Information for patients from the Respiratory Team

This leaflet provides information, care, and advice on using Non-Invasive Ventilation (NIV) at home.

The community respiratory team works alongside the specialist NIV nurses within East Kent Hospitals University NHS Foundation Trust (EKHUFT), to provide you with support and advice about managing your home NIV.

If you require support with your NIV, masks or equipment, please contact the NIV helpline on 01227 866402.

What is Non-Invasive Ventilation?

NIV is a treatment to help with your breathing. It involves wearing a mask connected to a machine which makes your breathing in and out easier and supports the muscles which make your lungs work. It is generally worn at night during sleep. The mask provided has been selected to fit your face and the machine has been specifically set for your breathing.

Why has this treatment been recommended?

NIV can improve sleep quality leading to better energy and concentration levels during the day. It can also make you feel less breathless than before. This may mean you may be able to perform more daily tasks. You may also feel brighter on waking and headache-free if this was a problem previously. It can also reduce the likelihood of being re-admitted to hospital.

What does NIV feel like?

In order to use this type of ventilator you will need to wear a face mask which fits firmly, but not too tightly. As you take a breath in you will feel a flow of air from the machine to support your breathing. As you breathe out, you will feel a little resistance which is there to keep the small air passages of your lungs open. This helps to improve the oxygen levels in your blood. It can feel a bit strange to start with, however, most people find that they get used to it fairly easily.

How do I clean my machine and mask?

Daily

It is important to wipe the mask around every morning with a damp cloth or warm water and washing-up liquid.

Every one to two weeks

The mask will likely need a better clean every week or two. In the morning separate the mask from all attachments and wash it gently in warm soapy water. Rinse with clean warm water and allow to air dry before using again. Do not dry near a source of direct heat. If you remove the headgear, it is a good idea to mark a line on the straps with a permanent marker so you know where to reattach after cleaning. The straps can be washed in warm soapy water every two weeks and allowed to dry before reusing.

Tubing

Wash the tubing every fortnight in warm soapy water. After, rinse with clean warm water and hang over a door to allow water to drain out and dry.

Machine

Unplug the machine from the power and wipe over with a damp cloth and allow to dry before plugging back in and turning the power back on.

FAQ's

Can I survive a night without my ventilator?

Yes, most patients can spend one or two nights off their machine. You may be more uncomfortable than usual and your symptoms of tiredness and headache may re-appear but this is rarely dangerous.

My ventilator does not feel comfortable or gives me a breath at the wrong time. Is this ok?

If your machine does not feel right, contact the NIV team on 01227 866402.

Do I need to bring my NIV to hospital with me if I am admitted?

Yes, and let the nursing staff know that you use NIV at home as well.

Should I use my ventilator during the day?

If you want a nap, or have a chest infection, it’s a good idea to use your ventilator during the day as well as at night. You will not become dependent on it and you may gain relief from wearing it.

Is there anyone I can contact out-of-hours if there is a problem with my ventilator or breathing?

The hospital respiratory nurses and NIV team are available from 9am to 5pm from Monday to Friday. If the machine is not working outside of normal working hours you should be safe to wait until the next working day before contacting the NIV team.

Are there any risks to having NIV?

As with any treatment, side effects can occur. However, those associated with NIV are rarely severe and easily resolved.

Common problems include the following:

Mask seal problems

A small amount of air leaking from the bottom of the mask is common and will not affect how well the NIV works. However, larger leaks, or leaks blowing into your eyes, can cause problems.

You can try gently tightening the headgear straps at home, but be careful not to make them too tight, as this can cause soreness or pressure on your face and nose.

If leaks continue to be a problem, contact the nurse who fitted your mask for advice. Sometimes a different mask or a change in fit is needed, and it may take a few adjustments to find the most comfortable and effective option.

Soreness on the nasal bridge

Soreness on the nasal bridge is an indication that the mask is too tight at the top or is a poor fit. The mask will either need refitting or replacing as the soreness can worsen over time. Contact your NIV nurse if this happens – do not wait for your next appointment.

Throat dryness

A dry mouth is very common when using NIV, particularly with a mask that covers the mouth. Usually a glass of water by the bed to sip from regularly can be enough to resolve this. In some cases humidification devices may help. You can discuss this with your nurse.

Nasal problems

It is common to suffer from nasal stuffiness or sneezing and a runny nose when you first start treatment. This should settle on its own. If it does not settle after a week or so then contact your GP or pharmacist to discuss whether a nasal spray may be useful.