Frequently asked questions on the use of positive airway pressure devices

CPAP Therapy titration takes from 1 to 2, on demand 3 nights, altogether 2-4 days. The exact duration is decided before admission to the sleep laboratory. On admission day one of our specialists is going to consult and examine you. In the evening all necessary sensors and electrodes of the polysomnograph are attached for the night recording in order to receive information about your breathing, bloodstream and your sleep. 

Then a CPAP machine will be introduced to you and your first breathing practice with it is going to take place under a supervision of an experienced technician. 

At the beginning of the first night the machine is set at a low airway pressure level. During the night our staff on duty is going to optimise the pressure individually. On the release date you normally receive a CPAP machine with an individual pressure set up. In a terminal conversation with a physician at the sleep lab you receive all information about the measurements and recording results of your tests at the sleep lab. He will discuss with you further procedure of the CPAP treatment. About midday you can leave the sleep laboratory.

When you leave the sleep lab you receive an individually adjusted CPAP machine, as well as all necessary complementary equipment, such as mask and tube, when you are ready to leave the sleep laboratory. Exceptions are different medical care versions of particular medical insurance companies. 

The medical insurance companies cover the costs for titration at the sleep laboratory as well as for the CPAP Machine. 

For the stay at the sleep laboratory you need (except private patients) a confirmation of cost coverage of your medical insurance. You will only have to pay your normal copayment for the stay at the clinic. Private patients need only the pink color prescription order. 

After successful therapy with a ventilator, we ask you in your own interest to have a first at-home follow-up check carried out after approx. 6 months. Unless otherwise agreed, these will take place in a facility with the possibility of outpatient sleep apnea measurement by a resident specialist.

The check-ups should be arranged in good time and in advance. In case of problems with the therapy or clinical necessity, controls can also be carried out in the sleep medical centre of the Charité.

The outpatient follow-up examination takes place in the same way as the initial diagnosis. You will be fitted with an ambulatory measuring device, sleep with it and your ventilator at home, and experience the result the next day.

Long-term checks are not necessary if the therapy does not cause you any problems. Before changing devices or in case of problems, you are welcome to register for a long-term check-up.

Compared to other therapy methods CPAP therapy is well tolerated. Due to airway flow one may suffer from sore throut and dry nose. Under circumstances the air flow should be moistened and heated additionally with the help of a humidifier. 

During the first days of the therapy you may have sore muscles in thorax. Rarely air swallowing happens during the night which results in morning belching and the feeling of bloating.

The unfavourable adjustment of the mask during the first weeks can cause pressure marks on the nose bridge which can also get infected. This can be solved by using another form or size of the mask. For this purpose we also recommend our mask consultation hours. 

Yes, you can, even if you do not beleive it.

You can compare the CPAP therapy with the glasses. You take them off and you are shortsighted again. If you take the mask off you have apnea again. 

Uptodate there is no healing method of sleep apnea. We can only suppress the appearance of breathing cessations. CPAP tratment also does not have any training effect which can diminish the apnea in case you drop the therapy.  If you sleep without mask you will have the same symptoms you had before the treatment. That is why it is very important to use the mask every night. Of course there could always be cases when you have to stay at a friend's place unexpectedly for a night or you cannot breathe through the nose due to a cold. In these cases you can surely  abandon the therapy for a short period of time. It is mostly important to use the machine as often as you can and minimum 5 hours per night. 

You will have to change some parts of the machine, for example the air filters, regularly. For this purpose you will have to send a completed and signed prescription to the manufacturer or distributor of your CPAP machine. The address of the company you will find on the machine, i.e. in the accompanying documentation. The spare parts will be sent to you per post. A prescription for spare parts you can receive during the followup checks at our outpatient service. On occasion you can also get help from your home doctor regarding the prescription. The same procedure is applied when you need a new mask, parts are damaged or an annual maintenance service is scheduled.

There are different types and versions of the CPAP machines, which concept of design and completion also varies from manufacturer to manufacturer depending on the field of application. During your stay at the sleep laboratory a special machine type is going to be adjusted. Afterwards the doctor chooses the airway pressure and ventilation type according to your needs. Further on the choice of the device depends on other diseases which you eventually suffer from, as well as from your subjective tolerance. If there are several machines which could be applied, other criteria could be a reason for your choice: economical factors or for example, size, weight, integrated humidifier, loudness and others. 

Other forms of therapy also eavailable for the treatment of a sleep apnea syndrome.

First, checking and, if necessary, changing certain factors is important: obesity, alcohol consumption, sleep deficit, and sedating medications can worsen sleep apnea. This is an initial treatment approach - knowing about and reducing risk factors.

For mild to moderate sleep apnea, alternative treatment options include ventilation therapy, mandibular advancement devices (MAD), or surgery if indicated. For severe sleep apnea, only ventilation therapy is usually considered; however, if it is not tolerated, MAD is also an option. Ultimately, the form of therapy is an individual medical decision, if necessary in interdisciplinary cooperation with colleagues from other disciplines.

An MAD is not as effective as a ventilation therapy, but if accepted, they are still a good alternative for mild to moderate and possibly severe sleep apnea.

The success of possible surgical procedures depends on the underlying cause of snoring and the anatomy and is not predictable in individual cases. Type of surgery range from minimally invasive manipulation of the soft palate to facial skull correction with advancement of the mandible and implantation of a lingual nerve pacemaker (hypoglossal stimulation). Our colleagues at the ENT clinic offer all of these therapeutic procedures.

A drug or other helpful procedures for sleep apnea are not currently available, but may occasionally be tried as part of studies. For this, please inquire specifically in our outpatient clinic or in the consultation hours.

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In this case you can use nasal drops, spray etc. (for no longer as 4 weeks). This remedy will help you normally to by pass the time you need to fall asleep. If your nasal medicine does not work or if you have a severe cold you will have to sleep without a device until your nose is free for breathing again. If you have a chronical nasal mucosa irritation you could also use nasal oil (before going to bed) or a nasal patch.  

At first, please contact us with any problems concerning your ventilation (PAP) therapy before seeking other medical advice. We are aware of many problems that may arise and can offer solutions. One of these problems is a possible persistent daytime sleepiness despite the use of ventilation therapy. This may be due to a lack of proper adjustment of the therapy (titration), which must be solved. But it can also be a so-called residual sleepiness under the therapy (independent whether PAP or MAD is used for therapy). In these cases a medication can help, which we can prescribe for you.

The manufacturer of your respective ventilator is the primary contact for spare parts, accessories and in case of technical problems with the medical device

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