SLEEP HYGIENE TIP OF THE WEEK: Using CPAP with a head cold

When the cold and flu season hits, the inconvenience of dealing with viral symptoms can be magnified if you're also using a PAP device (CPAP, BiPAP, APAP). Some people think it is better not to use your PAP therapy at this time, but the truth is, you still need it, even if you experience more discomfort while asleep. Your body will get through a respiratory illness more quickly if you continue your therapy because it will have more sleep (even if it doesn't consciously feel like it).

Here are some tips to stay the course through those nights when sore throats, runny noses, congested sinuses and coughs crop up this winter.

1. Adjust your sleeping position. A runny nose or congestion can make breathing very comfortable while you sleep. Try sleeping on your side, which will use gravity to drain your sinuses (one side at a time). If you have a reclining chair, that might also be helpful for the same reason. You don't want phlegm collecting in the back of your throat, which will just worsen matters. Avoid sleeping on your back or completely flat; even elevating the head of your bed by 3 inches can make a big difference.
   
2. Make sure you use your humidifier. The warm moist air will really help your passages remain pliable and comfortable through the course of a virus.
   
   If you don't know how to use your humidifier, ask the CPAP specialist who initially set you up with your current machine. Some people normally don't use the humidifier, but may turn it on just for head colds or allergies.
   
   If you have an older machine, it may not have a humidifier, or if it has a humidifier, it may not have a heated setting. If you get a lot of respiratory illnesses during the winter, you should ask your doctor about updating your machine to one with a heated humidifier.
   
3. Try using nasal sprays. These can be a quick, easy and affordable solution. Look for sprays which are designed for decongestion. Even a simple saline nasal spray (or gel) can help relieve stuffiness. If you have allergies, opt for a spray with an antihistamine in it, if you don't already have one.
   
   Avoid any over-the-counter spray which causes sedation; this can worsen your apnea. Unsure which spray is best for you? Ask your pharmacist.
   
4. Similarly, consider menthol. Menthol can help to clear blocked nasal passages pretty swiftly.
   
   You won't want to suck on menthol drops while trying to sleep, as that is an obvious choking hazard, but you could have a drop right before bed to help open up your airways.
   
   Also, 15 minutes before bed, try rubbing a little menthol ointment on your chest and let the vapors rise and help decongest your airways before applying your mask.
   
   Sometimes the challenge is just getting to sleep; once asleep, the humidity from PAP therapy can often take over and keep everything clear.
   
   Please do not add menthol products to your PAP humidity reservoir without first checking with your mask and PAP machine user's manuals to ensure you can safely do so; if so, they will also advise on which kinds of menthol products and how much to use.
   
5. Try cleansing your sinuses with a neti pot. These are little bulb- or teapot-shaped vessels that help you to flush your nasal passages out. They can be found in most drugstores and are often an effective pre-sleep solution for anyone with a problem with congestion.
   
6. Switch to a different style mask. There are many patients who have more than one mask. They use their nasal or pillow mask for normal use but switch to a full-face mask if they find they are breathing through the mouth, as full-face masks cover both mouth and nose and allow for oral breathing. Pillow masks are sometimes difficult to wear if the nose it sore and swollen; a nasal mask might be a good alternative if you aren't mouth breathing. However, having a head cold leads to mouth breathing even in those who don't normally do so; it might be worth it to look into having a spare full-face mask on hand for this reason.
   
7. If you use CPAP, consider APAP. This is a more expensive solution but if you suffer from seasonal allergies or viruses on a regular basis, the "smart technology" in an AutoPAP (or APAP) might help you breathe better when congestion is a regular problem. The APAP delivery system senses your need for more or less pressure and automatically adjusts, unlike the CPAP which, as its names suggests, only delivers one continuous pressure. Discuss this option with your physician; you will need a prescription in order to acquire one of these.

Here's what a simple neti pot looks like; there are also
more extravagant ones, but a simple over-the-counter
product can be just as effective.

Finally, keep everything clean! You should be vigilant about cleaning your PAP tubing and mask anyway, but if not, NOW is the time to change that bad habit to make it a regular part of your daily routine. Learn some basics here.
Keeping your tubing, masks and accessories clean and sterile is necessary to prevent the growth of bacteria inside your equipment, which can actually make you even sicker (or cause illness when you aren't sick).

