Adjusting to therapy can be challenging and frustrating, and it can often take several weeks before you feel like you’ve gotten everything exactly right. Here are a few tips to help you adjust when you first receive your mask and device.

How to get used to your mask

One tip is to first try using the mask while you’re sitting down watching TV or reading, either during the day or at night before you go to bed, to get used to the feeling of having something on your face. Another recommendation is to hold the mask to your face, without the headgear, and turn the device on. Once you are able to breathe easily, put the headgear on and keep breathing against the pressure.

Adjusting to your mask if you have claustrophobia

If you are claustrophobic, or if you just don’t like things on your face, you may want to try a nasal mask or a nasal pillow instead of a full face mask. These are smaller and don’t cover as much of your face as a full face mask does. Your doctor or medical supplier can help you determine if either of these is a viable option for you.

Remember, there isn’t one right way for everyone, so try a few different methods to see what works best for you.

Disclaimer: This blog post provides a general overview of medical conditions and potential treatments. It is not intended as medical advice. For personalized medical guidance, please consult your healthcare professional.

The American Academy of Sleep Medicine (AASM) Public Safety Committee is responding to frequently asked questions (FAQs) about the coronavirus (COVID-19). The following questions were submitted by patients who have obstructive sleep apnea. 

The AASM encourages you to follow the CDC tips on how to prepare for the coronavirus. The information below is for educational use only. The AASM is unable to provide specific medical advice. You should discuss your health and medical condition with a local medical provider.

View additional COVID-19 FAQs from ResMed.

Do I have a higher risk of getting coronavirus because I have sleep apnea?

It is unclear if sleep apnea causes you to have a higher risk of getting the coronavirus. People who do have a higher risk of the coronavirus include:

• Older adults
• Those who have serious medical disorders. These disorders include
  • Heart disease
  • Diabetes
  • Lung disease
  • Kidney disease
• Those who have a medical disorder, or take a medication, that weakens the immune system. 
• Those who have had close contact with another person who has the coronavirus. 

If I have symptoms of the coronavirus, should I continue using my CPAP?

If you have the coronavirus, it is important to talk to your medical provider before stopping any medical treatments. It is possible that using CPAP could increase the risk of spreading the virus to others around you. Be sure to talk to your medical provider about this risk.

If you are sick with the coronavirus, you should follow current CDC recommendations:

• Stay home except to get medical care. 
• Separate yourself from other people in your home. 
• Stay in a specific “sick room.” 
• Use a separate bathroom, if one is available.
• Call ahead before visiting your doctor.
• Wear a facemask when you are around other people.
• Cover your coughs and sneezes with a tissue.
• Wash your hands often with soap and water.
• Avoid sharing dishes, glasses or utensils with others.
• Clean and disinfect frequently touched surfaces in your “sick room” every day. 
• Seek medical care if your illness gets worse. (But call your doctor first.) 

If I have the coronavirus, will my CPAP be helpful for my breathing? Or could CPAP cause the coronavirus to get worse?

It is unclear whether CPAP could make the coronavirus worse. But using CPAP could increase the risk of spreading the virus to others around you. Talk to your medical provider about your treatment options for sleep apnea.

If I have the coronavirus, how should I clean and disinfect my CPAP mask and hose?

The CDC recommends that you should clean and disinfect your medical equipment according to the manufacturer’s instructions.* The directions for CPAP masks and hoses normally include regular cleaning with soap and water. It is unclear if extra CPAP cleaning is needed due to the coronavirus. The CDC also recommends that you clean and disinfect frequently touched surfaces in your household. This includes doorknobs, light switches and handles. Learn more from the CDC about how to clean and disinfect your household.

Real-Time Map of Coronavirus COVID-19 global cases by Johns Hopkins University

Source: American Academy of Sleep Medicine, Center of Disease Control and Prevention, ResMed

Disclaimer: This blog post provides a general overview of medical conditions and potential treatments. It is not intended as medical advice. For personalized medical guidance, please consult your healthcare professional.

COPD symptoms can start out subtle and may take years to develop. By the time the signs and symptoms are apparent, your lungs are already significantly damaged. It’s very important to discuss any symptoms you have with your doctor right away.

