Continuous Positive Airway Pressure (CPAP) is a non-invasive treatment for obstructive sleep apnea. It uses a machine, hose, and mask to deliver pressurized air, keeping the airway open during sleep and preventing soft tissues from collapsing. Correctly setting up the equipment is essential for effective treatment and patient comfort. This guide provides sequential instructions for assembly, mask fitting, comfort adjustments, and system maintenance.
Step-by-Step Machine Assembly
Proper assembly requires identifying the core components: the main unit, power cord, air tubing, and humidifier water chamber. Place the CPAP unit on a stable surface near your bed, ensuring it is near a power outlet. Position the machine at or slightly below head level to prevent water from entering the tube if the unit is jostled. Connect the power cord to the machine and plug it into the wall outlet, but do not turn the machine on.
Prepare the humidifier chamber, which adds moisture to the pressurized air to prevent nasal and throat dryness. Slide the chamber out and fill it only with distilled water. Tap or bottled water can cause mineral deposits (scale) to build up, potentially damaging the device. Do not exceed the maximum fill line indicated on the chamber before sliding it securely back into the machine.
Before connecting the air tubing, check the air filter location, typically on the back or side of the machine. Most modern devices include a disposable filter already installed, which prevents dust and particulates from being drawn in and delivered to the user. Finally, attach one end of the flexible air tubing to the air outlet port on the CPAP machine. This tubing connects the machine to the mask interface.
Mask Fitting and Adjustment
Achieving an effective seal and comfortable fit is essential for successful CPAP therapy. Masks come in three main varieties: nasal pillows (sealing at the nostril opening), nasal masks (covering the nose), and full-face masks (covering the nose and mouth). The choice depends on whether the patient breathes primarily through the nose or mouth. Once the mask type is selected, connect the mask’s swivel elbow or short tube to the free end of the air tubing.
To begin fitting, hold the mask against your face without the headgear straps to find the most comfortable cushion position. Then, put on the headgear straps loosely, making initial adjustments while sitting upright. Adjust the straps just enough to hold the mask in place. Over-tightening can cause the cushion to wrinkle and break the seal, so avoid pressing it tightly against the face.
Check the seal by lying down in your typical sleeping position and starting the machine. If air is leaking, gently adjust the headgear straps one pair at a time, moving the mask slightly until the leak minimizes. Many CPAP machines include a built-in “Mask Fit” check feature that runs a brief pressure test and provides visual feedback. A small, intentional leak is normal for carbon dioxide exhalation. However, a high leak rate, often above 24 liters per minute, indicates a problem requiring correction.
Initial Operation and Comfort Settings
Once the machine is assembled and the mask is fitted, initiate therapy and customize comfort features. Locate the power button or start switch, typically a single large button on the top or front of the machine, to begin airflow. The machine will then start delivering the prescribed pressure, which is set by a healthcare provider.
The “Ramp” setting is beneficial for new users, as it eases them into the therapy pressure. The ramp function starts airflow at a lower, more comfortable pressure (typically around 4 cmH2O) before gradually increasing to the full therapeutic level over a set period (often 5 to 45 minutes). Activating this feature helps users fall asleep without the initial discomfort of full pressurized air. Some advanced models feature “AutoRamp,” which monitors breathing and only increases pressure once the user has fallen asleep.
Check the humidification and heated tubing settings, which are adjustable through the main menu screen. Adjusting humidity prevents nasal dryness and irritation. Heated tubing prevents condensation, or “rainout,” from forming inside the hose. When using the pressure for the first time, focus on maintaining natural breathing patterns; the machine is assisting, not forcing, the air.
Daily Use and Cleaning Protocol
Consistent daily maintenance ensures equipment longevity and prevents the buildup of bacteria and facial oils that compromise the mask seal. Every morning, wipe down the mask cushion or nasal pillows with a damp cloth or specialized CPAP wipe to remove residue. Additionally, empty the water chamber of any remaining distilled water to prevent standing water from becoming a breeding ground for bacteria.
Perform a thorough cleaning of the entire system weekly to maintain hygiene. Disassemble the mask, headgear, tubing, and water chamber. Wash them in warm water using a mild, unscented soap, such as baby shampoo. Avoid harsh chemicals, bleach, alcohol, and antibacterial or scented soaps, as these can damage materials and leave irritating fumes.
After washing, rinse all components thoroughly with warm water and allow them to air dry completely, away from direct sunlight, before reassembly. Replacement of consumable supplies is necessary as components wear out. Disposable filters typically need replacement every two weeks to one month. Cushions and pillows may require replacement every two weeks to a month, and the tubing and headgear are often replaced every three to six months.