Learning To Love CPAP Therapy

By Gary Rothbard, M.D., M.S.

Getting used to CPAP in order to reap the benefits of consistent CPAP therapy — some of which have only recently been uncovered — requires time, patience, and a willingness to undergo some trial and error. While your doctor’s choice of CPAP machine will depend on your exact diagnosis and specifics, you will generally be free to choose the CPAP mask that suits you best.

This is an important choice and one that often involves a learning curve. Here I’ll offer some CPAP tips based on my personal experience across nearly 20 years of therapy, with the sincere hope that CPAP helps you as much as it does me.

My OSA Symptoms

My obstructive sleep apnea (OSA) story is not unlike that of others, and my symptoms were quite typical for OSA. There were several things, all classically associated with OSA, that led me to undergo polysomnography and finally seek a solution to my issues with sleep, or lack thereof.

The first inkling that something wasn’t right actually came secondhand, from those who had the misfortune of sleeping in a room with me. My snoring (which may or may not be a sign of OSA) had been described to me as “horrible,” “terrifying” (because of the breathing pauses), and “like a chainsaw next to my head all night.”

However, the only tangible remnant from this nightly horror show was a constantly sore throat. This soreness was a result of the minor trauma my soft palate and pharynx were experiencing throughout the night, as my diaphragm competed with their collapse to get air into my lungs.

Another problem I noticed was an inability to focus or concentrate. It felt a lot like when I had pulled all-nighters studying, where sleep deprivation clearly impacted my cognitive functioning. This, in turn, affected my emotional well-being, and I noticed distinct downswings in my mood.

But by far, the most significant effect was extreme daytime drowsiness, beginning immediately after waking. It didn’t matter if I had gotten two or 12 hours of broken sleep — I was always tired, to the point that I was having trouble staying awake. Although this was troubling, the final straw came when I briefly dozed off behind the wheel, coming perilously close to crashing my car. It was at that moment that I decided something needed to change.

Acclimating to CPAP Therapy

Many people have asked me how long it took to get used to CPAP. And the short answer is getting used to CPAP took a little while. The slightly longer answer is that it takes a good deal of patience and flexibility and a whole bunch of trial and error. For me — and likely many other CPAP users — the biggest hurdle was finding a CPAP mask that was comfortable enough to wear and fit without leaks.

As someone who went through several different masks before finding "the one,” I can attest to the importance of not settling until you’ve found a good match for your facial contours and sleeping style. As far as I’m concerned, this is the most crucial aspect of your CPAP therapy. Don’t settle on a CPAP mask just because you’re tired of trying different makes and models. It’s an incredibly personal decision, and there are dozens of options, so take your time and be open to changing CPAP masks as often as necessary until you find the right fit. After that, it just takes time to get used to your CPAP. For some, that means days; for others, weeks. Be patient and dedicated — you will be rewarded for your tenacity with restful sleep.

Becoming a CPAP Believer

Once I settled on a mask, I quickly began to see and feel the very real and life-changing CPAP benefits that CPAP therapy provided. I quickly became a true believer, advocating for sleep testing and CPAP treatment to anyone with possible OSA symptoms. It would not be an overstatement to say that CPAP therapy completely changed my life for the better. I can’t really sleep without it at this point, because it has made such a difference.

After a month or so of using my CPAP machine with my preferred mask, the benefits were evident and undeniable. My focus and concentration improved markedly, and my sore throats quickly became a thing of the past. But the most impressive change I noticed was in my ability to wake up feeling refreshed and then stay awake and alert throughout the day. Sure, I still get tired and sleepy during the day on occasion, but the urges to take naps — which didn’t help anyway — every hour are largely behind me.

CPAP to the Rescue

Getting used to CPAP took some time, but it was time very well spent. I honestly can’t imagine going back to a world without my CPAP machine. Starting CPAP therapy saved my life, both figuratively in terms of quality and quite possibly literally. It improved both my sleeping and waking hours to such an extent that I’d recommend any potential candidate give it a try. With time and perseverance, you will be rewarded mightily. So, take that initial leap, and learn to love your CPAP therapy like I do. You’ll be glad that you did.

Why and How to Get a CPAP Prescription

If you suffer from restless nights, unfulfilling sleep, and daytime drowsiness — and particularly if you’re a known snorer — there is a decent possibility that you may be a candidate for an obstructive sleep apnea diagnosis and treatment.

However, in order to confirm such a diagnosis, and to rule out other conditions, your doctor will first need to order a test called a polysomnogram or polysomnography. If this test shows that you have obstructive sleep apnea, then your physician can write you a prescription for a machine that provides continuous positive airway pressure (CPAP) or bilevel positive airway pressure (BiPAP) while you sleep—this machine helps keep your airway open and allows for normal nighttime breathing.

