Tips from Arrow Respiratory Care – CPAP Therapy Compliance:
We’re going to be honest with you: CPAP therapy is going to be tough when you first get it prescribed to treat your sleep apnea. You might tell yourself that “it’s just too difficult to tolerate”, and quickly go back to your old ways of getting terrible sleep, risking long-term health conditions, and feeling tired all the time. But at least you don’t have to wear a mask on your face at night with pressurized air blowing into your throat, right?
All too often patients go through the process of finally seeking help for their sleep troubles by contacting a sleep clinic, getting a consultation, having a sleep study, receiving their diagnosis, getting issued CPAP equipment, trying it for a few nights…and then quickly abandon treatment because they thought it was too tough.
It can be a little baffling to see people jump through so many hoops to get help, only to banish their CPAP device to the darkest reaches of their closet within a few days, when all they needed was a few helpful tips and tricks to make CPAP therapy a “can’t sleep without it” treatment.
One of the key reasons patients don’t follow through with their therapy is simply because they aren’t properly educated about sleep apnea, and the consequences they could face for leaving it untreated. Untreated sleep apnea is associated with an assortment of medical problems including heart conditions such as abnormal heart rhythms, coronary artery disease, heart failure, and increased risk of stroke.
It can lead to daytime sleepiness putting patients at an increased risk of having driving accidents, or accidents at work.
When you’re not sleeping well at night, you’ll be tired during the day, which can lead to decreased performance at work or school, memory troubles, and you could be more prone to mood swings and even depression.
All of these things (and more) can be caused simply by not treating a disorder which impacts your sleep and health making proper education all the more important in getting patients to understand the very real consequences of sleep apnea.
Find the right mask
Many patients don’t spend enough time trying on various CPAP masks to find one that will work for them each night. Quite often, patients will try on a mask for a few minutes, and select a mask based on their initial reaction to it without really considering what works best for them.
Then, when the patient gets home and tries to actually sleep with the mask they chose, they find that it doesn’t work as well as they thought. Maybe it makes them a little claustrophobic, it could block their view of the TV or the book they’re reading, or it might slip off easily when they sleep on their side.
All of which would be fine if they simply returned to the clinic they received their mask from and explained their complaints. Most DME distributors are more than happy to let you do CPAP mask trials until you find the one that both works for you. Really, all you have to do is ask.
There are a lot of troubles that CPAP users experience when they first begin therapy. And we’ve heard just about every one of them. Many of these complaints can be rectified by finding the perfect mask. Every patient is different and has unique needs, which is why there are literally hundreds of different sizes, shapes, and styles of masks. No single mask works for great for all (or even most) patients, so when you take the time to try a few on, you’re saving yourself a lot of discomfort further down the road.
Practice getting used to your mask
Most DME techs will tell you the best way to initially adjust to CPAP therapy is to wear your mask a little bit before you plan on going to bed. Any time you feel tired, want to relax, or read before bed, just put the CPAP mask on without it hooked up to the air so that you get comfortable wearing it.
Waiting until bedtime to put on the mask and turn on the machine’s air pressure right away can understandably be overwhelming for patients. It’s difficult enough getting used to having something cover your face and strapped around the back of your head without having it blowing air directly into your face.
Once you feel comfortable just wearing the mask by itself, and feel like you’re ready for bed, you can hook the mask up to the machine and start adjusting to it with the air pressure.
Wear the mask a little longer each night
Another great piece of advice to help with CPAP compliance is to wear the mask a little more each night until you’re sleeping with it on from the time you lie down till you get out of bed in the morning.
If you’re really concerned that you won’t be able to sleep the full night with your mask, take it off after a few hours. Of course it would be great if you could just power through and wear it for the full night, but it’s understandable that you will have to go through an adjustment phase.
However, don’t get into a routine consisting of wearing it to bed, and taking it off after a few hours of sleep. Instead, set goals for how long you will use it. Plan on wearing the mask just a little longer than you did the night before each time you put it on. Within a short time you’ll be able to wear the mask for the entire night. And not long after that, you won’t be able to sleep comfortably without it.
Track your CPAP compliance
Many sleep clinics offer some form of monitoring your CPAP compliance. Often, proof of compliance is required by your insurance policy. Some of these devices may have a card that you will need to bring into the clinic to have your data uploaded and others have remote monitoring installed on them. This is so technicians can verify your usage rates as well as see how well your therapy is working and if any adjustments need to be made.
You don’t have to leave your compliance tracking up to the sleep professionals. You have the power to take control of your therapy as well. There are many ways you can keep track of how you are doing with therapy yourself. Many machines offer data within the menu of the machine. There are even apps you can download onto your phone so that you can track how well you’re doing with therapy.
With these methods you can track things like total hours slept, how many hours you slept with the mask on, what the leakage rates of the mask were, and your apnea/hypopnea index (AHI).
Once you begin to take an active role in your therapy by closely monitoring it, a beautiful thing will begin to occur, you will start striving to see the best results possible, and adjusting things to make those results great.
Make other healthy choices
For best results, it’s not always enough to simply wear your CPAP mask every night. You should also be making other lifestyle changes that contribute to successful treatment.
Practicing good sleep hygiene can go a long way to getting quality sleep. Sleep hygiene consists of practices, rituals, and choices that help you get to sleep on time, stay asleep longer, and have restorative sleep every night.
Sleep hygiene consists of things like eliminating electronics from the bedroom, coming up with a nightly bedtime routine to get your mind and body ready for sleep, eating foods that promote sleep and avoiding those that rob you of sleep, avoiding caffeine and alcohol before bed, getting regular exercise, maximizing your sleep environment, and many more.
Losing weight can also contribute to successful CPAP therapy. If your treatment requires high pressure settings (which can be difficult to tolerate) you can often have those pressures lowered by losing weight. On the other hand, weight gain can contribute to the need for even higher pressure settings.
If you really want to get serious about getting great sleep every night and get the most out of your CPAP therapy compliance, start getting regular exercise, eat healthy foods, and practice sleep hygiene. The results will amaze you.
If you have been required to provide “compliance” in order to receive or maintain your commercial driver’s license, here are the USUAL requirements and how you can be sure you are compliant.
You need to use your CPAP machine AT LEAST 4 hours per night, 70% of the time.
What does this mean?
Everynight, you need to use your machine for at least 4 hours. Not 2 hours, not 3:59 minutes, but a full 4 hours. It is okay to take bathroom breaks, or even to turn off the machine between naps, but you NEED at least 4 hours in a 24 hours period. Using it 2 hours on one day and 6 hours on another day only counts for 1 day. Use it everyday for at least 4 hours!!!
What if I miss a day?
That’s okay and that’s where the 70% comes in. To have 70% compliance over the course of a 30 day month, you need to use the machine at least 21 days during the month. (30 days x’s 70% = 21 days).
In a 7 day week you need to use it at least 5 days.
For a 90 day period, you need to use it at least 63 days.
REMEMBER, to receive a day of credit, to use your machine at least 4 hours.
Please call us when your doctor or the DOT has requested a compliance report. We are here to help you. If you are having trouble adjusting to CPAP, consult the attached tip sheet or give us a call to see if you need a mask or pressure adjustment.
WE WANT YOU TO SUCCEED AND WE ARE HERE TO HELP!
ARROW RESPIRATORY CARE
9567 Arrow Rt Suite L
Rancho Cucamonga, CA 91730