General CPAP & Bipap Questions

General CPAP and BiPAP Questions

Q: Will I need to use my CPAP equipment for the rest of my life?

A: Most people continue to sleep using their CPAP devices for the duration of their lives, even though their pressure setting may need to be adjusted downward due to improvements in the severity of their sleep apnea. However, some no longer need treatment because they lose weight; experience changes in their muscle tone; undergo oral surgery;  or have their airway structures “trimmed” down by a physician.

Q: I’ve been diagnosed with obstructive sleep apnea (OSA) I don’t have trouble sleeping; in fact, I can sleep anywhere, anytime! Why do I need CPAP treatment?

A: Having OSA doesn’t mean you have trouble falling asleep. Having OSA means you have trouble breathing while you are asleep.

Q: If I go out of town for 1-2 days or less than a week, is it ok to leave my CPAP/BiPAP at home?

A: No. Every time you sleep your airway is obstructed and your oxygen drops your heart, brain, lungs, and other bodily systems are strained. That’s why it’s vitally important that you use continue your therapy whenever – and wherever – you sleep.

Q: How often should I be re-titrated. In other words, how often should I have another sleep study to determine if my equipment pressures are set appropriately for me?

A: The American Academy of Sleep Medicine (AASM) recommends that patients be “re-titrated” once a year or when lifestyle changes occur, to ensure that optimum therapeutic levels are maintained. This is especially important if you – Especially if/when you lose or gain weight; no longer feel you are getting optimal sleep; and/or if you are taking new medications (which can make apnea worse).

Q: Can I take sleep aids while using my CPAP like I did during my study?

A: You should always check with your physician and pharmacist before taking prescription or over-the-counter medication with your CPAP therapy in order to avoid any possible negative reactions.

Mask and Supply Questions

Q: What kind of mask do I need?

A: Using the right mask is essential to the success of your treatment. You will need a mask this is comfortable and fits properly. It should form a good seal on your face so that air doesn’t leak (this would be uncomfortable and make your therapy less effective). A nasal mask which covers the nose is the most common. However, some people breathe through their mouth when they sleep. In this case, a full face mask that covers both the nose and mouth is the best option. 
Another option would be a nasal mask and chinstrap. This will prevent the jaw from opening during sleep and still provide for effective therapy.

Q: My mask seems to be leaking. What does that mean?

A: Unfortunately, our faces are designed differently, and no mask will seal 100% of the time, because air will look to escape via every nook and cranny. However, you’ll want to get the best fitting mask and adjust your headgear properly to have the best seal. Also, before using your equipment make sure your face is clean and free from moisturizers, make up, or creams.

Q: How often can I pick up my supplies?

A: Use the following as guidelines, because they adhere to most insurance carriers’ requirements.

  • Once a Month – Face cushion/nasal seal cushion, nasal pillows, device filters.
  • Every 3 Months – Mask (excludes headgear) and tubing.
  • Every 6 Months – Headgear, chin strap, humidifier water chamber. 

Extra supplies are available for self-pay purchases. 

Q: I often wake up with water in my mask/tubing – what can I do? Why does this happen?

A: Your humidifier is on too high. Start at the 1st setting (1) and gradually increase as necessary each night.

Q: I have a full face mask and my humidifier is turned all the way up and I still have a dry mouth. What should I do?

A: Adding a chinstrap to your headgear is often helpful under these circumstances, because it will prevent you from keeping your mouth open and having more moisture evaporate. Additionally, your doctor may need to adjust some of your medications if he or she feels that it may be contributing to your dry mouth. 

Q: I am experiencing a cut on the bridge of the nose. What should I do?


A: If so, your mask is probably too tight so we suggest that you loosen it a bit. Also, put some zinc oxide, a band-aid, or skin tape on the affected area, but do not discontinue your CPAP therapy.  However, if your sore continues to worsen, contact your physician. You may need to return to your  CPAP clinic for another mask- one with a more comfortable, and better-fitting style. 

Q: How do I dry CPAP hoses after cleaning?

A: After cleaning your tubes and hoses in warm water (don’t use soap in the water or you may be blowing bubbles out of your tube!) and rinsing them thoroughly, you can dry them by leaving them alone for a while or using one or more of the techniques listed below.  It’s a good idea to have two hoses so you can rotate them as necessary.

  • Spin the tube gently. The centrifugal force pulls the water to the outside of the tube.
  • Tie a fishing weight to a nylon string, paper or cloth towel, or other fabric and pull it through the tubing.
  • Set a hair dryer on low and blow it through the connector hose (you can even duct-tape it to the end if you’d like to leave it there for a while)
  • Place the hose in a freezer for a couple of hours. The droplets will freeze and fall off the hose surface when you flex it from the outside.