Follow manufacturer's instructions for cleaning your PAP-related items or, if you know you are just not going to follow through on a daily regimen, look into one of the new PAP cleaning kits now available which sanitize all of your items with the push of a button.

Sleep Hygiene Tip of the Week: Humidify

You've got a fire in the stove. Maybe you've cranked up the heater. It's winter, right? And outside, the relative humidity plummets with a new high pressure zone, leading to high blue skies, but dry air. Bone dry. 

Having trouble sleeping? Even worse... have you noticed that is everyone in your house catching the same virus?

Here's why this could be.

A household humidity level of 43 percent or higher can significantly reduce the incidence of airborne viral infections, whereas a lower level of humidity leads to more disease transmission via coughing because... guess what? The air is too dry! You cough to encourage mucus flow, introducing more germs into the environment at the same time. 

Humidifying your household air can be done through a whole house system (very common in dry weather winter climates) or via tabletop humidifier units.

In either case, that added boost of moisture in the air is not only going to help keep you and your family healthier, it's also going to help you keep your upper respiratory system--the sinuses, the nasal passage, the tongue and insides of the mouth, even the vocal cords--soft, pliable, moist and comfortable. Even your eyes and skin will feel better.

The result? Less coughing, sneezing and sore throats throughout the season.

What's more, humidity can be the ticket for people who snore when the air runs dry. Add some moisture, et voila! No more snoring (or at least it won't be as loud)! Good not only for snorers but for people who have to sleep with them!

If you are using a humidifier, please remember that you need to keep it clean to avoid developing bacteria and mold.

For personal humidifiers, using distilled or demineralized water can help keep your humidifier cleaner longer and reduce the chances of bacterial growth. A weekly clean is easy and should do the trick. Also, look for filters that may need regular replacing.

Check with your owner's manual if you are using a whole-house humidifying system to determine its care schedule. This can include replacing filters.

Also, make sure you don't overhumidify. You can have too much humidity, even in the winter. This can lead to problems with condensation and mildewing.

The best way to check humidity is to use a tool called a hygrometer in the room where the personal humidifier is being used, or set your whole-house system to maintain a level between 40 and 50 percent.

Portable hygrometers are not hard to find: look at discount or hardware stores. There are also decorative "weather stations" many people hang on the walls of their homes that include a hygrometer along with a thermometer and barometer.

SLEEP STUFF: Cleaning gadgets and products for PAP users

Positive pressure airway (PAP) devices have revolutionized sleep apnea treatment. These devices include an air pressurizing machine with filters, a humidifying reservoir, tubing to deliver pressurized air and, of course, various kinds of masks to meet the various needs of patients.

Because the machines deliver therapeutic air pressure via devices that make constant contact with the face and airway, they require regular cleaning and care, not only so that they will work efficiently, but so they do not introduce foreign allergens and pathogens to the skin and airway, which can actually lead to health complications. Keeping them clean will help add longevity to their use so you don't need to replace them so often.

Unfortunately, not all users of PAP equipment understand the importance of keeping their gear clean and sanitized, and this results in poorer performance overall and side effects of usage that can be avoided. Don't think you need to clean your PAP gear regularly? Check out this article on what happens when you neglect to keep it clean.

Keeping your gear clean isn't actually too difficult; it's more a matter of making it a priority. Here are the basics:

Masks
Wash daily in warm water and mild fragrance-free soap or use wipes or spray cleaners specifically designed to clean PAP masks. Rinse with water; air dry on a clean cloth or paper towel away from direct sunlight (silicone can break down or discolor if exposed too long to sunlight). Before putting on your mask, cleanse your face and skip the moisturizer (which can break down the silicone and possibly interrupt the seal needed to keep your pressure uniform). That's it! Once weekly, sanitize the mask using 1 part white vinegar to 3 parts water and rinse in distilled water.

Headgear and chinstraps 
Wash by hand using warm soapy water, rinse well and air dry. Try not to stretch the material out of shape. Do not use a washer/dryer for this process.

Tubing/hosing
Clean this once weekly by soaking in a basin of warm soapy water. Rinse well and hang-dry away from direct sunlight.

Humidifiers
If your machine does not have a humidifier, it is likely time to get a machine upgrade! Humidifiers help reduce morning dry mouth and stuffy nasal passages while in use.

