Secrets to CPAP success: From how to WOW!
Secrets to CPAP success: From how to WOW!
Episode 1 Summary
Hi and welcome to the APAP podcast. My name’s Corinne Young. I will be your host today. And today we are talking to Anne Cartwright. She has been asked to come on this show today to talk about CPAP, CPAP compliance with patients, all the troubleshooting and problems that we have with CPAP.
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Corinne Young, APAPP President:
Hi and welcome to the APAP podcast. My name’s Corinne Young. I will be your host today. And today we are talking to Anne Cartwright. She has been asked to come on this show today to talk about CPAP, CPAP compliance with patients, all the troubleshooting and problems that we have with CPAP. Anne attended PA school at the University of New England. She’s been a PA for almost 14 years and has worked her entire career in sleep medicine. So that’s why she is our special speaker today. She’s currently working in the sleep clinic at the University of Colorado Sleep Medicine Center. She treats adult patients with all sleep disorders with a special focus on sleep apnea and positive airway pressure adherence. She enjoys the technology and the nuances of sleep medicine. She is regarded as the PAP guru. Working in a high elevation environment presents unique challenges and opportunities for her especially related to sleep disorder breathing and central apnea, which I know I only read about in books until I moved to this high elevation and now I see all the time. She is passionate about patient education, which is probably why her patients do so well. She’s created many patient education programs and resources to increase awareness of sleep disorders and sleep apnea, including a large CPAP support group in the Denver area. As a PA, she’s interested in the role of advanced practice providers in the field of sleep medicine. She has served on task force commissions by the American Academy of Sleep Medicine to investigate APPs working in sleep. As part of that task force, she helped create several live educational courses and online demand education for clinical providers entering the field of sleep medicine. So hopefully she’ll give us those resources to share with you at the end. And locally, she has served with APP leadership roles and enjoys serving as a preceptor for APP students. And besides all of that, she also is on the board of directors for the Association of Pulmonary Advanced Practice Providers. So thank you, Anne, so much for sharing your time and knowledge with us today.
Ann Cartwright:
Of course, thanks for having me.
Corinne Young, APAPP President:
My pleasure. Okay, I mean we have to have the Pap guru if we’re gonna be talking about Pap therapy, right? So first off, when you’re starting a patient on Pap therapy, right, I’m sure you do all the education on what sleep apnea is and why they’re being treated with this and how it’s supposed to help them and that type of thing. But is there anything else you do that you feel is pretty fundamental for improving their success to adherence or? maybe things that other providers do that may not help with them being as adherent.
Ann Cartwright:
Yeah. So I think it’s really vitally important to set the stage. What happens for a lot of people is they get told, hey, you have sleep apnea. You need a CPAP. I don’t know about in your area, but in my area, that often means that the machine gets shipped to them. It ends up in a box on their doorstep, and they’re kind of left to their own devices to figure it out. that’s probably not going to go well. So of course, they’re gonna not like it and give up after a couple of days. So I really think it’s important to, number one, give them realistic expectations of how it’s probably going to go, and number two, let them know what resources there are. So when I’m starting my patient on CPAP, I tell them, when you get it, you’re probably gonna hate it. That’s okay, you’re not failing, because they feel like they’re failing you.
Corinne Young, APAPP President:
Mm-hmm.
Ann Cartwright:
You’re not failing, you’re not doing something wrong, that’s part of the process. Asking people to wear a mask and blow air up their nose is the weirdest thing, and it’s so much more than just taking a pill, right, which we’re kind of a pill society, or taking an inhaler.
Corinne Young, APAPP President:
Right.
Ann Cartwright:
So I let them know, it’s okay, in fact, I expect that you’re going to hate it, and that’s okay. and giving them realistic timelines. This is gonna take time. It might take four to six weeks. Giving them some strategies to get acclimated to it and what issues do you think you’re gonna have that we can troubleshoot right off the bat? If you are having trouble, who do you call? When do you call me? When do you call the medical equipment provider? So really giving them the tools upfront to know what to expect. know that they’re not alone and where to go for help so they don’t give up after two or three days.
