How to Use Your Positive Air Pressure (PAP) Device

This information explains how to use and care for your PAP device. PAP devices are often used to treat sleep apnea.

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About Sleep Apnea

Sleep apnea is when you stop breathing for short periods of time while you’re asleep. Obstructive sleep apnea (OSA) is the most common type of sleep apnea. With OSA, the muscles in the back of your throat relax and partly or completely block your airway when you sleep.

Having sleep apnea makes it harder to get a restful night’s sleep. It also makes it harder to get enough oxygen while you’re asleep. This increases your risk of high blood pressure (hypertension), heart problems, and stroke.

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About PAP Devices

PAP devices work by giving you air through a mask you wear over your nose, mouth, or both. The pressure from the air flow helps keep your throat from closing and blocking your airway while you sleep. There are 3 main types:

  • Continuous positive air pressure (CPAP) devices. These give the same amount of air all the time.
  • Automatic continuous positive air pressure (auto CPAP) devices. These give different amounts of air based on how open or blocked your airway is throughout the night. It’s normal to feel the pressure changing as it adjusts. Auto CPAP devices are the most commonly used device to help treat OSA.
  • Bilevel positive air pressure (BiPAP) devices. These give more air when you breathe in (inhale) and less air when you breathe out (exhale).

Your healthcare provider will give you a prescription for your PAP device and settings. Once you have a prescription, you’ll get your device from a durable medical equipment (DME) provider that works with your insurance provider. If you’re allergic to latex, tell your DME provider. They will make sure your device is latex-free.

Most people need at least a couple of weeks to get used to using a PAP device. This can make it seem like the device isn’t helping when you first start using it.

Parts of your PAP device

Read your device’s user guide and talk with your DME provider to learn about the parts of your specific device.

Most PAP devices have the same basic parts:

  • A mask. This covers your nose, mouth, or both.
  • Headgear and straps. These go around your head to hold the mask in place.
  • Tubing. This connects the mask to the flow generator.
  • A flow generator. This pushes air through the tubing and mask, into your lungs.
    • Most flow generators also have a filter and humidifier to clean and moisten the air you breathe in.
    • All flow generators have a power cord that plugs into a wall outlet.

Some parts of your device (such as the mask, tubing, and filter) need to be replaced regularly. This helps the device work its best and helps keep it from breaking. When you get your device from your DME provider, you’ll also get a schedule for replacing its parts.

Many insurance providers cover replacement parts. Talk with your insurance carrier to find out about your coverage.

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How to Use Your PAP Device

The information in this section is general. Your DME provider should teach you how to set up and use your specific device. They should also give you written information about your device. Follow your DME provider’s instructions.

Setting up your PAP device

Here are some general tips for setting up your device:

  • Place your device on a level, secure surface near where you sleep.
  • If you use a room humidifier, make sure it’s at least 6 feet (1.8 meters) away from your device.
  • Avoid plugging your device into an outlet that’s controlled by a wall switch.
  • Make sure nothing (such as bedding or curtains) blocks airflow around your device. Air must flow freely around the device for it to work properly.
  • Don’t block your device’s vents or filter openings.
  • Don’t use your device around water (other than the water in the device’s humidifier).
  • Don’t smoke or let anyone else smoke in the room your device is in. Tobacco smoke causes tar build-up that can break your device.

Using your PAP device

Use your PAP device every time you sleep. This includes naps and vacations. If you’re going on a trip where you may not have electricity (such as a camping trip), talk with your DME provider about getting a portable PAP device.

Your healthcare provider will prescribe your PAP device and settings based on the results of diagnostic tests (such as a sleep study). It’s important to use your PAP device exactly as your healthcare provider prescribed. Don’t change the air pressure or other settings without talking with your healthcare provider first. It’s okay to adjust the humidity level.

Here are some general tips for using your device:

  • Clean your face before putting on the mask. This helps the mask form a better seal so air doesn’t leak around it. It also helps the mask last longer. It’s okay to use your usual facial cream or moisturizer.
  • Most PAP device masks have a valve to let the air you exhale flow out of the mask. Don’t block or cover this valve.
  • Before going to bed, always check the connections between the mask, tubing, and flow chamber. Make sure they’re secure.
  • If the mask is uncomfortable or there’s air leaking around it, adjust the straps on the headgear. A tighter fit isn’t always better. The mask can fit be slightly loose as long as it still forms a seal against your face.
  • You can unfasten or loosen just 1 strap to take the mask and headgear off and put it back on, if needed.
  • If you need to get up during the night, it may be easier to disconnect the tubing from the flow generator instead of taking off the mask and headgear. Reconnect the tubing when you’re ready to go back to sleep.
  • If you have nasal congestion (feel like your nose or nasal sinuses are blocked) while you’re getting used to your PAP device, talk with your healthcare provider about taking an oral non-sedating antihistamine (such as Allegra®, Claritin®, or Zyrtec®) or using a steroid nasal spray (such as Flonase®) 1 to 2 hours before you go to bed. You can buy these medications from your local pharmacy without a prescription.

If you’re using supplemental oxygen with your PAP device, your DME provider should teach you how to connect and use it. Below are general instructions.

  • Before going to sleep, turn on your PAP device first and the oxygen flow second.
  • When waking up, turn off the oxygen flow first and the PAP device second.
  • Keep your PAP device and supplemental oxygen equipment away from heat or open flame.
  • Don’t smoke near your PAP device or supplemental oxygen equipment.
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How to Clean Your PAP Device

It’s important to clean your device and its parts regularly. This helps the device work best and helps keep it from breaking.

