Continuous positive airway pressure (CPAP) is widely regarded as the best treatment available for obstructive sleep apnea. When correctly set and consistently used, it is highly effective, though early on, tolerance and compliance can be an issue.
It may be easy to tell when a CPAP machine is working, but what are signs that it is not working anymore? Consider some of the significant indications that your CPAP machine and equipment may need to either be adjusted or replaced. Here are some of the more typical scenarios.
CPAP Just Isn’t Working
If the machine does not turn on, it is not working correctly. When plugged in, most CPAP machines can be turned on with the push of a button. If placed in a particular setting, some devices will even start working when you breathe into your connected mask a few times. CPAP machines are prone to several problems, most of which you can troubleshoot easily.
If the CPAP stays off or does not generate any airflow, the device should be brought to your equipment provider for evaluation. It may indicate that the device needs to be repaired or replaced, especially if it stopped working after being dropped.
Though this is the most obvious sign that the CPAP is broken, there can be other signs that something is amiss.
If your heated humidifier tank does not need to be refilled more than once every 2 to 3 days, this may suggest that the temperature and humidity settings need to be adjusted.
If the water never goes down, the humidifier may not be working at all.
If the hot plate under the water chamber is not warming, this could be a problem. Some evaporation will occur as the air passes over the water, but it will typically be slower if the heating element isn’t working.
If the air feels uncomfortably chilly, this may be further evidence of its dysfunction.
Besides, if you have heated tubing and water is condensing inside it, this may suggest that the humidity setting is too high or that the tubing is either not connected properly or just isn’t working.
The machine may also become noisier or fail to generate an adequate airflow, often less than it did previously.
You Feel Worse
Some people notice a significant improvement with the use of CPAP in a matter of days or weeks. This may be experienced as fewer awakenings, more refreshing sleep, decreased daytime sleepiness, or improvements in concentration, short-term memory, or mood.
Over the long-term, other conditions associated with untreated sleep apnea may improve, such as high blood pressure, heart failure, or diabetes.
If the symptoms that prompted your evaluation for sleep apnea return, this could suggest that the CPAP is not working optimally, and you should speak to your doctor.
The most common complaint would be the return of excessive daytime sleepiness, often manifested by prolonged or frequent daytime naps. This could be due to an unrecognized mask leak or even a low treatment pressure.
Weight gain, alcohol use near bedtime, and aging may all lead to the need to increase CPAP pressures.
Therefore, if you find that your symptoms have recurred, check in with your sleep doctor to see if things can be improved by adjusting your setting.
You’re Still Snoring or Having Apnea
Snoring should never occur with adequate CPAP pressure. If the CPAP device is set correctly, the air’s constant flow will keep the airway from collapsing and will also eliminate the vibration of tissue that causes snoring.
If you are snoring with your CPAP mask on, and the mask is not leaking, talk to your doctor. The pressure likely needs to be increased to be fully effective.
Besides, witnessed pauses in breathing or episodes where you wake up gasping or choking when using the treatment are signs that the pressure is improperly set.
The apnea-hypopnea index (AHI) indicates the number of breathing disruptions that occur per hour of sleep. If the AHI is greater than 5, as can sometimes be provided on the CPAP display in the morning or with associated apps, the pressure should be increased.
If you experience these difficulties, you should speak with your sleep doctor about having the pressure adjusted.
You’re Not Sure How Long You’ve Had Your CPAP
Unfortunately, CPAP machines do not last forever. If your machine starts to make a funny noise, doesn’t seem to generate the same pressure as before, or is otherwise being temperamental, it may simply be time to replace the device.
In general, most insurance companies will pay to replace the CPAP machine every five years.
These devices do have some degree of built-in obsolescence, meaning that they will gradually begin to fail and require replacement with a new machine.
Therefore, if your CPAP is old enough and it is not working well, it may only be time to replace it. Fortunately, newer models are often quieter, have enhanced features, and are often more comfortable to use than older generations of equipment.