Can't keep mask on

[Harryl]

I have been declining steadily in my ability to use my Cpap equipment.
Somewhere in the last couple months I have developed the habit of falling asleep without my mask on and or mostly taking it off without being aware.
Sometimes when it's on an apnea event will wake me while I'm wearing it. At least I think it's an apnea event. I'm often having a bad dream that seems to be caused by the inability to breath. Other times I just take the mask off, in my sleep and go back to sleep. I do sleep but sometimes only an hour or two, other times up to 3-4 hours, without the mask. When I do wake from sleeping without the mask its often with a racing heartbeat or just a general uneasiness of not sleeping well. My machine says my ahi numbers are in the .5 to 3.0 range during the short periods, generally a few hours or less, sometimes 1/2 hour, when I do use the machine. I've tried experimenting with a fixed pressure using the epr set at 3 versus the variable pressure that was working for me. I almost never slept more that 3-4 hours at a time without waking before, while using Cpap but would frequently get 5-6 hours total by going back to bed. Those days seem long gone. have I developed central apneas? Headed back to the doc this week but not sure what to tell her. Anybody have
Any insights!

[PaulaO2]

Taking off the mask is a common thing. There's a few things to try. One is to sit during the day with the mask and machine on. This gets you used to the feelings and sensations of the mask, the air, etc. A few days at an hour or so at a time.

Another thing to try is to take a string or something and attach the hose to your pillow. This means that when you take off the mask, it can't go anywhere and the sound/sensation of the air should wake you.

If you are taking off the mask and the machine is still running, then those AHI numbers are worthless. The AHI is the number of events divided by the number of hours the machine was on. So if you spent 5hrs with it on but only one asleep, the AHI it calculates is wrong.

The EPR is considered a comfort feature. It lowers the exhale pressure. Some people sleep better without it and some people say their AHI is better without it. Any experimenting you do has to be done over time. Making a change just for a night or two isn't going to prove or disprove anything. It needs at least 7-10 nights to establish any hint of a trend. No two nights are the same so it takes a lot of nights to see anything.

[Harryl]

Paul
Thanks a lot but my machine cuts off
When the mask comes off.
I have been using Cpap for 3-4 years so
I'm use to the mask. Somehow I think I'm not
Going air even with the machine on so the mask
Comes off. I think I've learned to keep my
Mouth closed right even without a chin strap
So to breath it must come off. Then I fall asleep.
What's surprising is how much I do manage
To sleep without it. Some nights it's considerable
While others are marginal. Either way I'm distressingly
Going backward in my Ability to use Cpap
And sleep. I have been experimenting
With constant pressure if 10-11 against the
Auto settings but the mask seems to come
Off even quicker with the constant Cpap versus
The auto.

[vsheline]

I have been using Cpap for 3-4 years so 
I'm use to the mask. Somehow I think I'm not
Going air even with the machine on so the mask
Comes off. I think I've learned to keep my
Mouth closed right even without a chin strap
So to breath it must come off.
(snip)
I have been experimenting 
With constant pressure if 10-11 against the
Auto settings but the mask seems to come
Off even quicker with the constant Cpap versus
The auto.

Hi Harryl,

If you have the S9 Escape Auto it would be helpful to have that info in your user profile.

I take it AHI and hours are the only things your machine reports, but if not then is your pressure between 4-8 when the mask comes off or is the pressure at the top of your range, 16?

If you have the Escape Auto and do not have full data, then I suggest you might be taking off the mask when the pressure is too low, either when 4-8 or when unable to go above 16 (or 11 if using 10-11).

I suggest asking for a home titration (7 to 30 days, the more the better) using the fully data-reporting S9 AutoSet (not S8 AutoSet). I think this would likely provide MUCH more useful info than a few hours of overnight sleep study. And at much less cost. And an overnight sleep study could be done after the home titration, if called for, after your doctor (and you) have reviewed the data from the home sleep study.

At the very least, ask your doctor to raise pressure range from 4-16 to 9-16 or 9-20.

Take care,
--- Vaughn

[Sleepster]

I have been using Cpap for 3-4 years so
I'm use to the mask. Somehow I think I'm not
Going air even with the machine on so the mask
Comes off.

Are you conscious of the fact that you're removing it?

You're right in that you are damaging your body by not wearing it. You're also not training your mind to sleep properly because it's always afraid it'll have to wake you to make you start breathing again.

I would suggest you see a good doctor or respiratory therapist and get these problems sorted out.

[PollCat]

Maybe it's time to try a different type of mask.

[zonk]

have I developed central apneas? Headed back to the doc this week but not sure what to tell her. Anybody have
Any insights!

You don,t say which S9 do you use. S9 AutoSet and Elite flag central apnea while Escape and Escape Auto don,t

Tell her what you said here and do mention about the heart racing, its the second time you talked about heart racing

[PaulaO2]

It may also be time for another sleep study. Some folks need follow up ones if stuff changes too much.

If the machine turns off when you take off the mask, then I suggest you turn off the SenseAwake feature. That way it does wake you and you can put it back on.

[zonk]

If the machine turns off when you take off the mask, then I suggest you turn off the SenseAwake feature.

Harry uses S9. You must be thinking still in Premo Icon thread

[PaulaO2]

Crap. What's the name of the ResMed's on/off feature? I get them all mixed up after a while.