Q — My wife uses CPAP and is startingto develop nasal pressuresores and is complain-
ing about skin creases.
Excessivetightening of the interface and headgear are likely causes of pressuresores and skin creases on the face. Adjust the headgearfor a better and looser fit, strikinga balance betweenpotential inter- face leaks and interface tightness. Alternatively, a nasal prong type of interface is an option.If the pres- sure sores are in the nostrils from using a prong type of interface, a smaller size of prong is appropriate or a temporary switch to a nasal interfaceis indicated.
Use of a non-petroleum based ointmentin the nostrils will help to lubricate and protect the nasal membrane from the turbulence of the positive airway pressure. Some people just need to rotate the
use of a couple different types of interfaces. When using nasal pillows,it is a good idea to give the nose a two-day vacationevery once in awhile and go to a nasal interface.
Q— I recently started using CPAP, but I awake with gastric bloating and occasionally
with chest discomfort. What are my options?
Accidental swallowing of air during your PAP therapy may cause your symptoms.Verify with your health care provider that the pressuresettings are still appropriate for you as a slight decrease in pres- sure may help alleviate your symptoms. Alternatively, your physician may recommend the use of special machine features such as expiratory pressure relief or bi-levelPAP therapy to help decrease the pres- sure you must exhaleagainst.
If the chest discomfort is accompanied by other symptomsof a heart attack, you should call 911 and
go to the nearest emergencyroom.
Q — My husband was recentlyplaced on oxygen. Is it possibleto use oxygen andCPAP at the same time? If so, how — and how would we arrange this?
If needed,supplemental oxygen can easily be added to the PAP therapy. The HME provider of your PAP machine can normally also provide you with the appropriate oxygen equipment and demonstrate howto place the oxygen tubing inline with the PAP interface/machine.
If your husband's PCP ordered the supplemental oxygen, you may want to contact your husband's sleep physician. His sleep physician may want an overnight oximetry done a week or two after he has slept with PAP and the oxygen.
