No mask should cause pain nor discomfort if sized correctly and fitted properly.
If irritation or sores are developing, chances are you are over-tightening your
mask OR your mask cushion may be worn out. Fabric mask liners called
RemZzz’s or Pad-A-Cheek might also resolve skin irritation and mask leak.
Check out additional resources on Etsy.com (search ‘CPAP mask liners’). Let
sores heal by applying a band-aid when wearing the mask or take a break
for 1-2 days if the sore persists or worsens.

One is the Gecko nasal pad. It is an easy-to-use gel pad placed across the
nose bridge and under the mask. It helps with leaks in the upper part of the
mask frame and is beneficial to patients who have a narrow nose bridge or
are prone to cuts or irritation of the nose bridge.

This is a common occurrence, especially during the early adjustment period
of CPAP use. Chances are, you removed the mask due to discomfort or a
leak. This would indicate that your mask is not fitted correctly, or a chin strap
will be needed if mouth-breathing with a nasal mask.

Patients who experience claustrophobia usually find that nasal pillow masks
are more tolerable. Most patients have an adjustment period as they get
used to sleeping with anything on the face. While your goal is to sleep all
night on CPAP, try to increase usage over time until you reach your goal.
Your provider might be able to prescribe a sleep aid short term to help you
acclimatize.

No air should be directed up into the eye area with an appropriately sized
and fitted mask. This might indicate a leak in the top spot of your mask; gently
tighten the top mask straps taking care not to overtighten. This leak might
also mean a worn mask cushion that needs replacing.
Some people naturally sleep with their eyes partially open, which can cause
dryness or irritation; they benefit from wearing a simple fabric eye mask. If
swelling or irritation is chronic or persistent, consult your sleep or primary care
physician.

Skin irritation can quickly occur when the nasal pillows are not inserted correctly.
Try rotating the barrel that holds the nasal pillow inserts to a more comfortable
angled position against the nostrils. After best positioning, if a leak occurs at
the nostril opening, then size up. If your nostrils are not the same size, a leak
may occur on one side more than the other – consider switching to a nasal
mask. Non-petroleum skin barriers will also help, such as lanolin.

This may indicate a leak from the area where your mask makes contact, with
your skin. See tips for mask fit. Most masks have exhalation ports (look for a
tiny cluster of holes) that allow the escape of carbon dioxide when we
breathe out. These small holes must be checked to ensure they are not
clogged by body oils or bedding lint when routinely cleaning your mask
parts. When blocked, they can cause the mask to make a whistling noise.
Use a sewing needle to keep the holes free flowing.

All masks have exhalation ports to allow the escape of carbon dioxide. The
higher the machine pressure setting, the higher this escape flow will be. Some
patients resolve by side sleeping with their backs turned to their bed partner
to avoid distracting airflow and lowering the pressure needed.

Full Face – Mask users with forehead pads/brace: tighten the upper strap first, then follow with lower strap positioning and fit.

Mask Headgear – Masks come with a “one size fits most” headgear. Larger and smaller strapped headgear may be available by order.

Nasal Pillow Mask – Place mask on face, position headgear, and place side straps above the ears. Gently slip nasal pillows into the nostrils making sure to
rotate the angle of the pillow barrel for a comfortable fit. The pillows are meant to lie just against the nostril opening, not deeply inserted. Proper placement should not cause the tip of the nose to be raised.All masks have exhalation ports to allow the escape of carbon dioxide. The higher the machine pressure setting, the higher this escape flow will be. Some patients resolve by side sleeping with their backs turned to their bed partner to avoid distracting airflow and lowering the pressure needed.

When initially using CPAP, most of us are excited about its ability to help us
sleep. Please time your use of CPAP when you are very sleepy. Remember,
you dictate your breathing – not the CPAP. Switch on the CPAP, close your
eyes, get comfortable, and focus on your breathing – not the machine pressure.
The machine will adjust to you, not the other way around.

Practice makes perfect, nothing beats nightly use to increase your comfort
level. Most people take 2-3 weeks of nightly use to acclimatize to CPAP, give
yourself a chance to succeed. To help get used to wearing the mask during
sleep, practice wearing it during the day while sitting in a chair watching
television or reading. This will distract your focus from the mask to a positive,
familiar activity.