What are the early signs and symptoms of COPD?

Are you at risk for COPD?

COPD develops slowly and becomes worse over time. If you have risk factors such as long-term exposure to smoke (both first- and secondhand); exposure to chemicals, vapours and dust; or have been diagnosed with alpha-1 antitrypsin deficiency, talk to your doctor about any symptoms you may have, Check the post for COPD Definition and Diagnosis.

Understanding the four COPD stages

Stage 4:
Very severe COPD

The severity of your symptoms is significantly affecting your ability to breathe. Your lifestyle and mobility are very limited.

How COPD stages are diagnosed

Your doctor will be able to determine what COPD stage you’re in and what to expect from your treatment based on the ratio of your forced vital capacity (FVC) and your forced expiratory volume (FEV1).

• FVC is the measure of how much air you can forcefully push out of your lungs after taking a breath.
• FEV is the measure of how much of that air is exhaled in one second of your FVC test.

COPD treatment options

There is no cure for COPD at the moment, but the good news is there are treatments available to help you manage your COPD. Treatments may include:

• Quit smoking: If you smoke, quitting is the first step to slowing the progression of the disease.
• Medications: These can help you manage your symptoms and help prevent your condition from getting worse.
• Pulmonary rehabilitation: This program combines exercise and education about COPD, and will also help you manage your symptoms.
• Eating a healthy diet: Eating a healthy diet can improve your overall health. If you are overweight, weight loss may help make breathing easier.
• Surgery: In some cases, surgery may be an option when medications aren’t sufficiently managing symptoms.
• Oxygen therapy: Supplemental oxygen may be prescribed if there isn’t enough oxygen in your blood.
• Non-invasive ventilation (NIV): NIV machines help reduce the effort needed to breathe by pushing pressurized air through a mask or mouthpiece.

Chronic Obstructive Pulmonary Disease (COPD) is a long-term, progressive lung disease that makes it hard to breathe. It is a major cause of disability and a leading cause of death worldwide, affecting millions of people each year. Understanding COPD’s definition, its causes, symptoms, and diagnosis processes can empower individuals to seek timely medical attention and manage the condition effectively.

Definition

COPD is not a single disease but a term used to describe a group of lung conditions that cause breathing difficulties, including emphysema and chronic bronchitis:

• Emphysema involves damage to the alveoli (air sacs) in the lungs, making it hard for the lungs to exchange oxygen and carbon dioxide.
• Chronic Bronchitis is characterized by long-term inflammation of the bronchial tubes, which leads to increased production of mucus, coughing, and difficulty breathing.

These conditions limit airflow in and out of the lungs, making it difficult to breathe. The obstruction is usually progressive, meaning it worsens over time, especially if exposure to the cause, such as smoking, continues.

Causes

The primary cause of COPD is long-term exposure to substances that irritate and damage the lungs. This includes:

• Tobacco Smoke: The leading cause of COPD in developed countries. People who smoke or have a history of smoking are at high risk.
• Air Pollution: Exposure to indoor and outdoor air pollution can contribute to developing COPD.
• Occupational Dust and Chemicals: Long-term exposure to dust, chemicals, and fumes in the workplace can lead to COPD.
• Genetic Factors: A deficiency in a protein called alpha-1 antitrypsin can cause COPD. This condition is less common but can affect individuals at a younger age.

Symptoms

COPD symptoms often don’t appear until significant lung damage has occurred, and they usually worsen over time. Common symptoms include:

• Persistent cough, often referred to as a “smoker’s cough”
• Increased mucus production
• Shortness of breath, especially during physical activities
• Wheezing
• Chest tightness

Diagnosis

Diagnosing COPD involves a combination of clinical evaluation and diagnostic tests:

• Medical History and Physical Examination: A doctor will review symptoms, exposure to lung irritants, and family health history.
• Spirometry: The most common test for diagnosing COPD, spirometry measures how much air one can inhale and exhale, and how quickly. A significant reduction in airflow indicates COPD.
• Chest X-ray or CT Scan: These imaging tests can provide detailed pictures of the lungs, helping to rule out other lung conditions and assess the extent of lung damage caused by COPD.
• Arterial Blood Gas Analysis: This test measures how well the lungs are bringing oxygen into the blood and removing carbon dioxide.

