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getting used to cpap

Updated on May 5, 2011

I am starting this hub as a question and help forum for those of us trying to adjust to our new sleeping aides.

C-PAP or Constant Positive Air Pressure and Bi-PAP Bi-level Positive Air Pressure are used for among other things to treat the 3 types of apnea which include; Obstructive Apnea (or Apnoea in British English) OSA for short, Central Apnea or CSA, and Central Complex Apnea or CCSA. While CPAP is a constant flow of air Bi-level assists with both inhalation and exhalation.

Now lets talk about apnea and the different types and what they mean for you.

Apnea is a sleep disorder that interrupts normal breathing cycles during sleep. These interruptions can last from several seconds to a few minutes, or can be a period of abnormally shallow or low breathing also called hypopnea. These pauses can happen 5-30 times or more in a hour and disrupt the normal sleep cycles that we depend on for many aspects of our daily life. Sleep is often taken for granted by those who do not suffer from sleeping disorders and they are usually not aware of just how important a good night sleep is.

The average person goes through the sleep cycle 5 complete times in a night. However a person with apnea or other disorders rarely go through one complete cycle in a night with out the assistance of C/BiPAP.  There are four stages of sleep that do not involve dreams, one stage that does, known as Rapid Eye Movement or REM for short, and the final stage of sleep is waking. Though it is not fully understood these six stages of sleep are essential for us to survive and maintain good mental hygiene. During REM sleep your brain is extremely active, almost as much so if you are awake. People with apnea tend to spend much more time in this stage of sleep than the others. One stage of non-REM is a deep sleep when a person is out like a light. This stage is extremely important for the rest we need. Those people who suffer from apnea either do not reach this stage at all or spend very little time in this stage, and the amount of rest they get is negligible at best.

Apnea can not be diagnosed by a normal doctors appointment, a special sleep study is needed to confirm the problem. Other than being extremely tired the person affected by this problem usually does not know what is happening and the respiratory distress is usually noticed by a bed partner. Apnea is a serious disorder and if you suspect you have it, or any one has ever told you that they have noticed you having breathing trouble while sleeping you should inform your doctor as soon as possible, apnea can result in permanent brain damage or even death. Though in most cases brain damage is caused over a long period of leaving the condition untreated, the constant lack of oxygen is the cause of this. However more noticeable side effects include but are not limited to; memory loss, constant morning head aches, extreme tiredness regardless of time spent in bed, problems concentrating, loud snoring, snorting, choking, dry mouth, sore throat, shallow breathing, oxygen deprivation, irritability, depression, moodiness, forgetfulness, restlessness, waking at night, and feeling out of breath.

Obstructive apnea or OSA is the most common type of apnea, it generally effects overweight people but can effect people who are not overweight. It is characterized by an obstruction of the air way, such as the throat collapsing or an oversizes tongue blocking the air pathways, there are however other causes. In many cases Obstructive apnea can be corrected with surgery, reduction of an over sized tongue, removal of tonsils or tightening of neck muscles to prevent collapses. Obstructive apnea is usually accompanied by loud snoring or snorting.

Central Sleep Apnea or CSA exact cause is unknown. It is caused by the mechanism in the brain that controls breathing to stop working during sleep and sometimes even when awake. The controls that monitors carbon monoxide and oxygen levels in the body stop functioning correctly and breathing stops or becomes irregular. There is no cure or surgery for this type of apnea. After an episode of CSA hyperpnea or rapid breathing to rebalance oxygen levels in the body occurs.

Complex Central Apnea or CCSA is a mix of the two types of apnea listed above. Often the lack of air pressure in the respiratory system from CSA causes the air way to become obstructed in some way. This type of apnea is often caused by long-term high doses of narcotic pain medicine, or the long term effect from OSA causes the brain to adapt in a negative way to the lack of breathing and in anticipation of an apnea the brain slows or stops telling the body to take a breath.

These are simplified definitions of the disorder and should not in any way be used as a diagnosis. I am not a doctor, though I do suffer from Complex Sleep Apnea. There are several good websites on this topic that I will list below. 

Getting used to the C/Bi-PAP machine can be a very daunting task. Trust me when I say, 13cm of air is a lot and almost impossible to breath against. Most machines can sense when you are trying to exhale and briefly cut back on air pressure to allow for exhaling, if they didn't  with 13+cm's of air, you would find yourself holding your breath with no possibility of getting rid of it. Kind of like jumping into a brick wall, there is no give at all. However most machines give you some cushion for that jump, so don't worry too much. Some machines are also equipped with a "ramp" feature that starts the pressure at a lower rate and slowly increases to the therapeutic range over 10 to 45 minutes to allow you to adjust to it or fall asleep before the full amount of pressure is blowing down your throat. This also helps a person acclimate to the machine easier. Trust me when I say it is difficult to fall asleep when the machine is working at full force.

