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Treating and managing sleep apnoea is extremely important. Sleep apnoea affects people’s ability to breathe during the night, causing broken, unsatisfying sleep, leading to various issues including fatigue, hypertension (high blood pressure), cognitive issues, mood changes, decreased libido, elevated heart rate and more.
If left unchecked these issues can become progressively more serious. Lack of sleep has been linked to greater risk of developing long term cognitive diseases, including Alzheimer’s and dementia, increased risk of cardiopulmonary diseases, erectile dysfunction, weight gain, increased risk of type 2 diabetes and a raft of other serious medical complications.
CPAP machines are the best frontline treatment for sleep apnoea and allow users to breathe throughout the night, but some users may find it difficult falling asleep while using CPAP. Common complaints include not being able to acclimate to using the machine, the mask moving or leaking during sleep. Masks feeling claustrophobic, machine noise and other
While you may have difficulty sleeping at first when using a CPAP machine, there are a number of tips and tweaks you can try to help you get to sleep and become used to your CPAP machine.
1. Practice Makes Perfect
Although most sleep apnoea only occurs during sleep (as the name rather strongly suggests), getting used to wearing your mask and the different air pressure you will experience while wearing your mask can help make falling asleep easier. Try wearing your mask for short periods of time during the day, when you’re relaxing, watching TV or otherwise unoccupied so you can get used to the feeling of using the machine, and can help identify any adjustments you may need to make for optimal comfort. If you try to do all of this while trying to fall asleep, not only will you have a hard time falling asleep, you may actually condition yourself to resist sleep while wearing a mask.
Your CPAP specialist will have set the pressure on the machine, but there are other settings you can adjust to improve the experience, such as the tightness of your mask, the humidity level of the air (if our machine has a humidifier), and what have you.
2. Prepare your Sleep Space
Your sleeping environment plays a significant role in being able to fall asleep. Ensuring that both your bedroom and bed are properly set up to sleep comfortably is essential for getting a good night’s sleep.
Your bedroom should be dark, quiet and maintain a good temperature throughout the night. If your room isn’t dark, investing in some block-out curtains, or a decent eye mask (so long as you don’t feel claustrophobic in a mask) can help alleviate the problem. Similarly, if your bedroom isn’t quiet, or you can’t get used to the sound of your CPAP machine, quality earplugs may help.
Keeping your room cool is harder, but use of fans, heaters and the like can help you maintain a room temperature that is comfortable for you.
Your bed and pillows are extremely important when it comes to both quality of sleep and ease of falling asleep. A quality mattress that offers both comfort and support, as well as a pillow that supports your head and neck is essential. If you are a side sleeper, there are pillows available specifically designed to comfortably support CPAP masks.
If you are a back sleeper, an adjustable base bed can allow you to elevate your head so that you sleep on an incline. Sleeping on an incline may improve symptoms of mild sleep apnoea, and may help relieve some of the pressure on your airways, potentially allowing for a lower CPAP pressure to be required.
3. Create Good Sleep Habits
There are many habits a person can adopt to improve their quantity and quality of sleep. While many of us are regimented when it comes to our daily routines - wake at the same time every day and go to sleep at the same time, this isn’t necessarily the best practice. Waking up at the same time every day is a good way to get you into a regular sleep pattern, but when it comes to sleep, going to bed when you are tired is much better than simply going to bed at the same time every day.
We’ve all gone to bed when we weren’t feeling tired and stared at the ceiling for what feels like forever before we finally fell asleep more from boredom than tiredness. Going to bed when you’re not tired, or doing anything other than sleeping or having sex in your bed, such as watching TV or reading, can subconsciously condition you to associate your bed with activities rather than sleep, potentially making it harder to fall sleep. If you go to bed when you’re not tired and use a CPAP mask, especially if you are new to CPAP therapy, you may find yourself fixating on the mask, air pressure and sound on the machine, making it harder to fall asleep.
As a rule of thumb, if you can’t fall asleep within around 20 minutes of going to bed, it’s better to go to another room and do something relaxing, such as reading a book, until you feel tired again and then head back to bed.
