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By: Scott Powers on December 8th, 2015

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PAP Therapy Problems: Breathing Discomfort

Sleep Technologist Advice


PAP therapy problems are avoidable nuisances that can change the way the device works for you

Anyone who starts PAP therapy and doesn’t experience some feeling of distress has such bad sleep apnea they just have never slept like a human should.

We have all seen first time PAP users who have difficulty acclimating to PAP pressure, and while it is easy to just say “don’t panic, it’s going to be okay”, that often results in failure to adapt to much needed therapy. The anxiety often experienced at the beginning of therapy is simply normal.

From my experience as a technologist and a PAP patient myself, I developed a formula to help ease the PAP acclimation period for these folks. I managed to narrow this formula to 3 steps.

1. Your patient needs to understand what obstructive sleep apnea (OSA) is.

It’s not something that generally goes away. The fact of the matter is we are only just now scratching the surface of the problems associated with untreated sleep apnea. At the top of a very long list is heart attack and stroke. People with sleep apnea have died in their sleep or shortly upon awakening. Yeah… I know…. Wow, right?

2. Commitment to therapy is key.

You should impart to your patient that PAP is the #1 treatment for a condition that can be fatal or worse. The threat of stroke and the aftermath of that is what I would consider worse than death. The patient’s approach to this life saving treatment is crucial. I use an analogy with my patients and would like to share it with you. I tell my patients “If I had a pill that would keep you from getting cancer no matter what but you have to take this pill 3 times a day and can’t miss 1 dose ever or all bets are off, you would take that pill wouldn’t you?” I sure would. It’s the same for OSA treatment; PAP only works if you always use it while sleeping.

3. Have your patients practice, practice, practice!

Breathing pressurized air is just simply unnatural at first. We know we are continually breathing at atmospheric pressure on a regular basis and thankfully our brain does all the work. But trying to breathe at a higher pressure than we are used to makes the mechanics of breathing different. Have your patients do something to distract themselves while practicing with PAP, like watching TV or reading, until they get used to the pressure. Remind your patients that their brain will handle breathing for them and encourage them to relax as much as possible. The goal is to learn to breathe under pressure while awake, and to use PAP therapy while asleep, day or night, any time they sleep.

So to sum up, help your patients to understand, commit to therapy, and teach them how to PRACTICE if necessary until PAP therapy works for them!

Want to learn more about PAP therapy? Read our article on PAP therapy alternatives here as well as common cures to patient discomfort here.

Want to earn CECs while you learn more about how patient discomfort affects PAP therapy? Check out our Case of The Month on a patient who went through a split night study with a bad previous experience with PAP Therapy.

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