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Sleep Apnea page for more information.

YOUR APRIA

SLEEP THERAPY

USER GUIDE

For the Philips Respironics DreamStation

®

WELCOME.

Thank you for choosing Apria Healthcare as your home medical provider. You are receiving this package because your doctor has diagnosed you with sleep apnea and prescribed Positive Airway

Pressure therapy. Positive Airway Pressure therapy—also known as PAP therapy or sleep therapy—helps millions of users feel more energized and refreshed.

We are excited to accompany you on your journey to a better night’s sleep!

Responsive. On Time.

Apria Delivers.

With over 275 branch locations in the U.S., Apria is ready

to support patients every day and in times of need, with well-established emergency preparedness protocols in place. Apria has the knowledge, experience, and ability to provide excellent home health and equipment delivery services in all types of environments.

MOBILIZED EFFORTS: Trained staff members available around the clock to coordinate urgent and after-hours orders and carry out emergency services

24/7 DELIVERY SERVICES: Deliveries to homes, shelters and other areas pre- and post-catastrophic events

275+ LOCATIONS NATIONWIDE: Local branches with teams ready to serve patients, day or night

EXTENSIVE INVENTORY: Home oxygen therapy and respiratory services, sleep therapy and supply refills, non-invasive ventilation therapy, and negative pressure wound therapy

Care is just around the corner.

Make sure your home address can be easily seen from the street during both day and night.

If you are expecting a night delivery or visit, turn on the porch light.

Check to see that your address numbers are easy to spot and read from the street. This will allow all Apria Healthcare and emergency services to locate your residence easily.

Follow Emergency and Natural Disaster Instructions

In the event of an emergency or natural disaster, follow the radio or television instructions of your local authorities.

Overview

Your doctor has prescribed PAP therapy because you have been diagnosed with sleep apnea. Sleep apnea occurs when a person repeatedly stops breathing for 10 or more seconds at a time while sleeping. These events may occur hundreds of times throughout the night, causing oxygen levels in the blood to drop, putting stress on the heart. If left untreated, sleep apnea is linked to many other serious conditions like high blood pressure, diabetes, heart disease and stroke.

This guide contains easy step-by-step instructions for using your

PAP equipment, and is designed to help you benefit from therapy as soon as your equipment arrives. Please watch the sleep apnea video on the enclosed DVD and review the manufacturer’s user guides along with the other educational materials that were included with your equipment. The sleep apnea video can also be found on Apria

Healthcare’s website at www.apria.com/resource-center in the

“Video Library” section located at the bottom of the screen. Additional information is also available at www.apria.com/sleep-apnea.

Your Device and Settings

A licensed Apria clinician has programmed your PAP machine with the settings prescribed by your physician. If your doctor recommends changes to your PAP settings, please notify Apria Healthcare immediately, so that the clinician can make any necessary adjustments.

3

STEP 2 STEP 1

GET STARTED.

Start your therapy tonight so you can feel refreshed in the morning.

1. Open the box and unpack your PAP machine, humidifier chamber, tubing, mask, power cord and supplies.

2. Plug the power cord into an electric wall outlet. Attach the power cord and tubing to the

PAP machine.

3. Fill the humidifier with distilled water and insert the humidifier into the PAP machine. (It is recommended that you use distilled water. However, if you do not have distilled water on hand, in order to start your therapy today, bottled water can be used as a substitute to distilled water as a temporary measure.)

4. Place the PAP machine on a table next to your bed. The height of the table should be lower than your head.

Please watch the sleep apnea video on the DVD and review the manufacturer’s user guides and other materials that were included with your equipment. The sleep apnea video can also be found at

www.apria.com/resource-center in the “Video Library” section

located at the bottom of the screen.

2

1

If your doctor prescribed a specific mask and size, follow the fitting instructions provided by the manufacturer, then proceed to Step 3. If you received a mask with multiple cushions, follow the instructions below and on the next page.

There is a mask cushion currently attached to the frame of your mask. This size fits most patients.