Corinne Young, APAPP President:
I like that telling them you’re going to hate it, that’s okay, that’s expected, because I think some people may not realize that. They think, well, I hate it, I don’t like this at all, therefore I’m not gonna continue therapy, because everyone else who does it must love it and feel so much better instantly, you know,
Ann Cartwright:
Yeah.
Corinne Young, APAPP President:
and then they give up. So I do like, I’m going to adopt that. Okay.
Ann Cartwright:
Yeah,
Corinne Young, APAPP President:
I think.
Ann Cartwright:
and then they feel like if they put it on and they go right to sleep and they do great, then they’re like a big winner and they’re an overachiever. Yeah.
Corinne Young, APAPP President:
Yes, yes, yes, yeah. Low expectations, high performance maybe.
Ann Cartwright:
Exactly.
Corinne Young, APAPP President:
I do that with my kids.
Ann Cartwright:
Yeah.
Corinne Young, APAPP President:
So for first time users. I can see that being very helpful. What do you do for patients who maybe failed in the past and now
Ann Cartwright:
Yeah.
Corinne Young, APAPP President:
they are returning to because they have to, because that pesky cardiologist tells them they have to,
Ann Cartwright:
Yes!
Corinne Young, APAPP President:
or because maybe now they’re just so symptomatic, they wanna do treatment, but they are already coming in with like, I don’t wanna do this.
Ann Cartwright:
Yeah, I get that a lot. In fact, five times just today. So it’s very, very common. First of all, I find it really helpful to educate those patients. Often, I find that patients have not really had a thorough description of what sleep apnea really is. Why do they have it? And really get in depth with how is it impacting your medical issues. If they’re just told, hey, you really should use this, but they don’t really have a lot of insight as to why it’s so important. They’re less likely to stick with it. So making sure they actually really understand what it’s about. I see people that have been on CPAP for 15 years that still actually don’t really understand why they’re supposed to be using it. They just know that they are. So creating that fundamental groundwork of education and knowledge. Next thing I do is, I talk about all options, even if CPAP is what they should do and what they have to do, I still talk about every treatment option with every single patient. And that, I, you know, talk about the pros, talk about the cons, talk about this is an option, it’s probably not going to work or it’s not a great option for you and here’s why. And that way, people are choosing CPAP. It’s not being forced upon them. they are actually making a conscious effort to choose it and therefore more likely to be successful with it. And then third, I talk to them about why didn’t you like in the past? How did it go? And a lot of times, just talking about the technology advances that have been made in CPAP, if they tried CPAP 15 years ago, it’s a much different experience now. And I tell them, you know, your cell phone’s not what it was 15 years ago, neither is CPAP. It does
Corinne Young, APAPP President:
Mm-hmm.
Ann Cartwright:
not mean that we’re putting you on this huge, loud, clunky machine with a Darth Vader mask.
Corinne Young, APAPP President:
Mm-hmm.
Ann Cartwright:
And so those talking points, a lot of times, will convince patients to be a little bit more willing to give it a try.
Corinne Young, APAPP President:
Yeah. The ones that you do encounter those barriers, what would you say the biggest ones are for your patients so that maybe people that are new to sleep or that are encountering a lot of patients giving up,
Ann Cartwright:
Thank
Corinne Young, APAPP President:
maybe
Ann Cartwright:
you.
Corinne Young, APAPP President:
even sending equipment back before even coming to their next appointment, what would you say those most common barriers are? And then maybe also what then would be a great way to pre-educate them about those barriers?
Ann Cartwright:
Yeah, so a common barrier is just getting used to wearing a mask. You know, having something physically on their face and blowing air up the nose. And it takes time. I always introduce graded exposure, which means they start small and they work up to it. So I tell patients, you know, our goal is to get you to the point where you can sleep with your CPAP all night, every night. But we don’t expect you to do that on night one. Start with putting it in your living room, put on a movie, and just sit and practice with it. And if it starts to feel uncomfortable, take it off. When you’re calmed down again, put it back on again. So just having them start practicing with it while they are awake to get used to the sensation of the mask, the air, they’re not playing with the buttons in the dark. And then as they are able, slowly working up sleeping with it. So that’s really helpful. The analogy I like to use is scuba diving. If you have never been scuba diving before, if you threw all the scuba gear on and jumped in the ocean, it would probably not go well. You’d feel kind of panicked. So you work your way up to the ocean. Same kind of thing with the CPAP. Work your way up to using it all night. So that’s a very common barrier, just kind of getting over that initial discomfort hurdle. Masks, again, they’ve come a long way. So there are
Corinne Young, APAPP President:
Yeah.
