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PAP Troubleshooting

Man fitting CPAP Mask
We realize PAP therapy can be a difficult adjustment. Our team of Respiratory Therapists is here to assist you through that transition. Give yourself time to become accustomed to the therapy!

In order to succeed, it's essential to apply the therapy every night. If you experience any of the following problems, please follow the suggestions listed. If your problems persist, don't hesitate to call our office for assistance at 716-667-9600.

Dry/Bloody Nose or Runny/Congested Nose
This may signal inadequate humidity. Nasal congestion or a runny nose can be the body's attempt to compensate for the dryness by flushing fluid to the area. Slowly increase your humidity level.

[Please note: a very small percentage of people react to high heat levels which could create more congestion. The range is available to allow you to adjust to your most comfortable setting. If you try the higher heat settings with no success, try the lower settings.]

Dry Mouth
First, try increasing the heat level on your humidifier. You may be breathing through your mouth or leaking a small amount of air through your mouth. If you're wearing a nasal mask, consider changing to a full face mask. If you're already on a full face mask, an oral lubricant (e.g. Biotene or Oasis, which may be purchased at your local drug store) may help.

Fatigue
If you're using your therapy nightly for a minimum of four hours a night, you'll usually notice a decrease in your feeling of fatigue. You may notice this as soon as the first night you start using your new therapy. But it may take as long as a month, depending on the duration and severity of your OSA.

Feeling Air Starved
You may be adjusting to the feeling of pressure resistance on exhalation; give yourself time to adjust. After a period of time, if this feeling continues, contact our Respiratory Therapy Department for assistance.

Gastric Distention
You're probably swallowing air. Limit yourself to using only one pillow while you sleep. If this doesn't correct the problem, contact us.

Mouth Breathing
If you've just started therapy, give yourself a little time to see if your body will adjust. Sometimes people will begin to breathe through their nose to avoid the high air flow caused when opening their mouth.

Popping or Gurgling Noise
Your tubing probably has water inside it. Condensation develops when the warm, moist air inside meets the cool tubing in a cool room. You have a couple options: (1) lower your machine to allow the water to drain back into the humidifier, or (2) call our office to purchase a hose wrap or heated tubing system.

Red Marks on your Face
The marks could be from dry skin irritation from the mask material. Try using the CPAP Moisture Therapy cream we carry.

Too much pressure can cause sores on the face. Please refer to your mask fitting guide for the correct application of your mask. Be sure to use the minimal amount of tightening needed to obtain a good seal.

A mark at the bridge of the nose may go away after a short period of time if you loosen the headgear and apply a cushioned band-aid to the area. You may also try our Sleep Comfort Care Pad, which will help protect this area of your nose.

Snoring
If you continue to snore while on your therapy, please contact us.

Unable to Fall Asleep
Use for an hour each night, slowly working up to a full night's use by applying the therapy more and more every night. After one week, if you see no improvement, please contact our Respiratory Therapy Department.

Waking Up after 1-2 Hours with the Need to Remove
You may not be receiving enough humidity and your body may be trying to compensate by pushing fluid to your nose, which can create inflammation or congestion. Increase your heater temperature to increase your humidity.

If these suggestions don't alleviate your problem, please contact our Respiratory Therapy Department at 716-667-9600 option 8.

Pro2 LLC Buffalo NY

The Epworth Sleepiness Scale

Sleepy ManThe Epworth Sleepiness Scale is widely used in the field of sleep medicine as a subjective measure of a patient's sleepiness. The test is a list of eight situations in which you rate your tendency to become sleepy on a scale of 0 (no chance of dozing) to 3 (high chance of dozing).

When you finish the test, add up the values to your responses. Your total score is based on a scale of 0 to 24. The scale estimates whether you are experiencing excessive sleepiness that possibly requires medical attention.

How Sleepy Are You?
How likely are you to doze off or fall asleep in the following situations? You should rate your chances of dozing off, not just feeling tired. Even if you have not done some of these things recently, try to determine how they would have affected you. For each situation, decide whether or not you would have:
No chance of dozing = 0
Slight chance of dozing = 1
Moderate chance of dozing = 2
High chance of dozing = 3

Write down the number corresponding to your choice after each situation and then total your score below.
Sitting and reading
Watching TV
Sitting inactive in a public place (e.g. a theatre or a meeting)
As a passenger in a car for an hour without a break
Lying down to rest in the afternoon when circumstances permit
Sitting and talking to someone
Sitting quietly after a lunch without alcohol
In a car, while stopped for a few minutes in traffic

Total Score =

Interpretation:
0-7: It is unlikely that you are abnormally sleepy
8-9: You have an average amount of daytime sleepiness
10-15: You may be excessively sleepy depending on the situation. You may want to consider seeking medical attention.
16-24: You are excessively sleepy and should consider seeking medical attention.

Pro2 LLC Buffalo NY

Source: Johns MW. A new method for measuring daytime sleepiness: The Epworth Sleepiness Scale. Sleep 1991; 14(6):540-5