CPAP therapy just plain works. In fact, its so effective that most doctors aren’t much interested in precisely WHY you have sleep apnea. If your doc suspects you may have it you’re shipped off to the nearest sleep clinic for a study and a month later you’ve got your machine.
But there is a problem with CPAP. A biggie. Its compliance. It ain’t natural to put on a bulky mask at night to have some machine blow air in your face for several hours. The machine itself can be pretty loud. My wife says that when my mask occasionally slips on my face that the bedroom sounds like an airport. And if it sounds like that to your spouse, its certainly an audio nuisance to you too.
Plenty of other things can affect compliance. Poor eating habits, a bedroom that allows in too much light, a bad mattress, the list goes on.
But the very first hurdle is the CPAP mask itself. Just putting one on can remind someone of a visit to the hospital. That’s not a pleasant memory. The head straps put pressure on a noggin that is normally restraint free. If you’ve got a good bit of beard development you might find a full face mask rubs uncomfortably on your nighttime stubble. A common problem is fit around the bridge of the nose. Both full face and nasal masks are susceptible.
By far the most important issue though is claustrophobia. You can’t deal with those other problems if you are just plain afraid of the mask. The therapy can’t work if you don’t put on the mask. Too many sleep clinics don’t help their patients deal with this.
In the confines of a sleep clinic plenty of people do quite well on their fitting night but fail miserably at home by themselves. And its no wonder. Sleep clinics wouldn’t be very useful if you couldn’t, you know, SLEEP in them. So everything is done to provide the patient with the proper conditions for a restful slumber. That goes for both the diagnostic appointment and machine fitting. A proper bed, sheets that are always clean. The carpet on the bedroom floor is vacuumed daily. A perfect temperature and humidity is maintained at all times. A trained professional is just steps away from the door. In the bigger clinics an entire staff is at the patient’s beck and call should the need arise.
And some of these rooms resemble accomodations in nice hotels. My wife had her appointments in a room with a private shower. She even received a voucher for breakfast the next morning in the hospital cafeteria. The food was pretty good!
In such an artificial environment accompanied by trained professionals, acclimating to CPAP therapy is a breeze. But at home its a different story. There is maybe someone else in the bed with you. There might be a pet roaming about that you have to worry about. You’re not sure you set the machine up properly. And when you put that mask on your face and power the machine up you’ve got a blast of air forcing your throat open in a way you’ve never experienced before. You might not even make it 30 seconds before you take the mask off, scared silly.
Take it easy. You can work through this. Here is a simple progression that the kindly doc at my SECOND, successful titration appointment taught me:
First, just sit on the edge of your bed with the mask next to you. You don’t even have to touch it. Just look at it. Take your time; you’re not going anywhere.
Then when you feel comfortable, pick the mask up. Don’t do anything with it. Just hold it. Look at it if you like. Pay attention to your breathing, your heart beat, and the thoughts running through your head.
When you feel calm and relaxed, put the mask up to your face. You don’t even have to put your head inside the apparatus. Just breathe comfortably for a few moments. That is not so hard is it?
Take the next step; its time to put the CPAP mask on, head straps and all. This will take a moment or two if you are a beginner. Don’t panic. Just concentrate on breathing in a calm fashion.
Now turn your machine on. Be sure to press the button that starts the ramp up procedure. Your CPAP provider did show you how to do this. Do you remember? All sleep machines these days come with a ramp-up button that starts off your air pressure fairly low, and over about 15 minutes gently ramps up to the prescribed pressure setting.
You aren’t lying down on the bed yet, are you? Just continue sitting on the edge of the bed with your mask and machine on. Then, when you are ready, go ahead and lie down. Within a few minutes you’ll be fast asleep!
Now if at any time in this progression you feel uncomfortable, just move back a step. If you have a problem when you turn on the machine, just turn it off. If you have problems lying down, just get back up and sit. At first I had problems putting on the mask, so I simply held it. Take your time, and when you are ready just move back up to the next step.
Now if you have problems coping with this process, you might try turning on a radio. Make sure it has the ability to shut off automatically after some period of time. In the beginning this helped distract me from my mild claustrophobia. Now for me music didn’t help much. If I didn’t like a particular selection I found myself wanting to change the station. So I had to have some other type of program on. The local NPR station broadcasts an Americanized version of the BBC overnight. Its just stimulating enough to distract me from the CPAP machine, but earnest and conventional enough to make me sleepy even in the middle of the afternoon.
But listen to anything that helps. You’ll know you’ve found it when you think you are paying close attention yet can’t remember a single thing about what you heard the next day. That means you are falling asleep in a matter of a few minutes at most.
One more piece of advice: when you are working thru the progression, don’t spend too much time with the mask on and the machine off. The carbon monoxide level will build and that could cause problems. You can always call your CPAP machine or mask provider for more info.
Just follow the simple steps I’ve outlined and you too can stop going through life as a zombie. I lied to myself for years that I was coping with sleep apnea rather well. Bull. I know it now and if you’ll just practice my advice it won’t be long before you agree: suffering from sleep apnea is like being the undead. Get your life back with CPAP!
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