The water reservoir must be cleaned daily to eliminate both bacteria and mineral buildup along its sides. Wash with warm, soapy water, then rinse well and dry on a clean towel away from direct sunlight. Always fill with distilled or sterile water; tap water contains minerals and chemicals that can damage the mask or tubing. Note: Water filters for tap water do not remove these substances.

Once weekly, sanitize the reservoir using 1 part white vinegar to 3 parts water for 20 minutes, then rinse in distilled water.You may have the option of cleaning your humidifier reservoir in the dishwasher; check your PAP machine manual to confirm.

Air Filters
PAP machines draw air from the room to filter and pressurize before they deliver it as therapy. They require filters to remove typical household debris from the air such as allergens like dust, smoke or pet dander. Filters are generally disposable and require regular replacement. Fortunately, filters for PAP devices are cheap, costing maybe $2 a month. It's recommended that you change them at this interval as well. Filters allowed to become dirty for a long time will have a negative impact on your PAP machine's effectiveness and could fail to remove particulate matter from the air coming to you through the hose.

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Unless otherwise indicated, the products discussed below can be used for nearly all kinds of PAP gear regardless of therapy (CPAP, BiPAP, AutoPAP, etc.). They can help you establish better cleaning and maintenance practices with your gear. Not only will keeping your equipment clean keep you healthier, but it will also help you keep your gear in better shape, which means less frequency in making replacement purchases down the line.

It's always recommended that you consult your PAP machine manual for advice about cleaning and sanitizing your gear, as it will have the most accurate information available for your particular gear.

SHC cannot be held liable for any damage to any PAP devices caused by using the products listed below.

HOME PAP DEVICE SANITIZER
SoClean may be expensive at $300 a pop, but the time-pressed PAP user may find this to be the perfect solution for keeping up with a daily cleaning schedule.

This home PAP device sanitizing appliance is advertised as "a faster, easier, more effective way to clean your CPAP equipment. SoClean kills 99.9% of CPAP germs and bacteria in your mask, hose and reservoir with no disassembly, no water, and no chemicals."

It really is simple: just place your mask with the tubing still connected into both the SoClean unit and your humidifier, then turn it on and leave for the day. When you get home, your mask, humidifier and hose will be clean and sanitized.

The appliance makers claim it uses the same sanitizing process as used for water purification, produce handling, hotel housekeeping and hospital sanitizing; SoClean is FDA approved and their website at Better Rest Solutions offers laboratory evidence of these claims.

As of the timing of this post, there are no other cleaning machines available to do this kind of work. You can also purchase travel versions and spare parts from the SoClean website.

MASK WIPES & CLEANERS
If buying a sanitizing machine for your system is out of the question, you can certainly simplify the daily task of cleaning your mask by using any one of a number of mask wipes or cleaners made specifically for this task. Mask wipes are generally made of natural products that are biodegradable, alcohol and latex free and with a choice of fragrance or unscented products. Their chief use is to remove dirt, facial oils and other residues from your mask and other PAP gear and they are considered safe and gentle.

Some brands of wipes to look for: Beaumont Citrus II, Contour, Reliable Respiratory

In the same vein, there are spray cleaners that can also be used to clean PAP gear from the same manufacturers listed above (see also: Respiclean). Simply spray onto a lint-free towel and wipe down your mask.

TUBING CLEANER
The trick to cleaning the tubing is to effectively remove the bacteria from the hose, but this can be difficult without the right tools. A good cleaning kit will allow you to gently run a cleaning brush or pads through your tubing in one pull as well as flush out the tubing easily and with little mess. A tube cleaning kit should not damage your tubing and insertion tools should be long enough to do the job. Some brands to consider: AG Industries, Beaumont Citrus II, Clair Devices

MACHINE AIR FILTERS
PAP machine manufacturers have filter recommendations included in their manual as well as instructions for how to install, remove and replace them (plus a recommended filter replacement schedule). Your best bet is to find the filters best suited to your particular machine.

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SleepyHeadCENTRAL strongly encourages people with ongoing sleep health problems to approach a medical professional to determine appropriate differential diagnoses and treatment. This post, like all other posts on SHC, is not intended to substitute for medical advice.

See SLEEP STUFF series main disclosure notifications here regarding any products discussed on this blog.