Sleep Service

  • Diagnosing and treating individuals with sleep disordered breathing disorders.

  • Address: Maidstone Hospital,  Tunbridge Wells Hospital and the West Kent Community Diagnostic Centre,

What we do

We offer a range of home non-invasive diagnostic sleep studies:

  • Overnight oximetry is used to measure oxygen levels and heart rate to screen for sleep-disordered breathing such as sleep apnoea. It involves wearing a small wristwatch and an oxygen sensor on the thumb. It must be worn for a minimum of 6 hours during sleep.
  • WatchPAT is used to diagnose sleep apnoea. It involves wearing a wristwatch, finger probe and chest sensor to assess breathing, oxygen levels, heart rate and blood flow.
  • Respiratory polygraphy is used to diagnose sleep disordered breathing. It involves wearing belts over the chest and abdomen, a finger probe and a canula in your nose. This helps us assess your breathing, snoring, respiratory effort and oxygen levels.

We offer two main treatments for sleep disordered breathing:

  • Continuous positive airway pressure (CPAP)
  • Non-invasive ventilation (NIV)

Our team includes respiratory consultants, healthcare scientists and sleep/respiratory physiologists, supporting the diagnosis and treatment of sleep-related breathing disorders.

Get in touch

Call the department directly on 01622 224521 or email us:

When you contact us please be ready to provide your name, hospital number, NHS number and date of birth to help us find you in our clinical system. 

Where to find us

The Franklin Unit (Unit A) at the West Kent Community Diagnostic Centre is where we perform our range of sleep diagnostics.

At Maidstone Hospital we offer treatments and follow ups for patients on CPAP or NIV treatments.

Find us in the purple zone, in the Acute Stroke Unit (lung function department).

At Tunbridge Wells Hospital we perform sleep diagnostics and offer treatments and follow ups for patients on CPAP or NIV treatments.

Find us in Outpatients zone 1.

Clinical and service leads

  • Sleep and NIV Clinical Lead: Dr. P David Davidson, Respiratory Consultant
  • Sleep Service Lead: Ricardo Sales, Lead Respiratory and Sleep Physiologist

Your appointment

At your sleep diagnostic appointment you will be shown how to set up and use your sleep study equipment.

We will record your height, weight, peripheral oxygen saturation (commonly abbreviated as SpO₂) and a take a measurement of your neck circumference to help with clinical diagnosis.

You will be given a small number of sleep questionnaires to detail your symptoms and record your sleep quality on the night of study.

As all our sleep studies are home sleep studies they are to be performed in your normal sleeping environment.

The next day you are expected to return the device, by 10am, to the same location you collected it from.

We will show you the drop off point at your appointment.

If the device is not returned, we cannot analyse your results and we cannot use the equipment for further tests. If it isn't returned you may incur a fee equal to the cost of the device.

Sleep-disordered breathing

Our service primarily treats sleep-related breathing disorders. The two main conditions include obstructive sleep apnoea (OSA) and obesity hypoventilation syndrome (OHS).

Obstructive sleep apnoea (OSA) is a common sleep disorder in which breathing repeatedly stops during sleep. The airway becomes blocked (obstructed) during sleep as the throat muscles relax and collapse. In most cases, this leads to a drop in oxygen levels.

When oxygen levels fall, the brain sends signals to resume breathing, resulting in frequent, often unconscious awakenings to restore normal oxygen levels. This can lead to excessive daytime sleepiness.

OSA is associated with several risk factors, including excess weight, smoking, older age, and alcohol consumption.

Lifestyle changes such as losing weight, quitting smoking and sleeping on your side can all improve symptoms. The gold standard treatment for OSA is continuous positive airway pressure (CPAP).

Obesity hypoventilation syndrome (OHS) is a breathing disorder that can affect individuals with obesity and sleep disordered breathing. Due to increased weight on the chest an individual may not be able to breathe effectively which can cause the body to retain too much carbon dioxide.

Symptoms include excessive daytime sleepiness, morning headaches, shortness of breath and fatigue.

OHS is treated with CPAP or NIV therapy to support breathing during sleep, while working towards weight loss. 

Continuous positive airway pressure (CPAP)

CPAP is a medical device used to treat obstructive sleep apnoea. The machine delivers a continuous flow of air at a prescribed pressure through a tube and a mask worn on the face.