My machine is fitted with several neat features and this machine is almost as smart as my laptop and has a sizable SD memory card that is easily removable so I don't have to lug the whole machine when I go in for my check-up's. My machine is the same one in the picture above also it is a Philips Respionics with a removable humidifier. I like it, it has many features and controls. It has sensors that adjust the pressure to what helps me best, it has already adjusted to my normal breathing cycle as I use bi-pap. It also has an automatic cut on, simply put the mask on, inhale then exhale and the machine turns on; but you have to hit the ramp button to cut the pressure it doesn't do that automatically though that would be a great feature. This machine does more than I can explain right now and most of the stuff you shouldn't touch and is most likely locked by your provider anyways, unless they made a mistake like they did with  me and forgot to lock certain features. Though I know this is an important machine to my health and have no intentions of making changes without the express permission from my doctor.

There are a huge variety of masks that you can chose from to find the most comfortable one for you. This is something you will most likely be using for the rest of you life, so trust me when I say don't settle for close enough and find the right one for you, there are many many many types out there. Tell your doctor if your mask is not comfortable. I use the same mask in the picture above, it is a Respironics comfort gel full mask. I find it comfortable enough, the gel is very soft and there are several adjustments and features on this mask. If you don't breath through your mouth when sleeping nose pillows are an option, they usually come with a face garb in case you do start breathing through the mouth; by the time you put all that extra garb on you might as well use a full mask.

If you are like me and you sometimes sleep with your mouth open, I would highly recommended asking for a machine with a humidifier or you will wake with an extremely dry mouth. Most humidifiers like mine can be adjusted to allow for the amount of moisture that suits you best. Under no circumstances should you turn on the humidifier with out water in the tank. USE DISTILLED WATER ONLY, remember you are breathing this stuff in. Also remember to clean your mask, tube, filter, and humidifier tank daily, again you are breathing this stuff. Also use ONLY MILD DISH SOAP AND WARM WATER. Not only will strong cleaners eat the materials this thing is made of, but again you are breathing this stuff. That is the single most important thing to remember, YOU ARE BREATHING THIS STUFF!!!!

Anyways, Please feel free to add any suggestions or facts that I missed. This is a very huge topic and I am quite sure I have forgotten something. Also I am seeking help and ideas myself with this machine. Thanks everyone for reading and for any input you may add. Please fill free to ask me any questions, I will do my best to answer or point you in the right direction. Another important point is good sleep Hygiene and I think I will make another hub covering that, however please feel free to add suggestions here in the comment boxes. Remember sleep health is extremely important do not make your self suffer there is help.

Helpful sites:

for search results on sleep apnea from google go to this link:


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    • pintails7886 profile imageAUTHOR


      7 years ago from Memphis TN

      Of course he would. LOL.

    • profile image


      7 years ago

      thats funny, vader would need cpap

    • pintails7886 profile imageAUTHOR


      8 years ago from Memphis TN

      One thing I should add for those in their first couple days of using the machines, Do not be shocked to find that you wake in the morning and your mask is not on with no memory of how it was removed. Also this is all monitored on the compliance chip, The machine is smart enough to know if it was just left on all night or if you were actually using it. I did have one good night with it 2 nights ago but the last two nights I have taken the mask off, one time I remember and had all intentions of putting it back on but fell asleep before I did, last night I have no memory of removing it even though I did, though it may have been a good thing as we lost power last night, and it is dangerousness to wear your mask when the hose is attached and the machine is not on. However wearing the mask without the hose attached is reasonably safe. I actually recommend doing this for a night or two to get used to it better.

      Though if you are like me the mask in its self is not the problem, I can sleep all night with just the mask, however it is the air blowing in your face and down your throat all night that is so hard for me, and 13-20cm H2O is a whole lot of air compared to what you normally breathe.

      It is roughly equivalent to the pressure of standing in chest deep water and trying to inhale, though it is in reverse.

      The ##cm H2O is the measurement of pressure they use with these machines. Compared to PSI or Pounds Per Square Inch they are negligible. The CM H2O measurement used in these machines is how many Centimeters X amount of air will push water in an air tube. The same principle as a barometer though instead of mercury, water is the medium used.

      I know my explanation is very crude but perhaps it will help point you in the right direction for answers if you are curious about such things.

      Anyways, good luck to all of you out there stuck on these machines, like me, for the rest of our lives.

    • pintails7886 profile imageAUTHOR


      8 years ago from Memphis TN

      I can tell you micky that getting used to this thing sucks I hope you dont need it, but for a good nights sleep I guess it is worth the effort. I am trying to get used to it by wearing it as long as I can until it wakes me, then i take it off for a few mins and put it back on until it wakes me again. It sucks but the sleep I'm getting with it on is better sleep. Apnea used to wake me all the time too but the difference is the sleep I get with the mask on is much better quality, so I guess its worth it.

    • Micky Dee profile image

      Micky Dee 

      8 years ago

      I may be needing this info soon! God bless Pintails!

    • Freya Cesare profile image

      Freya Cesare 

      8 years ago from Borneo Island, Indonesia

      Darth Vader mask! LOL.

      I know nothing about this thing but what you told me only, so my opinion will not helpful at all. I hope you will get used to it as soon as possible.

      Fighting! :)


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