4. Change Sleep Position
The position in which you sleep may affect the severity of your sleep apnoea symptoms, so making a sleep posture change may help you get to sleep faster. Back sleepers typically suffer more severe sleep apnoea symptoms than side or stomach sleepers, so if you are a habitual back sleeper, changing your posture may allow your CPAP specialist to lower the pressure of your machine, making it easier and more comfortable to use.
Changing the position in which you sleep isn’t necessarily easy and you may require some mechanical help to force you to adopt the new sleeping position, such as what is referred to as a “bumper belt”. These belts strap around the chest or waist and have pockets for inflatable bumpers that make it impossible for you to roll onto your back. If you don’t want to fork out for a belt, a similar effect can be achieved by sewing a tennis ball into the back of a sleep shirt or pair of pyjamas.
If you are a dedicated back sleeper or have a condition that prevents you from sleeping on your side comfortably, an adjustable base bed can help you raise your head and sleep on an incline, helping to relieve pressure on your airways.
5. Wind Down Before Bed
In the hours leading up to going to bed it’s important to wind down your activity, as well as your consumption. You should avoid going to bed on a full stomach, but you should also avoid trying to sleep on an empty stomach, so not having anything to eat one to two hours before bed should help you find that happy medium.
Stressful or overly stimulating activities can promote the release of cortisol, a hormone that promotes alertness, making it harder to fall asleep, so for a few hours before sleep, try and partake in relaxing activities, such as reading a book, watching TV, having a warm bath, meditating or the like.
6. Ensure Comfort
Making sure your bed is comfortable is extremely important, but equally important is getting your nasal pillow, nasal mask or face mask as comfortable as possible. If your mask is uncomfortable, it’s more likely you’ll concentrate on that instead of falling asleep, and even if you do fall asleep, the discomfort may wake you up again, especially if you regularly move around in your sleep.
The fit of your mask is important, both for comfort and for effectiveness. If it’s too small, too big or too loose, not only may your mask be uncomfortable, it may also leak, making therapy less effective.
Your mask will be initially fit by your CPAP specialist, but before you try sleeping with it, it’s worthwhile to try on your mask a few times to adjust the straps to make sure the fit is tight but comfortable. Make sure you also try the mask on when laying down, as the topography of your face may change slightly when you’re horizontal.
You should turn on your CPAP machine while you’re trying to optimise your mask fitting to ensure that there is no leakage. Some machines have a special mask testing mode to make fitting easier. Depending on the kind of mask or pillow you use, there may be ways of making the mask more comfortable while maintaining an airtight fit, such as gel or memory foam guards that sit between the mask and your face, or elbow hoses that allow for better hose placement so you don’t get tangled or kink the hose if you move around.
7. Use a Humidifier or Nasal Spray
The CPAP pump draws air from the room. If you use an air conditioner or heater to maintain the temperature in your room, the air flowing into your mask may be uncomfortably dry. If you find yourself waking up due to a runny, dry or irritated nose, or dry mouth and throat, you may benefit from using a humidifier.
Some CPAP machines have a built-in humidifier, or have a connection for an optional humidifier so you can control the humidity of the air in your mask. Even if your machine doesn’t have a built-in or optional humidifier, a standalone humidifier can help “soften” the air being pumped through your mask and cut down on irritation.
If you can’t use a humidifier and use a nasal mask or pillow, saline nasal sprays may help to prevent your sinuses drying out and becoming irritated.
8. Ramp
If your CPAP machine has a “ramp” setting, this may be a great deal of help when it comes to falling asleep. CPAP machines deliver constant positive air pressure. If you require high pressure in your CPAP therapy, or simply can’t get used to wearing a CPAP mask, the air pressure may make it difficult for you to fall asleep.
Ramp settings allow you to ramp up the air pressure over time, rather than starting at full pressure. Some machines have automatic ramp sensors that switch pressure on when sensors detect a change in breathing signalling sleep, while other ramp settings may simply slowly raise pressure over a period of time, making it easier for you to acclimate to pressure as well as fall asleep.
If you’re worried about the possibility that you suffer sleep apnoea, or would like a referral through to a sleep or sleep apnoea specialist, schedule an appointment to see a sleep apnoea specialist from ResMed . The fastest and easiest way to search for and book healthcare appointments online is through MyHealth1st.