PAP Therapy Resources
Welcome
At Prism Health Care Services, we understand how eager you are to start your new sleep journey. Our goal is to make sure you are prepared with all the right tools so that you can sleep soundly on your first night. Our program is focused on creating patient engagement centered around your needs.
Complete the Following Before Your Appointment
There are three important things we encourage you to do prior to your Sleep Compliance Coach consultation.
- Not mandatory but highly encouraged for a good night’s sleep and ongoing support: Customers who enjoy having instant access to information that will support their therapy experience should download the free ResMed myAir app and establish a username and password. The respiratory compliance coach will help you complete the registration during your education session. The app is available in the App Store and in Google Play.
- Purchase two gallons of distilled water. Using the distilled water in the PAP therapy humidifier chamber will provide you with humidification and prevent dry mouth while you sleep. The PAP equipment manufacturer does not recommend the use of tap water. Tap water contains mineral deposits that can potentially damage your new machine.
- Find a location within two feet of your bed, such as a nightstand, where you can place and plug in your PAP therapy device.
More information about myAir is available in this video from the manufacturer.
General Information
Recommendations Prior to Your PAP Education Appointment
Please click here for our recommendations that will hep you prepare for your first appointment.
What is PAP Therapy and How Will The Equipment Improve My Health?
A CPAP (continuous positive airway pressure) machine is prescribed for the treatment of sleep apnea. The machine delivers continuous pressurized air through tubing to open your airway while you sleep. We encourage you to download this booklet and watch the video to better understand how CPAP will improve your sleep and health..
Booklet: How to Start CPAP Therapy
Video: All You Need to Know About Sleep Apnea and Its Treatment: Video length 2 min 19 seconds
Benefits of Quality Sleep
Sleeping helps you stay healthy because it gives your body the chance to:
- Heal damaged cells.
- Boost your immune system.
- Recover from the day’s activities.
- Recharge your cardiovascular system.
What to Expect from the Enhanced Respiratory Care Program
- Research shows the important role coaching plays in improving patient compliance to PAP therapy. Source: Sedkaoui K et al. Efficiency of a Phone Coaching Program on Adherence to Continuous Positive Airway Pressure in Sleep Apnea Hypopnea Syndrome: A Randomized Trial. BMC Pulmonary Medicine 2015;15:102.
- Personalized clinical advice tailored to respond to your sleep therapy data.
- Remote monitoring to make sure that PAP therapy is improving your health condition.
- Proactive communication to address issues as they happen based on remote monitoring.
Getting Used to Therapy
Sleep Deprivation Side Effects
- Tiredness, irritability, and sometimes depression.
- Poor concentration.
- Inability to make decisions.
- Unhealthy food cravings which can cause weight gain.
Sleeping with a CPAP: 5 Tips for a Better Experience
Getting used to CPAP therapy isn’t always easy. As many people with sleep apnea can attest to, the first time you try your CPAP mask, you hate it. You may feel hesitant about wearing the mask to sleep, or fear you’ll never find a comfortable sleep position. The good news, you’re not alone. The better news, there are plenty of tips and tricks to make it easier to adjust to your sleep apnea therapy so you can get start getting quality sleep every night.
Tip 1: Practice makes perfect
Like anything else you try for the first time, wearing a CPAP mask can feel weird. But if you don’t get accustomed to wearing it, you’ll have trouble sleeping with it. Instead of putting it on right before you try to sleep, start by wearing it as much as you can before bedtime. If you’re sitting around the house relaxing during the day, wear it. Or even just try wearing it for an hour or so before you get into bed every night.
The more you get used to wearing it, the sooner you’ll have sweet dreams.
Tip 2: Use your CPAP mask every time you sleep
This might be the most important part of adjusting to your new sleep apnea therapy. In medical terms, physicians call this “patient compliance.” Don’t use it one night, but not the next. Make sure you’re using it every night, and for naps (if you’re a frequent napper), even if it’s a bit uncomfortable at first. Get yourself in a routine right away by putting it on as soon as you get finished with another routine, such as brushing your teeth.
Tip 3: Make small adjustments to your CPAP mask nightly
Your mask may need adjustments every night. If you’re waking up with red marks on your face, loosen the mask up a little. If it falls off your face in the middle of the night, tighten it up. Even if your physician or medical equipment provider personally fits your mask for you, it doesn’t mean you can’t tweak it to make it more comfortable.
