As a sleep technician, you often provide treatment for individuals with sleep apnea. A successful and popular therapy for sleep apnea is continuous positive airway pressure, or CPAP. When they are asleep, sleep apnea patients employ the non-surgical procedure to widen their airways.
More than 18 million Australians, according to the National Sleep Foundation, suffer with the disorder. Therefore, it should come as no surprise that the community of sleep technologists is so familiar with the cpap machines. Another well-known fact is how important it is to support your patients in sticking with their treatment. Learn more how migraines affect your sleep hygiene.
In this post, we’ll look at the significance of CPAP adherence, the reasons why patients find it challenging to follow instructions, and eight strategies you may use to assist your sleep apnea patients use their CPAP more consistently.
Why Is Adherence to CPAP So Important?
Around 50% of patients who are administered CPAP either don’t follow their treatment plan or stop it, according to a 2012 MedScape article. The illness returns quickly if or when CPAP therapy is interrupted, thus people with sleep apnea must stick to it religiously.
After only two weeks without CPAP, hourly arousal occurrences had more than quadrupled, according to a small randomized experiment. A 2011 report in MedPage Today said that the prevalence of apnea-hypopnea has grown by a factor of 17 as well.
Though subjective drowsiness and OSA reappeared a few days after the CPAP therapy ended, objective sleepiness measurements did not alter appreciably. By the conclusion of the trial, morning heart rate, blood pressure, and urine catecholamine levels had considerably risen, and endothelial function had significantly diminished in comparison to persons using CPAP.
You can see that, in order to ensure their continued health, patients must follow their therapeutic regimen exactly.
Why Is Patients’ Adherence to CPAP So Difficult?
Many pressure, patient, and mask-related problems might have a detrimental effect on a patient’s CPAP tolerance and adherence. As a sleep technician, you can spot risks for nonadherence by being acquainted with the most typical CPAP-related symptoms and issues of sleep apnea.
There are several typical problems related to treatment, as our article, Top 10 Most Common CPAP Mask Problems and Discomfort (& How to Solve Them), illustrates. These include:
- A sense of discomfort with the CPAP mask and an inability to get accustomed to it.
- Being concerned that they have an allergy to their mask.
- Not being able to stand the mask’s forced air.
- After using a CPAP machine, developing a runny or congested nose.
- A feeling of constriction when wearing the mask.
- Having trouble getting asleep when using a CPAP machine.
- After putting on the mask, having a dry mouth.
- Constantly taking off their sleep mask.
- Not being able to tolerate the machine’s loudness.
Any of the aforementioned problems might cause new CPAP users to abruptly cease their therapy. This makes it crucial to go through possible CPAP issues and how to fix them with your patients.
What can sleep scientists do to increase CPAP compliance?
As a sleep technician, it’s critical to provide patients the tools, knowledge, and encouragement they need to feel at ease with CPAP therapy and, as a result, increase adherence. To do this, take the following actions:
Educating Patients Before Treatment (And Continuing Throughout Treatment)
Before handing your patient the CPAP mask, be sure they are aware of all of the machine’s features, the treatment it provides, any potential problems, and how it will assist them with their sleep apnea symptoms. Let them know how to respond to each of the usual objections and how to anticipate them all.
Make sure they are aware of the dangers of quitting their medication and the fact that, despite their initial discomfort, they will eventually become used to it. Your patients need to be aware that untreated sleep apnea has a negative impact on both their health and quality of life. Discuss any medical issues that are known or believed to be present. They may be more likely to embrace their treatment plan and exert greater control over their health as a result.
Treatment discontinuation is more common in the early phases of therapy. When initially used, the CPAP mask might feel extremely strange. Therefore, it is recommended that you inform patients about the efficiency and advantages of CPAP treatment. During the first phase of the shift, this could encourage them to continue with their therapy.
Spending Time Locating the Right Mask
Using the incorrect mask causes problems for many people. Giving your patient all of their alternatives up front can boost adherence since, often, following a negative mask-type encounter, patients are hesitant to attempt another.
Masks come in three primary categories:
- Nasal cushions.
These are located under the nose near the opening of the nostrils. With glasses on, patients may use nasal pillows without their vision being obstructed.
- Face-covering masks.
Full-face masks enclose the lips and nose. For patients who breathe through their lips, they are a suitable option.
- Nasal masks.
Nasal masks are smaller and lighter than full-face masks, and they cover the nose. They also provide more protection than a nasal cushion.
To assist your patients understand which mask is appropriate for them, make sure to go through the advantages and disadvantages of each variety.
3. Regular Check-Ins & Support Availability
Make sure you often check in with new CPAP users about how comfortable they are with the therapy and monitor their adherence so that, if it begins to decline, you can remedy any problematic behaviors as soon as possible.
To have to wear a mask every night to get some sleep might be perplexing and weird. Numerous changes are taking place in your patients’ health. You may make sure they are as at ease as possible during their treatment by being present for them and showing empathy. If kids do have troubles or issues, they’ll also find it simpler to talk to you about them.
4) Begin Small
Do not immediately insist that new CPAP users who are struggling with the sleep apnea treatment wear the mask throughout the night. To ease them into wearing the mask, suggest that they try wearing it for a little bit longer each night. As they progress toward wearing the mask full-time, set them tiny, doable objectives. For instance, while they are awake, they may practice donning their mask.
They may first wear the mask on their faces without fastening anything. They may attempt putting on the straps and the mask once that is comfortable. Then, with the ramp function activated and the machine’s low-pressure setting selected, they may test holding the mask against their faces while the hose is attached to it. While they are awake, they need to do this. They may attempt sleeping with the mask on once they are at ease enough.