Common Patient Complaints and Questions
This article will provide a list of the more common complaints a patient might have while experiencing PAP therapy and some suggested actions that can be taken to assist them.
| "I wake up with an empty water chamber" | Ask the patient if they have a leak in the tubing. They can feel this by running their hand down the tubing when the device is on or if there is a high leak shown in MyAir. Ensure everything is connected properly or that there isn’t a crack in the water chamber |
| "I have water drops in my mask" (aka rainout) | Rainout is usually because of the humidification or temperature of the patient's bedroom. If the patient's room is cool advise them to increase the humidification, and if the patient's room is hot decrease the humidification. This may also be caused by a leak in the tube |
| "Can I reuse supplies?" | Patients should never reuse supplies. Supplies are disposable due to the increased bacteria buildup and, over time, can change shape. Neither of these factors provide proper sleep therapy and can increase the risk of the patient becoming sick. Advise patients that supplies should only be used for recommended timeframes per the resupply schedule. |
| "I always wake up with severe dry mouth" | First, find out what kind of mask the patient is using – if they have a nasal or pillow mask, they may be sleeping with their mouth open and may require a chin strap. Does the patient's MyAir show a high leak reading? If the patient has a full face mask, ask about their room temperature and if they are using a humidifier and climate line tubing. If they have recommended humidification in their tubing, they can change this to help with dryness. It is also possible that there may be secondary causes such as medications or lifestyle choices causing their dry mouth. |
| "The air always blows into my eyes, drying them out" | The most typical cause of this is a leak around the mask. If the leak is at the top of the mask, the patient can adjust it with the top velcro of their headgear. Ask what position they put it on their mask in (laying down or sitting up) and suggest they tighten it when they are laying down. Ask them when they last replaced their cushion? They can increase the ramp time and also ensure the size of cushions is the right fit |
| "I wake up with constant nasal issues" | This is normal and could be caused by a humidification issue or possibly mask leak. If they are prone to allergies or cold symptoms, they may be able to switch to a full face mask during these times for proper sleep therapy. |
| "I feel like I’m choking/suffocating" | This may be something they need to speak to the RT about. If their pressure is too high and they have trouble breathing out against the device, they may need to increase the EPR (this eases the tension of the exhale breath). If they continue to have difficulties, suggest they use a longer ramp time, but suggest a respiratory therapist review their settings. Offer to send an e-mail to the HME asking someone to contact the patient about their concerns. |
| "I’m claustrophobic" | It is perfectly normal to feel this way and it is a part of the adjustment to therapy. Suggest the patient wear their mask while watching tv, put it on 30 minutes before bedtime, wear their mask while taking a nap (if they can) and try to use small increments of time to get used to the feeling of therapy. If none of these work a different kind of mask may work (ie. a nasal or pillow mask). |
| "My mask/headgear slips off my head during the night" |
Ask them where it is slipping and what mask they are using. Making an adjustment at the top of the headgear will adjust the mask around their cheek bones, while adjusting the lower will adjust it at the bottom of the nose or jaw line. If the patient has a full face mask – are they putting the mask on while sitting up or laying down? Ask if their headgear stretched out. Ask if the patient sleeps on their side - if they do, perhaps they would benefit from a cpap pillow. Advise the patient to make sure their hair is pulled through the headgear straps (or adjust the tubing). |
| "It causes a rash on my skin" | First reassure the patient that there is NO latex used in any of the ResMed masks. Ask if the patient is using cream or moisturizer before bed. Tell them it may be best if they wait until morning to use these products as it can cause irritation after being under their mask for the night. Ask how frequently the patient is cleaning their equipment and what they are using for a cleaning solution? Vinegar and some soaps will cause irritation, blisters and open sores on their face. Advise the patient to use an unscented or soft soap to clean their supplies (such as baby shampoo). |
| "Can I wash the heated tubing that includes the metal part?" | Absolutely, the coils in the tube are protected by a lining, but advise the patient not to submerge the tubing water as it may ruin the connection piece. Suggest the patient use warm water with a gentle soap (suggest baby soap). This solution can be run through the tube, afterwards the tube can be hung up to dry. Make sure the patient keeps the tube out of the direct sun. |
| "Can I get the elbow replaced?" | The elbow piece that connects the tubing to the mask or the small tubing that connects the tube to the nasal pillows or mask is considered a piece of the mask. You can place an order for the mask or send a notification to the hme asking for their specific item request. |
| "Can I get cloth to cover the mask that touches the face?" | This is a cloth that wraps around the headgear, around their cheek bones to reduce irritation or marks on face. These are referred to as Snuggle Straps - send a specific item request to the HME (either by task, e-mail, or by work item) to see if it is something they carry. There are new mask has silicon straps or use a Gecko pad. https://www.cpap.com/cpap-comfort-cl...irritation.php |
| "My mask leaves marks on my face" | Ask the patient if they are putting the headgear on too tight or if it moves around their face. Any adjustments the patient makes should not be tight on their face, but if they have a small head let them know there are gecko pads or soft pads to reduce this for them. Check to make sure the patient is washing their silicon cushions every day. It may be possible that they need a new mask because of their facial structure. https://www.cpap.com/cpap-comfort-cl...irritation.php |
| "Can I order the velcro part of the mask?" | Find out what mask the patient is currently using. Any part of the velcro is part of the headgear, but it is normal for this to become less adhesive because of usage. |
| "My machine makes a lot of noise." | Ask the patient where the noise seems to be coming from. If it is from the machine, confirm with the patient that their device is put together properly (ie. water chamber secured & undamaged, filter door on tight, etc.). Ask when they last changed their filter as it may be clogged. Another source of noise may be a leak from their mask. Ask what the patient has their machine resting on as it could be vibrating and making noise. Ask the patient to try inserting the tube and confirm they are using the right tubing for their device. If none of these suggestions resolve the issue, reach out to the HME and advise them of the patient's equipment concerns. |