Ann Cartwright:
so many more mask choices now than there were 10, 15 years ago. Often patients get fairly poor service from their medical equipment provider or they’re given one mask and not really made aware that there’s others to try. So… you know, telling patients up front, you may have to try four or five different masks before you figure out what’s going to be comfortable. So if mask you get you don’t like, there’s other options. That’s not the only one. In my area, the medical equipment providers typically give patients a 30 day mask trial period, but they don’t always. advertise that, so I tell patients that use that first month to try different masks. You’re not just restricted to you know one or two mask choices. Being in Colorado, we’re in a very dry climate, so humidification can also be a really big barrier. If their nose is dry or their mouth is dry, super uncomfortable to wear it and they’re less likely to continue with therapy. Nowadays machines typically ordered with heated humidification, but most people were not told how to actually change their humidification. So it’s just a matter of providing a little education. You can change your humidity, you can change your temperature setting and letting them know that that’s an option. Nasal congestion also, that’s been well documented in the literature. The more stuffy their nose is, the harder it’s going to be to use. Often, that’s because of inadequate humidification, so really tackling that moisture. If that’s not enough, then we’re usually looking at things like nasal sprays, nasal lavages, antihistamines, or nasal steroid sprays, depending on the situation. So those are probably the most common barriers, at least at the outset that I find.
Corinne Young, APAPP President:
Yeah, I think that’s exactly what I see in practice also. And
Ann Cartwright:
Mm-hmm.
Corinne Young, APAPP President:
Yeah, if they come in the office and they can’t breathe through their nose before they even start therapy, you know, sometimes I try to tackle that first because I
Ann Cartwright:
Mm-hmm.
Corinne Young, APAPP President:
know that’s going to be a big issue once they throw that on.
Ann Cartwright:
Yeah.
Corinne Young, APAPP President:
And so many of them are so afraid to touch any of the buttons on their machine. They’re afraid that they’re
Ann Cartwright:
Right.
Corinne Young, APAPP President:
going to mess up their settings and I try to tell them, it’s patient-proof. You really can’t mess it up. You know, it’s
Ann Cartwright:
Mm-hmm.
Corinne Young, APAPP President:
meant for you to be fumbling around in the dark pressing all sorts of buttons. You can’t, you really can’t mess it up. So
Ann Cartwright:
Mm-hmm.
Corinne Young, APAPP President:
kind of encouraging them to be proactive with their device. And then also, I’ll say, just bring the whole machine in and we can do some
Ann Cartwright:
Yes.
Corinne Young, APAPP President:
education with you on it too.
Ann Cartwright:
Yeah. Yeah, some patients unfortunately are told by the respiratory therapist at SUDUP, it’s all set for you, don’t touch anything, which I hate it when they do that because patients
Corinne Young, APAPP President:
Yeah.
Ann Cartwright:
are so afraid. We also at our clinic, we tell patients, bring all of your equipment every single time so we can troubleshoot, we can show you things, we can actually see what’s going on in real time.
Corinne Young, APAPP President:
That’s a really good idea. Yeah,
Ann Cartwright:
Yeah.
Corinne Young, APAPP President:
I don’t tell them to bring it every single time, but sometimes they’ll do it on their own, or during a visit I find out they’re struggling with something, so I say next visit, bring it in, or just come in
Ann Cartwright:
Yeah,
Corinne Young, APAPP President:
for
Ann Cartwright:
yeah.
Corinne Young, APAPP President:
an appointment with our RT or something, but that’s pretty smart to do.
Ann Cartwright:
Utilizing on that topic too, if you’re not already or not aware, the machines nowadays, the Philips devices and the ResMed, which are the most common machines used in the United States, there are patient apps and websites that are extremely helpful.
Corinne Young, APAPP President:
Yes.
Ann Cartwright:
So the patient can create an account. type in their serial number and they get all their data, they get coaching, they get feedback, and there’s a whole library of information, everything from what is sleep apnea to I forgot what my provider said, how do I change my humidifier?
