Bit of a battle with the chinstrap, P10 itch

[Bassline]

Hi All, 

I'm curious if anyone else has fought with this, and what they ended up doing: 

I've been at this for a few months now (mainly AirFit P10, AirTouch F20 only for the occasional nap - which thankfully hasn't been required too often - both used with a chinstrap). Up until a couple of weeks ago, I was doing pretty well: AHIs at or below 3.5 on a consistent basis, minimal number of times waking up, etc.. 

Lately I've been running into two problems: the first is waking up repeatedly to deal with itching just inside and around the nostrils. I've replaced the pillows a couple of weeks ago, and this helped a bit maybe for the first day. Based upon what I've read here, I've tried a bit of lanolin ointment before bedtime: it seems to help somewhat, although it's a careful balance - slightly too much and the ointment actually causes sticking (not to mention harder cleanup next morning). I changed out the pillows about two weeks ago, more as a matter of course, rather than obvious need. The first set lasted a couple of months.

The second problem is with the chinstrap. I have two different ones (both from Supplier #1, for reference): the Phillips "Premium Chinstrap" and the generic knockoff for the Respironics "Deluxe Chinstrap". For the first, the tension apparently required to keep my mouth closed places too much pressure on my cheekbones. For the latter, it's often pressure on my ears or (for whatever reason this morning) ache in my jaw muscles on one side ... maybe I was clinching, don't know. Lessening the tension lessens the problem, but then results in far more mouth opening issues. 

Any ideas? The odd thing is that all of this didn't seem to be a big deal until just recently, so I'm not sure what changed. My AHIs are now averaging about 4.7 - 6, but I suspect that much of this is due to the issues above bothering my sleep.

Thanks much.

[OpalRose]

The nasal pillow may be too small. Try one size larger so it doesn’t go inside the nostril.
Males have more of an issue with nose hairs, if so, try trimming so that it doesn’t cause itching.
You can also try a nasal get like AYR. Works well and has a cooling effect.

Don’t have much advice on a chin strap, as I’ve never liked them.
If your looking for something to help keep your mouth/jaw from dropping open, try a soft cervical collar.

[Bassline]

Hi OpalRose, 

The Ayr is a good idea - will have to pick some up. It may be less sticky and easy to clean up than the lanolin. 

I definitely try to keep the nose hairs trimmed, but the itching is mainly around the "rim" of the nostrils and outside of the nose, not inside the nose so much. When I got some inside nose irritation during the initial nights, I tried going up a size. That didn't work so well, from a sealing and required strap tension perspective. I discovered that my problem was more the way that I had the mask positioned. Still, I may try a large again just for kicks to see if things changed. 

I agree that I'd rather not have a chin strap if I could somehow get past the jaw drop thing. (Apart from the issues that I mentioned, I also have to be careful not to get the "face fuzz" pulled too much. This is more of a problem with the large elastic band of the Respironics clone.) That was part of the motivation to try out the AirTouch F20. Tried it one night without a chin strap ... that REALLY didn't work well: jaw drop caused leakage, caused pressure to go up, causing more leakage ... and the net result was being felt like I was being force-fed air. Not pleasant. 

May have to try the soft cervical collar. How much do these press on one's throat, lying on back or on side? I've learned that it doesn't take too much of pressure to cause me all sorts of coughing issues.

[Melman]

The collar is worn just tight enough to prevent the chin from dropping inside the collar but loose enough that there is no or little pressure on the throat. When adjusted properly I can easily insert a finger between the collar and my neck. Depending on position I sometimes feel it touching my throat but with no real pressure. You would have the least throat contact lying on your back. I suggest looking at the OTC collar on amazon because they have a sizing chart and come in 3 different heights for different neck lengths. There are many others that are popular and you will probably get other recommendations.

[Bassline]

I suggest looking at the OTC collar on amazon because they have a sizing chart and come in 3 different heights for different neck lengths.

Thanks for the reference! Not having worn one of these before, is the sizing that one would use for keeping one's mouth closed during sleep be the same that one would use for "standard purposes" (reduction of neck movement while awake, I'd assume)?

[holden4th]

I suggest looking at the OTC collar on amazon because they have a sizing chart and come in 3 different heights for different neck lengths.

Thanks for the reference! Not having worn one of these before, is the sizing that one would use for keeping one's mouth closed during sleep be the same that one would use for "standard purposes" (reduction of neck movement while awake, I'd assume)?

The cervical collar is easily the best way to go. Many of the collars you can purchase in store are wrapped in plastic so you can try them out before you buy.

[Bassline]

Quick update and bigger cervical collar question:

First, I figured out the nose itching thing. Turns out that I had started getting my nightly facial scrub too close to my nose. Took a couple of days to cause problems. (Pro tip: don't use facial scrub around your nostrils, especially with nasal pillows. It can be annoying.)

I'm now past my second night with the soft cervical collar. (Decided to go with OTC for reasons suggested.) I can see the appeal as far as chin positioning goes. However, how do folks deal with laying down with the back of the collar pressing on the back of the neck? Currently, it's kind of like having a padded brick pressing against my neck. (And here I was wondering how "soft" foam would be firm-enough for chin support.) Is there some magic pillow position that solves this? 

Thanks again,
Bassline

[jaswilliams]

Quick update and bigger cervical collar question:

First, I figured out the nose itching thing. Turns out that I had started getting my nightly facial scrub too close to my nose. Took a couple of days to cause problems. (Pro tip: don't use facial scrub around your nostrils, especially with nasal pillows. It can be annoying.)

I'm now past my second night with the soft cervical collar. (Decided to go with OTC for reasons suggested.) I can see the appeal as far as chin positioning goes. However, how do folks deal with laying down with the back of the collar pressing on the back of the neck? Currently, it's kind of like having a padded brick pressing against my neck. (And here I was wondering how "soft" foam would be firm-enough for chin support.) Is there some magic pillow position that solves this? 

Thanks again,
Bassline

I have used a Dr dacota anti snore pillow that only has a wedge of foam at The front of my  neck so I dont have issues when side sleeping

[Big Guy]

I was using an AirFit F20 mask. I'm currently using an AirFit F30 now. 

I just figured that itching was part & parcel of the whole SA mask thing. For the most part, it doesn't bother me all that much. I do have a mustache, but I keep it trimmed. No beard, and I shower / shave every night, just before bedtime. 

No matter how closely I shave, the mask straps do make me itch at times. My F30 mask tends to rub the bottom of my nose, and it of course, ends up itching. 

Even the sides of the mask rub enough to make my cheeks itch. I either end up ignoring the itches, or I do wake up and take corrective action, which is usually a finger or two coming to the rescue. 

Worst case scenario, is that the itching is bad enough, that I have to get out of bed, go into the bathroom and take a tissue and wipe the insides of the mask pillow to remove moisture. As hard as I try not to, I do drool a bit at times. I'm a mouth breather and that fact isn't going to change any anytime soon. 

I can't fathom not itching from time to time while geared up for SA therapy. 

[Hydrangea]

My skin reacts to the material that the P10s are made of. My nostrils itched for probably 1-2 months, until (I believe) my skin became a bit thicker, or maybe adapted? But even still, throughout the entire year I used the P10, every few weeks the skin (that touched the P10) would peel.

For me, nose hair helps because it provides some buffer between my skin and the P10 material.