Help! New To All This - Oscar Reports Analysis + General Advice

[only613]

I need help. I have had a Resmed 10 for a few months after being diagnosed with an AHI of 61. I use an F20 M face mask and have struggled to acclimate to the machine, and most nights only manage to keep it on for an hour or two. I know that I need this machine to work for my health, and initially, I slept much better once I started to wear it, but I am slowly losing my mind. I need help and can use some advice. Also, I have no clue how to read my OSCAR, which all seems quite intimidating.  

Here are my questions:

1 - I have trouble falling asleep with the mask, even if I am desperately tired - it is still hard to fall asleep with the thing hugging my face. Any tips to make this process easier?
2 - Some nights, when I fall asleep, it does not feel like I am getting enough air - even with the ramp mode off. When I breathe out, it feels like the exhaled air is filling the mask and does not leave quickly enough. 
3 - If I wake up during the night or as I am driving off, I often feel like the pressure gets way too high, and I am leaking air everywhere. The air is blasting open my mouth, and breathing is hard. 
4 - I wake up often because moving my face against the pillow (I have a Purple pillow that I love) causes a leak below my mouth or above my nose, and the air starts getting everywhere. I try to make the straps tighter, which makes things more uncomfortable. What am I doing wrong? 
5 - I apparently drool a bit during the night, and the wetness in my mask drives me nuts. I am constantly removing the mask to wipe my mouth, and it is all getting a bit much. 
6 - Somehow, no matter how determined I am to wear the mask, I will unconsciously take it off at some point during the night. I do not know how to stop this. 
7 - How do people deal with a sense of self-consciousness with the mask? I feel embarrassed to wear it next to my wife or when one of my kids walks into our bedroom. 

I am attaching some screenshots from OSCER for this past week. 

Any and all advice would be very much welcomed.

[TonyVivaldi52]

I need help. I have had a Resmed 10 for a few months after being diagnosed with an AHI of 61. I use an F20 M face mask and have struggled to acclimate to the machine, and most nights only manage to keep it on for an hour or two. I know that I need this machine to work for my health, and initially, I slept much better once I started to wear it, but I am slowly losing my mind. I need help and can use some advice. Also, I have no clue how to read my OSCAR, which all seems quite intimidating. 

Yes, it can be hard to get going, and many people are unable to stay the course. However, with an untreated AHI of 61 you have very severe apnea, which is no doubt doing substantial damage to your long term health. You've already recognised this, so we need to work on some strategies to make it easier to sleep with the machine, and gain the health benefits it provides.

1 - I have trouble falling asleep with the mask, even if I am desperately tired - it is still hard to fall asleep with the thing hugging my face. Any tips to make this process easier?

Many of your questions are related to the mask in one way or the other. The simple (and unfortunate) fact is that getting a mask which suits your face, is comfortable and doesn't leak is one of the hardest parts of this treatment. You may need to try different masks to find one that is right for you. You might find a nasal mask or nasal pillows is preferable.  In the meantime, get yourself accustomed to the mask by wearing it for a few hours while reading or watching TV. Then, when you go to bed it won't be such a novelty for your face. 

2 - Some nights, when I fall asleep, it does not feel like I am getting enough air - even with the ramp mode off. When I breathe out, it feels like the exhaled air is filling the mask and does not leave quickly enough. 

3 - If I wake up during the night or as I am driving off, I often feel like the pressure gets way too high, and I am leaking air everywhere. The air is blasting open my mouth, and breathing is hard.

Your pressure settings are not conducive to getting enough air:  a) Your minimum pressure is set to 4.0, which is too low for many adult people and can make you feel starved of air.  b) You have EPR set to 3, which reduces your exhale pressure by 3 cm. This confounds matters by holding your exhale pressure at 4.0 for too long.  c) Despite having such low pressures, you have ramp on, which again is holding your pressure down and not allowing the machine to react to any incipient events during the ramp period. 

Your pressure is maxing out around 12 or 13 which is not enormous, though it can take some getting used to. If you get the right mask and have it adjusted properly, you should be able to tolerate this pressure quite well.

My recommendation would be:  a) Work on getting a comfortable mask that doesn't leak. b) Set minimum pressure to 7.0.  c) Turn the ramp off.

4 - I wake up often because moving my face against the pillow (I have a Purple pillow that I love) causes a leak below my mouth or above my nose, and the air starts getting everywhere. I try to make the straps tighter, which makes things more uncomfortable. What am I doing wrong?

Again, the type of mask may be an issue. Try something more minimalistic, like the nasal pillows types. You need to work closely with your suppliers to get the right one.  As a general rule, the headgear should be firm but not too tight. If it causes discomfort then it's too tight.

