CPAP: Use It And Live

The majority of patients I encounter in the ICU/CCU who have a diagnosis of sleep apnea do not use their CPAP machines. Those who DO use them seem to have better outcomes. Nurses Announcements Archive Article

You are reading page 3 of CPAP: Use It And Live

meggzluv

21 Posts

I have sleep apnea as well. COMPLEX/MIXED sleep apnea to be specific! For those of you who don't know, that means a combination of obstructive and central. Had sinus surgery back in 2005 that supposedly [according to sleep doc and sleep study] brought my originally purely obstructive SA down to a level that didn't require treatment. In 2009, I begged them to give me a repeat sleep study b/c I felt like the sleep apnea was back. The docs poo-poo'ed me and said no no no, it's just season, it's winter and you're extra tired from the lack of sunlight. Well, I insisted and they finally ordered the study. SURE ENOUGH, results said now that my sleep apnea had gone untreated for years (due to my deviated septum returning to it's pre-op position etc), I had severe complex SA. Awesome. Now I wear a non-vented nasal pillow-only CPAP and it is one of my best friends :D To the original poster--yes, I definitely believe CPAP compliance directly relates to cardiac outcomes, etc. Low levels of oxygen for 8 hours [or however long you sleep] and the lack of restful sleep that so many body systems require to recuperate every night is soooo detrimental to everyone's health, whether they have apparent cardiac issues or not.

big kudos on writing this and big kudos to the other nurses who use their ownnn CPAPs faithfully!! :nurse: To those of you who don't, I swearrrr your life will improve tenfold or more!!! You are more rested, pleasant, clear-thinking etc.

Specializes in Subacute, ICU.

Thank you so much for this post! I work in a Sub-acute facility that only admits Ventilator Dependent Respiratory Failure patients. I see way to many patients that have obstructive sleep apnea with or without obesity who were non-compliant with their CPAPs and other regimens. Needless to say, they end up in my unit with VDRF and a laundry list of co-morbidities, sometimes with an inability to ever wean off their trach or vent. Strapping on that CPAP every night is a cake walk compared to a life on permanent Trach/Ventilator Therapy! Kudos for continuing to educate and intervene with your patients before it's too late :)

:yeah:

blueheaven

832 Posts

I have question for nurses that use them. Did it force you to move of your bedroom because it is noisy and keep your spouse awake?

We always play a rainshower CD, so any noise made by our (yes our) machines or masks is a non issue :)

dcinma

9 Posts

I have had two of these things and could never use them. The first one was prescribed about 13 or 14 years ago, when I was still married. I was able to wear it for a few weeks and I did get better sleep with it for a while, but then it became so irritating to me that I was tearing it off when asleep and then later it just kept me up all night if I tried to use it.

Later my doc ordered a different one, with a gel mask and some kind of humidifier attached to it. I think I used it once or twice and that was enough for me. I think there are pieces of it in one of my closets.

I sleep alone nowadays although my daughter says that I snore sometimes (I'm a divorced dad who has sole custody). I don't believe her :-). I do know that if I sleep on my back it's not unusual to wake up gasping.

What to do? I don't know. I'm reluctant to mention it to my PCP; he'll order another (3rd!) sleep study and probably a CPAP that I can't tolerate. Back in the first go around the whole thing started because of muscular issues; the PCP sent me to a rheumatologist who felt that it was fibromyalgia and that sleep disturbances go along with that; the sleep specialist/neurologist said I had sleep apnea. Then we had a 3 way battle between the docs...the neurologist wanted me to have surgery in my throat for it; the rheum and the PCP strongly disagreed and wanted me to use meds and a CPAP. I gave up on all of it and just deal. If they could find another way to treat the apnea I'd be interested but the CPAP was completely unacceptable and I couldn't sleep at all with that thing on my nose and the air forced in.

SCSTxRN

258 Posts

Specializes in Psych.

You might talk to your doctor about a chin strap alone - sometimes in PACU we pushed up on the lower chin to raise O2 sats.

blueheaven

832 Posts

Please, please, try to find something that will work for you. Do some web surfing-the web site that another poster mentioned is excellent.

I have always snored, even when I weighed 120lbs. Of course I don't weigh that now but still! A few years ago, I started noticing that I was having difficulty with my memory (not good when you work ICU). When I would wake up in the mornings and every muscle in my body would ache as well as having severe headaches.