If you’re making adjustments, make sure you do so lying down and with the device on. Many masks inflate slightly with the air on, which is a function of how they seal, so lying down with the machine on can help ensure you’re getting an accurate fit.
Tip 4: Use AutoRampTM on your CPAP machine
This is one of the most popular settings on CPAP machines. The AutoRamp setting allows you to adjust to air pressure by starting at a very low air pressure setting while you’re trying to fall asleep and then it increases to full pressure after you’re asleep. The reason for this feature is so you can fall asleep easily and comfortably, and then get the full treatment while asleep.
Tip 5: Use the CPAP humidifier to Prevent Nasal and Throat Dryness
Keeping your nose and throat moist is a must when receiving CPAP treatment. All that air pressure can and will make it drier than what you’re used to, especially if your room is already lacking moisture.
Humidity is essential for success with CPAP, and while room humidifiers are good, CPAP machines now come with their own heated humidifier and heated tubing. Being able to custom-tailor the right amount of humidity for your body can help keep your throat and mouth less dry, for a more comfortable experience.
How to Get Used to a CPAP Machine
Getting started on sleep apnea treatment isn’t always easy. Despite the positive life changes it can bring, nearly 1 in 5 quit using a CPAP machine within five years. Sleeping with a mask, tubing and constant air pressure can take time to adjust to. Thankfully, there are some tips that can help make getting used to CPAP therapy easier.
Wear your CPAP mask during the day
It can be hard to fall asleep wearing a CPAP mask, especially if you’re not used to wearing it. To help make it easier to fall asleep, try wearing your mask before bedtime so you can get used to the mask by itself. Try these tips to help you get used to wearing your CPAP mask during the day:
- Hold the mask in front of your face without the headgear and tubing. Breathe normally for 1 minute.
- Then connect the mask to your CPAP machine, turn the air on and hold it in front of your face for 1–2 minutes (still with no headgear). Focus on breathing normally. If the air pressure is uncomfortable, remove the mask from your face and try again after a few minutes.
- Now put your headgear on, sit and practice breathing through the mask and air pressure for 2 minutes at a time.
- Try building up to wearing your mask for longer periods of time. You can read or watch TV with your mask, headgear and air pressure on, aiming to have it on for 30 minutes at a time.
Sleep with your CPAP mask in stages
Once you’re comfortable wearing your mask before bed, you can try to use CPAP for sleeping. Remember, it’s ok to start slow. Try these steps below to help ease into using your CPAP therapy to sleep.
- Start by trying to sleep with your CPAP machine during a daytime nap.
- You don’t need to wear your mask for the entire duration of your nap initially. It’s ok to use it for just 30–60 minutes on your first attempt. Try to add 30 minutes of use each time you use it. You can even make a game out of it to help you stay motivated. You can use the ResMed myAir™ app to help you track your progress.
- Keep a diary of your efforts and challenges. This can help you see how far you’ve come, notice when issues become trends that need addressing and embrace the idea that CPAP therapy is a process.
- Involve your friends and family and ask them for support. Research shows that people are more likely to stay on treatment if their families are supportive and if they continue sleeping with their bed partners at night.
Set up your CPAP machine and equipment before bedtime
When you’re tired at the end of the day and are ready to go to sleep, adding an extra step to your routine can be a hassle. Instead of waiting until you’re ready for bed to get your CPAP equipment ready, have everything set up and ready to go:
- Set up your mask, tubing and machine at your bedside during the day. If you have a humidifier, have distilled water ready as well.
- Buy your cleaning supplies before you start sleeping with CPAP and set them up where you’ll clean your mask and humidifier.
- Clean your CPAP mask and other equipment in the morning when you get up so it’s clean, dry and ready to use when you get ready for bed.
Give yourself time to get used to a CPAP
Remember that it’s ok to give yourself time to get used to therapy. Adapting often takes patience and perseverance. Your body needs time to adjust to the therapy and may not feel better right away, but it’s important to not give up. If you ever feel discomfort or that something’s not right, talk to your doctor or call Prism Health Care Services at 847-310-4730.
What Your Health Plan Requires to Continue Therapy Beyond the First 90 Days of Therapy
The first 90 days of your PAP therapy are commonly called the “compliance period.” Your health insurance allows this period of time for you to get acclimated and use the therapy compliantly.
Once you have been using PAP therapy to manage your sleep apnea for three months, your medical plan will require a follow up visit with your doctor will need to reassess how well it’s working for you. This assessment should be scheduled between the 31st and 91st day after Prism Health Care Services completes the admission education for the device.
