Home Non-Invasive Ventilation (NIV)

Non-invasive ventilation (NIV) is equipment including a machine and mask, that aims to improve your breathing during your sleep.

There are several conditions which can cause you to struggle to get enough oxygen into your lungs and get the waste gas (carbon dioxide) out, particularly during your sleep. This could be due to an increase in your weight affecting your breathing, lung conditions such as COPD, weakness in the muscles that you use to breathe, or due to changes in the shape of your chest.

NIV is used during sleep to assist your breathing, when your breathing muscles are more relaxed and you breathe less deeply and less often.

The aim of using NIV is to help to reduce the symptoms associated with sleep related breathing problems; poor sleep, headaches, tiredness, and fatigue during the day.

NIV therapy is also associated with long term health benefits, and can reduce the likelihood of breathing related hospital admissions in some cases.

By using NIV to improve your breathing at night, there are several long term health benefits.

The potential benefits of using NIV include:

• Reduced daytime tiredness
• Improved concentration & mood
• Reduced risk of hospital admission
• Prolonged life

You will be advised how to use your oxygen therapy overnight. If you are advised to use both therapies, you will be issued with an adapter to connect your oxygen supply to your NIV equipment.

You may be advised to use your oxygen therapy on a different setting at night time compared to your usual daytime prescription.

Modern NIV machines are equipped with technology to allow information to be sent to your healthcare team. This allows us to be able to monitor your therapy and reduce the number of times you need to attend an appointment with your NIV equipment.

This information includes usage, mask leak and breathing information. There may be occasions where we need to see you face to face for an appointment.

Please refer to any appointment letters for the type of appointment booked. We will discuss whether we can monitor you remotely, at your
first appointment, and would need your consent to do this.

Starting your therapy

On your first appointment a Respiratory Physiologist will briefly explain why you have been referred for NIV. The Physiologist will then fit you with a suitable mask and explain how to adjust and maintain it.

It is very important that the mask fits correctly; this will ensure that the therapy works effectively. You will be shown how to operate the NIV device.

The length of time that you can use your NIV machine during the night is individual to you, however sleep is important and adults are recommended to get 7 to 8 hours sleep per night.

We would hope you can use your machine for at least 4 hours a night for it to be beneficial. It can take a few days or weeks to get used to your machine so please keep trying to use it as much as you can.

You will be contacted by telephone approximately 1 week after your first NIV appointment for a remote review of your therapy if you have consented to this, otherwise it will be face to face. You will have the opportunity to discuss your therapy and any issues you may have had.

Your therapy data will also be reviewed and any necessary changes to settings will be made remotely.

Once you are using NIV regularly, we will book a face to face follow up appointment, where we will take a capillary blood gas (a type of blood test that you will likely have had before as part of your NIV assessment). This will help show us how well your NIV therapy is working.

Your NIV machine is on loan to you for as long as you need it. It is usually a long term treatment but please see the tips below regarding how you can help to improve your breathing during sleep.

You are advised to use the NIV machine every night for as long as possible whilst you are asleep in order to gain the most benefit from therapy.

• Weight loss
• Stopping smoking
• Avoiding alcohol
• Avoiding certain drugs (sedatives) - ask your healthcare team if unsure

For help with weight loss and/or stopping smoking, Get Healthy Rotherham provide free advice and support.
Telephone: 01709 718 720

You may encounter some minor problems initially which usually can be overcome quite easily:

Never run the machine without a filter.

The filter should be replaced every 6 months or as necessary, as demonstrated at your initial appointment. Replacement filters can be posted to your home address. Please contact the department if new filters are required or if you require advice on how to replace the filter.

Wipe the mask daily.

Fully clean the mask and tubing once a week:

1. Wash the mask and tubing in a mild detergent (please see below) (disconnect from the machine first)
2. Rinse thoroughly
3. Dry mask with a soft clean cloth
4. Hang the tubing to dry

Ensure the mask and tubing are completely dry before re-connecting.

Do not use any antibacterial detergents or any detergents with additives such as aloe vera. Mild, fragrance free washing up liquid is recommended.

If you have any problems or queries at all with your NIV therapy please do not hesitate to contact us, we are here to help answer any questions or problems you may have. Contact us by telephone on 01709 421780 or by email at rgh-tr.sleepservice@nhs.net.

Please do not attend the department without an appointment as we will be unable to see you if we are seeing other patients.

We may also need to order replacement parts depending on the problem you have. Please call or email to arrange an appointment or request replacement parts, and we will try and deal with your request as soon as possible.

We would hope that you will get used to using NIV. If you have tried to use NIV for a few weeks or months, and you do not wish to continue with the therapy, please contact the department.

Contact us by telephone on 01709 421780 or by email at rgh-tr.sleepservice@nhs.net.

Unused equipment should be returned to the department so that it can be restored and used again.

If possible, take your NIV into hospital with you. The ward may transfer you onto one of their machines whilst you are in hospital or they may advise you to continue to use your own NIV overnight on the ward.

You can take your NIV with you wherever you travel. Prior arrangements may need to be made to take your NIV on certain airlines or ships.

In most cases, we can give you a letter confirming the NIV is a medical device which should allow you to take the machine through airport security without hassle. To use your NIV during travel, you will need to ensure adequate power supply is available. For example, ensuring you have a plug socket adapter if travelling abroad.

Please contact the department should you have any questions about travelling with your NIV.

For current guidance on driving and daytime sleepiness, please refer to the DVLA guidelines or contact the department using the contact details in this information and ask to speak to a Respiratory Physiologist.

You must never drive if you feel tired.

If you have any questions regarding your therapy, please do not hesitate to contact us.

Respiratory and Sleep Physiology

01709 421780
Monday to Friday, 8am to 4pm

For therapy issues email:

rgh-tr.sleepservice@nhs.net

For appointment issues email:

rgh-tr.respiratory.sleepphysiology@nhs.net