One of the most common issues I encounter with drivers, especially during their acclimation phase, is waking up after treatment only to realize that their mask is on the floor. This may be related to lack of sufficient pressure, especially if they are using an APAP (Auto-Adjusting Positive Airway Pressure) unit. When this happens, most drivers report that they are asleep and don’t remember removing the mask. Other issues that might be associated with removing the mask could be related to nasal congestion during treatment-but for the purpose of this article- we’ll talk about the pressure related issues.
If you are using an APAP unit and the pressures have not been properly adjusted- the unit may revert to very low pressures when you aren’t experiencing an Apnea or Hypopnea. This very low pressure can cause the feeling of suffocation as many drivers describe. It is important to report this issue immediately to your clinician so that your pressures can be assessed and modified to help keep your mask on your face for the duration of treatment. On an APAP unit there are 3 pressure settings that must be addressed:
START PRESSURE – The pressure you initially start off with when you turn on your APAP unit.
MINIMUM PRESSURE – The minimum amount of pressure programmed to be be delivered during your treatment.
MAXIMUM PRESSURE – The maximum amount of pressure to be delivered during your treatment.
The start pressure should be set to keep you comfortable when you first start treatment- this pressure varies from person to person and can be controlled with your RAMP button. Some drivers like to start treatment with a fairly strong amount of pressure and others prefer a low and steady rise in pressure. Sometimes drivers who complain of claustrophobia at the beginning of treatment benefit from feeling a stronger flow of air on their face and hence a higher starting pressure and/or a shorter or no ramp period.
The minimum pressure should be set close to your 95% average pressure range and your Maximum pressure should be set 2-4 cmH2O above your 95% pressure.
The next time you find yourself picking up your mask from the floor call your clinician or whomever is following your treatment and providing you with treatment support. Don’t go another day without proper pressure settings on your APAP equipment.
Note: Pressure adjustments should only be made by a qualified DME specialist or MD office who are under the guidance of a medical doctor.