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Help with new mask
#1
Help with new mask
Hi all! 

I've been using my CPAP for 5 months now. I started out with a ResMed P30i nasial mask, but because of the message I was getting from myAir about large leaks, correlating data in OSCAR, and waking up with extremely dry mouth, I think/worry I'm spending a lot of the might with my mouth open. OSCAR shows my AHI between 2-3 on average but I'm worried that the number is wrong because of having apneas while my mouth is open so it can't detect them. So, I decided to try switching to a full face mask, the F30i - but it's been AWFUL. First I noticed after installing the new mask and switching the machine settings from pillow to full face that the auto start/stop feature was no longer working accurately. No big, I can just manually start/stop the machine. I ran a mask fit and that was fine, got the straps adjusted so it didn't leak. I try sleeping with it but an constantly woken up in the night because the machine is blowing so hard it's trying to expand my nose out, blowing my cheeks out like a chipmunk, and pushing so much air it's hard to even close my mouth. Then it starts feeling like bubbles across my cheek and then farting. Scared the dog out of the bed and work up my wife too. I try to tighten down the straps and do so as much as is comfortable, no real change. It blows so hard it's making my ears close up. 

I've attached three screen shots from OSCAR. They are my attempts to get used to the new mask until giving. The final screen shot is an attempt to change my settings after reading several posts here and at reddit. I took my 95% pressure average from OSCAR and changed it from an APAP to a CPAP at 10, disabled the auto start, and set the ramp from auto down to 5 min. Easily fell asleep, the pressure at 10 is comfortable and doesn't make issues with the mask on my face - but looking at the data the next day my AHI was BAD - and I was so tired I was falling asleep at my desk all day. 

Help!  What can I do?  To further complicate the problems I have two kids 5 and under and I frequently get up during the night with them. I must be able to get out of my mask and bed and get to the kids. I don't feel like it's realistic to be able to do something like taping my mouth and 1. not have that look terrifying to a kid seeing me in the dark, or 2. realistically count on me reapplying that two or three times a night. I have thought about chin straps but they sure don't look comfy to sleep in, and the better reviewed ones cover the head and again seem hard to have to get all situated multiples times a night.  

Thanks for your advice!


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#2
RE: Help with new mask
I’m sure someone will be along to assess your settings. Clearly, they’re not working.

Some of your issue, though, is from positional apnea. This cannot be fixed by xPAP. You fix it by addressing your sleep position. Perhaps you could describe your position, pillows, etc, and get some input.

Absolutely turn SmartStart off. It doesn’t work correctly.
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#3
RE: Help with new mask
Hi, 

The first thing that really appears significant are these clusters in the flow rate graph, likely caused by positional apnea

Often sleeping on your back can provoke this situation. See Supine positional apnea (video)

Sometimes a soft cervical collar can be an excellent solution, indicated in this link, optimisation of therapy.

From your text, there could be some mouth breathing (leakages) adding to the mix, creating great discomfort. See  mask primer

I think that the cluster situation needs to be resolved before meaningful titration can really start. 

Once a clearer picture evolves, we hopefully can bring down your pressures.

Perhaps initially a minimum of 7, maximum of 10, with an  EPR of 3.

Is there any information in your sleep study that could help? 

What was your initial prescribed pressure?


Thanks
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#4
RE: Help with new mask
I agree with everything ExPat31 said, very sound advice. The only thing I suggest is opening the range and using it to self-titrate to find what works best.

Mode APAP
Min pressure 7
Max pressure 15
EPR 3 full-time
No ramp

That should hopefully be more comfortable and allow us to find what is the minimalist range you need for therapy and comfort. Give that a try for a few days and let’s see how things go.
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#5
RE: Help with new mask
Did your sleep study show a large number of CAs? If you don't know, it would help if you post a redacted copy of your sleep study. If you don't have it, ask your doctor for a copy. Under US law the doctor has to provide it to you.
Machine:  ResMed AirCurve 10 Vauto
Mask:  Bleep DreamPort Sleep Solution
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#6
RE: Help with new mask
Hey all, thanks for the feed back so far. I am not sure how to share my sleep study. I have the PDF redacted but I'm not allowed to post PDFs and I have a share link but am not allowed to post links either. I have ordered a SCC from amazon to try out, looks reasonable and I could see how it would also help keep my my mouth shut. 

I love to sleep on my back, especially now that my wife doesn't complain when I do!  I had taught myself to sleep on my sides before as I could tell that was better sleep pre-CPAP. I have two pillows I lay on, I like being up more and generally lay with my shoulders just on the pillows, but I will try going to just one pillow with the SCC. And I also know my weight doesn't help anything - but I'm happy to say I'm already down 38lbs from that sleep study and still actively loosing!  

Based on the replies I've gotten I'm thinking I'll try APAP 7-12 with EPR 3.
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#7
RE: Help with new mask
How about sharing the link to my sleep study this way https://1drv . ms/b/s!Aj60fShwK1SI8hBD0DS3RykrapjZ (remove the spaces before and after the period after 1drv)
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#8
RE: Help with new mask
Since you have the sleep study, tell us how many CAs you had, if you can tell by the chart.
Machine:  ResMed AirCurve 10 Vauto
Mask:  Bleep DreamPort Sleep Solution
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#9
RE: Help with new mask
(07-14-2024, 10:18 PM)Deborah K. Wrote: Since you have the sleep study, tell us how many CAs you had, if you can tell by the chart.

My Clear Airway Index in OSCAR shows as 2.33 for the last 30 days, is that what you mean?
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#10
RE: Help with new mask
What is SCC?
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