The pressurised air acts as a splint, helping keep the airway open and prevent it from collapsing during sleep. This allows breathing to remain uninterrupted, preventing oxygen levels from dropping and improving sleep quality.

It is important not to adjust the pressure settings on your machine, as they have been specifically tailored to your individual needs.

CPAP appointment

At your first CPAP appointment, we will explain your sleep study results, as well as the causes, symptoms, and potential consequences of sleep apnoea. You will also be shown how to set up and use your CPAP machine.

We will discuss the different mask options to find one that is suitable for you and provide advice to help you adapt to CPAP therapy. In addition, we will explain how to care for and maintain your equipment.

Once you are at home, you will be expected to manage your CPAP independently and use it whenever you sleep to effectively treat your obstructive sleep apnoea.

Following your initial appointment, you will have a telephone review after two weeks to discuss your progress. This will be followed by a face-to-face appointment after 4–6 weeks to provide further support.

Ongoing follow-up appointments will then be arranged based on your individual needs. We can also offer additional appointments if required.

The Myair app gives you access to videos, coaching tips and therapy reports. Every morning, your myAir score shows you useful information about your sleep and your therapy.

Non-invasive ventilation (NIV)

Non-invasive ventilation (NIV) gives a form of mechanical ventilation without the need for invasive procedures.

It supports breathing by delivering two levels of pressure: a higher pressure when you breathe in, and a lower pressure while you breathe out. This helps make breathing easier.

Like CPAP, NIV involves wearing a mask on your face. This is connected to a machine which delivers the different pressures.

Your appointment

At your first appointment, we will explain your sleep study results, as well as the causes, symptoms, and potential consequences of obesity hypoventilation syndrome (OHS).

We will also show you how to set up and use your NIV machine.

We will find a suitable mask for you and give you advice to support your NIV therapy. We will also explain how to care for and maintain your equipment.

Once you are at home, you will be expected to manage your NIV independently and use it whenever you sleep and/or as advised to support your breathing.

Following your initial appointment, you will have a telephone review after two weeks to discuss your progress. This will be followed by a face-to-face appointment after 4–6 weeks to provide further support.

Ongoing follow-up appointments will then be arranged based on your individual needs, and additional appointments can be offered if needed.

During these appointments, an earlobe capillary blood gas sample will be taken to assess the effectiveness of treatment by measuring oxygen and carbon dioxide levels in your blood.

Fitting, cleaning and maintaining your mask

The myMask app gives you access to step-by-step fitting, cleaning and fine-tuning videos and troubleshooting advice. 

Fitting your mask

 

Cleaning and maintenance

Following a simple cleaning routine will extend the life of your equipment and ensure treatment remains effective. A humidifier is mentioned in the cleaning routine below. You may not have a humidifier as these are only given in certain circumstances.

 

What you need to do every day

Mask

You should clean the silicone cushion of your CPAP mask every day. You should wipe the silicone with a clean damp cloth with mild/ unscented dish soap. The goal is to remove facial oils as these can build up over time, creating a barrier between the mask and skin. If left, this will result in mask leak. An unscented wipe can be substituted but may leave a film on the mask.

Humidifier (If applicable)

  • Disconnect from machine and empty old water 
  • Rinse in either clean water or a mild soapy solution. 
  • Rinse free of soap and allow to air dry 
  • Once dry refill with clean water. We recommend boiled water that has completely cooled, or bottled water.
  • Reconnect to CPAP machine ready for next use.

 

What you need to do every week

Mask

  • Disassemble the mask so all components can be cleaned
  • Soak in warm soapy water for a few minutes. An unscented/mild dish soap works best and you can gently rub components that may have a build up of dirt or grime
  • Rinse the mask free of soap with clean water
  • Leave to air dry out of direct sunlight (a towel can be used if parts do not dry in time for next use) and once dry, reconnect components ready for next use

Tubing

  • Disconnect your tubing from the CPAP machine and ensure there is nothing blocking it
  • Soak/wash through with warm soapy water and gently rub off any dirt that has built up
  • Rinse thoroughly with clean water
  • Allow to air dry before next use. Hang the tube over a shower/towel rail, or over the top of a door with both ends facing downwards
  • Once dry reconnect to CPAP machine ready for next use

Filter

  • Open your filter panel. This is on the back or side of your machine depending on the model.
  • Pinch the fabric filter out and gently flick off excess dust
  • Place back into panel and close ready for use.

