Caitlin Whyte (Host): C-PAP equipment is a common solution prescribed to those coping with sleep apnea, but not everyone has an easy time adjusting to using it. So, today we're talking about some common concerns patients have, with Sadie Olson, a Clinical Sleep Coordination Specialist at Upland Hills Health.

This is the Inspire Health podcast from Upland Hills Health. I'm Caitlin Whyte. So Sadie, we're going to get into a few complaints that you hear from patients and what we can do about them in this episode. So, the first is I just can't get used to it. I feel claustrophobic with my machine on and I'm finding it hard to relax. How will I ever get past this?

Sadie Olson: Good question. So, there are a few things to get past this or to get used to the C-PAP. One thing, if you are claustrophobic, that's a big issue. We want to address that before you even start actual therapy. So, if we know that ahead of time, we can do certain things. Kind of the biggest thing is desensitization therapy, where we would get you set up with a machine of some sorts, hopefully, and have it at a low pressure. And find the right mask for you. And what desensitization is, is basically desensitizing you to the C-PAP machine and the feeling of it.

Basically, what we tell people to do is to start it out with maybe a minute or two on it, when you're awake in a comfortable setting, like the living room, when you're just chilling out watching TV is the best way to get through desensitizing your C-PAP and then work yourself up to where you can wear the C-PAP for anywhere from 30 to 40 minutes is ideal without having any claustrophobic like issues.

So every, every few days you're going to add a few minutes. The other thing about getting used to the C-PAP itself is to making sure you have been fitted and have the right mask. If you ever at any point get C-PAP and you find out I hate this mask. I do not like this. Then you need to get a different mask. The biggest part about being compliant and being able to be comfortable and wear C-PAP is liking the mask, having the right mask. That is a huge, huge thing. So, you need to be proactive about your mask and how you like it.

Host: You know, with my mask on, I feel like I'm just not that attractive to sleep next to any more. And I'm worried about intimacy in my relationships. What can I do about that?

Sadie: There's some big fears about that. And I get it. Some things to know about untreated sleep apnea is that it can cause its own problems in relationships. You're fatigued, you're tired. Untreated sleep apnea can be the cause of erectile dysfunction. So treating C-PAP is I look at it as a treatable type of therapy for other disorders such as high blood pressure and erectile dysfunction. Can be a part of it, I should say. And, and bringing back your energy and not being so fatigued. With that, C-PAP, it improves your quality of life with your partner, improves satisfaction with your partners.

You can feel close to one another when you have energy. So if you have a partner with sleep apnea, who's using C-PAP, your support can make all the difference. It's a huge deal. So open communication about that, getting over the feeling silly about it or not sexy when you have it on, that makes all the difference.

Host: I must be taking it off in the middle of the night without even realizing it. Do you have any suggestions for that?

Sadie: Yeah. So, sometimes people, when they report that they're taking their C-PAP off in the middle of the night, what we do first and foremost is we check to see that you have the right pressure. When we test people, the magic number that we look at is how many times do you quit breathing per hour of sleep? Or how many times per hour of sleep are you obstructing or partially obstructing in your airway? That's essentially sleep apnea. When we put C-PAP on, that opens up the airway and allows you to breathe.

So then essentially, what we can do from these machines nowadays is get a report off of the machine and see how many breathing events you were having per hour with the right pressure. If you're still having a lot of breathing events per hour, if that magic number is higher than what we want it to be, that might be the culprit as to why people are actually ripping their mask off in the middle of the night.

Other reasons might be if your mask is not fitting correctly, if there's skin irritation, if there's nasal congestion or irritation. So get the right mask is the one thing. Look into or talk to your provider or your sleep provider to ask about treatment options for the skin therapy, skin irritation, I should say.

And nasal congestion. I'm big on telling people, try a neti pot to help clear congestion. Use humidity with your C-PAP to prevent and to treat nasal congestion and or dryness. And then we get into the claustrophobia issues. You know, some people might wake up in the middle of a dream and be having a breathing event or might be having that feeling that they're claustrophobic. So, those are things that we need to kind of delve into. It is important to talk to your sleep provider and follow up with your sleep provider.

Host: Now, what do you recommend if I get the flu or I have a cold, you know, what happens to all that virus and bacteria? Should I stop using my machine?

Sadie: There, there are filters on the back of the machine. It's important to have a clean atmosphere in general for your health, but when you have the C-PAP on, yeah, you're going to get, you know, if you usually, typically people have humidity with it or they have heated humidity with it, and obviously just your germs alone is going to contaminate the, the tubing and the mask.