Once you begin therapy, if your mask is leaking or feels uncomfortable, try removing the existing cushion and replacing it with a different size cushion. If you are between sizes, it is best to use the larger cushion. Use the Fitting Template (for nasal mask and full face mask) and/or the manufacturer’s instructions included with your mask for help.

4

4 STEP 1: GETTING STARTED Questions? Call 877.265.2426 Select Option 4 Questions? Call 877.265.2426 Select Option 4

1.

4.

2.

5.

3.

1.

2.

5.

4.

Nasal Mask

1. Release the lower strap magnets from the frame of the mask. Make sure the logo on the

headgear is facing outward. While holding the mask against your face, pull the headgear

over your head.

2. Position the lower straps so they both sit below the ears. Bring each of the magnets up to meet their corresponding clips on the frame.

3. Adjust the fastening tabs on the upper straps until the mask feels even and stable.

Do not overtighten. Reattach the fastening tabs.

4. Repeat Step 3 with the lower straps. Reattach the fastening tabs.

5. Connect the hose to the front of the mask. Ensure that the nasal mask fits securely over your nose. It is normal to feel some air escaping through the small air vents on the elbow of the hose.

Please refer to the manufacturer’s instructions for additional information on topics, such as:

• How to properly remove your mask

• How to remove and change the mask cushion

• How to adjust the length of the mask straps

6 STEP 2: GET FAMILIAR WITH YOUR PAP EQUIPMENT Questions? Call 877.265.2426 Select Option 4

Nasal Pillow Mask

1. Hold the pillows away from your nose with the left (L) and right (R) indicators correctly facing towards you.

2. Guide the nasal pillows into your nostrils.

3. Pull the headgear over your head by holding the bottom strap and stretching it around the back of your head.

4. Adjust the top and bottom straps. The top strap should fit comfortably on the top of your head.

5. Ensure that the nasal pillows fit securely into your nostrils with both pillows positioned upright.

If not, move the mask away from your face and then place it back again.

6. To achieve a comfortable fit, adjust the straps. Spread the straps apart to loosen, or draw them closer together to tighten.

Please refer to the manufacturer’s instructions for additional information on topics, such as:

• How to properly remove your mask

• How to remove and change the mask cushion

• How to adjust the length of the mask straps

Questions? Call 877.265.2426 Select Option 4 STEP 2: GET FAMILIAR WITH YOUR PAP EQUIPMENT 7

3.

6.

1.

4.

2.

5.

3.

6.

Full Face Mask

1. Twist and pull both magnetic clips away from the frame. With the logo on the headgear facing outward, hold the mask against your face and pull the headgear over your head.

2. Bring the lower straps below your ears and attach the magnetic clip to the frame.

3. Undo the fastening tabs on the upper headgear straps. Pull the straps evenly until the mask is stable and positioned as shown in the illustrations. Reattach the fastening tabs.

4. Undo the fastening tabs on the lower headgear straps. Pull the straps evenly until the mask sits firmly on the chin and reattach the fastening tabs.

5. Connect the air tubing from your device to the elbow. Attach the elbow to the mask by pressing the side buttons and pushing the elbow into the mask.

6. To achieve a comfortable fit, readjust the straps. Evenly, apply only enough tension so that a seal is achieved.

Please refer to the manufacturer’s instructions for additional information on topics, such as:

• How to properly remove your mask

• How to remove and change the mask cushion

• How to adjust the length of the mask straps

8 STEP 2: GET FAMILIAR WITH YOUR PAP EQUIPMENT Questions? Call 877.265.2426 Select Option 4

Heated Elements

Heated Humidifier

The heated humidifier is used to control the desired temperature and humidification of the air that is delivered to you from your PAP device.

Heated Tubing

Heated tubing is designed to maintain the temperature of the humidified air as it passes through the tube to improve comfort. Keeping the air temperature in the tube at a constant level ensures that rainout is avoided even if the temperature in the room drops during the night.

a b

1

To attach the heated tubing to the heated humidifier, line up the connector (a) located at the top of the heated tube with the top of the air outlet port (b) located on the humidifier.