The information in this section is general. Your DME provider should teach you how to clean your specific device. They should also give you written information about your device. Follow your DME provider’s instructions.

Always unplug your device before cleaning it.

Mask

Clean the mask every morning. To do this:

  1. Take the mask off the tubing.
  2. Take the headgear and straps off the mask. Set them aside.
  3. If there are parts of the mask that come off (such as a pillow or cushion), take those off the mask.
  4. Clean all parts of the mask with ammonia-free mild dish soap (such as Dawn®) and warm water in a clean basin or container. It’s okay to use tap water.
  5. Rinse all parts of the mask well with warm running water. Make sure to rinse off all the soap. If there’s dried soap on the mask when you use it, your skin may get irritated.
  6. Let all parts of the mask air dry.

If the mask is still damp when you’re ready to use it, connect the mask to the tubing. Connect the other end of the tubing to the flow generator. Turn the flow generator on and let air flow through the mask for 10 to 20 minutes.

Tubing

Clean the tubing once a week. To do this:

  1. Disconnect the tubing from the mask and flow generator.
  2. Clean the tubing with a few drops of ammonia-free mild dish soap and warm water in clean basin or container. Swirl the soapy water in the tubing for a few minutes.
  3. Rinse the tubing well with warm running water.
  4. Hang the tubing to dry so that all the water drips out. For example, hang it over a shower rod, on a towel rack, or in the laundry room.
 

Headgear and straps

Clean the headgear and straps once every 2 weeks. To do this:

  1. Take the headgear off the mask.
  2. Unfasten the straps.
    • To make it easier to adjust the headgear and straps after cleaning them, you can use a permanent marker to mark where the end of each strap is fastened.
  3. Clean the headgear and straps with mild dish soap (such as Dawn®) and warm water in a clean basin or container.
    • It’s best to clean them by hand, not in a washing machine.
    • It’s okay to use tap water.
  4. Rinse the headgear and straps well with warm running water. Make sure to rinse off all the soap. If there’s dried soap on the headgear and straps when you use them, your skin may get irritated.
  5. Let the headgear and straps air dry. Never put them in a drying machine.

Flow generator

Clean the flow generator once a week. To do this:

  1. Unplug the device.
  2. Moisten a cloth with water. Wring it out so it’s only slightly damp.
  3. Wipe the outside of the flow generator with the damp cloth.
  4. Make sure the flow generator is completely dry before you plug it back in.

Never put the flow generator under water or let water get into any of its vents or ports.

Filter and humidifier

How you clean the filter and humidifier depends on the specific device you have. Follow the instructions that come with your device or that your DME provider gives you.

 
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Tips for Managing Common Issues

It’s normal to have some problems as you’re getting used to your PAP machine. Common issues include:

  • Air leaking around the mask
  • Sore or dry eyes
  • Skin irritation
  • Dry mouth
  • Feeling like the air pressure is too high or too low
  • Feeling like the air flow is too warm

Often, the instructions that come with your device have information about what may be causing your issue and offer tips for addressing it. If the information in the instructions isn’t helpful, contact your DME provider or healthcare provider. You can also follow the tips below.

Adjust the mask

If your PAP mask doesn’t fit correctly, it can cause air leaking around the mask, sore or dry eyes, a feeling that the pressure is too high or low, or all 3. Many people stop using their PAP device because of these issues. But, adjusting the mask often solves them.

  • Tighten your mask so it’s comfortable and little to no air leaks out. But, don’t tighten it so much that it’s uncomfortable.
  • If your skin is irritated or you notice an imprint from your mask when you wake up, you may need to loosen or readjust your mask.
  • The first mask you get may not be the best fit. This is because everyone’s facial structure is different. If adjusting the mask doesn’t help, ask your DME provider if they can help you choose a different mask that may fit better.
 

Adjust the humidity

Dry mouth is another common side effect of using a PAP device. If your mouth feels very dry:

  • Try increasing the humidity level of your device.
  • Try using a saline-based nasal spray.
  • Keep a glass of water with a straw at your bedside. Take sips when your mouth feels dry. If your mask covers your mouth, you can take it off to drink.

Lowering the humidity can also help if the air from the device feels too warm. If you have a heated tube, you can also lower the temperature of the tubing.

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Tips for Traveling With Your PAP Device

  • If your device came with a carrying case, always use that case when you travel. Put the device and all its accessories inside the case.
  • Don’t check your device as baggage (such as if you’re traveling on an airplane or train). Carry it with you instead. On many airlines, medical devices such as PAP devices don’t count towards your carry-on item limit.
  • Don’t let your device get very hot or cold (such as if it’s left in a car for too long). If it does get very hot or cold, let it get back to room temperature before turning it on.

Most PAP devices work with voltage from electrical outlets both in the United States and in other countries. But, it’s best to check the instructions that came with your device to make sure it will work with the voltage where you’re traveling. Call your DME provider if you have questions.

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When to Call Your DME Provider

Call your DME provider if:

  • You have questions about setting up, using, or cleaning your PAP device
  • You’re having issues using your PAP device
  • Your PAP device is damaged (such as if it’s dropped or if liquid gets inside the flow chamber)
  • If you need a new mask or supplies
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When to Call Your Healthcare Provider

Call your healthcare provider if:

  • You can’t contact your DME provider about your device
  • Your DME provider doesn’t answer your question
  • You have questions about your PAP therapy that aren’t related to your PAP device
  • You have questions related to your OSA or other sleeping problems
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