have a clip (Respironics: Stability Selector) that can be adjusted to pull the mask closer or farther away from the bridge of one’s nose. Masks are usually adjusted at the snuggest level so one should try to loosen the clip for comfort.
• Rubbing a small amount of lotion or Vaseline on the affected area(s) may also help avoid the mask from rubbing the bridge of your nose “raw.” Too much, and the mask can leak easier, so please apply conservatively. Some prefer using a band-aid or a thin sheet of cotton. 
• Skin Irritation: Make sure that mask is being cleaned daily and weekly. Also, double check your mask adjustment and make sure that headgear is not over tightened. If these tips do not help, trying a different mask altogether may be the solution.

Why am I taking my mask off in the middle of the night? (Having problems falling asleep/staying asleep with it on)

• This is a usual problem for first time CPAP users, which eventually goes away in time. As long as you are using your machine every day, your body will get acclimated to wearing the mask the entire time that you sleep. Also, keep in mind that getting used to your therapy will take time. It takes anywhere between a couple of weeks, and for some up to a couple of months, to get fully adjusted to your therapy (since every one is different).
• Try using your mask while the airflow is turned on for a couple of hours during the day while watching TV or reading the newspaper. This will help you get used to how the air pressure feels as well as how your mask is supposed to fit.
• Make sure that your mask is fitted properly.

Why are my nostrils sore after using my nasal pillows mask?

• Try using different sizes to see if a smaller/bigger size nasal pillow is needed.
• Make sure that your headgear is not too tight. The alignment of your nasal pillow mask to your nostrils can be adjusted on most styles nowadays.
• Why do I hear my machine “breathing in and out” with me (machine noises)?
  à Most machines have a comfort feature that automatically lowers the air pressure as you exhale to make it easier for you to tolerate the pressure on your machine. This is called your CFlex feature (Comfort Flex) on Respironics devices, and EPR on ResMed devices. For some, this may sound like the machine is also “breathing in & out” with you or may sound like a vacuum. These noises are normal and can be considered as natural machine motor noise.
• Wrap a towel around the machine to “drown out” the noise and/or place the machine under your bed.  However, if you do this, please make sure you do not block the filter area in the back of the machine.
• If you believe you are hearing too much noise, please contact your home medical provider for more assistance.

Why does the air pressure on my machine feel different? (Does not feel as strong as it once did)

• Check all connections from mask to machine and vice versa to make sure all connections are properly attached as well as the connection from the water chamber to the machine. Also, check machine for any error/service messages on the LCD screen and/or lights blinking on any of the buttons on the machine.
• After all basic troubleshooting has been done and the pressure still feels faint, using a manometer may be the next step to ensure proper calibration is done.  Your homecare provider can help you do this.
• If all else fails: You may want to consider getting a follow up sleep study done to see if your sleep apnea has changed. Any lifestyle changes (lose/gain weight; stop/start smoking, etc.) can affect your sleep apnea. Getting an overnight follow up study is the best way to find out if you need a different pressure setting.

Why is the air pressure so strong? (Cannot tolerate pressure once it “ramps” up to prescribed setting)

• It can take up to several weeks (sometimes longer for some people) to get acclimated to using your machine and mask. If you feel that you are unable to fall asleep or even stay asleep because of the pressure of your machine, try using it for a couple of hours during the day while watching TV, or reading a book. This method, called “desensitization” will help you “practice” getting used to how strong the pressure is, so by the time you are ready to go to sleep, the pressure won’t feel too much of a ‘shock’.
• *RAMP: Once you turn your machine on, the airflow will start at your prescribed, optimal setting. This setting is different for each person that uses PAP therapy. Some may have a strong starting pressure so using the ‘Ramp’ button will help you fall asleep easier. The ramp feature on your machine lowers the air pressure temporarily, and then gradually increases over a set time period as you fall asleep. (ramp time can be set at patient’s convenience).

Why is there a lot of air leaking around my mask?

• After making initial adjustments with your mask; as you lie down and turn the machine one, make final adjustments until air leaks are kept at a minimal amount or eliminated. Reposition the mask on your face (also try lifting it away from your face then ‘re-seat’ it back on your face) until you get a good seal. If this fails, you may need to try a different size or a different mask altogether.
  **Excessive air leakage can also cause eye redness/irritation**

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Humidifier Related Questions

The air from the machine feels cold! Isn’t my humidifier supposed to be heated?