2

Press the tubing into place over the air outlet port until the tabs on the side of the tube click into place with the slots on the sides of the outlet port.

Using Oxygen with Heated Tubing

1. Attach heated tubing circuit to the device outlet (shown above).

2. Attach pressure valve to the to the other end of the heated wire tubing (the opposite end of the pressure valve connection and the end closest to the mask).

See diagram of pressure valve placement on page 10.

3. Attach the O2 tee adaptor to the open end of the pressure valve.

4. Attach the O2 tee adaptor to mask hose.

Attach oxygen tubing here

A

Pressure

Valve

C

Heated Wire Tubing attached to device

O2 Tee

Adapter

Mask Hose

IMPORTANT SAFETY NOTE: If you are using prescribed oxygen with your PAP device, be sure to observe all the fire and safety rules associated with the use of oxygen. Make sure to follow this sequence of steps when turning your oxygen on and off. 1. Always turn your PAP machine ON before turning ON the oxygen flow from your oxygen source. 2. Always turn OFF the oxygen flow from your oxygen source before turning OFF the PAP machine.

Questions? Call 877.265.2426 Select Option 4 STEP 2: GET FAMILIAR WITH YOUR PAP EQUIPMENT 9

STEP 3

Using Oxygen with Non- Heated Tubing

If you are using non-heated tubing, and you are also using prescribed oxygen, follow these instructions.

When using oxygen and non-heated tubing, the pressure valve must be used at the outlet of the machine.

1. Attach the pressure valve to the machine outlet.

PRESSURE VALVE

A Inlet (larger end)

B Vent do not block)

C Outlet

2. Attach the oxygen tee adapter to the open end of the pressure valve.

3. Connect the large-bore PAP tubing to the open end of the oxygen tee adapter.

4. Connect the small-bore oxygen tubing to the small port of the oxygen tee adapter.

If you did not receive a pressure valve or oxygen tee adapter with your PAP device, please contact Apria.

For detailed instructions on oxygen use, you should also review the PAP and oxygen manufacturer’s user guides included in your package.

1. First, put on your mask. Next,

attach the tubing to the mask.

2. Lie down and take four deep breaths.

The machine should start automatically.

If you do not hear the machine start, press

the Start/Stop button. Relax and begin to

take slow breaths through your nose.

3. Check for air leaks. Small leaks

are acceptable. If large leaks

occur, try the following:

• Grasp the mask frame and lift it away from your face. The cushions should also lift off your face. Lightly place the mask back on your face.

• If large leaks still exist, adjust the

headgear. If the headgear is either

too tight or too loose it can cause leaks.

• Additional tips for managing mask leaks

are provided on the next page.

You should also review the manufacturer’s

user guides provided in your package.

1

2

10 STEP 2: GET FAMILIAR WITH YOUR PAP EQUIPMENT Questions? Call 877.265.2426 Select Option 4 Questions? Call 877.265.2426 Select Option 4

Helpful Tips

For Nasal and Full Face Masks

• To resolve leaks at the upper part of the mask, adjust the upper headgear straps.

• For leaks at the lower part, adjust the lower headgear straps.

• When adjusting straps, loosen or tighten both the left and right straps so that adjustments are made evenly.

• Adjust only enough for a comfortable seal.

• The upper strap adjustment is the key to seal and comfort.

• Do not over-tighten the lower straps. They mainly serve to keep the cushion in position.

For Nasal Pillows Masks

• Position the pillow cushion tips into your nostrils so they sit comfortably under your nose without any gaps. Pull the mask away from your face, then place it back to get a comfortable fit.

• Adjust the side straps evenly by pulling downwards; the mask should feel secure and comfortable against your face. Do not over-tighten.

• If leaks persist, try the next larger set of cushions.

• If the pillow is not staying in place in your nostrils, try the next smaller cushion size.

Hand washing Technique

Thorough hand washing must be done prior to all procedures. Contaminated, dirty hands are one of the most common sources of infection.