CPAP machine

Wipe the machine with a dry or slightly damp cloth to remove dust.

 

What you need to do every three months

Replace the filter.

Each mask has a standard life cycle of one year. Masks will be replaced every year at annual review.

If you had not had a new mask, or your mask is damaged, you can contact us on 01622 224521 or at mtw-tr.cpapandnivenquires@nhs.net to arrange a replacement. 

Frequently asked questions

Adapting to CPAP should be a slow and steady process. The Sleep Apnoea Trust has a range of information leaflets including how to manage CPAP claustrophobia and frequently asked questions for those new to CPAP.

How long does it take to get used to CPAP?

Most people adjust to CPAP within one to two weeks, although it can take a little longer for some. This may be due to sensitivity to the noise, or the feeling of the mask.

When will I notice an improvement?

If your symptoms are caused by OSA, you should notice an improvement quite quickly after starting CPAP. However, some symptoms may persist if they are related to other health conditions or medications.

How often should I use my CPAP?

CPAP should be used every night. If you stop using it, your symptoms are likely to return.

Will my pressure settings need to change?

Your CPAP automatically delivers the pressure needed to keep your airway open, but occasional adjustments may be needed. If you notice discomfort, increased symptoms, or snoring, please contact us for advice.

Will my blood pressure improve?

Sometimes, but you should not change your medication without consulting your doctor.

Can CPAP help with weight loss?

It may help indirectly, as improved sleep can increase your energy levels and motivation to be more active.

Do I need to bring my CPAP to hospital?

Yes. Always bring your machine and clearly label it. Inform your healthcare team, including the surgeon and anaesthetist, if you are using CPAP.

What if my CPAP is noisy?

Try placing the machine on a padded surface to reduce vibrations or positioning it under the bed or in a well-ventilated space. Earplugs may also help. If the problem persists, contact the service for advice.

CPAP is irritating my nose - what can I do?

This is common when starting treatment and usually settles within a few days. If it continues, contact us for advice.

The air feels cold and uncomfortable

Try warming the room, placing tubing under your bedding, or insulating the tubing. A heated humidifier can also help.

What if my nose is blocked?

Keeping your nose clear is important. Short-term use of nasal sprays or oils may help. If needed, a different mask (such as a full-face mask) can be arranged.

Air is leaking from my mouth

If you are using a nasal mask, try keeping your mouth closed. A chin strap or full-face mask may help—please contact us for advice.

Can I use CPAP if I have a cold?

If you cannot breathe through your nose, stop using CPAP until you recover. Be aware of increased tiredness and avoid driving if affected. If you continue using CPAP, clean your equipment daily.

Will I ever be able to stop using CPAP?

OSA is usually a long-term condition and CPAP will control your symptoms while in use. Losing weight may help  reduce severity, and in some cases CPAP may no longer be needed, but this requires reassessment.

I remove my mask during sleep—what should I do?

This may indicate pressure or comfort issues. Contact us for advice and to review your treatment. Addressing nasal blockage or adjusting your mask may help.

Why does breathing out feel difficult?

Some people notice resistance when breathing out. This is normal, and your machine may have a comfort setting to reduce it.

Emergencies

Most people can manage without CPAP/NIV for a few nights. Although you may not sleep as well, this is not harmful.

However, your level of daytime tiredness may increase, so it is not advisable to drive until you are using your CPAP/NIV and your symptoms have improved.

Occasionally, you may be unable to use your CPAP/NIV due to unforeseen circumstances, such as:

Power cut

If you are aware of a power cut during the night, remove your mask and turn the CPAP/NIV machine off.

Sleeping with the mask on while the CPAP machine is switched off is not dangerous. All CPAP/NIV masks have a safety valve that allows you to breathe room air in the event of a power cut, so there is no need to worry if this happens while you are asleep.

CPAP/NIV machine breakdown

CPAP/NIV machines can occasionally break down. If this happens, please contact the Patient Helpline. Your call will be returned as soon as possible to arrange a convenient time for you to return the faulty machine so that it can be assessed, repaired, or replaced.

If your mask breaks

Contact us for assistance.

Patient-initiated follow up

Patient-initiated follow up means less time attending hospital appointments while still having access to clinical support when you need it. 

Find out more in our patient information library