Sleep Therapy FAQ

During our time in business we have learned that many of our clients are unfamiliar with sleep apnea and oxygen therapy and have questions about what to expect. For your convenience we have collected some of the questions we hear most often from our clients and provided the answers. Click on any of the listed headings to jump directly to that section. Have a question that is not addressed here? Contact our office for more information.

Sleep Therapy

Sleep apnea (Obstructive Sleep Apnea-OSA) is a disorder characterized by abnormal pauses (apneas) in breathing during sleep. Symptoms of OSA include excessive daytime sleepiness, poor concentration, poor memory, depression, and irritability. OSA is diagnosed by polysomnogram “sleep study” and is treated with Continuous Positive Airway Pressure (CPAP).

CPAP stands for Continuous Positive Airway Pressure. This pressure is used to maintain positive pressure in the airways to prevent obstruction, which causes apneas.

CPAP is a set continuous pressure that does not change. BiPAP or bi-level has two set pressures, one for inhalation and one for exhalation. AutoPAP automatically adjusts the pressure required to keep airways open by sensing breathing patterns.

Physicians may request a preliminary night study to be performed by Breathe Easy. An oximeter capable of performing night studies will then be provided to the client for a period of 1 or 2 nights. The outcome of the night study will be assessed with a report forwarded to the prescribing physician. If the night study indicates possible sleep apnea or nocturnal desaturation (low oxygen levels at night), the physician may refer you to a sleep clinic for a further assessment.

Once is a valid prescription is obtained; contact Breathe Easy at 519-439-1166 to set up an appointment with one of our Registered Staff.

PAP therapy was prescribed by your physician and is to be used every night and during naps. CPAP equipment is portable, lightweight and may be taken on vacations and business trips. If you find it difficult to wear your CPAP at first, try to wear it as long as you can tolerate it; 4 hours is considered therapeutic. Try to work up to the entire night as it may take time to adjust using your CPAP.

Some of our clients notice an immediate improvement from the first night. Improvements experienced may include dreaming, improved memory, more energy, weight loss, improved focus, being more efficient at work, having the ability to work out, taking fewer or no naps, not feeling tired anymore, and so on.

If a client has a valid health card, has obtained a prescription from a registered Ontario sleep lab, and has been diagnosed with obstructive sleep apnea, that client may qualify for funding. For more information, contact Breathe Easy at 519-439-1166.

Proper and effective cleaning of your equipment will help prevent bacteria from growing, help minimize infections, and will also help prolong the life of your equipment.

We recommend clients clean their equipment daily according to the manufacturer’s guidelines as noted in the instruction manuals for all PAP therapy systems and masks. Clients are to clean their mask parts and hose with mild soap and warm water, followed by a rinse with warm water. Allow all parts to air dry. CPAP units, only when unplugged, may be wiped down with a damp cloth. Headgear may be cleaned weekly.
It is best to clean your equipment first thing in the morning or after you wake up (for clients working shifts) to allow for it to properly air dry before its next use. Clients need to take all necessary precautions to ensure their safety when drying their PAP therapy equipment. Water may drip from accessories leading to spills and the possibility of slips and falls. We recommend that PAP therapy hosing is hung and dried in a clean sink or tub to avoid this possibility.

Breathe Easy offers a variety of CPAP cleaning products to help minimize cleaning times of masks and mask parts. These products are available for purchase at our office.

Water used in the humidifier should be changed daily to prevent bacterial growth. The humidifier is to be cleaned daily with warm soapy water. Rinse well. Only use distilled water in the humidifier chamber (refer to your manufacturer’s user manual for more information).

As most manufacturers have suggested, the average life of a mask is six (6) months depending on use and care. Most masks will have parts that can be replaced to help keep costs down. PAP system filter replacements will also vary on usage, unit placement, home environment, the presence of pets, etc. Check your manufacturer’s guidelines for recommended filter changes. Most filters will need to be changed between 3 to 6 months.
Contact your insurance provider if applicable, to determine the frequency your mask and/or mask parts as well as other accessories may be replaced. Accessories that will eventually need a replacement include masks, mask parts, hose, humidifier chamber and filters.

Yes, our infection control procedures consist of an initial soap and water cleaning, followed by high-level disinfection (HLD). The HLD used at Breathe Easy is Accel HLD5 which contains 2% hydrogen peroxide. HLD5 is sporicidal, virucidal, fungicidal, bactericidal and tuberculocidal when used according to the manufacturer’s directions. Various low-level and high-level disinfectants are also used to clean PAP therapy systems in between clients, including vinegar. Mask and PAP therapy unit filters are also changed between clients.

Over-tightening your headgear can lead to mask leaks. Tightening the top straps too much can cause leaks at the mouth while tightening the bottom straps too much can cause blowing at the eyes. Clients are to loosen off their headgear and slowly re-tighten the straps just until the leak stops. Another cause of leaks is a worn-out mask or mask part that may need to be replaced.

Your humidity settings may be too low and may need to be increased (refer to the manual on how to adjust humidity settings). Make sure your equipment is being cleaned regularly as un-cleaned or contaminated equipment may lead to sinus infections. Should you suffer from allergies, you may need to consult your physician regarding possibly prescribing a nasal spray to help decrease nasal inflammation/stuffy nose.

A dry mouth signifies that you have opened your mouth at night while using your PAP therapy equipment. This will let the pressure escape out of your mouth and hence prevent you from properly treating your obstructive sleep apnea. The dryness is caused by the pressure blowing through your mouth. If you use a full-face mask, your humidity setting may need to be increased. If using a nasal mask, you may need to wear a chin strap or switch to a full-face mask.

