The term sleep disordered breathing encompasses a variety of sleeping disorders that include, but is not limited to: Obstructive Sleep Apnea (OSA), Central Sleep Apnea (CSA), Complex/ Mixed Sleep Apnea, and Cheyenne Stokes Respiration.

Obstructive Sleep Apnea is the most common disorder and is characterized as a cessation of breathing during sleep. It is caused by the collapse of the soft pallet at the back of the throat which causes an obstruction of the airway that can cause the patient to wake many times during the night. It is estimated that over 4 million American’s suffer from OSA with the majority of these patients remaining undiagnosed.

1. Reduced Hospitalization in Patients on CPAP Treatment

2. Utilization of Health Care Services in Patients with Severe OSA

3. Epidemiology of Obstructive Sleep Apnea 

Central Sleep Apnea although not as common as OSA; central sleep apnea is when the brain forgets to tell the muscles that control the respiratory system to breath. Unlike people who suffer from OSA the airway remains open and unobstructed, but the patient is unable to initiate breathing.

1. Adaptive pressure support servo ventilation: A new spin on the treatment of heart failure with central sleep apnea

Complex/Mixed Sleep Apnea is characterized by both obstructive and central sleep apnea. Often people whom have been missed diagnosed with OSA find that CPAP treatment can actually make their condition worse. For this reason, it is important to find a lab that is truly committed to accurate, quality sleep diagnostic services (such as Fountain Valley Regional Sleep Center).

1. Pathophysiology of Central Sleep Apnea Syndrome

Cheyenne Stokes Respiration is a condition often seen in critically ill patients and patients on long term opiate use to help control chronic pain. The condition is characterized by alternating periods of shallow and deep breathing. A new treatment option for these patients is found in noninvasive servo ventilation (auto-bi level).

Difficulty tolerating mask/interface:
1. Have DME or sleep center check to make sure you have the correct mask size.
2. Make sure mask/interface is positioned correctly.
3. Loosen mask/interface slightly (make sure there are no areas that leak).
4. Make sure you are replacing mask every 6 month to keep in good working order.
5. Consult w/DME to see if a different mask/interface may be required.
6. Make sure you are cleaning your mask on regular basis to keep in good working order.

Therapy makes you feel claustrophobic:
1. Practice using device in the daytime to get used to breathing while on the device.
2. Consult DME or sleep center to see if new nasal pill hybrid mask is appropriate.
3. Consult DME or Sleep center to see if using nasal mask w/chin strap is an option if you currently using standard full face mask.

Problems w/CPAP Pressure:
1. Use CPAP ramp feature.
2. Practice using CPAP while awake to get used to breathing on CPAP.
3. Consult w/DME or sleep center to see if Bi-level or Auto-PAP is appropriate therapy for you (physician prescription is required).
4. Consult w/DME or sleep center to see if lowering pressure by 1 or 2 cmH20 is appropriate for you (Physician prescription is required).
5. Make sure you are using heated humidifier to optimize comfort.

Problem Falling Asleep w/CPAP or Other Devise:
1. Delay going to bed until extremely tiered.
2. Make sure you are using good sleep hygiene.
3. Consult with your physician about temporarily using sleep medicine.

Therapy Causing Nasal Irritation:
1. Make sure you are using heated humidification.
2. Make sure humidifier is set at appropriate level to optimize comfort.
3. Use nasal saline spray before starting therapy.
4. Make sure you are properly cleaning clean humidifier water chamber.
5. Use nasal corticosteroid spray (consults DME, sleep center, and physician).

**Always consult DME or Sleep center before contacting physician**


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