Patient education: How to use a PAP device (The Basics)

What is sleep apnea? — Sleep apnea is a condition that makes you stop breathing for short periods while you are asleep. If you have obstructive sleep apnea, you stop breathing because your throat narrows or closes (figure 1).

People with sleep apnea do not know that they stop breathing when they are asleep. But they do sometimes wake up startled or gasping for breath. They also often hear from loved ones that they snore or stop breathing.

What is a PAP device? — "PAP" is short for "positive airway pressure." It is sometimes called "continuous positive airway pressure," or "CPAP." A PAP device helps people with obstructive sleep apnea keep their airway open while they sleep (figure 2). With PAP, you wear a mask, and the device gives a steady level of pressure to keep your airway open.

Some devices give different levels of pressure:

●"Bilevel positive airway pressure," or "BPAP– This device gives you more pressure when you breathe in and less pressure when you breathe out.

●"Auto-titrating positive airway pressure," or "APAP" – This device automatically changes the pressure it uses, based on how you are breathing.

Most PAP devices have:

●A face mask with straps to keep it in place – There are different types of masks. They can go:

•In the nostrils

•Over the nose

•Over the nose and mouth

●Tubing – This connects the mask to the device.

●A pump or motor – This creates the air pressure that flows through the tubing to the face mask.

If needed, your machine can also give you extra oxygen.

How do I use PAP? — Some people start using PAP in a sleep lab. For others, a respiratory therapist (breathing specialist) comes to their home. The therapist can help fit the mask and teach the person how to use the device.

Here are the general steps:

●Put the face mask on, and fasten the straps.

•The mask needs to be comfortable and fit snugly so no air can leak out. You might need to try a few different masks to find one that is most comfortable for you.

•It might be easier to adjust the mask with the device turned on. This can help you tell if there are air leaks.

●Connect the mask to the device with the tubing.

●Turn on the PAP device. It is set to give you air at a certain pressure. The therapist sets the pressure level based on your doctor's instructions.

Most often, you will use the PAP device when you sleep. For most people, this means at night. Sometimes, your doctor will have you use it when you sleep during the day or at other times. Your doctor might want you to wear the PAP device for at least 4 hours each night to benefit from using it.

How long you need your PAP machine is based on why you are using it. Most people with obstructive sleep apnea need PAP for the rest of their life.

What else should I know? — Your doctor can help you manage any problems.

●If you are having trouble getting used to wearing the mask, try these steps:

•While you are awake, start by just holding the mask up to your face.

•Next, add the hose to the mask, but don't put the straps on.

•Hold the mask and hose on your face, and turn the machine on.

•When you are comfortable, put the straps on.

•When you are able to breathe comfortably sitting up, try lying back a little at a time. Work on lying back until you are fully reclined.

•Use the PAP for a nap or a few hours during the day, and then move on to using it at night.

●If your nose is dry, use a humidifier in the room where you sleep. Some PAP machines come with a built-in humidifier. Ask about using a saline spray or a prescription spray to help with a stuffy nose.

●Talk to your doctor if you need help with how the mask fits or if it is bothering your skin. Swelling and sores on the nose are often a result of a poorly fitting mask.

●Some people find it helpful to read a book or watch TV while trying to get used to wearing the mask. Others find talk therapy or other motivational tools helpful.

●Learn how to care for the PAP device. Know what parts need to be cleaned or replaced and how often. Keep the contact information for your equipment company where you can easily find it, such as close to your machine.

●Think about how you will handle a power outage. Plan for emergency situations. You might need a generator or battery backup.

More on this topic

Patient education: Sleep apnea in adults (The Basics)
Patient education: Sleep apnea in children (The Basics)
Patient education: Good sleep hygiene (The Basics)

Patient education: Sleep apnea in adults (Beyond the Basics)