So, anytime you're set up with a C-PAP machine, you should be educated on how to clean the actual tubing and your mask and everything and how often. Typically, rule of thumb, ideal world is every day. At the very least you should be doing it weekly. And everybody, every manufacturer has different rules or suggestions on how to clean, but essentially it's soaking in water and, and maybe like a Dawn dish soap or water and vinegar, and then rinsing thoroughly and then air drying.

And it's important just to do that often enough that you're, you're not getting those bad germs. I will say there's, I don't know if there's a lot of ads lately, but there were a lot of ads with things like So Clean or anything with ozone cleaners may affect the warranty of your C-PAP machine. So be aware of that when you just want to go the easy route and use those So Cleans. You still need to one, clean the surface of your mask because it's on your skin. And two, you should really be leery about the ozone cleaners. They found that it's kind of been damaging to machines. So the overall message there, I guess, is to soak it, rinse it and air dry it. Very important. And to replace your equipment. Replacing your equipment can be a big deal to keep the seal of the mask, especially, and just to keep the integrity of all of your supplies in good working condition.

Host: Gotcha. Absolutely. Now for some, I know sound is a major complaint. Having a machine for years, but not using it consistently because it's so loud, because it's like sleeping next to a motor. What can we do about that sound?

Sadie: Yeah. If it's that loud, you should get a new machine. That's the short of it. I had, when I've been in this business for 18 years and my first year, I had a 92 year old woman who came in. Because you needed a new sleep study to get a machine. And she heard the machine and she broke into tears. She's like, I can't believe those sounds so quiet. My husband has been sleeping by me and it sounds like an airplane. And so she waited way too long for the machine. It's important. Typical life of machines are anywhere from five to seven years. 10 is pushing it. Most insurances allow a new machine after about five years.

So if you're feeling like, man, this thing is getting loud or this thing is too loud, Talk to your provider and talk about getting a new machine.

Host: Now, what about if I still use my C-PAP and I still snore? I mean is it even helping then?

Sadie: Well, so there's some reasons why you're snoring. Typically, like I said, how these machines, how they can, they can tell us how many breathing events you're having per hour, these newer machines. Right? So if you're snoring through that, those machines should sense that, and they will report that. If you're on like an autotype setting, it will go up. But if you're just on a set pressure of a C-PAP machine and you're snoring, it's likely because you need a little bit more pressure. Now that can be related to position. Some people are worse on their back than they are on their side. So when they get on their back, they may be snoring because they need a little more pressure on their back. Some people, if they've had alcohol that night. And they normally don't, you know, I'm, I'm sure a lot of people who have had their typical sleep study and get fixed at a set pressure, they don't have alcohol on board. Well, when they go home and they have a couple drinks or whatever, they're going to snore louder because of that. So that can cause the snoring. Medication can do that too. If you've been at a certain pressure for years and your weight has increased, that can cause a snoring.

So it's important to kind of look at the why's. Why, why might I be snoring when I wasn't before? That's important to talk to your sleep provider about as well.

Host: And last but not least in our list of grievances, do I have to wear this for the rest of my life?

Sadie: Yes and no, it depends on who you are, I guess. So sleep apnea, it can hit anybody. The number one reason for most people with sleep apnea is typically excess weight. So, a lot of people who lose their weight may not need it, but there are also people within normal weight limits that have terrible sleep apnea. So it all depends of both of those, the, your, your airway, the anatomy of your airway, your weight. It also can be hereditary. So that being said, typically once, if it's not the weight issue, then sometimes people can look into other options for treatment of sleep apnea, such as oral devices. Oral devices are good for milder sleep apnea, kind of brings the jaw forward and allows the airway to stay open. There's new surgery options for sleep apnea.

And so these are things you can discuss with your sleep provider. If you are, you know, looking into alternative options for the C-PAP, it's very important to keep the lines of communication open for that.

Host: Well, thank you for clearing some of this up Sadie. We so appreciate your time and work in sleep health. If you're coping with sleep apnea, don't just give up on the machine, reach out for help and advice. If you think you might be suffering from sleep apnea, talk to your sleep provider or primary care provider. Referrals are needed for sleep studies. To learn more search sleep@uplandhillshealth.org. This has been the Inspire Health podcast from Upland Hills Health.

I'm Caitlin Whyte. Sleep well.