CPAP machines: Tips for avoiding 10 common problems

CPAP machines: Tips for avoiding 10 common problems

CPAP is an important treatment for obstructive sleep apnea, but it’s not without its frustrations. Learn how to avoid uncomfortable masks and other common CPAP problems.

Continuous positive airway pressure (CPAP) therapy is a common treatment for obstructive sleep apnea. A CPAP machine uses a hose and mask or nosepiece to deliver constant and steady air pressure.

Common problems with CPAP include a leaky mask, trouble falling asleep, stuffy nose and a dry mouth.

The good news is that if one CPAP mask or device doesn’t work for you, you have other options. And most CPAP masks are adjustable, to help make them more comfortable for you.

Here are 10 common CPAP problems and what you can do about them:

1. The wrong size or style CPAP mask

Work closely with your doctor and CPAP supplier to make sure you have a CPAP mask that fits properly. Everyone has different face shapes, so the right style and size mask for someone else may not work for you.

  • Try a different mask. A range of CPAP masks are available. For example, some feature full face masks that cover your mouth and nose, with straps that stretch across your forehead and cheeks. These may make some people feel claustrophobic, but they work well if you prefer to breathe through your mouth during sleep. They also provide a stable fit if you move around a lot in your sleep.Other masks feature nasal pillows that fit under your nose and straps that cover less of your face. These can feel less cumbersome.Nasal pillows may work well if you wear glasses or read with the mask on, because some don’t block your eyes as much as full face masks do. However, this may not be an option if you move around a lot in your sleep or sleep on your side.
  • Pay attention to size. Most masks come in different sizes. Just because you’re a certain size in one mask doesn’t mean you’ll be the same size in another. CPAP masks are usually adjustable.Ask your doctor or CPAP supplier to show you how to adjust your mask to get the best fit. Manufacturer product instructions also can help show you how to do this. A properly fitting mask shouldn’t be uncomfortable or cause pain.

2. Trouble getting used to wearing the CPAP device

First, try wearing just the CPAP mask for short periods of time while you’re awake — for example, while watching TV. Then try wearing the mask and hose with the device turned on during the day while you’re awake.

Once you get used to how that feels, start using the CPAP device every time you sleep — including naps. Just wearing the CPAP device every now and then may delay getting used to it. Stick with it for several weeks or more to see if your mask and pressure are right for you.

3. Difficulty tolerating forced air

You may be able to overcome this by using a machine with a “ramp” feature. This setting allows you to start with low air pressure. The machine then automatically and slowly increases the air pressure to your prescribed setting as you fall asleep. Your doctor can adjust its rate.

If this feature doesn’t help, talk with your doctor about changing to a device that automatically and constantly adjusts the pressure while you’re sleeping. An example is a bi-level positive airway pressure (BPAP) machine that delivers more pressure when you breathe in (inhale) and less when you breathe out (exhale).

4. Dry, stuffy nose

Check to make sure your mask fits well. A leaky mask can dry out your nose. If you have to tighten straps often to prevent air leakage, the mask does not fit properly.

A CPAP device that features a heated humidifier, which attaches to the air pressure machine, can help. You can adjust the level of humidification. Using a nasal saline spray at bedtime also can help ease a dry, stuffy nose.

5. Feeling claustrophobic

Practice using your mask while you’re awake. First, just hold it up to your face without any of the other parts. Once you’re comfortable with that, try wearing the mask with the straps.

Next, try holding the mask with the attached hose on your face, without using the straps. Turn on the CPAP machine, perhaps with the ramp feature turned on. Next, do this using the straps too. Finally, try sleeping with the mask and machine on.

Relaxation exercises, such as progressive muscle relaxation, may help reduce anxiety related to CPAP use.

If you’re still feeling claustrophobic, talk to your doctor or CPAP supplier. It may help to get a different size mask or try a different style, such as one that uses nasal pillows.

6. Leaky mask, skin irritation or pressure sores

A leaky or an ill-fitting mask means you’re not getting the full air pressure you need, and you may be irritating your skin. The mask can also blow air into your eyes, causing them to become dry or teary.

Try adjusting pads and straps to get a better fit. If the device fits over your nose, make sure it doesn’t sit too high on the bridge of your nose, which can direct air into your eyes.

You may need to ask your supplier to help you find a different size mask, particularly if your weight has changed a lot. Or try a different style device such as a nasal pillow. If you develop skin deterioration or sores, such as on your nose, tell your doctor promptly.

7. Difficulty falling asleep

Wearing the mask alone for some time during the day may help you get used to how it feels and make it easier to fall asleep at night.

Machines with the ramp feature that slowly and gradually increase the air pressure to your prescribed pressure setting as you fall asleep may make you more comfortable at bedtime.

