Frequently asked questions on the use of positive airway pressure devices
Most questions on CPAP are answered her.
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What is the procedure of a titration adjustment with a CPAP Machine?
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.
How do I get the CPAP Machine at home?
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.
What do I have to pay?
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.
What to expect after treatment?
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.
What side effects may occur during a CPAP Therapy?
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.
Can I sleep with all the tubes?
Yes, you can, even if you do not beleive it.
Do I have to use the CPAP Machine every night?
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.
Where do I get the spare parts for the CPAP Machine?
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.
What does it depend on which type of a CPAP machine I receive?
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.
Is there really no other therapy as CPAP for treatment of sleep apnea syndrome?
There are also other therapy options for the treatment sleep apnea syndrom.
First of all behavior therapy is very important. Overweight, alcohol consumption, sleep deficit and sedative medication can enforce respriation arrests. So the first treatment approach would be clarification of the risk factors.
If your sleep apnea is mild to moderate there are other therapy options possible: mandibular repositioning device or by special indication surgical options. Severe sleep apnea can normally be treated only with a CPAP machine. Finally it is your sleep medicine doctor who decides about your therapy individually and according to the interdisciplinary work with other collegues.
However the succes of the surgical methods depends always on the basic reasons of snoring and is not predictable in the individual case. The range of operations expands from minimally invasive manipulation of velum to face sculp correction with the forward replacement of the lower jaw.
Mandibular repositioning devices are not that effective as the CPAP therapy, nevertheless it is a good alternative by acceptance if you have mild to moderate sleep apnea.
Currently there are no medication or other options for the treatment of sleep apnea.
What should I do as a CPAP patient if I get a cold and currently cannot breathe through the nose?
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.
What do I do if I have problems during the CPAP therapy?
Before getting in touch with other physicians please contact us first if you have any problems, which have to do with your CPAP therapy. A lot of them are already known to us and we can suggest the best possible solution. The manufacturer of your CPAP device is your contact for spare parts, additional equipment and technical emergency cases. However please bear in mind that for spare parts and additional equipment you need a prescription, so your medical insurance would cover the costs.