The medical plan requires that your doctor evaluate and document in your medical record whether your symptoms have improved and if you’ve been consistently using the device as prescribed.
They’ll consider factors like whether your sleep quality has gotten better and if you’ve been using the device for at least 4 hours most nights. If everything looks good, you can continue using the device. However, if the assessment indicates that the device isn’t providing the expected benefits, your coverage for it may be discontinued, and you may not be eligible for additional supplies.
Patients who do not meet the established compliance period in the first 90 days, will need to complete a new facility based sleep study to determine the underlying reasons. Until all the necessary requirements are met, your medical plan may not cover the PAP equipment and related supplies.
CPAP therapy: How to successfully achieve the medical health plan 90-day compliance period: Successful compliance is defined as using CPAP 21 out of 30 consecutive days for at least 4 hours during the night in your first 90 days of therapy. That equates to using the device 70% of the time. While we strongly discourage not using PAP therapy, there are lifestyle circumstances that can lead to therapy disruption, such as illness or forgetting to bring your CPAP while you travel.
Pediatric patients are typically not subject to these guidelines. Compliance usage varies by payer. For more information we encourage caregivers to contact the medical health plan.
What CPAP compliance might look like:
Bi-level therapy: How to successfully achieve the medical health plan 90-day compliance period: Patients using bi-level therapy must be re-evaluated to establish medical necessity of continued coverage beyond the first three months of therapy. The re-evaluation by your physician should occur no sooner than 61 days and no later than 90 days after initiating therapy. Your physician will need to document in your medical record information about the progress of relevant symptoms and usage up to the time of your visit. Failure to use the therapy for an average of four hours per 24-hour period will result in your medical health plan denying coverage for the therapy and related supplies beyond 90 days. Your physician will need to sign and date the medical record with this information and submit the information to Prism Health Care Services to have on file to prevent disruption to your supplies and continued billing of the device.
Dispelling Myths About CPAP Compliance
You do not need to achieve compliance in the first 30 days. However, clinical evidence suggests that customers who become compliant in the first 30 days are most likely to continue using PAP therapy.
During this time, your health insurance and medical provider will require you to complete a follow up visit no sooner than the 31st day and no later than the 90th day after starting therapy. The purpose of this visit is for the doctor to document that you are benefitting and are compliant with therapy. Upon completion of this visit, your doctor will fax over the visit progress notes which will then be provided to your insurance to continue payment for CPAP and related supplies.
Customers who do not achieve compliance and do not follow up with their physicians may be financially responsible for CPAP therapy and related supplies. Refer to your individual medical health plan for additional information.
Caring For Your Supplies and Equipment
How to Place Your First CPAP Supply Order and Enroll in the Resupply Program
No sooner than 30 days after your admission, you can establish a rapid reorder account. Please visit our CPAP Reorder page to learn more.
Health Insurance Resupply Fulfillment Frequency
Medicare, Medicare Advantage, and private commercial health insurance plans:
| Billing Code | Description | Maximum Quantity Allowed for Medicare and Private Insurance | Medicare and Private Insurance | Quantity Allowed Medicaid Managed Care Organization | Medicaid and Medicaid Managed Care Organizations (MCO) |
|---|---|---|---|---|---|
| A7030 | Full Face Mask | 1 | 90 Days | 1 | 180 Days |
| A7031 | Full Face Cushion | 1 | 30 Days | 1 | 365 Days |
| A7032 | Nasal Cushion | 2 | 30 Days | 2 | 60 Days |
| A7033 | Nasal Pillow | 2 | 30 Days | 2 | 60 Days |
| A7034 | Nasal Mask | 1 | 90 Days | 1 | 180 Days |
| A7035 | Headgear | 1 | 180 Days | 1 | 180 Days |
| A7036 | Chinstrap | 1 | 180 Days | 1 | 180 Days |
| A7037 | Standard Tubing | 1 | 90 Days | 1 | 180 Days |
| A7038 | Disposable Filters | 2 | 30 Days | 2 | 30 Days |
| A7039 | Non- Disposable Filter | 2 | 180 Days | 1 | 180 Days |
| A7046 | Water Chamber | 1 | 180 Days | 1 | 120 Days |
| A4604 | Heated Tubing | 1 | 90 Days | 1 | 6 Months |
Medicaid and Medicaid Managed Care health insurance plans:
| Medicaid and Medicaid Managed Care Organization Plans |
|---|
| Aetna Better Health MCO |
| Blue Cross Blue Shield Illinois Community FHP/MCO |
| CountyCare MCO |
| Humana Health MCO |
| Illinois Department of Health and Human Services (Medicaid) |
| IlliniCare Health Plan MCO |
| Meridian Health MCO |
| Molina Healthcare of Illinois MCO |
| Wellcare-Medicaid |
| YouthCare Health Choice Illinois |
PAP Supply Care Schedule
Daily Care
1. Mask:
- Clean the mask cushion: Wash it with warm, soapy water. Use a mild soap without any fragrances or lotions.