Following good general sleep habits also are helpful. Exercise regularly and avoid caffeine and alcohol before bedtime. Try to relax. For example, take a warm bath before you go to bed. Don’t go to bed until you’re tired.

8. Dry mouth

If you breathe through your mouth at night or sleep with your mouth open, some CPAP devices may worsen dry mouth. A chin strap may help keep your mouth closed and reduce the air leak if you wear a nasal mask.

A full-face-mask-style device that covers your mouth and nose also may work well for you. A CPAP-heated humidifier that attaches to the air pressure machine also may help.

9. Unintentionally removing the CPAP device during the night

It’s normal to sometimes wake up to find you’ve removed the mask in your sleep. If you move a lot in your sleep, you may find that a full face mask will stay on your face better.

You may be pulling off the mask because your nose is congested. If so, ensuring a good mask fit and adding a CPAP-heated humidifier may help. A chin strap also may help keep the device on your face.

If this is a consistent problem, consider setting an alarm for sometime in the night, to check whether the device is still on. You could progressively set the alarm for later in the night if you find you’re keeping the device on longer.

10. Bothersome noise

Most new models of CPAP devices are almost silent. But if you find a device’s noise is bothersome, first check to make sure the device air filter is clean and unblocked. Something in its way may worsen noise. Ask your doctor or CPAP supplier how to properly clean your mask and hose.

If this doesn’t help, have your doctor or CPAP supplier check the device to ensure it’s working properly. If the device is working correctly and the noise still bothers you, try wearing earplugs or using a white noise sound machine to mask the noise. Placing the machine as far away from the bed as possible also may help make any machine noise less noticeable. Ask your doctor or CPAP supplier if extra tubing is available and right for your machine.

Time and patience are key to success

Using a CPAP device can be frustrating as you try to get used to it, but it’s important you stick with it. The treatment is essential to avoiding complications of obstructive sleep apnea, such as heart problems and excessive daytime sleepiness.

Work with your doctor and CPAP supplier to ensure the best fit and device for you. Regular visits to your sleep doctor are important and can help troubleshoot any problems and adjust settings, if needed. It can take a while to find the correct settings and get used to the mask.

With time and patience, CPAP can positively affect your quality of life and health.

What is the Difference Between CPAP and BiPAP Therapy?

BiPAP (also referred to as BPAP) stands for Bilevel Positive Airway Pressure, and is very similar in function and design to a CPAP machine (continuous positive airway pressure). Similar to a CPAP machine, A BiPAP machine is a non-invasive form of therapy for patients suffering from sleep apnea. Both machine types deliver pressurized air through a mask to the patient’s airways. The air pressure keeps the throat muscles from collapsing and reducing obstructions by acting as a splint. Both CPAP and BiPAP machines allow patients to breathe easily and regularly throughout the night.

What Makes BiPAP Different from CPAP?

For the most part, CPAP machines have been the go-to treatment for obstructive sleep apnea. CPAP machines deliver a steady, continuous stream of pressurized air to patient’s airways to prevent them from collapsing and causing apnea events. After a CPAP titration study, your sleep technician and doctor will determine the pressure settings for your CPAP machine and set the machine to deliver that exact amount of pressure continuously.

CPAP machines can only be set to a single pressure that remains consistent throughout the night. However, many CPAP machines have a ramp feature that starts off with a lower pressure setting and gradually builds to the prescribed pressure. This comfort feature simply makes the pressure at the beginning more tolerable and less immediate, once the pressure builds to the required setting, it stays at that setting for the rest of the night.

What is BiPAP Good For?

One of the complaints about CPAP devices is that some patients find the constant singular pressure difficult to exhale against. For patients with higher pressure strengths, exhaling against the incoming air can feel difficult, as if they’re having to force their breathing out.

BiPAPs can also be set to include a breath timing feature that measures the amount of breaths per minute a person should be taking. If the time between breaths exceeds the set limit, the machine can force the person to breath by temporarily increasing the air pressure.

The main difference between BiPAP and CPAP machines is that BiPAP machines have two pressure settings: the prescribed pressure for inhalation (ipap), and a lower pressure for exhalation (epap). The dual settings allow the patient to get more air in and out of their lung

Who Would Benefit from BiPAP Therapy?

  • BiPAP machines are often prescribed to sleep apnea patients with high pressure settings or low oxygen levels.
  • BiPAPs are often used after CPAP has failed to adequately treat certain patients.
  • BiPAPs can be helpful for patients with cardiopulmonary disorders such as congestive heart failure.
  • Often prescribed to people with lung disorders or certain neuromuscular disorders.

Why Not Use CPAP with C-Flex Instead of BiPAP?