Anyway, had a sleep study and found out there was good reason for my difficulties. My oxygenation would drop at times to the 60s. We intubate people with better sats than that! Even now, I have nights where I take my mask off but 95% of the time it stays on. It was like turning on a light switch. The muscle pain, morning headaches, hypertension, decreased vision went away. I can tell that the hypoxia fried off a few brain cells but overall my memory is better.

Do I like wearing it? Heck no. For me it beats the alternative. Keep trying! Find a system that will work for you. There are other systems besides the nasal and full face mask. Good luck!

CNA2day

197 Posts

I have a question. My fater has sleep apena and states that he can not wear the cpap because it "collapses his sinuses" and he can not breathe.

He did recently undergo surgery to fix a deviated septum, but states he still can not wear the cpap.

Is this something that actually happens or is he being belligerent? (he has a history of that!)

Also what are some other options to help people with sleep apnea? Are there alternative therapies? Any information would be great!

Ruby Vee, BSN

17 Articles; 14,030 Posts

Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
i have a question. my fater has sleep apena and states that he can not wear the cpap because it "collapses his sinuses" and he can not breathe.

he did recently undergo surgery to fix a deviated septum, but states he still can not wear the cpap.

is this something that actually happens or is he being belligerent? (he has a history of that!)

also what are some other options to help people with sleep apnea? are there alternative therapies? any information would be great!

actually cpap forces open the airway so you can breathe. the first few times you put it on, however, it seems as though it's a lot of work to breathe because you have to exhale against the pressure.

if you're looking for good information, try http://cpaptalk.com. the wonderful folks there helped me through my first few months of cpap and i'm sure they can help you or your father, too.

bradleau

146 Posts

Specializes in Med/surg, ER/ED,rehab ,nursing home.

I had problems with my nasal allergy, which clogged my nose. Using a CPAP just was not working. Finally I was put on a decongestant, and singular. Other than having a cold, my nose stays open and I can use the CPAP. Sometimes just using a full face mask will do the job. But for me I really had a hard time learning to breath out against the pressure of my machine...which was set at 12. It took me nearly 3 months of being hard headed ....I WAS NOT GOING TO FAIL AT USING MY CPAP. I use it faithfully. I have had about 4 machines in the 20 yrs I have had apnea. My husband is now on one. His is set at 17. He did not have any problems getting used to it. He no longer falls asleep behind the wheel or at work. So I would think that your issue with your father? not using the CPAP may only be that he has not been fitted with the proper mask and his nasal congestion has not been addressed. Let him know he will be much happier and have more energy, sleep better, too.

RetRN77

153 Posts

Specializes in Labor/Delivery, Pediatrics, Peds ER.

My husband has Central Sleep Apnea and he is pretty good about using his CPAP, but he has allergies as well, and when he has difficulty he doesn't use it. He also refuses to travel with it. :( He tells me his therapists told him that as long as he uses it 5 or 6 hours a night that is good. I never know what to think of that. I'm glad he uses it as much as he does, but my dad died of OSA right after being diagnosed and before being put on treatment, so I'm always afraid. I try not to think about it as he is stubborn as a mule and my talking about it never changes anything. Thanks for your article - I will email it to him. :redpinkhe

riverwink

47 Posts

Specializes in ICU, Hospice.
Just like the American Express card ad: Don't leave home without it, my CPAP travels where ever I go, including AN headquarters.

The machine is the size of a large tissue box, found Profile lite gel masks work best and saved my life past 16 years .

Only time not worn is during power outage--- then I'm praying for the electric company's quick fix.

My husband and I each wear a CPAP. We invested in a small generator. Runs the refrigerator and our CPAPs. Considered the small travel models with built in batteries but decided we may not have them charged when we need them. :twocents: :)

Specializes in Case Management.

Love this post. I too wear a CPAP. I hate it. It took me several weeks to get used to the idea of having to wear it. I have tried numerous masks trying to find the right fit and one that doesnt give me pressure ulcers all over my face. Sometimes I do fall asleep without it on, and I can really tell the difference. I am a strong advocate for my patients and CPAP usage. I work in an ambulatory care setting and everytime I see sleep apnea listed as a diagnosis, I open a dialogue about it with the patient. I dont know if it makes a difference for them, but I would like to think that it does. Also, alot of doctors are not on the bandwagon with CPAP. I see patients all the time, obese, diabetic, hypertensive, etc, etc..complaining of depression, fatigue, headaches...the first thought in my head is sleep apnea? I have suggested this a few times to different docs, but have learned to treed lightly with some docs. They dont appreciate nurse's knowledge.;)