Early diagnosis and treatment are crucial in managing COPD, slowing its progression, and improving quality of life. Lifestyle changes, such as quitting smoking, avoiding lung irritants, and adhering to a treatment plan, including medication, pulmonary rehabilitation, and possibly oxygen therapy, can help manage symptoms and enhance the ability to stay active.

A shower or bath is a great way to start your day. But a refreshing dip and a good hygiene routine are just as important for your CPAP as it is for you.

Proper upkeep of your CPAP machine can help ensure the device functions properly. “It is vitally important to keep everything as clean as possible, as hoses/tubing and masks can be a prime breeding ground for bacteria and mold,” said Phoebe Ochman, Director of Communications for Sleep Apnea Treatment Centers of America.

The thorough cleaning of your CPAP machine can be divided into daily and weekly cleaning, she said.

Daily Cleaning

Get in the habit of wiping down your mask (including areas that come in contact with your skin) using a damp towel with mild detergent and warm water. This will remove any oils, dead skin cells and sweat on the mask that can affect the quality of the seal. Gently rinse with a clean towel and let the mask air-dry.

You can also use pre-moistened towels designed specifically for cleaning CPAP masks, which are available at many sleep centres.

If your unit has a humidifier, empty any leftover water instead of letting it sit in the unit all day. Refill the humidifier with clean, distilled water right before bedtime for optimal use.

If you’ve been sick, it’s smart to wash your mask, tubing, humidifier chamber and daily until your cold, flu or virus symptoms are gone. That can help reduce the amount of time you spend under the weather.

Weekly Cleaning

Your mask and tubing need a full bath once a week to keep it free of dust, bacteria and germs.

Clean the CPAP tubing, nasal mask and headgear in a bathroom sink filled with warm water and a few drops of ammonia-free, mild dish detergent. “Swirl all parts around for about five minutes, rinse well and let air dry during the day,”. Hang the tubing over the shower rod, on a towel rack or in the laundry room to ensure all the water drips out.

The mask and headgear can be air-dried on a towel or hung on a hook or hanger.

“You should also wipe down your CPAP machine with a damp cloth,” Ochman noted. The towel shouldn’t be too damp or wet, as water could get into the machine.

Clean the filter by removing it and rinsing it in warm tap water. “Squeeze it under the water and squeeze to make sure there is no dust. Then blot down the filter with a towel,” she said.

But don’t wash your machine’s white filter, if one is present—those are disposable and should be replaced once a month, Ochman said. “Just like your house filters, if the white filter is dirty, it should be replaced sooner than once a month.”

If your CPAP has a humidifier, that also needs to be cleaned weekly.

Empty any remaining water and then wash the water chamber in the sink with warm soapy water. Rinse well and drain out as much of the water as possible. Let the chamber air-dry before placing it back into the CPAP unit.

“Every other week you should disinfect the humidifier,” Ochman said. Do that by soaking it in a solution of one part vinegar to five parts water for 30 minutes, thoroughly rinsing and then placing in your dishwasher’s top rack for washing. And keep it clean by using only distilled water to prevent mineral deposits that can build up and cause damage to your machine.

With a little upkeep, your CPAP can continue to help you breathe better for a long time. Just a few minutes a day can help keep your CPAP running efficiently for years to come.

Measurements in sleep lab

A sleep study (polysomnogram) is performed in a sleep disorder center and is typically used to diagnose sleep apnea. It is also possible for the condition to be diagnosed based on home sleep apnea testing.

A lot of information is collected, and part of the purpose of these studies consists of tracking your breathing patterns through the night. This is accomplished with several sensors:

• Nasal cannula (or thermistor) with plastic prongs that sit in the nostrils
• Respiratory effort belts that stretch across the chest and/or stomach
• An oximeter clip that measures continuous oxygen and pulse rate by shining a laser light through a fingertip

learn what is sleep apnea and AHI

read our ultimate Sleep Apnea

All of this information is analyzed to determine how many times you breathe shallowly (flow limitation and Hypopnea) or stop breathing altogether(complete Obstructive) during the night. Any partial obstruction of the airway is called a hypopnea. Hypopnea refers to a transient reduction of airflow (often while asleep) that lasts for at least 10 seconds. Shallow breathing or an abnormally low respiratory rate may be called hypoventilation.

