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Thursday, March 20, 2014

How to select the best cleaning and care products for CPAP masks and machines.

With declining reimbursements, cash products are a great way to increase revenue while also providing your patients with convenient, easy-to-use cleaning products. This article describes the best products for cleaning CPAP equipment, as well as recommendations for cleaning schedules and techniques.



To prevent growth of mold and bacteria, regular cleaning is essential. However, this task can be tedious without the right supplies.

Daily Care
To remove dirt and oils and prevent buildup, clean the mask and cushion with a cleanser or wipe that is gentle enough for daily use. As a general rule, people can use any cleaning product on their mask that they would use on their face. Anything stronger with scents, alcohol, antibacterial agents or bleaching ingredients can cause the cushion to break down or irritate the skin.

Several products are designed specifically for CPAP masks with all-natural ingredients that are safe enough for daily use. One of the most popular brands is Citrus II, available in a dispenser with 62 wipes or a box of 12 individually wrapped wipes. Both options have their uses.   The dispensers are compact. Many of our customers provide each of their respiratory therapists with a few dispensers of wipes, one to demonstrate to the patients how to clean their masks during the initial fitting and additional ones to sell. This helps show proper maintenance and can also lead to a cash sale on the spot.

The individually-wrapped wipes are great to give away as a sample with each new patient setup, and are useful for patient travel or in-store promotions.

If your patients prefer to use a spray, Citrus II offers CPAP Mask Cleaner Spray in either 8-ounce or 1.5-ounce travel size bottles.

In addition to wiping down the mask, instruct your patients to empty the humidifier chamber each morning and leave it open to air dry for the day. They can refill it with distilled water at night. Avoid using tap water to prevent mineral buildup in the chamber that could damage the machine.

Weekly Care
Clean all equipment on a weekly basis, or more frequently if the patient is recovering from illness. First detach the mask from the tube and remove the headgear and cushions. Soak the headgear, tube, mask, humidifier chamber, reusable foam filter, chinstrap and any connectors or adapters in a 50/50 solution of warm water and Citrus II CPAP Concentrated Cleanser for 10-20 minutes.

After soaking, rinse thoroughly with warm water. For best results, hang the tube, headgear and chinstraps to allow them to dry completely. The mask, cushions, chamber and filter can be left out on a towel to dry. Ensure the filter is fully dry before placing it back into the machine. If your patient lives in a wet or humid climate and they have trouble getting their tube and mask to dry fully, Hurricane makes a Home Edition CPAP Equipment Dryer that safely dries products without damage. However, make sure patients are aware that they should not machine wash or dry headgear or chinstrap as it will damage the material or affect the size.

To clean the machine, make sure it is unplugged, and wipe it with a cloth soaked in warm water or a mix of warm water and CPAP Concentrated Cleanser.

With filters, a good rule of thumb is: If it is foam or labeled as reusable, it can be washed weekly and reused for six months, per Medicare guidelines. If it is labeled as ultrafine or disposable, it cannot be washed and must be thrown out and replaced every two weeks. Washing a disposable filter will cause it to lose shape and effectiveness. Some machines use only disposable filters while others can accommodate reusable foam filters, as well as disposable ones. Check with the manufacturer, and explain the difference to your patients to avoid confusion.

During the weekly washing, patients can substitute vinegar, unscented liquid dish soap or hand soap in place of the CPAP Concentrated Cleanser, but they should not use rubbing alcohol, bleach, scented soaps or antibacterial soaps as they can break down the equipment.

Effective Display
How do you encourage patients to clean their products regularly? First, inform them of the health implications of inhaling mold and bacteria growing in their equipment. Also, make the cleaning products easily accessible, and start them off on the right foot with samples or cleaning demonstrations during setup. To assist in this, one product is the CPAP Cleaning Product Display Kit (see below), which is a full display of all the most popular CPAP cleaning products in a tabletop format. The display signage spells out the features and benefits of the cleaners. It displays well next to the register to encourage cash purchases.

About the author:
Ashley Wood is the director of operations for Sunset Healthcare Solutions, a national manufacturer and distributor of CPAP and oxygen products and accessories. She can be reached at 312-997-9980 or ashley@sunsethcs.com. For more information or to purchase the products listed in this article, call 877-578-6738 or visit www.sunsethcs.com/cleaning.