1. Wet your hands thoroughly with warm water.

2. Use soap.

3. Scrub hands for 20 seconds using a rotary motion and friction. Wash:

• Back and palm of each hand

• Between all fingers

• Fingernails

Need a timer? Hum the “Happy Birthday” song from beginning to end twice.

4. Rinse your hands under the running water.

5. Dry on clean towel or with a paper towel.

For additional good health habits, visit our patient education section on apria.com.

12 STEP 3: START YOUR PAP MACHINE Questions? Call 877.265.2426 Select Option 4

Use your PAP therapy during all hours of sleep, including during naps. Some people may need up to one or two weeks to adjust to PAP therapy, but the benefits are well worth it.

Ways to help you adjust:

• Try watching TV or reading while wearing your mask and headgear. Turn on the PAP device

for short periods of time while wearing your mask to get used to the pressure.

• Use your equipment every night.

• Keep the device turned on for as long as you can tolerate, building up each night until you

have reached at least 4 hours per night.

• Keep practicing until you are using PAP therapy during all hours of sleep, including during naps.

Questions? Call 877.265.2426 Select Option 4

You can track your progress by registering for Philips Respironics DreamMapper at

www.philips.com/mydreammapper. You can track your previous night’s results, create goals and get feedback. You can also access other helpful information, like tips to help you stay motivated in adhering to your PAP therapy.

Questions? Call 877.265.2426 Select Option 4

GET SUPPORT.

If you are having difficulties getting used to therapy, try using your machine’s “comfort features” to help.

How to Turn On The Ramp Feature:

If ramp is enabled on your device, after you turn on the airflow, press the Ramp ( ) button on the top of the device. You can use the Ramp button as often as you wish during the night.

How to Change the Humidity Level:

1

To adjust the temperature of the tube, press the tube temperature icon (1) located in the upper right-hand corner of the screen.

2

To adjust the humidity level, press the humidity icon (2) located in the lower right-hand corner of screen. You can change the setting from 0 to 5.

Rotate the control knob to select either of these settings. Then, press and rotate the dial to change the setting.

Note: If you are using a humidifier with non-heated tubing, the adjustable tube temperature icon is not available.

Do you have a dry nose or throat, or a runny nose?

Increase the temperature or humidity level.

Are there droplets of water or condensation inside your nose, mask, or tubing?

Decrease the temperature or humidity level.

Is the air pressure making it difficult for you to fall asleep?

Turn on the Ramp feature by pressing the button.

Do you feel bloated?

You may be swallowing air. Turn on the Ramp feature by pressing the button.

Do you feel like you are not getting enough air?

Do not turn on the Ramp feature when initiating therapy.

Do you have sore or dry eyes?

Adjust your mask or headgear. It may need to be repositioned. Refer to the instructions provided in the manufacturer’s user guide for your mask. Also review Steps 2 and 3 in this guide.

Are you experiencing redness on your face where the mask touches the skin?

Your mask may be too tight. Try adjusting your headgear. If redness persists, contact Apria Healthcare.

Do you have nasal, sinus or ear pain?

You may have a sinus or ear infection. Stop using your machine and contact your doctor.

This information is intended for your general knowledge only and is not a substitute for medical advice or treatment for a specific medical condition. Should you have any healthcare-related questions, please consult your doctor.

Questions? Call 877.265.2426 Select Option 4 14 STEP 3: START YOUR PAP MACHINE

1.

Oil from your face and ingredients in facial products can cause the

PAP mask cushions to wear down and decrease the useful life of the

mask. Get in the habit of wiping down your mask each day, especially

the areas that come in contact with your skin. Clean your mask and

headgear weekly according to the instructions in the mask user guide.

2.

Wash the water chamber and air tubing in warm water, using a mild

deteriorate the plastic.

3

. When needed, wipe the exterior of the machine with a dry cloth.

4.

Your device has an automatic air filter reminder. Refer to the

manufacturers’s instructions for information on how to replace the filter.

Replace your sleep supplies regularly. This helps to ensure a good mask seal and reduce buildup of bacteria, viruses, and allergens.

