1 Year on and mostly pulling the mask off

[mw1655]

Hi All

Wondering if some fellow board members can help. A little over a year ago I was diagnosed with mild sleep apnea at the age of 47 with an AHI of  16.2/hr. To cut a long story short I have been on a CPAP every night and I still struggle with pulling my mask off unconsciously for most nights. On a few occasions I do wake up an pull it back on. There have been a very days where I have slept through and felt pretty good in the morning but in general I struggle to get a good nights sleep and struggle through the following day generally grumpy and sometimes with a headache (don't know how my wife and young daughter put up with me - they are angels). I work late due to overseas conference calls, etc so I don't get to bed till 11pm-midnight and wake around 6.30-7.

Numerous visits to the doctor and sleep technician and they haven't been able to help. The CPAP is set to min 4 max 10. Options that I have tried

- Humidifier for a month (I don't have a dry nose or mouth) but the doc recommended I try it
- Tried switching from the CPAP to a BiPAP for a month  - not much difference
- Switched from a nasal pillow to nasal mask (DreamWear - more comfortable)
- Had acid reflux for a while but that seems to be resolved now (cut out spicy foods and alcohol for over 6 months)


Have attached some graphs from SleepHead with the last three nights I have had which are typical of the nights over past 12 months

Any help or advice will much appreciated

[Sleeprider]

The instruction for organizing daily detail charts and posting on the forum are in my signature. Your reports lack a lot of important data that shows up when you post the .png charts from the daily details rather than a pdf report. My impression is that you have a good AHI, but pulling off your mask causes a major disruption. I think your minimum pressure should be at least 6.0, and I could easily argue for 7-8 cm for a minimum. As far as removing your mask subconsciously during your sleep, this is a habit we have seen from a number of members. It is a habit or behavior you have to break, or you cannot make this work. I don't have a good idea how you should prevent yourself from removing the mask, but it's usually related to whether you view the therapy as something you enjoy and find comfortable, or if you have a negative feeling towards wearing the mask. How do you think you might persuade yourself to not remove the mask?

[mw1655]

Sorry Sleeprider. Thanks for the feedback though and appreciate you taking the time to look at my post. Feelings around the mask is somewhat neutral - I don't have a problem with putting it on and falling asleep. I did try wearing it when watching TV for a couple of weeks - didn't help and my daughter kind of found it amusing and kept playing with it.

Have attached the charts in png format.

[PoolQ]

I can't wear the mask below 5 I feel like I am not getting enough air. As said above raise that number up at least a couple. when you are comfortable wearing the mask and using the system you will just sleep through it all. gotta focus on getting you comfortable with it

[mw1655]

Thanks PoolQ

Will try that tonight. Do you think I need to bump up the max setting ?

[jaswilliams]

Thanks PoolQ

Will try that tonight. Do you think I need to bump up the max setting 

Your max pressures are going no where near your max settings so leaving where it is or pushing it up th the machine max of 20 won't make a difference based on the graphs you posted

[mw1655]

Thank you for the confirmation

[SarcasticDave94]

I'd try bumping minimum to 6 and view results. Most adults are going to feel air starved below 6 IMO. That can make you tear the mask off subconsciously as you're trying to get more air.

Otherwise, build the habit of always masking up before sleeping and if/when it's taken off overnight, put it back on when you're aware of it. It'll take time to build the habit, but eventually it'll get you there. Best to success.

BTW you could try turning on Leak Alert; that is if your machine has it as an option. I had to do that at the beginning of my ASV usage. Maybe it'll reinforce the habit build-up for keeping mask on.

[Sleeprider]

Thanks for posting the updated information with the machine settings. I continue to think 6.0 is a good minimum pressure to try, and I'd like you to lower the Flex setting from x3 to 1 or 2. It's a comfort setting, but my experience with Flex at 3 has never been good. Give it a try and decide for yourself.

[Davidb]

How about something that wakes you up as soon as you remove the thing. A simple way would be to get one of those personal alarms designed to go off when a purse is pulled out of a ladies hand. Tape the keychain part to one side of your rig and the string to the other such that removing it sets it off. They are crazy loud, so you may want to tape a wash cloth around the nose maker to muffle it a bit. Good luck.