5 - I apparently drool a bit during the night, and the wetness in my mask drives me nuts. I am constantly removing the mask to wipe my mouth, and it is all getting a bit much.

A nasal or nasal pillows mask will help overcome this.

6 - Somehow, no matter how determined I am to wear the mask, I will unconsciously take it off at some point during the night. I do not know how to stop this.

You're not alone - lots of people do this, even after years of CPAPing. Get yourself comfortable with the mask, and it will happen less. If you do wake up and find your mask is not on, put it on straight away and go back to sleep (easier said than done, I know).

7 - How do people deal with a sense of self-consciousness with the mask? I feel embarrassed to wear it next to my wife or when one of my kids walks into our bedroom.

The machine and mask are there for your benefit and to preserve your long term health so you'll be there with your wife and your kids as they grow up. Your wife will recognise this, even if the kids don't. There is absolutely no need to be self-conscious. Putting the mask on is usually the last thing to do before you fall asleep - if you and your wife get intimate, it's very easy to slip the mask off and put it on again afterwards.

Looking at your charts, your treatment is actually very successful during the periods you're actually using the machine. Your AHI is low and leaks are very well controlled according to the numbers. Don't despair - you're more than half way there

[upsman]

Like most new users, you've been given the default range of pressures for your therapy and it's not giving you effective treatment and is the cause for your feeling of suffocation. You could try raising your minimum to 8 cm to start. Your events are mainly obstructive, so this should help there.

At this low pressure, you can try turning the ramp off as you're not getting any treatment while it's on.
The main thing is to try and use the machine as long as you are trying to sleep. You'll become more accustomed to it as time goes on. You'll be more comfortable once your pressure settings get dialed in properly.
Take a look at this mask info and try fitting again.

http://www.apneaboard.com/wiki/index.php...ask_Primer

[btbderek]

Welcome! I’m only a few months in and facing very similar issues to you. Patterns of around 2 hours of sleep then throwing the mask off. I’m getting to the point where I will have a good night more often now. I think Tony’s 3 things he listed for you to work on along with upsman’s advice is a great place to start.

As you see in your OSCAR chart’s, as soon as you fall asleep your pressure shoots up straight to around 8. At a starting pressure of 4, you are having to work to breathe properly, that doesn’t help getting to sleep any quicker. Try bumping the minimum to 7 and see if you can get to sleep with that setting. I’d also advise taking the ramp off if you can handle it.

Getting a good mask seal is also extremely important. I highly suggest reading the link to the thread Upsman left you, and I’m going to leave a link to this thread that helped me dial in my mask fit.

http://www.apneaboard.com/forums/Thread-...qZDUKRb_ps

That thread post helped me dial in an almost perfect mask fit and did a better job at preventing leaks than when I had my mask cranked down to an uncomfortable level of tightness. If you can get a good consistent mask fit, that is a big help and one less thing to worry about. When working on this, check your OSCAR data the next morning. People vary on what they consider a bad leak, I have heard that anything over 5 is bad, while others say anything over 15 or 20 is bad, I would say somewhere in the middle is probably the right answer, but again I’m new to this too, just my observation.

If you aren’t already, wear your mask with the machine on when watching TV or something. Believe it or not, it definitely helps you get used to the mask. I felt claustrophobic at first but this helped me break that, and I also think it helped me keep my mask on longer at night.

Two more things.

Try not to make too many adjustments to your machine at a time, or your therapy in general. If you make too many changes in too many areas of your therapy, you won’t know what changes worked and what worked against you. I’d suggest starting with the 3 things Tony suggested, and focus on that and see what happens. If you decide to make another change after that, give it 5 to 7 days to see how it affects your therapy. Look at the OSCAR charts, and don’t be afraid of posting them in this thread here to ask for advice.

Last of all, don’t give up! I just got diagnosed with an AHI of 102 right after my 30th birthday. It was embarrassing at first, I shared similar feelings that you have. But, it is very important that you stick with this. It has been ups and downs for me, but I have decided that Failure isn’t an option. Not sticking with this can lead to an early death for guys like you and me with a high AHI. I’ve seen several people post about their loved ones passing away at early age in their sleep, and they didn’t use their machine. Family is important to me and I want to be around for them as long as possible. Don’t be embarrassed, I know that your family wants you around too. Talk to them about how you feel, I’m sure they will reassure you it isn’t anything to feel embarrassed over. Just stick with it, everyone’s progress takes different amounts of time. You are in a great place to get help. Lots of knowledgeable people here. I also use the a DME-owned forum .com forum and watch YouTube videos to educate myself anyway I can on treatment ideas and such.

Good luck!