A complete cessation in breathing is called apnea (from the Greek meaning “no breath”). Hypopnea is less severe than apnea (which is a more complete loss of airflow). It may likewise result in a decreased amount of air movement into the lungs and can cause oxygen levels in the blood to drop. Sleep apnea is more commonly due to partial obstruction of the upper airway.

To count in the AHI, these pauses in breathing must last for 10 seconds and more which is associated with a decrease in the oxygen levels of the blood or cause an awakening called arousal. These awakenings may fragment sleep, make it unrefreshing, and lead to daytime sleepiness.

Some sleep facilities use other measures to assess this degree of severity. The respiratory disturbance index (RDI) may be used if a measurement of airway resistance with a pressure oesophagal manometer is also included in the study. The oxygen-desaturation index (ODI) attempts to calculate the number of apnea or hypopnea events per hour that lead to an oxygen drop of at least 3%. This is thought to be important in assessing the risk of long-term cardiovascular (high blood pressure, heart attack, and heart failure) or neurocognitive (stroke and dementia) consequences.

If your sleep study does not contain these more specific measures, this is nothing to worry about.

An additional benefit for sleep apnea sufferers

Researchers have found that continuous positive airway pressure (CPAP) treatment of obstructive sleep apnea (OSA) can improve depression symptoms in patients suffering from cardiovascular diseases.

Using data from the Sleep Apnea Cardiovascular Endpoints (SAVE) trial led by Flinders University, the new study has found a significant decrease in cases of depression after patients received CPAP treatment for their sleep apnea.

This is by far the largest trial of its type and one of the very few studies reporting such an effect, says Professor Doug McEvoy from Flinders University.

From the detailed analysis of the SAVE data, Flinders University experts and collaborators at the George Institute have found that CPAP for moderate-severe OSA in patients with cardiovascular disease has broader benefits in terms of preventing depression, independent of improved sleepiness.

Prior studies investigating the effect of CPAP on mood with various experimental designs and length of follow-up periods have yielded heterogeneous results.

“Patients who have had a stroke or heart attack are prone to suffer from low mood and are 2 to 3 times more likely to develop clinical depression, which then further elevates their risk of future heart attacks and strokes,” says SAVE principal investigator Professor McEvoy, a senior author in the paper just published by The Lancet in EClinicalMedicine.

With up to 50% of patients with CV disease likely to have OSA, the study is “welcome news that treatment of OSA substantially relieves cardiovascular patients’ depressive symptoms and improves their wellbeing.”

The paper’s first author, Dr Danni Zheng, from the George Institute for Global Health (UNSW), says the 2687 OSA patients enrolled in the SAVE trial were based solely on their history of cardiovascular disease and not on their current mood status.

“After following them for an average of 3.7 years, we found that CPAP provided significant reductions in depression symptoms compared with those who were not treated for OSA. The improvement for depression was apparent within six months and was sustained.”

As expected, those with lower mood scores to start with appeared to get the greatest benefit.

“Our additional systematic review which combined the SAVE study findings with previous work provided further support of the treatment effect of CPAP for depression,” Dr Zheng says.

Story Source: Materials provided by Flinders University. Note: Content may be edited for style and length.

Journal Reference:Danni Zheng, Ying Xu, Shoujiang You, Maree L. Hackett, Richard J. Woodman, Qiang Li, Mark Woodward, Kelly A. Loffler, Anthony Rodgers, Luciano F. Drager, Geraldo Lorenzi-Filho, Xia Wang, Wei Wei Quan, Manjari Tripathi, Olga Mediano, Qiong Ou, Rui Chen, Zhihong Liu, Xilong Zhang, Yuanming Luo, Nigel McArdle, Sutapa Mukherjee, R. Douglas McEvoy, Craig S. Anderson. Effects of continuous positive airway pressure on depression and anxiety symptoms in patients with obstructive sleep apnoea: results from the sleep apnoea cardiovascular Endpoint randomised trial and meta-analysis. EClinicalMedicine, 2019; 11: 89 DOI: 10.1016/j.eclinm.2019.05.012