Corinne Young, APAPP President:
Mm-hmm.
Ann Cartwright:
So there’s a lot of resources right there. So you don’t necessarily have to spend time doing that in clinic because I know we all have a ton of time to do those things. But just getting people those resources and knowing where to turn is really helpful.
Corinne Young, APAPP President:
I really like that over the last couple years now with the serial number you can go to the website enter it in and I can manipulate their settings
Ann Cartwright:
Yes.
Corinne Young, APAPP President:
right there at the visit and I tell them that ahead of time if you’re really struggling with the pressure you know with that type of thing call me or you know come in and I can do it right then we don’t have to hack into your machine or you know we don’t have to do all this send wait send an order to the DME wait for them to contact you wait
Ann Cartwright:
Yeah.
Corinne Young, APAPP President:
to see if it gets done. So I’ve had a couple patients say, oh, that makes me feel so much better that you can change it instantly if I call.
Ann Cartwright:
Yes, yeah, just call or we’ll try something else. Say, try it over the weekend, try it for a few days. Just let’s just see. Yeah, and if you’re not doing CPAP or sleep therapy a lot, you can pretty much change anything and everything remotely. So even if you have a patient that lives really far away or it’s hard for them to get to the clinic, you can change their pressure settings, their ramp, their flex or the EPR settings. In most cases, it’s a little bit machine dependent. You can change their humidity and temperature for them. So it’s very, very easy to make simple changes.
Corinne Young, APAPP President:
So let’s talk a little bit about complications of PEP therapy outside the dry mouth. That
Ann Cartwright:
Mm-hmm.
Corinne Young, APAPP President:
kind of impacts their compliance and adherence. One being claustrophobia.
Ann Cartwright:
Mm-hmm.
Corinne Young, APAPP President:
And sometimes that’s just the mask, but sometimes it’s the pressure, you know, and that reflex
Ann Cartwright:
Mm-hmm.
Corinne Young, APAPP President:
to
Ann Cartwright:
Mm-hmm.
Corinne Young, APAPP President:
hold their breath. And then the other being gastric inflation. So I’d love your opinion on when you hear this from patients, what is your go-to or what’s your algorithm that you use to help those patients?
Ann Cartwright:
Yeah. So when patients say the word claustrophobia, I do a little bit more digging. I find that true claustrophobia where they are literally feeling anxious because they feel like they’re being smothered or having something on their face, I find that that is actually pretty rare. It’s more often they’re just not comfortable with it or the air pressure is not right and kind of their go-to the way they describe it is, I can’t stand it, I’m claustrophobic. So just asking a lot more questions, like what does it feel like when you put the mask on? How long does it take before you start to feel like this? What are you actually feeling? Do you feel like you can breathe? Do you feel like your breath’s being sucked out of you? Do you feel like it’s hard to breathe in? Do you feel like it’s hard to breathe out? What happens when you take the mask off? So just trying to ask more questions and get the patients to describe a little bit more about what is going on. Usually it’s not claustrophobia.
Corinne Young, APAPP President:
Okay, so good.
Ann Cartwright:
Sometimes it is, and I find that true claustrophobia, patients know they have this, if I get an MRI machine, like that’s it, it’s over, like the thought of putting the mask, those patients sometimes they will just look at their mask and start having anxiety. So it does happen. I do find that claustrophobia and those extreme anxious feelings tend to be more common in women, unfortunately, that have been victims of domestic violence. A lot of times they have been strangled or smothered with pillows. Also, this sounds silly, but people that have grown up with brothers. I don’t know, they always say, brother smothered them with their pillows and they have a harder time with that feeling of, oh my god, I can’t breathe, something’s covering my face. People that have had near drowning experiences and people that have really severe pulmonary issues and are very worried about their ability to breathe. That’s when we tend to see more of the true claustrophobia. What we do about it, graded exposure. Typically those patients have to go slower. My worst claustrophobic patient, she could literally only tolerate wearing the mask for 10 seconds and that was it. Full blown anxiety attack. It took about six months and now she wears it all the time and she does
Corinne Young, APAPP President:
Thanks.
