Tips to Address Common Problems Patients Encounter When Using Cpap and Possible Interventions

Problem	Cause	Possible Solution
Box 14-1	Tips to Address Common Problems Patients Encounter When Using CPAP and Possible Interventions
Congestion, nasal irritation, runny nose, nosebleed	Dry air	Addition of heated humidification
Dry throat and/or mouth	Dry air, improperly fitting mask	Addition of heated humidification; check fit of mask/nosepiece; tighten straps on mask/nosepiece
Trouble getting used to wearing the CPAP device	Feeling claustrophobic, sensitization to new device	Gradually increase time wearing equipment; practice using the mask while awake. First just hold the mask to their face, then try wearing just the mask with the straps. Then, put the hose on the mask and hold the mask on their face, then try wearing with the straps. Finally, turn on the machine while wearing Try wearing just the mask for short periods of time during the day while relaxing Use every time during sleep, including naps
Patient has a hard time falling asleep or staying sleeping	Noise from motor	Try using earplugs while sleeping Consult with health care provider to consider use of ramp or delay Follow good general sleep habits, regular exercise, avoid caffeine Use relaxation techniques Check/replace filter in device
Abdominal distention or a sensation of bloating	High airway pressure	Decrease CPAP pressure
Poorly fitting/leaking mask/nosepiece	Wrong size or style CPAP mask/nosepiece Excessive facial hair	Try a different mask or nosepiece Check sizing Check fit/adjustment of straps Shave facial hair
Difficulty tolerating forced air	High air flow/pressure Sensitization to new device	Consult with health care provider to consider use of ramp or delay Consult with health care provider to consider use of bi-level positive airway pressure
Irritation or redness of the skin that comes in contact with equipment	Incorrect size/type of mask/nosepiece Incorrect fit Sensitivity to mask/nosepiece Heated humidification	Check size/fit of mask/nosepiece Consider use of padding on straps Readjust straps Clean mask/nosepiece and tubing regularly and replace as directed Lower temperature on humidifier Wash face before putting on the mask

Source: Adapted from American Sleep Association (ASA). (2021). CPAP user guide. https://www.sleepassociation.org/sleep-apnea/cpap-treatment/cpap-user-guide/; Hess, D. R., MacIntyre, N. R., Galvin, W. F., & Mishoe, S. C. (2021). Respiratory care: Principles and practice (4th ed.). Jones & Bartlett Learning; Mayo Foundation for Medical Education and Research (MFMER). (2018, May 17). CPAP machines: Tips for avoiding 10 common problems. https://www.mayoclinic.org/diseases-conditions/sleep-apnea/in-depth/cpap/art-20044164; Pinto, V. L., & Sharma, S. (2021, May 7). Continuous positive airway pressure. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK482178; and Suni, E. (2020, September 11). How to use a CPAP machine for better sleep. Sleep Foundation. https://www.sleepfoundation.org/cpap/how-to-use-cpap-machine

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Box 14-1