Sleep Apnea Diagnosis at Home vs. in a Sleep Lab

The first step in treating any disease is to confirm a proper diagnosis. The gold standard for an obstructive sleep apnea diagnosis remains an overnight polysomnographic evaluation at an accredited sleep center, where you will be connected to multiple hoses, tubes, and wires that will monitor your heart rhythm, brain waves, breathing rate, and airflow while you sleep.

An in-lab sleep test offers the most accurate and comprehensive assessment of your condition. It provides clinicians with the best information with which to make or rule out an obstructive sleep apnea diagnosis.

However, recent advances in sleep medicine have resulted in the availability of another less cumbersome option for those who suspect they may have apnea: an unattended sleep test that you undergo in the comfort of your home, also known as a home sleep test.

This is a test that you take while sleeping in your own bed, involving considerably less hardware, with results that are clinically reviewed and reported directly to your physician.

There are advantages and disadvantages to each test, and you will need to discuss with your doctor which test is appropriate for your specific clinical scenario. For some patients, the home sleep test will be sufficient to diagnose your apnea and allow a doctor to write you a prescription for a CPAP machine.

However, for others, a home sleep test will sometimes need to be followed by a standard polysomnography to confirm or rule out the presumptive diagnosis. Certain patients may be referred directly to a sleep center for testing.

How To Get a CPAP Prescription

Once you’ve received a definitive diagnosis of apnea, getting a prescription for the proper machine (your results will determine CPAP vs. BiPAP) is simple. Any qualified provider with a valid license can write you a prescription for a CPAP, which should include the pressure level (or levels in the case of BiPAP). However, it is preferable that the sleep physician who oversaw your diagnostic home sleep test and/or polysomnography write your prescription, as he or she knows you and your clinical situation best.

In some cases, a remote physician (teledoc) may be able to read your unattended sleep test results and, if deemed appropriate, write you a prescription for a CPAP machine.

Aeroflow can assist you in navigating this pathway and help determine if you are eligible to receive an online prescription after sending in your home sleep test for evaluation and, if so, help you obtain this prescription and your CPAP machine through relationships with board-certified teledocs.

It is essential that you proceed through your treating clinician and purchase or rent your machine and supplies from a well-known and reputable durable goods vendor such as Aeroflow.

While several websites offer CPAP prescriptions online based on your answers to questionnaires, this should NOT be the path you follow. Getting CPAP prescriptions online is considerably less precise and riskier than doing so from a practitioner who has reviewed your medical records and test results.

Even though it is possible to buy a CPAP without a prescription (generally used machines through online marketplaces), this is ill-advised.

There is no quality control or guarantee that you will receive the proper machine that is functioning at the settings required. And when you’re dealing with something as crucial as breathing regularly throughout the night, it pays to ensure that you’re using a clean machine with the correct settings.

When to Speak to Your Doctor About a Possible Apnea Diagnosis and Treatment

Your sleep issues may stem from something other than sleep apnea, but with the high prevalence of obstructive sleep apnea in the United States and globally, it is certainly worth investigating. Your internist, pediatrician, or family physician should be the first step in this investigation, as he or she is best equipped to evaluate your complaints and make the proper referrals and/or write the prescriptions you’ll need for further testing and potential treatment.

The actual sleep apnea diagnostic criteria primarily depends on the technical findings from your polysomnography. However, some common symptoms that may indicate a hypopnea or apnea issue include loud snoring, daytime sleepiness, and (especially) periods of breathing cessation observed by a third party while you sleep.

Your risk for sleep apnea may be increased by obesity, high blood pressure, advanced age, and male gender. If you believe you may be suffering from undiagnosed obstructive sleep apnea, or are having trouble getting a good night’s rest, it is important to discuss this with your doctor immediately.

Self-care is essential, and getting enough quality rest is no exception. Untreated obstructive sleep apnea can seriously hinder your health . Conversely, successful CPAP therapy can make a world of difference. By following the guidelines above on how to get a CPAP prescription, you will have taken the first step toward a better night’s sleep and a more productive waking life.


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About the Author: Gary Rothbard, M.D., M.S., is a non-practicing physician with nearly 20 years of experience as a medical writer. He has authored or contributed to a wide variety of material related to healthcare — including manuscripts, abstracts, feature articles, flashcard sets, posters, blog articles, advice columns, advertorials, drug summaries, slide decks, study summaries, laboratory exercises, question banks, and textbook reviews — directed at diverse audiences, including students, clinicians, researchers, patients, and caregivers.

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