Ann Cartwright:
great. It takes time. So it takes willingness on the patient to stick with it, kind of fight through that discomfort. So we go very, very, very slow. That’s a situation when I would refer them to my sleep psychologists. So the same sleep psychologists that are going to do your, you know, CBTI and insomnia therapy, also very, very good at helping claustrophobia and significant anxiety around using CPAP. And I’ve never had a patient go wrong working with them.
Corinne Young, APAPP President:
That’s awesome. That’s
Ann Cartwright:
Yeah.
Corinne Young, APAPP President:
awesome. So, what about gastric inflation?
Ann Cartwright:
Gastric inflation. So first of all, I think it’s something that’s important to ask about. So what happens, we call it aerophasia, which literally means swallowing air. Some of the air, instead of going into their lungs, goes down the wrong tube and gets into their stomach. It can make patients very gassy and it can come out either end. So they can be belching a lot in the morning, they can be passing gas in the morning. Sometimes they have significant distension and bloating that can be
Corinne Young, APAPP President:
You okay?
Ann Cartwright:
quite uncomfortable and
Corinne Young, APAPP President:
You
Ann Cartwright:
painful.
Corinne Young, APAPP President:
okay?
Ann Cartwright:
And sometimes it can be pretty profound. I have one patient, she would, two patients come to mind. One, she would get up two hours, set her alarm for two hours before she had to get up to work, take the mask off so she had time to pass all of her gas before she had to get up to go to work. So she wasn’t gassy at work. So her last two hours of sleep were no CPAP. And then I had another patient, she was so bloated from her CPAP in the morning, she would buy bigger pants, she would put those on, and then after a couple of hours when the gas was on, then she could put on her regular pants for the day. So sometimes it can be very dramatic and uncomfortable. It’s important to ask about, because patients won’t always make the connection, oh, I’m gassy, especially if it’s passing gas, they won’t necessarily think of their CPAP.
Corinne Young, APAPP President:
Mm-hmm.
Ann Cartwright:
So the solution is to maximize their pressure release features. So most of the CPAP machines have some kind of pressure relief. It’s called different things depending on their machine, where the machine syncs with the patient’s breathing and when they exhale it drops the pressure. And by dropping that pressure with exhalation often we can get that aerophasia or gastric inflation to go away. If not, my next step is bilevel
Corinne Young, APAPP President:
Mm-hmm.
Ann Cartwright:
and almost always by switching to a bilevel device it goes away.
Corinne Young, APAPP President:
So could you give people examples, again, if you’re not very familiar with
Ann Cartwright:
Mm-hmm.
Corinne Young, APAPP President:
your CPAP patients, CPAP machines, so what are some examples before going to bi-level that you would see options on your underemployed?
Ann Cartwright:
the devices. Yep, so if it’s a Philips Respironix device, the pressure relief is going to be called flex, and it’s level one, two, and three. The higher the number, the more the pressure is going to decrease with exhalation. It’s arbitrary, so one drops it a little bit, two’s a little bit more, three is a little bit more. The patient actually has complete control over turning that on or off or setting the level. On ResMed devices, which are more common now because of the recall, it’s called EPR, which is expiratory pressure relief. Again, it’s level one, two, or three, but the number actually corresponds with the pressure drop. So
Corinne Young, APAPP President:
Okay.
Ann Cartwright:
if their EPR is on level two and they are on CPAP at 10, That means it’s almost like a mini bi-level. When they inhale, it’s 10, but when they exhale, it’s dropping to eight. On the ResMed devices, the patient can turn it. Oh, now I’m going to get confused on the spot. I think the patients can turn it on or off, but they can’t set the level, or
Corinne Young, APAPP President:
Okay.
Ann Cartwright:
it’s flipped, or they can set the level, but they can’t turn it on or off. One of those. They don’t have complete control over it like they do on the ResMed devices. So
Corinne Young, APAPP President:
Thank
Ann Cartwright:
it is
Corinne Young, APAPP President:
you. Very
Ann Cartwright:
a more
Corinne Young, APAPP President:
good.
Ann Cartwright:
substantial pressure drop on ResMed compared to the Phillips Respironics devices.
Corinne Young, APAPP President:
Okay, okay. Yeah, that’s good to know, because I know for a while there, I was seeing providers in my practice who were, you know, if that was happening, they were just going straight to bi-level pressure, which I
Ann Cartwright:
Yeah.