C-Flex is similar to BiPAP therapy in that it offers pressure relief as the patient exhales so that they don’t feel like they’re fighting against the incoming airflow during expiration. However, C-Flex is more of a comfort feature for CPAP machines that only offers pressure relief up to 3 cm, whereas BiPAP pressure relief starts at 4 cm and goes up. For those who need only a little pressure relief, a CPAP with C-Flex might be the right choice.

Another difference between BiPAP and CPAP with C-flex is that the pressure relief from C-flex is not a fixed amount, and the pressure drop can vary from breath to breath, whereas the BiPAP maintains a set, prescribed exhalation pressure.

Ask Your Doctor About the Benefits of BiPAP

Depending on the results of your CPAP titration study, more than likely your doctor and sleep technician will know outright if a BiPAP machine is right for you. However, if you’ve tried CPAP and find the pressure settings too difficult to manage exhaling against, talk with your doctor and see if a BiPAP machine is right for you.

The Alaska Sleep Clinic diagnoses and treats thousands of patients every year in Alaska suffering from sleep apnea. Often as a result of our diagnosis, patients are prescribed CPAP or even APAP machines for therapy. However, compliance is one of the keys to successful treatment, and if you’re finding that your CPAP pressure settings are too difficult to manage, give us a call and we’ll help you find the proper alternative, which may just be a BiPAP machine

Sleep Apnea


About Sleep Apnea

What is Obstructive Sleep Apnea?

Obstructive sleep apnea (OSA) is the most commonly diagnosed of all sleep apnea related disorders. OSA is characterized by brief pauses in breathing that can last anywhere from 10-40 seconds during sleep. The “apneas”result in depleted oxygen saturation levels, increased pressure on the cardiovascular system, irritated nose and throat, periodic nighttime arousals that leads to fragmented sleep. A typical apnea episode is a cessation of breath followed by a deep gasping for air, more snoring and thrashing around. Most times people are completely oblivious that this is happening to them and it is quite common that a person’s sleeping partner will notice these symptoms first.

Who has Obstructive Sleep Apnea?

  • Obstructive sleep apnea (OSA) occurs in all age groups and both sexes but is more common in men. The ratio is 2:1 men to woman, however, after menopause that ratio changes to 1:1
  • In 2009 alone, Public Health Agency of Canada reported 860,000 Canadian adults were diagnosed. It remains a highly under diagnosed condition, with an estimated 3 million Canadians that already have it or will develop it within their lifetime.
  • Incidence rises as we age with 25% of seniors (over 65) diagnosed as having OSA.
  • People most likely to have or develop sleep apnea include those who snore loudly, have larger necks, craniofacial deformities, obese, high blood pressure, and diabetes,
  • It seems to run in some families, suggesting a possible underlying genetic link.
  • If left untreated, it can greatly diminish quality of life and can lead to early death.

Other Types of Sleep Apnea

Obstructive Sleep Apnea (OSA) is the most common of the sleep apnea disorders, but there are others.

Central Sleep Apnea (CSA) is when the brain fails to send the signals to inhale and exhale to the muscles that control the body’s breathing, causing one to miss one or more cycles of breathing. Patients with Central Sleep Apnea generally experience less sleepiness during the day than people with OSA.

Complex/ Mixed Sleep Apnea (MSA) is a combination of OSA and CSA. Studies from the Mayo Clinic reported a significant fraction of people diagnosed with severe OSA, which did not respond to treatment of sleep apnea called Continuous Positive Airway Pressure (CPAP). Instead some of their apnea episodes would mimic the characteristics of CSA, indicating that the signals from the brain were not being sent.

What Are the Most Common Symptoms?

  • Snoring and pauses in breathing
  • Gasping or choking during sleep
  • Excessive daytime sleepiness
  • High blood pressure
  • Morning headaches
  • Poor judgment or concentration
  • Dry mouth in the mornings

Health Complications and Risks

Higher risk people include those with obesity, a thick neck, and those who regularly drink alcohol prior to bedtime. Unfortunately, only 5% of people who have OSA are properly diagnosed and treated for their condition. If you think you or a loved one has this potentially life threatening condition, please make an appointment to visit your doctor for a proper diagnosis. Additionally you may want to complete the Sleepiness Questionnaire, before hand and bring it with you. Ask us about our FREE Level 3 Home Sleep Test

  • Heart problems
  • Heart attacks
  • Poor quality of life
  • High blood pressure (Hypertension)
  • Strokes
  • Death
  • Car accidents and accidents due to sleepiness

Currently, there is no cure for sleep apnea, so it is very important that you receive and continue therapy, whether by CPAP, BiPAP or oral appliances. OSA is a life long condition, if you stop therapy, it will come back. At Clinical Sleep Solutions we are committed to making your CPAP therapy an enjoyable experience and offer free public education seminars and cleaning clinics on a regular basis, so that you can stay on top of your game.