1 Ordering fresh, clean supplies to replace your old items helps improve the comfort of your mask and maintains the overall effectiveness of your therapy.

Twice Monthly

• Nasal mask cushions and

nasal pillows

• Disposable filters

Recommended Replacement Schedule

Once Monthly

• Full-face mask cushions

Every 3 Months

• Mask frame

• Tubing (standard or heated)

Every 6 Months

• Headgear and chin straps

• Humidifier water chamber

• Non-disposable filters

Please note that the frequency of resupply and your insurance’s coverage of supplies will be governed by your insurance plan and may differ from the schedule provided above.

Source:

1. Horowitz A, Horowitz S, Chun C. CPAP Masks are Sources of Microbial Contamination. SleepHealth Centers, Div. of Sleep

Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston. APSS Poster; 2009.

16 STEP 3: START YOUR PAP MACHINE Questions? Call 877.265.2426 Select Option 4

When ordering fresh supplies through Apria, shipping is always free, and we verify and bill your insurance for you.

Enroll in Apria’s Continuous Sleep Resupply Program*

Determine if you want fresh PAP supplies shipped to your front door every three or six months, and let Apria do the rest. Visit apria.com/papresupply to access the online form or call a Sleep

Resupply Expert at 877.265.2426 and select option 2.

Order Online

Apria.com/PAPResupply — Register for the PAP Patient Portal with your Apria Patient ID, and place an order when you need new supplies.

ApriaDirect.com — Order supplies anytime on the retail (non-insurance) website.

Call Our Automated System

Dial 800.436.5657 to use Apria’s automated phone system available 24/7 to place your order.

Speak with an Apria Sleep Resupply Expert

Dial 877.265.2426 and select option 2 to order supplies with an Apria Sleep Resupply Expert.

Monday-Friday: 8 a.m. to 9 p.m. EST or Saturday: 8 a.m. to 7 p.m. EST

Note: If you decide not to participate in the PAP Resupply Program, you will receive convenient, automated calls from Apria to remind you that it is time to order replacement sleep supplies.

* This Continuous Sleep Resupply Program is not available to all Sleep patients. Patients with certain payors, such as

Medicare, Medicaid, Managed Medicaid or TRICARE, are not eligible.

18 STEP 3: START YOUR PAP MACHINE

We are here for you! With Apria’s Premium Care Sleep™ program, you can rest assured that you will receive the support you need to achieve a better night’s sleep. It’s not uncommon to experience some discomfort during the first several days.

Remember that regular use will help improve your overall quality of life so you can look forward to:

• Increased energy and alertness

• Improved blood pressure

• Improved glucose tolerance

Data from your PAP machine is securely communicated to Apria Healthcare using cloud-based software. if you register for Philips Respironics DreamMapper, you will get feedback on your progress.

One of Apria’s Premium Care Sleep Experts will reach out to you during the first few days of therapy to see how you are adjusting. If you are struggling with therapy or have questions about your equipment, please call us right away. We are here to help you.

Remember to use your PAP therapy anytime you sleep, including during naps. Compliant use is defined as at least 4 hours per night for at least 70% of the days.

If you have questions about PAP therapy, please contact Apria’s Premium Care Sleep Experts.

Dial the number below and select option 4.

877.265.2426

Monday - Friday: 8 a.m. - 10 p.m. EST

Saturday and Sunday: 11 a.m. - 7:30 p.m. EST

Questions? Call 877.265.2426 Select Option 4

If you have any questions, or need help setting up your device and getting started, please call a member of Apria’s Premium Care Sleep Expert team. Dial the number below and select option 4.

877.265.2426

Monday - Friday: 8 a.m. - 10 p.m. EST

Saturday and Sunday: 11 a.m. - 7:30 p.m. EST

Apria is committed to safe, quality patient care.

Concerns to be reported to your local Apria Healthcare branch. If your concern is not resolved, please contact

Patient Satisfaction.

800.260.8808

DreamStation is a registered trademark of Philips Respironics.

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