Corinne Young, APAPP President:
don’t know if is necessarily wrong, but you know, just not knowing as technology is changing with
Ann Cartwright:
Yeah.
Corinne Young, APAPP President:
these devices that there is that option on there.
Ann Cartwright:
It’s not wrong, it just may not be needed.
Corinne Young, APAPP President:
Right.
Ann Cartwright:
Oh, one other tidbit on ResMed with EPR, if it’s on, it could be on all the time. There’s also an option to only turn it on during the ramp. So at the beginning it’s on, but then it’s off the rest of the night.
Corinne Young, APAPP President:
Oh, okay, all right, okay.
Ann Cartwright:
Mm-hmm.
Corinne Young, APAPP President:
All right, so the more difficult patients, the ones with insomnia. So,
Ann Cartwright:
Mm.
Corinne Young, APAPP President:
you know, CPAP initially does not, for everyone, improve their quality of sleep. It tends to worsen their quality of sleep initially.
Ann Cartwright:
Mm-hmm.
Corinne Young, APAPP President:
And for patients with insomnia, they are definitely more likely to struggle.
Ann Cartwright:
Yeah.
Corinne Young, APAPP President:
So what are you doing with your patients with a known history of insomnia coming in to see you that, you know, maybe start with patients with insomnia that you know is controlled and those ones that are not controlled?
Ann Cartwright:
Yeah, so I, as part of kind of the laying out expectations ahead of time, I do tell them, you know, this may cause more sleep disruption at first so that that’s not, doesn’t cause them to abandon therapy. But a lot of people, if you can get them over the first couple weeks, particularly if they have poorly controlled insomnia, a lot of times it does get better. Now it will depend a little bit if they have more sleep onset insomnia compared to sleep maintenance insomnia. Sleep onset insomnia where they just really have a hard time initiating sleep, they can’t get their mind to shut off, that’s not usually going to always get better. Sometimes. Not as often though with using CPAP compared to sleep maintenance insomnia. Often when they wake up and they’re having a hard time getting back to sleep. it’s because of their sleep apnea that’s waking them up and they just have so that sympathetic surge and adrenaline going through their system. It’s just hard to sleep. So it will depend a little bit on what type of insomnia they have. But I tell people, try it out. If it’s not going well and you’re really struggling, sometimes I will do a sleeping pill, something that does not cause respiratory depression. I try not to use a Benzo. Something like Ambien, Lunesta, Trazodone, just to kind of help get them to sleep a little bit better and kind of sleep through that discomfort can be really helpful. And they don’t typically need it long term, often just a few weeks, maybe a month or two. And then if they’re acclimated to CPAP and their insomnia is not better, Then we’re getting into the whole insomnia world of do they need to be on long-term medications, insomnia therapy, things like that.
Corinne Young, APAPP President:
Yeah, we’re very lucky to have an insomniac clinic down here with a cognitive
Ann Cartwright:
Yeah.
Corinne Young, APAPP President:
behavioral specialist and all that.
Ann Cartwright:
Mm-hmm.
Corinne Young, APAPP President:
So that’s always really helpful for those
Ann Cartwright:
Very
Corinne Young, APAPP President:
patients.
Ann Cartwright:
helpful. Yeah.
Corinne Young, APAPP President:
And I think, like you said before, setting those expectations of this is not normal to do to strap something to your face and it’s
Ann Cartwright:
Mm-hmm.
Corinne Young, APAPP President:
likely to go bad and that’s
Ann Cartwright:
Mm-hmm.
Corinne Young, APAPP President:
okay.
Ann Cartwright:
Yep.
Corinne Young, APAPP President:
All right. So last question I have for you is… When do you abandon PAP therapy? When do you finally say, let’s move on to something else?
Ann Cartwright:
Yeah, it depends on the patient. I mean some of it is when the patients are ready. Some patients you know I’m like do you want to talk about other options and sometimes like no you know I still want to keep trying. I still
Corinne Young, APAPP President:
Mm-hmm.
Ann Cartwright:
want to keep trying. So some of it is really up to the patient. But in general you know if it’s been three to six months and they just cannot get comfortable with it. really cannot sleep with it, even with a sleep aid. If they’re feeling like it’s just causing more sleep disruption, they sleep worse with it, and we’ve kind of tried all the tricks, then we’ll start looking at a potential other option.
