Iowa Sleep Blog

Starting PAP Therapy

Tuesday, October 08, 2019


The brain needs to adjust to wearing a Positive Airway Pressure (PAP) machine. Nightly use will help you adjust as quickly. If uncomfortable wearing it during sleep, practice with it during the day when not trying to fall asleep. During this practice, you can listen to the radio or watch TV.

PAP therapy should be worn when you sleep, even during naps. We recommend using your PAP unit for your entire sleep time.

PAP Comfort Features

There are features on the PAP machine that can help you feel comfortable. Your DME (durable medical equipment) company should teach you these techniques. If you have problems, call us to get advice. Below is a description of what to adjust to help comfort and success.

1) Humidifier

The humidifier sits on a heater plate which warms its water and thus increasing moisture levels. If the heat bothers you, turn the humidifier down to a comfortable level. You can also turn the heater off (zero), this provides a cool pass-over humidity.

2) Dry Mouth

a) For a dry mouth, increase your humidifier to a higher setting.

b) If you continue to have a dry mouth after adjusting your humidifier, consider the possibility of excess air leak around your mask. You may need to switch to a different mask.

3) Mask

a) A mask has been provided with your PAP machine. If you find the mask is uncomfortable, leaking, or causing skin, call the DME within the 1st 30 days. DME companies have a 30 day swap policy.

b) If you have a nasal pillow mask (one that inserts into the nostrils), and develop a tender nose during the 1st week of use, a nasal gel may help. A common gel used is Ayr Gel. No prescription is required. Do NOT use any product that contains petroleum (ex: Vaseline or Neosporin)

4) Ramp

This feature allows starting off at a sub-therapeutic pressure and building up to an adequate airway controlling pressure. The downside of this is the time it takes to get to adequate pressures. If you dislike this feature, it can be turned off.

Initial Benefits of PAP Therapy

a) Patients come with different sleep apnea symptoms. Thus, the exact improvement each patient experiences will be different. The first symptoms to improve is snoring. Ask family members if snoring has resolved when wearing the PAP machine.

b) If you are using the PAP machine properly for at least 7 hours, you may notice improvements in sleep including less awakenings, less need to get up to urinate, and more energy.

c) It can take a month to notice the full benefits of PAP therapy. Often the 1st few weeks are spent giving your brain time to adjust to a new sleeping pattern and the equipment.

PAP Cleaning and Maintenance Recommendations

Reminder – Save an old set of disposable supplies in case the equipment breaks or gets lost. 

Daily Care

a) Wipe the inside & outside of your mask/nasal pillows with a damp cloth.

b) Empty the water out of your humidifier in the morning.

c) Open you water reservoir and allow it to dry between uses.

d) Use distilled water to avoid calcium carbonate buildup on water chamber.

Weekly Care

a) Before starting the cleaning procedure-- disconnect the tubing from the machine, remove the filters and the water chamber (reservoir), and take the mask apart.

b) Wash your mask, tubing, water chamber and filters with mild soap & water. Use plain dish soap or baby shampoo. Rinse well and allow to air dry. Then reassemble.

1) You can hang your tubing up to dry on the shower rod. If the tubing is still wet in the evening, running air through the tubing for a few minutes with the unit attached will help.

2) You can also soak your water chamber in a vinegar solution monthly (1 part white vinegar to 3 parts water for 20 minutes) if desired. Rinse well after soaking.

3) When you reassemble the equipment, check for air leaks.


Seasonal Care (every 3 months)

a)Inspect your mask seal or nasal pillow inserts. If they are leaking and not providing a good seal, call your DME for replacement.

b)Wipe your machine off with a damp cloth if it is dusty. Avoid use of oils or polishes.

c)Your machine comes with disposable filters. These should be changed if they can’t be easily cleaned. Call your DME for replacements.


When you have a cold

a) After a respiratory illness, clean your equipment with soap and water as instructed above. Then soak your equipment in 1 part white vinegar mixed with 3 parts water for 20 minutes. Rinse well after soaking.

b) DO NOT USE Bleach to clean you equipment, it can irritate your lungs.


If you are hospitalized

a) Use your home PAP machine while in the hospital. You will be more comfortable using the machine and equipment you are used to.

b) If you are going to have a surgical operation, tell your anesthesiologist that you have sleep apnea so they can watch you more closely in the recovery period.



Modified from work of Loretta Colvin ARNP & Ann Cartright PA