- Rinse thoroughly: Make sure to rinse all soap residue to avoid skin irritation.
- Dry: Let the mask air dry completely on a clean towel away from direct sunlight.
- Do not use antibacterial products or alcohol gel to disinfect.
2. Humidifier Chamber:
- Empty the water: Every morning, empty the remaining water in the humidifier chamber.
- Rinse: Rinse the chamber with warm water to remove any residue.
- Distilled Water: Only use distilled water in your humidifier chamber.
Weekly Care
1. Mask and Headgear:
- Deep clean: Wash the entire mask, including the headgear, in warm, soapy water. Let it soak for a few minutes before rinsing thoroughly.
- Inspect: Check for any signs of wear and tear or damage.
2. Humidifier Chamber:
- Deep clean: Wash with warm, soapy water. You can also use a mixture of one part vinegar to five parts water to disinfect and remove any mineral buildup.
- Rinse thoroughly: Make sure all soap or vinegar residue is completely washed out.
3. Tubing:
- Wash: Use warm, soapy water and clean it thoroughly. DO NOT submerge the humidifier end of the heated tubing in water.
- Rinse: Flush the tubing with clean water to remove all soap residue.
- Dry: Hang the tubing over a towel rack or a similar place to air dry completely.
4. Filter:
- Inspect and clean: Disposable filters should be replaced according to manufacturer guidelines and/or when discoloration appears
Monthly Care
1. Tubing:
- Deep clean: Use warm soapy water and clean it thoroughly. DO NOT submerge the humidifier end of the heated tubing in water.
- Rinse thoroughly
- Dry: Air dry completely before using.
2. Headgear and Chinstrap:
- Inspect: Check for signs of wear, elasticity loss, or damage.
3. Humidifier Chamber:
- Inspect for damage: Look for any cracks or signs of wear that could affect its performance.
4. Machine and Power Cord:
- Wipe down: Use a damp cloth to wipe down the exterior of the CPAP machine and power cord to remove any dust.
5. Filter:
- Replace disposable filters: Change disposable filters according to the manufacturer’s recommendations, usually once a month.
By following this care schedule, you’ll ensure that your CPAP supplies remain clean, functional, and effective, contributing to better overall CPAP therapy and health.
Non Medicare CPAP Supply
Private and commercial medical health plans requiring prior approval for supply replenishment may require insured members to continue to demonstrate compliance beyond the first 90 days of initiating therapy. Contact your health plan for more information.
Troubleshooting
CPAP Therapy Data and Time Zones
Your CPAP therapy device is not a smart device that automatically changes time, for example when daylight saving time begins. Your device has been programmed with central standard time. When using the myAir app, your compliance data during fall daylight saving time will download to myAir at 11 a.m. central standard time. During spring daylight saving time, your myAir compliance data will download at 12 p.m. central standard time. Please keep this in mind when you are travelling. Your PAP therapy device will always operate in central standard time.
CPAP Therapy Remote Monitoring: Important Message
Your medical health plan, doctor and respiratory compliance coach will have the ability to view your data and make changes to therapy as directed remotely.
It is important that your device be plugged in and not in airplane mode to view your progress therapy and to make adjustments as directed.
MyAir Is Not Downloading Data
- Your PAP device operates on central standard time.
- During the fall and winter data will download at 11 a.m. CST.
- During the spring and summer data will download at 12 p.m. CST.
- If you are travelling the data will download in accordance with Central standard time.
My PAP Is Not Recording Data
- Like a mobile phone, PAP uses cellular data to record usage. Check the cell connection bars on the PAP display.
- Unplug PAP from the electrical outlet for 1 minute.
- Re-plug PAP into the electrical outlet.
- Do you see cell connection bars on the screen? If not, try connecting the device in another area of the house. You may have a disrupted signal in your home.
