How do I stop mask removal while sleeping?

[SarcasticDave94]

Thumbnail sketch of history:

Started CPAP 7/15 and used for 3 months, had to return as failed compliance, pressure setting 18, couldn't breathe out against pressure

No CPAP again until 3/17, time period between was preparation for my bariatric sleeve stomach surgery for weight loss, resulted in 100 pound loss

On BiPap 3/17 to about 4/17, was failing compliance already, more tired with than w/o BiPap, CA discovered and going to ASV after passing heart echo test

8/11 after fighting to get ASV, I finally have ResMed ASV at home as result of 6/30 PSG for ASV

Above results in I'm still an xPAP newbie IMO

After posting a rough looking early SH chart, I made pressure adjustments as suggested on my Newbie post. They are still my current settings and are as follows: EPAP of 8-12 and PS of 2-15. Other settings such as humidifier and heated hose vary but are always used. Ramp time is another area that's variable, I cannot fall asleep quickly, as in more than 30 minutes is typical. I have tried ramp time of 5-15 and 30 min. with pressure of 6 - 6.6.
 
I am going to primary care doc today to discuss a prescription sleep aid for a month or two until I get used to the machine so I don't take the mask off and turning off the ASV. I have moved the machine further away after from the bed after the first night. So, maybe it turns itself off? Smart start is set to off. I am turning on the leak alert for tonight, which BTW disables smart start as an option. I'm guessing if I remove the mask, it will alert me and I can put it back on and fall back asleep.

I can understand not using the first 2 machines as neither was a good therapy choice, but now I'm on the right machine and I have to get over the speed-bump of using it all night to gain positive results.


Thoughts, suggestions, or whatever may assist is asked for so I can do better. Thanks in advance.

Dave B. 

[Walla Walla]

You could glue tacks to the mask.

[Sleeprider]

Bad habits are hard to break, and removing the mask is a habit that needs to change to one that adjusts and secures the mask. I don't know a magic solution to keeping the mask on your face, but a couple things to think about. Is the tubing supported over your head, or loosely draped across the bed? Suspending the hose can eliminate the potential be it getting tangled and removing the mask, and it's just more comfortable.

You know that if you don't demonstrate compliance by using this machine at least 4-hours in 21 out of 30 days, you will lose it. Your health depends on you resolving this issue soon, even if it means using the machine while awake. If it comes to that, just flip it to CPAP mode and breath and watch TV, but get in your hours.

[OpalRose]

I can't help with the problem of removing your mask, as I've never (thankfully) been through that.  You could try using a wide chin strap "over" top of the mask straps.  That would make it harder to remove the mask. Or at least it would be a battle and would wake you up enough to adjust the mask.

I have been following your journey, and for what you have been through so far and the amount of time you waited to receive your ASV......it is important that you do everything possible to get at least 4 hours of use in, or as SleepRider stated, they could take the machine away.

Before bed, sit up watching TV or reading and use the machine for an extra hour to help with compliance.

Good Luck!

[SarcasticDave94]

Thanks to each reply. I'm very much aware of compliance. And if/when needed I will CPAP while awake for making compliance as needed. I will do whatever I must to keep this therapy going; trust me. I don't know where exactly I saw it, but sometimes a sleeping pill can help. I snatched that piece of info and visited the primary care physician. Just got back from there BTW. He gave a script that should assist. I couldn't read the med's name but I will take it 1 hour before bed so that I'll be more relaxed and tired. He said it will help get more sleep overnight. He is aware of me being on the ASV. Just like I told the doc, I'm so sleep deprived and tired that I can no longer fall asleep but for short periods of time.

As for the hose, it does not currently have a support; I have as much of the hose as possible near the inside edge of the daybed I sleep on. If I don't have it situated that way, the hose finds a way of pulling some on the mask. I can notice the weight difference between standard and heated hoses BTW. A hose support is on the "Obtain List", along with a new pillow of buckwheat or similar AND a soft cervical collar, and a chinstrap if it's needed. I'm considering also the aroma therapy stuff that sits outside the blower intake on the fabric pad and stand. (chloroform vanilla maybe) But right now I still am a zero income disabled but not collecting disability person, so I have to choose free things to modify the therapy requirements, etc. until income resumes.

OK thinking out loud: can my EPAP min be too low? Does it make sense to try a bit more, maybe 9 to see if my mask removal is from an awareness of not enough air? BTW I'm either editing or eliminating ramp altogether, just not sure yet which, and I would rather have a space of time per adjustment so I know if it was a good or bad adjustment. I'm assuming the ramp on my super blower is similar to other ResMed 10's. It starts with whatever it's set at upon pushing the start button whereas the PR DreamStation's have a dedicated ramp button to activate it.

I am positive I will beat this glitch. Thanks again for input.

Dave B.

[PaulaO2]

Sit up with it on during the day. Not to cheat on the compliance, which would be wrong and insurance fraud, but to get you and your body used to it.

Try turning the ramp off if you have not tried that already. If your minimum is 8, ramp isn't necessarily needed.

Have you tried other masks?

As for taking off the mask, attach the hose to your pillow as close to the mask as you can without it impeding you. That way if you take it off, the noise and/or air sensation will (hopefully) wake you. Taking off the mask in one's sleep is a common problem, so you aren't alone.

[SarcasticDave94]

I will try those suggestions. As for the mask question, I have not tried many yet. I did like the Amara View, which I still have, but after trying the AirFit F20, the AV is best as a backup. I'm finding it to be harder to adjust the AV mask for leaks and comfort than what I first recall when paired to the PR Dreamstation. The DME said I've got 30 days to try the F20 and then I can try others as well. I'll try anchoring the hose to the pillow also.

Thanks for the advice,
Dave B.

[CB91710]

You could glue tacks to the mask.

Haha...  given this is SarcasticDave, I was going to suggest duct tape.

[SarcasticDave94]

You could glue tacks to the mask.

Haha...  given this is SarcasticDave, I was going to suggest duct tape.

If I thought it would work, I'd probably try it. I have ruled out staples. I'm allergic to pain too.

[Crimson Nape]

Don't use Gorilla Tape. Your lips will look like Daffy Duck after pulling it off.