Day 2 and having troubles

[rich2905]

Hi,

I am renting a resmed s9 autoset with a F&P simplus full mask,
My pressure is set to fixed of 15 with a ramp up from 6 in 45 minutes.
I am updating to an S10 at the end of the week.

Hope that says it all.

I am on day 2 of using the machine.

The machine seems OK. Last night my AHI was 3.8 (down from over 40 in my initial test).

OK now why the post.

I am having a hell of a time with the mask.

1)I have been waking up in the middle of the night with the mask leaking when at full pressure (i.e. 15). I have tightened the straps and can stop the leaks a bit after a lot of mucking around but the straps are very tight. Is that right.

2)I noticed. During the test I found breathing out difficult. I don't seem to be having this problem now, perhaps I have got used to it. I also notice the air is not blowing into my nose, just into the mask. Is it supposed to blow up your nose.

3) I am not sure of the settings, but is the pump supposed to stop if you take off the mask.

4)This morning my mouth was very dry. Does this mean I have a setting wrong.

Sorry if this has been covered before.


Rich

[justMongo]

#1 Mask leaks are one of the biggest obstacles. Depends upon your facial features and the mask.
it's not supposed to be overly tight; but will require some tension to seal.
#2 No, just into the mask. EPR may be set on your S9 to relieve exhale pressure.
#3 Only if autostart is enabled. Generally not recommended for a full face mask (may even by grayed out in the menu.)
#4 Try turning up the humidity on the H5i.

I'd turn the ramp off; so you can mask up at full pressure. At least shorten the ramp time and increase the ramp starting pressure.

[DeepBreathing]

G'day Rich, welcome to Apnea Board.

My pressure is set to fixed of 15 with a ramp up from 6 in 45 minutes.

45 minutes is a very long ramp time. While the machine is ramping up it's not providing treatment pressure and doesn't respond to apneas which occur during the ramp period. As you get more accustomed to the therapy you want to try reducing the ramp period as far as you comfortably can.

I am having a hell of a time with the mask.

Yep! We all do - getting the mask right is the hardest part of CPAP therapy. Every face is different - that's why there are so many different makes and models on the market.

1)I have been waking up in the middle of the night with the mask leaking when at full pressure (i.e. 15). I have tightened the straps and can stop the leaks a bit after a lot of mucking around but the straps are very tight. Is that right.

The theory behind the Simplus and similar masks is that the straps should only be tight enough to hold the mask in place gently against your face. When the pressure builds up, the seals on the mask inflate like a hovercraft skirt and seal it against your skin. If the straps are too tight they won't allow the seal to inflate.

Well that's the theory. I use the Simplus too, and I need to keep the straps pretty tight - but not so tight that they cause discomfort or induce headaches and neck pain. I always have a quick shave and face-wash before going to bed to ensure there are no oil residues on my skin, and I put a couple of layers of flannelette over the bridge of my nose to stop the thing leaking into my eyes.

These tricks might work for you - or you may need to try a different type of mask.

2)I noticed. During the test I found breathing out difficult. I don't seem to be having this problem now, perhaps I have got used to it. I also notice the air is not blowing into my nose, just into the mask. Is it supposed to blow up your nose.

Resmed machines have a setting called exhalation pressure relief or EPR. this drops the pressure as you exhale, by 1, 2 or 3 cm. It sounds like yours is set OK.

The Simplus is a full face mask, allowing you to breathe through your nose or mouth as you prefer (but see next point). The air hose pressurises the whole mask, so you don't get a feeling of air blowing up your nose. You can also get nasal masks and nasal pillows which do blow directly into your nose. many people prefer these to the full face mask.

3) I am not sure of the settings, but is the pump supposed to stop if you take off the mask.

Check that you have "SmartStart" enabled. Personally I don't find it any problem to reach over and hit the button.

4)This morning my mouth was very dry. Does this mean I have a setting wrong.

