CPAP Troubleshooting Guide

	Symptom	Cause	Intervention
	Dry eyes	Leak	Verify mask fit/size
	Redness or skin abrasions	Headgear too tight or Ill-fitting mask	Observe patient apply mask/headgear & observe tautness

	Symptom	Cause	Intervention
	Sinus discomfort	Lack of humidification	Rx humidification
	Congestion	Mouth breathing	FFM
	Runny nose Dry mouth/Dry nose	Possible infection	Chin strap

	Symptom	Cause	Intervention
	Patient feels "too much air"	Claustrophobic	Verify Rx to FG pressures
	Patient "starved for air"	Sub or high-pressure	Notify physicians for possible device/ pressure change
	Patient still sleepy	Low usage	Possible acclimation protocol
	Patient still snoring	Mask fit or Leak	Check leak

Frequently Asked Questions

How long will it take to get used to CPAP?
Most people adjust to CPAP in one to two weeks. Occasionally it may take alittle longer if, for example, you are very sensitive to noise or the feel of the mask on your face.

How soon after I start using treatment will it be before I notice an improvement?
You should notice an immediate improvement when you start treatment though some people may take a little longer.

How often will I need to use my treatment?
You will need to use your treatment every night of the week while you sleep. If you do not, you will return to your previous level of snoring, sleep apnea, and daytime tiredness.

Will the pressure on my device ever need changing?
If you are using CPAP or bilevel (VPAP) therapy, the pressure will remain set as levels that suit your requirements. Sometimes, however, there is a need for fine-tubing or adjustment to pressure levels, for example if you lost or gain weight. If you find your pressure difficult to tolerate, it may be dropped slightly for a short time at the beginning of therapy at the discretion of your doctor or sleep physician. A sleep physician will review you if symptoms of snoring and daytime sleepiness have returned.

If you are using AutoSet therapy the device will automatically adjust the pressure levels to suit your continuously changing needs. This type of treatment is particularly recommended if your weight fluctuates regularly, or you regularly consume alcohol or sleeping tablets.

Will my blood pressure improve after I start treatment?
Yes it can but please do not alter your medication without consulting a doctor. Your doctor should review your blood pressure regularly even if your mediation does not change initially.

Is it easier to lose weight when using treatment?
It may be. You should find that your energy levels increase and you are likely to feel motivated to take part in many activities that your previous sleepiness has prevented you from doing. However, permanent weight loss requires long-term lifestyle changes to diet and exercise.

My partner (or I) sleep very lightly. What do I do if I find my device a bit noisy?
ResMed devices are designed to be extremely quiet. However, if you have trouble adjusting to the noise, try placing your device on the floor next to your bedside until the noise no longer bothers you.

A humidifier can help by "muffling" the noise. Ask your sleep clinic or equipment supplier for details.

If you find the noise that disturbs you is coming from the air escaping from the vents on the mask frame, check that there is nothing blocking them.

Alternatively you could place your device in another room using longer air tubing or joining two air tubes together with an air tubing connector.

Note: If you do this you should have the pressure checked to make sure it is still adequate to treat your OSA. If your device has a SmartStart facility you may find that the lengthening the tubing interferes with its performance. In case you should either use just one length of air tubing or take your machine to your supplier who can turn the SmartStart feature off.

I've just started treatment and it's irritating my nose.
The cool dry air treatment can cause a runny nose and sneezing in some people, but it usually settles down within a few days to a week. If it does not settle down, you should consider using a heated humidifier; which will help by adding warmth and moisture to the air. Remember, if you are using a fixed pressure CPAP device, your set pressure may need to be adjusted slightly if a humidifier is used. If you are using a ResMed AutoSet device, it will automatically compensate for the pressure if a humidifier is used.

I find the air delivered through the mask is cold and disrupts my sleep.
Some people experience dryness of the nose, mouth, or throat when on treatment, particularly during the winter months. If the air delivered through the mask is cold and disrupts your sleep, the alternatives are heating the room, placing the tubing under the bedclothes (as body heat will increase the temperature of the air passing through the tubing), or humidification. A heated humidifier adds warmth and humidity to the air before you breathe it, reducing these symptoms and making the air more comfortable to breathe.

My nose gets blocked regularly, so I have to breathe through my mouth. What do you advice?
Since the nose is a very effective point of entry when using nasal positive airway pressure therapy, it is necessary for it to be clear. One option is to use a nasal decongestant and we recommend you discuss this with your doctor. Please note that overuse of nasal decongestants can also cause a blocked nose over time. You may find that a full face mask is the answer to this problem, particularly if you do not wish to use decongestants on a long-term basis.

A full face mask covers both your nose and mouth so that you can continue to receive effective therapy, even if you are breathing through your mouth.

I feel air leaking out of my mouth as I fall asleep.
Your mouth needs to be closed while you sleep to prevent any air escaping from the mask. A full face mask that covers your nose and mouth will ensure that you will continue to receive effective therapy as you fall asleep. An alternative solution is to use a chin strap, which can help to keep your mouth closed.

Can I use my treatment if I have a cold?
If you experience an infection of the upper respiratory tract, middle ear, or sinus, you should consult your physician before continuing treatment. You may be advised to discontinue until the infection has cleared. If you continue with treatment during infection, it is advisable to wash your mask and tubing more often. A full face mask may be good alternative at this time as it covers both your nose and mouth so you continue to receive effective therapy.

Do I need to take my device into hospital with me if I need hospitalization for any reason?
Yes. Your recovery may take longer if you stop your treatment and your general well being starts to deteriorate. If you are having surgery, it is very important that you tell both the surgeon and the anesthetist that you are being treated.

You should also inform the physician treating you for sleep apnea that you are going to the hospital.

Will I ever be able to stop treatment? Will I ever be cured of my snoring and sleep apnea?
OSA is a long-term condition for which there is presently no known cure. The good news, however, is that positive airway pressure therapy will effectively control your sleep apnea-as long as you continue to use it.

I often wake and find I have taken my mask off in my sleep. How can I avoid doing this?
If you are on CPAP or bilevel (VPAP) therapy, this may indicate that your treatment pressure is not enough to completely control your sleep apnea and a slight increase in pressure may solve to problem.

Alternatively some ResMed devices have a mask alarm that alerts the user if the mask is removed. Discuss this symptom with your sleep physician.

Why do I feel that it is hard to breathe out when using CPAP?
When first using CPAP, most people find they experience a need to push against the airflow when they breathe out. It may take a little time to get used to breathing out against the pressure. Practice sessions in the daytime while relaxing or listening to music may help overcome this feeling. However, breathing out against the flow of air will happen automatically when you are asleep.

For people who have more that the usual difficulty in getting used to breathing out again the air pressure, some of ResMed's CPAP devices have options such as the ramp feature. This feature allows you to fall asleep at a lower pressure while your device ramps up to your full treatment pressure over a period of time. Alternatively, you could consider using an AutoSet device or a bilevel device such as ResMed's VPAP.

I'm going overseas-can I use my device in other countries?
ResMed devices have a switch mode power supply which means they will operate on the various power supplies in different parts of the world. They accept 110-240 V, 50-60Hz without any special adjustment. Please note that you will still need to use the correct adaptor for the type of power outlet in the country you are visiting.

With the use of suitable inverter unit, your device can operate from a battery supply (e.g. in a truck, recreational vehicle, or boat). The inverter should be capable of supplying mains voltage in the range 110-240V and should be sufficient capacity. Your ResMed distributor can assist in your choice of a suitable inverter for your device.

Note: A rated capacity of up to 200 W may be necessary with some brands of inverter to ensure satisfactory operation.