CPAP Blows My Mask Off After Awhile

[Gideon]

milboltnut,
Depending on the mask, there may or may not be a 'safety' valve, but there is always a vent
This technique is strictly to modify and slightly increase the amount of CO2 in the blood. It can be applied with either CPAP or BiLevel machines. It does NOTHING to change the performance of a BiLevel Machine. IT SHOULD NOT BE RANDOMLY APPLIED!!!

[dmorgen]

Welcome to the forum.  
Let's try some new settings.

Ramp off
Min pressure = 6
EPR = 2
Max pressure = 10 for now.

Try for 1 night then repost

I've been reading & learning a lot ... Mask Primer, EERS, ERP & finally how to get into the CPAP's Clinical Menu.  Yesterday, I went through the existing settings, mostly in the Clinical Menu.

Some surprises:
Minimum Pressure = 8.0
Maximum Pressure = 12.0

ERP was already set On:  FULLTIME, Level = 3.

I already knew:
Ramp Time = 15 min.
SmartStart = On

So, I made the changes you suggested, including changing ERP Level to 2, Turning Ramp to OFF, changing pressures to 6-10.  Left Smartstart ON.

Last night I very carefully adjusted the mask, keeping it as loose as possible.  I had massive leaks, but the mask wasn't being blown around.  Eventually, I tightened the straps until the leaks stopped ... tighter than I had hoped, but really not very tight.  However, there wasn't much more room to tighten.

Everything felt different than before the changes.  I felt it was on the verge of leaking, but it was not.  But overall it felt fine.  However, I did run into problems.  The air coming in was much too warm;  very uncomfortable & I couldn't sleep.  The room was warmer & more humid than usual, but not extreme.  The window was open for fresh, somewhat cooler, air.  Tube temperature was set in low 70's, 72 I think.  I lowered the tube temperature a couple of degrees;  after awhile it felt unchanged, so I turned tube heating OFF.  Eventually the air got cooler & was no longer a problem. 

But my air channels in nose, etc. were not fully open (not stuffed) & I couldn't get enough air through my nose.  I usually breathe through my mouth, but I guess I still breathe some air through my nose.  So even though mouth breathing didn't have any problems, I found the nose breathing problem to be annoying enough I could not sleep!  I used to have this problem, but it's been so long I can't remember how long ago.  I just remember, typically when this happened throwing some cold water on my face usually fixed it.  If the problem occurs again, I'll try the cold water trick.  Weird that it happened.  Maybe the lower pressure.  At 1 point earlier I had noticed the pressure was 6.1.  4-5 hours earlier I had gone for a run, which usually clears my head;  I didn’t have any problems at any time when I was outside running or walking or even afterwards.  So these problems were just odd!  Nevertheless, I couldn’t fall asleep with the mask on.

Finally, I gave up & fell asleep with no mask.  Not the greatest night’s sleep, but at least I could get some sleep, & actually feel fairly good today.

So I’m not sure how to proceed.  Essentially, I had problems & could not sleep, but never encountered the usual problems!  I’m thinking I will try again tonight, keeping the tube heat OFF, throwing cold water at my face if necessary, etc.  Any suggestions?  I appreciate the help!

Dave

[dmorgen]

   

Tell me about your EERS setup, and how you started using it.  This is an important part of what you are doing and may impact the advice we would give.  A picture of your setup would help a bit with that.  I assume you mean e one 6 inch length of coraflex tubing inserted.  
Here is our EERS Wiki http://www.apneaboard.com/wiki/index.php...ace_(EERS)
and our wiki on Treatment-Emergent6 Central Apnea in which EERS is one of the treatments mentioned.  http://www.apneaboard.com/wiki/index.php...tral_Apnea

I read those articles & learned a lot! 

If the 2 pieces of straight ribbed tubing are coraflex, then the total of the 2 pieces is 10.5".  I believe I started with this to help with my central apnea.  The actual pieces & length have been modified from time to time.

Thanks for your help!

Dave

Sorry about my first attempt resulting in all that garbage ... my first attempt at attaching a photo!  Any way I can erase it?

[Gideon]

Where is your vent? Is it the elbow at the end of the dark blue coraflex?

I'll have a moderator delete post #13

[dmorgen]

Where is your vent? Is it the elbow at the end of the dark blue coraflex?

I'll have a moderator delete post #13

I believe the vent is part of the elbow.  I can feel air coming out there.

I tried using the mask again last night.  It actually worked ok!  After awhile it began feeling uncomfortable, probably because I haven't used a mask for more than 2-3 hours in a long time.  But I had no problems with high pressure air, leaks, etc.

So, I'll probably try again tonight.  Should I make any changes to the parameters I previously changed or others?

Thanks!

Dave

[Gideon]

And you have blocked the mask vent?

[dmorgen]

And you have blocked the mask vent?

Yes.  I should re-check that the silicone is still blocking all the holes, although that hasn't been a problem.  Will do before sleep tonight.

Last night I was getting some of the higher pressure air problem, small noisy leaks.  But they were not extreme as before the changes.  Some small tightening of a strap solved the problem.  But I still had the problem of lasting the night with the mask.  I think the mask isn't right for me;  it's too big a bulky.  The Amara View never bothered me this way, at least to this degree;  occasionally I didn't last the whole night with the mask on;  but it was rare & it was after I used it for most of the night, usually after awakening for some other reason (e.g. bathroom).

BTW, I have a phone meeting with my sleep person on Wed.  So I'm sure all this will come up for discussion.  It will be more productive if I've at least demonstrated the high pressure air problem & a solution!  But there's still the overall solution required.  I definitely want to discuss getting a different mask, maybe even going back to the Amara View, which was a joy compared to the Quattro Air for me!  I don't even remember for sure why I switched;  I think it might have been based upon the detailed data from the CPAP.  But it had to be better than 0-2 hours I'm usually getting now!

Thanks again for your help!

Dave

[Gideon]

Expand to a 5 or 10 minute flow. Then scan the flow rate for any sinusoidal waxing and waning that may be occurring. This is what EERS is designed to prevent.
Because of the problems you are having maybe you want to go back to a non-EERS setting and titrate to eliminate obstructive issues then bring the EERS back into the picture.