• Most machines today come with a heated humidifier. This doesn’t necessarily mean that the airflow will also feel heated. The metal plate on the bottom of the chamber heats up the water in order to create water vapor to travel with the airflow to prevent nasal and oral dryness. If you normally keep your room temperature cool, the air from the machine may feel cold. The best way to remedy this issue is to try to increase your humidifier setting, as well as insulating your tubing. Try to keep it as warm as possible either by putting it underneath your covers with you or by wrapping a towel around it.

What setting should I use for my humidifier?

• There is no right or wrong setting for your humidifier. Since it is only used for comfort, your humidifier can be set at any setting you wish. Try setting it half way then gradually increase or decrease as needed.

Why is there water inside my mask and/or tubing?

• This is most likely a result of condensation, or “rain out.” Your machine’s humidification may be affected by the room temperature around it. If you normally keep your room temperature cool, chances are the temperature inside the machine will be different from outside the machine-causing water build up. Insulating your tubing, or keeping it as warm as possible, by putting it underneath your sheets or wrapping it with a light towel (as long as it doesn’t put too much weight on the tubing) normally prevents water from building up.
• Also, the position of your machine has a lot to do with the water flowing all the way to your mask. Putting the machine on the floor or any lower than where it is currently will keep the water on the lowest point of the tubing instead of flowing down to your mask.
• Adjust humidifier setting.
• Contact your homecare provider about tubing cover options.

What kind of water should I use with my humidifier chamber?

• Any kind of water is fine as long as it is not tap water. The minerals found in tap water can cause calcium build up on the bottom of the chamber, which may be difficult to remove.  We recommend using distilled water.

Why am I experiencing dryness? (Mouth, throat, nasal passages)

• Make sure that your humidifier is working properly. Check water level and observe if it decreases throughout the night. The metal plate underneath your humidifier chamber should be checked to make sure it is heating up. Also, try higher humidifier settings (higher than what it is currently set to).
• Dry Mouth: Try tips noted above. If using nasal mask: your mouth may be opening at night. Trying a chinstrap together with the nasal mask you currently have will help keep your mouth closed at night. There is also a full-face mask available for mouth breathers.

Why do I feel bloated (stomach is filled with air) after using my machine?

• This is one of the most common problems a CPAP user encounters. This condition is called “aerophagia” (swallowing too much air).  This typically happens towards the beginning of using the machine and eventually goes away. In the meantime, trying different positions in your sleep (which ever one you do not sleep in currently) will help prevent swallowing too much of the air from your CPAP machine. In addition, elevating the upper half of your body will also help prevent too much of the air from settling in your stomach.
• If problems persist, consult your doctor about possibly getting your machine’s pressure lowered to se if that will help.

Why is my nose stuffy and congested every time I use my machine?

• Nasal congestion and dryness is caused mainly by lack of proper humidification. Your humidifier may be set too high or too low. First, try your humidifier at different settings to see if that will help prevent your congestion.
• This normally happens towards the beginning of getting used to your therapy especially if you are a first time user. This problem should go away eventually but if problems persist; contact your home care provider for other options.

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Cleaning

Mask & Headgear:

• Clean daily by using a damp cloth or baby wipes to wipe the surface of the mask that touches your skin (don’t forget forehead cushion). Weekly cleaning is also recommended for your mask. Hand wash with mild soap (as long as there is no alcohol in the ingredients) and water and air dry. Headgear does not need to be cleaned daily but you may hand wash

Humidifier Chamber:

• Empty any left over water in your chamber every morning and replace with fresh water. Hand wash with soap and water weekly. We do not recommend using a dishwasher to clean your water chamber because the rubber sealant around the chamber tends to melt due to high temperatures inside the dishwasher.

Tubing:

• Clean weekly with soap and water. The most common issue with cleaning your tubing is drying it out. You may hang your tubing over your showerhead to air dry. Keep in mind that it may not dry out completely but as long as you let it air dry for most of the day before using it at night should get rid of most of the water inside.

Filters:

• Black Sponge Filter:  Flick the dust off of the filter, and then gently hand wash weekly with mild soap and water. Let it dry completely before placing back in the machine.
• Ultra Fine White Filter: Cleaning is not recommended since this filter is made from paper material. Replace at least every 3 months.

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