Corinne Young, APAPP President:
All right, well, could you share some of the resources you mentioned, or I mentioned about you a little earlier, maybe some great resources for patients and then some resources for those looking to improve their sleep medicine skills or those that are coming in new to sleep medicine?
Ann Cartwright:
Yeah, so for patients, I already mentioned the machine apps and websites. There’s a list of really good websites that I give to patients. I like the AASM, the American Academy of Sleep Medicine website. It’s sleepeducation.org, and it’s geared towards patients. Lots of very helpful information. The American Sleep Apnea Association is helpful. The National Sleep Foundation is helpful. And then the ASM, not specific to sleep apnea, but sleep in general, they have kind of a new wellness sleep campaign, and their website is called sleepisgoodmedicine.com. So just general information about why sleep is important and what can happen if you don’t get enough sleep. So those are really good resources as well. If there are… CPAP support groups in your area. That is always a helpful resource, or you can create your own. The other thing, it’s through the American Sleep Apnea Association, they have a peer mentor program, where if your patient is struggling, they can sign up to get paired with a fellow CPAP user. So it’s not just their doctor telling them what to do, but they’re actually getting that commissary, if you will, with
Corinne Young, APAPP President:
Yes.
Ann Cartwright:
a fellow user. On the flip side, if you have a patient that is doing well, they love their CPAP, especially if they struggled and now they are just gung-ho about it, you might talk to them about being a mentee and actually coaching and mentoring other people. They do get trained, they don’t just like, let them talk to people, so they do get trained in some resources. But those are all good resources for patients. On the provider side, all of the big societies have really helpful information on their websites. The American Academy of Sleep Medicine and CHEST are the two that I find most helpful. Provider information and patient information, patient handouts that you can use as well. Some of the stuff I was involved in through the AASM, at the time, it was before we were kind of called APPs, it was APRN modules. And so it’s 15 hours or so of online on-demand content. It’s geared towards people that are kind of newly going into sleep. So it’s a good foundation of about sleep, a lot about sleep apnea, but also other sleep disorders as well like insomnia and narcolepsy.
Corinne Young, APAPP President:
Well, that’s 15 hours of free education. That’s pretty awesome. Oh,
Ann Cartwright:
It’s not free, you don’t have to
Corinne Young, APAPP President:
oh,
Ann Cartwright:
pay
Corinne Young, APAPP President:
sorry. I
Ann Cartwright:
for
Corinne Young, APAPP President:
assumed, I
Ann Cartwright:
it.
Corinne Young, APAPP President:
assumed
Ann Cartwright:
No,
Corinne Young, APAPP President:
free.
Ann Cartwright:
it’s
Corinne Young, APAPP President:
I assumed
Ann Cartwright:
not,
Corinne Young, APAPP President:
free.
Ann Cartwright:
no, they do make you pay for it. It’s not bad though. There is another webinar that got released and I’m not sure the name of it, but it’s about improving CPAP adherence more from the psychological perspective, not like the physical let’s deal with your mask, but more the psychological background. I believe that one is free and that is wonderful as well.
Corinne Young, APAPP President:
I think 90% of the problem is the psychological piece of it.
Ann Cartwright:
Yeah. Yeah.
Corinne Young, APAPP President:
Yeah,
Ann Cartwright:
Yeah.
Corinne Young, APAPP President:
yeah. Well, thank you so much. I’m so glad
Ann Cartwright:
Welcome.
Corinne Young, APAPP President:
you joined us and shared all that information. I know everyone listening is going to take that back to their practice. And please let us know if we can have you back. Maybe we’ll talk about central apnea next time.
Ann Cartwright:
Always happy to have you
Corinne Young, APAPP President:
I always
Ann Cartwright:
back.
Corinne Young, APAPP President:
have
Ann Cartwright:
Ha
Corinne Young, APAPP President:
to
Ann Cartwright:
ha
Corinne Young, APAPP President:
do
Ann Cartwright:
ha ha ha.
Corinne Young, APAPP President:
that. Well, thank you so much and thank you to everyone listening. Bye.