My AirSense 11 CPAP continues to turn off
- Make sure the water chamber is inserted in the PAP device. The PAP device cannot function properly without the humidifier chamber. If you do not use a water chamber, contact our office for a side closure.
- This is typically a sign that the water chamber has not been inserted properly. Remove the water chamber and re-engage. Make sure you hear a click.
I Am Waking Up With Water in the Hose
- Under the MyOptions screen make sure to set the humidifier manual temperature to the same exact temperature on your home thermostat when you go to bed. If you decrease your home temperature at night the humidifier temperature should be the same as your home thermostat; or
- Turn down your humidifier to 4 or lower.
My PAP Is Not Powering On
Check the power source (Brick). Unplug the power source from the PAP and electrical outlet. Re-plug the power source into the wall. On the side of the power pack with the ResMed name, a green light should come on. If the green light does not come on, the power pack is damaged and the patient will need a new one. If the power pack light comes on, plug it into the unit. If the green light goes off the unit is damaged and will need to go in for repair. Always check a different power source just in case the electrical outlet is bad.
The Humidifier Is Not Heating
- Plug the unit into an electrical outlet.
- Run a test drive on the humidifier plate by going to the MyOptions screen.
- Scroll down to the bottom of the menu and select “warm up.”
- Remover the humidifier chamber from the unit.
- Place pressure on the warmer plate with your hand.
- The warmer plate should get warm. If it does not, it’s not working and must be replaced.
Mask Concern in the First 30 Days of Therapy
Customers experiencing mask issues which include air leaks/poor seal, noise, mouth breathing, mask not staying in place, mask is too confining, or mask discomfort/irritation within the first 30 days of starting therapy should call Prism Health Care Services at 847-310-4730.
Dry Mouth/Nose
- Turn on the humidity on your machine (select my options from the home screen)
- Place a cool mist humidifier at your bedside.
- Over the counter remedies: Biotene, Xylimelts, Nasogel (consult with your doctor first)
Air Leak
- Try adjusting your mask/headgear while laying in sleeping position versus sitting up
- Wash and dry your face prior to putting your mask on
- If applicable: shave facial hair at night (or before wearing CPAP/BIPAP)
- Replace your mask cushion (at least once per month) and/or headgear every 3-6 months.
- Purchase RemZzzs
Nasal Congestion
- CPAP/BIPAP can cause nasal passages to dry out and mucous membranes try to protect the nasal passages by producing excess mucous.
- Over the counter remedies, Flonase, Nasacort, Sinus Rinses (consult with you doctor first)
- Call Prism Health Care to schedule a full- face mask fitting.
Additional Resources
How to Travel with CPAP Therapy
CPAPs, BiPAPs and APAPs are allowed in carry-on bags but must be removed from the carrying case and undergo X-ray screening. Facemasks and tubing may remain in the case.
You may provide a clear plastic bag to place the device in for X-ray screening. A TSA officer may need to remove the device from the bag to test it for traces of explosives.
Liquids associated with nebulizers are exempt from the 3-1-1 liquids rule, in reasonable quantities. For more information, see TSA special procedures.
Devices containing lithium metal or lithium ion batteries should be carried in carry-on baggage. Most other consumer electronic devices containing batteries are allowed in carry-on and checked baggage.
For more information to portable electronic devices, see the FAA regulations.
- Keep CPAP/BIPAP in original bag when traveling and place luggage tag on bag.
- Most airlines consider CPAP/BIPAP to be medical device, therefore it is allowed as a carry-on item.
- If unable to get distilled water, bottled water is safe while traveling, DO NOT use tap water.
- When traveling outside the U.S, only a power adapter is necessary (CPAP/BIPAP can operate
without a converter)
- Remove water from the water chamber before packing the machine.
AirMini Travel PAP Therapy Video
Transcend Micro Travel PAP
CPAP Product Videos: AirSense 10 and 11
Important Information About Humidification
Humidification is important to prevent mouth and nasal dryness. If you are not using climate line tubing or decide to adjust the humidification to manual mode, you must match your room thermostat temperature to the temperature on your CPAP to prevent “rainout.” Rainout occurs when heated air cools in your tubing and reaches your mask as water. Many customers refer to this occurrence as an uncomfortable sensation that can often wake patients from their sleep due to the feeling of water on their face and/or gurgling in the tube.
Video: Maximizing Your Comfort with Heated Humidification
While this video refers to the AirSense 11, the same applies to the AirSense 10.