Tuesday, March 11, 2014

How Is Sleep Apnea Diagnosed?

Doctors diagnose sleep apnea based on medical and family histories, a physical exam, and sleep study results. Your primary care doctor may evaluate your symptoms first. He or she will then decide whether you need to see a sleep specialist.

Sleep specialists are doctors who diagnose and treat people who have sleep problems. Examples of such doctors include lung and nerve specialists and ear, nose, and throat specialists. Other types of doctors also can be sleep specialists.

Medical and Family Histories

If you think you have a sleep problem, consider keeping a sleep diary for 1 to 2 weeks. Bring the diary with you to your next medical appointment.

Write down when you go to sleep, wake up, and take naps. Also write down how much you sleep each night, how alert and rested you feel in the morning, and how sleepy you feel at various times during the day. This information can help your doctor figure out whether you have a sleep disorder.

You can find a sample sleep diary in the National Heart, Lung, and Blood Institute's "Your Guide to Healthy Sleep."

At your appointment, your doctor will ask you questions about how you sleep and how you function during the day.

Your doctor also will want to know how loudly and often you snore or make gasping or choking sounds during sleep. Often you're not aware of such symptoms and must ask a family member or bed partner to report them.

Let your doctor know if anyone in your family has been diagnosed with sleep apnea or has had symptoms of the disorder.

Many people aren't aware of their symptoms and aren't diagnosed.

If you're a parent of a child who may have sleep apnea, tell your child's doctor about your child's signs and symptoms.

Physical Exam

Your doctor will check your mouth, nose, and throat for extra or large tissues. Children who have sleep apnea might have enlarged tonsils. Doctors may need only a physical exam and medical history to diagnose sleep apnea in children.

Adults who have sleep apnea may have an enlarged uvula (U-vu-luh) or soft palate. The uvula is the tissue that hangs from the middle of the back of your mouth. The soft palate is the roof of your mouth in the back of your throat.

Sleep Studies


Sleep studies are tests that measure how well you sleep and how your body responds to sleep problems. These tests can help your doctor find out whether you have a sleep disorder and how severe it is. Sleep studies are the most accurate tests for diagnosing sleep apnea.

There are different kinds of sleep studies. If your doctor thinks you have sleep apnea, he or she may recommend a polysomnogram (poly-SOM-no-gram; also called a PSG) or a home-based portable monitor.

Polysomnogram
A PSG is the most common sleep study for diagnosing sleep apnea. This study records brain activity, eye movements, heart rate, and blood pressure.

A PSG also records the amount of oxygen in your blood, air movement through your nose while you breathe, snoring, and chest movements. The chest movements show whether you're making an effort to breathe.

PSGs often are done at sleep centers or sleep labs. The test is painless. You'll go to sleep as usual, except you'll have sensors attached to your scalp, face, chest, limbs, and a finger. The staff at the sleep center will use the sensors to check on you throughout the night.

A sleep specialist will review the results of your PSG to see whether you have sleep apnea and how severe it is. He or she will use the results to plan your treatment.

Your doctor also may use a PSG to find the best setting for you on a CPAP (continuous positive airway pressure) machine. CPAP is the most common treatment for sleep apnea. A CPAP machine uses mild air pressure to keep your airway open while you sleep.

If your doctor thinks that you have sleep apnea, he or she may schedule a split-night sleep study. During the first half of the night, your sleep will be checked without a CPAP machine. This will show whether you have sleep apnea and how severe it is.

If the PSG shows that you have sleep apnea, you’ll use a CPAP machine during the second half of the split-night study. The staff at the sleep center will adjust the flow of air from the CPAP machine to find the setting that works best for you.

Home-Based Portable Monitor
Your doctor may recommend a home-based sleep test with a portable monitor. The portable monitor will record some of the same information as a PSG. For example, it may record:


  • The amount of oxygen in your blood
  • Air movement through your nose while you breathe
  • Your heart rate
  • Chest movements that show whether you're making an effort to breathe

A sleep specialist may use the results from a home-based sleep test to help diagnose sleep apnea. He or she also may use the results to decide whether you need a full PSG study in a sleep center.