Snoring, choking, and gasping-like noises should be eliminated during CPAP
use. If not, you may be opening your mouth with a nasal mask (use a chin
strap) or your full-face mask (FFM) may not fit well. If you cannot adjust to a
nasal mask with a chin strap, consider requesting an FFM. If you are already
on an FFM, you may need a different size.

This occurs when the air delivered by your CPAP enters the esophagus and
stomach rather than the lungs. An air leak from around your mask may cause
your CPAP to increase the pressure and divert some of that air pressure into
your stomach. It can also happen if you are a mouth breather but not wearing
a full-face mask. With an automatic CPAP (or Auto-PAP), you can sleep with
3 pillows or on your sides to reduce the pressure of the machine. Sometimes
simethicone helps.

Often, side or stomach sleepers find that the head sinks into their bed pillow,
which causes mask frame movement (pushed off-center), causing mask
leak, or pressure point soreness. To resolve this, purchase a PAP pillow, a specially
made bed pillow designed for CPAP users who are side or stomach sleepers.

Try placing the tubing behind your head near the top of your pillow or positioned
behind the headboard bedpost. Most online CPAP suppliers offer an inexpensive
Tubing Lift to help tube positioning for better sleep. Easy to use, the small frame
is held between the box spring and mattress. The lift holds tubing above the
head, allowing for better freedom of movement. Check out additional
resources on Etsy.com (search ‘CPAP hose holder/hanger).

Ensure the electric plugs to the wall and the machine is firmly in place. Check
your electric outlet to make sure it is working. Otherwise,
email cpap@sliiip.com to inform them of a machine malfunction.

Most noise from newer CPAPs is from mask leaks (See Mask Problems FAQs).
Today’s machines are nearly silent, so this would indicate a problem unless
you are hypersensitive to noise (try earplugs). Check the machine filters. They
should be changed monthly or when visibly discolored to help keep the machines
running smoothly. There will be a slight audible noise if you use a Bi-Level machine
as the pressure transitions between inhalation and exhalation settings. There
will be a small audible noise if you use an Auto-CPAP as the machine changes
inhalation pressure. If your machine is otherwise noisy, there may be a machine
defect. Otherwise, email cpap@sliiip.com to inform them of a machine
malfunction.

The length of standard CPAP tubing is about 6 feet. Active sleepers toss and
turn and are more apt to tug on the tubing and pull their machine off the
bedside table. Most CPAP suppliers offer tubing in 10-foot lengths, giving patients
more freedom of movement, especially when coupled with a Tubing Lift. You
may be able to place the CPAP on the floor beside your bed with a 10-foot
hose. Please use a mat under the CPAP to avoid access dust buildup.

A CPAP humidifier or temperature adjustment usually resolves all the above
issues. Start with the lowest heat setting and turn up as needed for more moisture.
If humidity adjustment does not resolve your dry mouth or throat, consider a
mask leak either around your mouth or nose (See Mask FAQs). Check the
sizing and fit of the mask. As masks are used longer, it may shift during sleep
and cause an air and moisture leak. Biotene spray or oral rinse products may
also help with dry mouth. If you are using a nasal mask, a chin strap or switch
to a full-face mask may be needed if adjusting the humidity does not address
the issue. Flonase, Ocean, or other saltwater nasal sprays may satisfy chronic
nasal congestion. Consult with your provider if the problem persists.

All manufacturers recommend the use of distilled water. Tap water may be
used on occasion. The long-term use of tap or bottled water leads to calcium
and mineral build-up in your CPAP, shortening the device’s lifespan.

Excess condensation can form in the CPAP tubing/mask. Try reducing the
humidity level on your CPAP. Some people prefer it OFF. The humidity level
will need to be adjusted as seasons change and bedroom temperatures
fluctuate. If adjusting the humidity level does not work, add an insulating
hose cover. Most CPAPs now have the option for a climate control hose,
which helps regulate condensation. Check out additional resources on
Etsy.com (search ‘CPAP hose cover).

Two to three times a week, empty any leftover water, rinse the chamber, and
let air dry. Once a week, fill the chamber with warm soapy water and let soak
for an hour. You may also use 1/3 white distilled vinegar to 2/3 tap water solution
to soak. Rinse with water, and air dry thoroughly.

Remove the water chamber unit from the machine before filling it with distilled
water. Some people find a funnel helpful. Spilling water into the device may
compromise the interior circuits and void the warranty.