A significant number of patients struggle in various ways in finding comfort with their positive pressure therapy. There are so many different problems that can arise that if I attempted to list them for you, I would probably overlook something. That is humbly being honest. However, a problem that I suffered with when starting with my personal therapy, and a problem that I find very common when working with patients, is removing the mask unknowing throughout the night. The sensation of taking the mask off without an inclination to how, or why, it was removed can be somewhat confusing and unsettling. In some, it has such an effect that they no longer feel they can adhere to their positive pressure device.
Typically when a person brings this problem to me and asks for a quick fix, I have to reply honestly that there is not one. Now, of course, we can take some good old fashioned duct tape. Then I assure you that your mask will likely stay on. I cannot lie to you that I have seen this mentioned and tactics used with tape or other adhesives because I certainly have. And, to be completely honest, they have worked! Now that I have admitted that, I am not going to suggest that to you simply because of the harm it could cause. So if you are looking to for a quick and easy answer, I’d stop reading now. I do not feel that this is something that can be correctly addressed in a single night or two. This particular problem is something that, when handled appropriately, can be conquered over a course of two to three weeks.
The first step is to identify some of the factors that could be bothering. If something is making you uncomfortable, then this could be leading to the natural reaction of removing the discomfort. A key to getting passed this issue is understanding why it is an issue and the possibilities of what make it happen! I describe removing your mask unknowingly as this; do you ever remember putting a blanket on during the night if you are cold or removing the blanket if you are hot? Sometimes you may slightly remember and a few times in detail, but for most of the population we simply put on, or take off, the blanket to assure better comfort. This mirrors, in most patients, what is happening when removing the mask without being aware. You are simply taking it off to help you, a normal reaction. So the goal should be first to identify where the problem is coming from, take action and follow through.
Step One: Identify
Are there any problems that have risen causing you to feel discomfort? Think closely and sharply identifying whether this problem could be with the machine pressures, the heated humidifier or even some settings such as expiratory pressure reliefs? Do you feel that there is a problem with the mask, tubing or accessories? Do not ignore any factors that could be causing you have discomfort.
Outside of your therapy, look into the external factors as well. Is it the lighting of your room, the placement of your bed, the temperature, the noise and so forth? Everything should be considered when trying to evaluate why your unmasking throughout the night.
Step Two: Take Action
Consider having a professional help you whether it is your healthcare provider or durable medical equipment company. However, I must always warn you. Sometimes these providers are not willing to help you make changes that you need, so do not settle for any one piece of information. There is a vast system available to you online. So ask questions and dive into this! If you feel that the pressures are low, or to high, then speak with your provider about adjustments. If it is about your mask, tubing accessories talk to your provider about your different options and changing. If you cannot get the answer you need these suggestion do not help you, then simply move away and attempt a second opinion. There is always blogs such as this one, forums and other avenues of resources available to you.
The point here is simple. Do not ignore these little problems, address them! Dissect what is bothering you, and if you are struggling with adhering to your device despite the help your given – seek more help! Do not ignore the problems no matter how insurmountable the odds may feel. Identity them and take action. Seek advice.
Step Three: Follow Through
After you have identified and sought out help, it is entirely up to you to put that into action. Do not hesitate and put everything you feel may help to action. Remember, that these issues will likely no go away on a single night, it will take two to three weeks of effort. An effort that only you can give!
So, this is the thought process I usually walk some patients through when struggling with compliance and especially, when removing the mask unknowingly. This problem can be a challenge and finding structure within the struggle seems to help when getting through these adversities. Especially with the instruction that I typically give to patients. Now – if a user is having pressure problems or mask discomfort then making changes is always something that should be addressed. However, if you are comfortable and cannot find a true reason other than simply needing to get used to wearing your positive pressure therapy throughout the night I have a different approach.
My approach is simple – wear your CPAP! There, that is it. Wear it. As much as you possibly can. Put the mask on while doing something leisure at home and wear it with pressure as much as you can while being entirely awake. Not right before you go to bed for thirty minutes or so – entirely awake while doing something leisure in your home. Adhere to doing this daily for one hour to two hours daily for 10-14 days and you will find that you are adhering to wearing you mask and machine much more compliantly.
Before you stop reading and right my blogging away, let me explain why this process is something I feel can help you! Taking off your mask is a natural reaction. So the goal here is to bridge over the discomfort into different forms of comfort. By wearing the machine during the day completely awake, it will help you identify the problems that arise causing you to remove the mask. It could be simple. Such as a few mask adjustments or humidifier settings changed. It could lead to something slightly more complicated as identifying that you need to make some changes to settings. If it is simply getting used to wearing the therapy, then you are learning to work through little distractions that can cause discomfort. Maybe it is just the headgear to the mask that is causing you discomfort or possibly the pressure in general causes anxiety. By learning these small issues, you can begin the before mentioned process or start working through them in any manner you need. Adhering to this process for 10-14 days and you should see results to the problems you are having. Resulting in wearing your therapy for longer hours, and hopefully ultimately all night long.