You're probably breathing through your mouth. Try adjusting the humidity setting, and confirm that the water tank is full before you hit the sack. Also try training yourself to only breathe through your nose.

Sorry if this has been covered before.

Not a problem - these are common problems that many people have, so it's good to keep discussing them.

Take care.

[trish6hundred]

Hi rich2905,
WELCOME! to the forum.!
The mask is the hardest part of this therapy so if you are having trouble and just can't get used to the one you are using, don't be shy about asking to try different masks.
Good luck to you with your CPAP therapy, hang in there for more responses to your post.

[rich2905]

Many thanks for the replies.

I have increased the humidity to 4.5. It was on 3 , hopefully adjusted the right thing .
The 45 min ramp was based on how long it takes me to get to sleep but as it is not causing me grief when at full blast I will drop it down or off so that I can get the mask set up ok before going to bed.

I had a very bushy beard before doing the test. I am glad I shaved that off.

I am still on a big learning curve here and do appreciate any help.

Thanks again, on to day 3

Rich

[cate1898]

Welcome to Apnea Board rich2905!

Getting a mask that works well for a person is always the most difficult part. I didn't notice anyone mention this, but sometimes people use mask liners to help with the seal. Not sure if that would help you or not.

Good luck as you get used to this new way of life as it will improve your health!

[icyura10]

The 45 min ramp was based on how long it takes me to get to sleep but as it is not causing me grief when at full blast I will drop it down or off so that I can get the mask set up ok before going to bed.

Years ago, before they really had "ramp time", like you, it took me forever to get to sleep.

I found it simply miserable to sit there being blasted with some higher value of cmH20 until I finally went to sleep.

I finally learned to put myself to sleep usally within 5 mins or less.

I got a clock radio with a sleep setting on it. You know, one where you can set the amount of time the radio runs until it turns off.

I started with setting it to 20 mins and if I had to restart the 20 min sleep timer, I knew I failed.

After about a month, I'd trained myself to get to sleep within about 10 mins or less.

After about 2-3 months I trained myself to beat the radio to sleep, meaning and at that time it took me less than 5 mins to sleep.

I can still beat the radio to sleep 99% of the time, unless the bloody phone rings.

I can tell you setting a TV's sleep timer to go off in 30 mins usually wakes me up. Sure, I go to sleep within about 5 minutes, but it seems the flickering light of the TV, when it ends, wakes me up! Grrrrrr...

Now where did I leave my bucket of sand so I can bury my head?

Much success to you on your effort.. just sharing how I did it... I truly believe falling to sleep can be controlled partly by self training.. and hardheaded determination!

[rich2905]

Well I just did day 4.
AHI last night was 2.9, so going in right direction I guess
Leaks down to 6.
I have turned the ramp off and increased the humidity.

The mask is still a pain.

I found I have had to tighten the straps a fair bit to stop/reduce leaks. it is the noise the leaks make that gets to me. Mind you when blowing in your eyes it is not good.

Thanks for all the above replies.

Rich

[chill]

In the past I kept my Simplus straps quite loose. It worked up to about 13cmH20. When the pressure hits 15 or so, with my face, I need to tighten it a lot to prevent leaks. Top part touched my forehead. It is noticeably tighter than at lower pressures but it not uncomfortable. I sleep much better as the leaks are not waking me. I still have some problems around the bridge of my nose - which is a common place to have leak problems.

[Crimson Nape]

Rich,
Here are 5 things that have worked for me using the Simplus:
1.While measuring out as needing a medium size, I tried a large and found it worked much better and was more comfortable.
2. Leave the top straps loose, leaving about a thumb's width between your face and the frame. Use the lower ones for tension.
3. After obtaining full pressure, gently pull the mask slightly away from your face to allow the seal to fully inflate.
4. This mask seems to work better if it is worn lower than expected. Trying to accurately describe the placement is beyond my vocabulary skills.
5. Being clean shaven and a fresh washed face has helped as well.

I hope one or more of these may help - Good Luck!

-Red