1. Working together to elevate the well-being of Tairawhiti Mahia nga mahi I roto I te kotahitanga kia piki ake te orange o te Tairawhiti SLEEP SERVICE Gisborne Hospital Sarah Garrett March 2015

2. DO NOT’s……… Cover the CPAP machine in any way while in use due to the risk of overheating. Place anything on top of the machine ( especially liquids) Transport the CPAP machine when there is water in the chamber Sarah Garrett March 2015

3. CLEANING TUBING: Once a week clean in warm soapy water, rinse well and hang out to dry out of direct sunlight. WATER BOWL: Empty remaining water each morning. If build up occurs this can be removed using a diluted solution of 1:2 white vinegar to water. Soak for 10 minutes then rinse. Water bowl can be washed in a domestic dishwasher. MASK: If they become oily it wont seal effectively. Wash in warm soapy water, rinse and dry out of direct sunlight. Headgear can be hand washed in a similar fashion Sarah Garrett March 2015

4. TROUBLE SHOOTING Sarah Garrett March 2015

5. COMMON PROBLEMS Mask leak Runny nose Water/ Condensation Dry mouth Sarah Garrett March 2015

6. You wake up with a dry mouth -Increase the temperature on the humidifier. This puts more moisture in the air you breath from the CPAP. - Are you sleeping on your back- are you perhaps still obstructing? Try sleeping on your side where you are more likely to breath through your nose. - Drink sufficient water during the day and try keeping a glass of water beside your bed to sip on overnight if needed. Sarah Garrett March 2015

7. Your CPAP is noisy OR Your eyes are sore and puffy the next morning These issues are likely caused by mask leaks -Adjust your mask to stop the leaks. -This may require you to adjust the headgear and / or the mask position on your face. If you continue to have issues please contact the sleep clinic to arrange an appointment Sarah Garrett March 2015

8. You pull the mask off while sleeping This is usually a sign that you are obstructing overnight. Were you lying on your back?? - Try to limit supine sleep. You can utilise objects such as pillows or a rolled towel to try and keep you on your side or discuss with the Sleep clinic in regards to trialling a snore belt Sarah Garrett March 2015

9. Pressure feels too high Do you find it difficult to breath out against the pressure? This means that you are likely to be breathing too deeply. In the beginning taking short shallow breaths can help ease this issue 1) As soon as you put the mask on- start breathing out hard against the pressure. 2) Now take a little breath in and push it out 3) Start to breath more slowly and gently- after a short while your breathing should settle. Still struggling? Try utilising the RAMP function on your CPAP. This function is useful to use when you are falling asleep. It works by dropping the pressure for a short time before ramping back to your prescribed pressure setting. Please contact Sleep Clinic if your problems persist Sarah Garrett March 2015

10. Abdominal bloating Passing increased amounts of wind and / or trapped wind in stomach. Caused by swallowing the air instead of breathing it off Easier said than done but can be achieved. We recommend trialling: -Controlled breathing as discuss on the previous slides, making sure you breath in gently and slowly then breath right out. Practice Practice Practice If you continue to have concerns or issues, please contact the Sleep Clinic to arrange an appointment Sarah Garrett March 2015

11. Runny nose This may be caused by the cold air from the CPAP. OR Can occur due to not using the humidification 1) Start using your humidification unit. Modify settings ↑ ↓ 2) Usually settles within 1-2 weeks 3) If it concerns please see your GP as you may benefit from utilising nasal spray Sarah Garrett March 2015

12. Water issues Water blows in your face at night and makes you feel like you’re drowning?? Can happen when your machine is at the same level as your bed. Easily solved by placing CPAP at a lower level but not directly on the ground as this increases dust intake into the filter. Water in the tubing? Condensation- CPAP is warm and the room is cold- causing water droplets to collect in tubing. Solved by: 1)With compatible units- utilising heated tubing and humidification (water chamber) 2) Insulation tubing if it is not compatible with heating device. 3)Placing tubing over your head and tucking under your pillow helps to ↓ water collection by face and directs it back towards machine. Demonstration Sarah Garrett March 2015

13. Discomfort Nose- Top head straps may be too tight ▪ Loosen Facial skin becomes itchy or inflamed ▪ Clean mask ▪ Trial gentle facial cleanser such as Cetaphil Sarah Garrett March 2015