Initially, this is common with the use of PAP therapy but typically resolves itself in time.  If you have issues with your stomach valve, pressure from your PAP therapy equipment may push air into the stomach. It is best to speak with your physician regarding this matter. Another cause is mouth breathing with a nasal mask leading to the swallowing of air. Clients may opt to try and train themselves in keeping their mouths closed during the night. A chin strap in conjunction with a nasal mask or the use of a full-face mask may help alleviate this problem.

It can take some time to adjust to using a CPAP mask. You may take the mask off in your sleep due to being unaccustomed to having a mask on your face. This happens to a frequent number of clients. Most adjust in time, generally within a month. Should the problem continue, clients are encouraged to contact Breathe Easy to make an appointment to discuss mask options. Another possible solution is to ensure the humidifier setting is adequate.

If you are opening your mouth while you’re asleep, you aren’t treating your sleep apnea. Your pressure setting may need to be adjusted or you may need a full-face mask.
Our registered staff will check your prescription to determine if there is a range allowing for an increase without having to consult your sleep specialist. For instance, if the current pressure setting is at 8 cmH²0 and your prescription reads: 8 cmH²0 +/- 1-2cmH²0, it would allow our staff to adjust the pressure between 6 and 10 cmH²0. If your current prescription does not allow for a pressure adjustment, your sleep physician will have to be consulted.
You may require a referral from your primary care physician to the sleep clinic if it has been more than a year since your last sleep clinic appointment.

Sometimes a smaller mask with minimal headgear may assist. Many clients are choosing a direct nasal mask that fits directly in the nares/nostrils. Another option is to use a full-face mask to give you the ability to breathe through your mouth and nose.
Proper mask fit and the right humidifier settings are two key factors in helping you feel comfortable when using your PAP therapy equipment.
A high humidity setting may make it feel very hot and/or uncomfortable. Try turning down the humidifier setting to minimize heat and humidity. An improper mask fit may also make you uncomfortable. Clients are to ensure the mask is not too tight. Try loosening the straps of the mask and tightening the headgear, just enough to prevent leaks. Start with the bottom straps first and then tighten the top straps.

Sleep apnea is usually a lifelong challenge. Feeling better with PAP therapy is a good thing as you are treating your sleep apnea with the required therapy. Stopping therapy will likely cause symptoms to return, including increased fatigue and the inability to sleep. Some people overcome their sleep apnea through diet, surgery or dental appliances, but most will require PAP therapy for an indefinite duration.

With Obstructive Sleep Apnea (OSA), your sleep is disrupted to the point that you are unable to get into a deep sleep. This prevents dreaming or only allows fragmented dreams. When you start using your CPAP, you can get to the deep level of sleep required to dream. You may experience a lot of dreams at first, and then taper down to a normal amount. This occurs due to the body getting used to deep sleep again. Once you are used to “normal sleep” again, dreams should be more normal in frequency.

There may be a crack in your humidifier chamber and the chamber will have to be replaced. Humidifier chambers must be properly put back together when taken apart to clean to ensure there is a good seal to minimize the possibility of leaks.

Your humidifier setting may be too high and may need to be turned down. Mask leaks and mouth breathing may lead to more water being used as more airflow will be going through the humidifier chamber (see the section on mask leaks and mouth breathing).

If you keep your house cool at night, the cool room may be causing the warm moist air from your PAP therapy humidifier chamber to cool, leading to condensation or water build-up in your tubing. To prevent this, you may consider the following options: purchasing a heated hose provided it is compatible with your PAP therapy unit; purchase a sleeve for your hose; sew a sleeve to go over the hose (but ensure it comes off to properly clean your hose); tuck your hose under your blankets to avoid exposure to the cold room; increase the temperature in your home, or decrease your PAP therapy humidifier setting as it may be set too high.

A white film may be caused by a calcium build-up from tap water. Only distilled water is to be used with all PAP therapy humidifier chambers.

Clients are encouraged to contact Breathe Easy to set up an appointment for a pressure adjustment. A copy of your prescription will be required, along with a valid health card.

In the event of a power outage, your PAP therapy system will not work. There are some options for an alternative power supply (see section on battery use). Clients are strongly encouraged to use a power surge protector in conjunction with their PAP therapy systems.

Some clients have also taken their PAP therapy unit camping. Certain accessory equipment will be required. For clients using certain ResMed units, an inverter or converter will be required. For certain Fisher & Paykel units, a deep cycle battery/marine battery will be required. For more information, please refer to your manufacturer’s manual or the following websites:

Yes, many of our clients have travelled all over the world for business and leisure. Our current line of PAP therapy units adjusts to 100 – 240 volts (50 – 60 Hz). All that is required is an outlet adapter. Clients are encouraged to take their unit as part of their carry-on to ensure it is not damaged. The X-ray machine will not damage your unit, but it may be inspected by security. It is best to carry a copy of your prescription when travelling and to directly contact the airline should you intend on using your PAP therapy equipment in flight.

If distilled water is not available, use bottled water or cooled boiled water. Never transport your humidifier with water. Always make sure it is empty prior to transport.

Our staff may be contacted by phone at 519-439-1166, toll free at 1-800-267-3279 or by email at breatheeasyresp@gmail.com. We strongly encourage our clients to book an appointment as our registered staff do visit oxygen clientele in the community and are not always available in office.