How to overcome if you breath with mouth and nose same time when wear mask

[luckydxx]

a. on Friday report, she said she almost no sleep during all thess 6 hours, so i don't know whether that's the reason events are less. Can you tell by looking at chart did she fell into sleep?

b. How can you prevent mask leak when you are a side sleeper. She did said she feels there is leak sometimes.

c. Do you think I should still let her try the collar?

Now what i want is let her remain in right pillows etc and continue this until I get the new nasal mask to try. My goal is get her use cpap long hours and be able to sleep as well.   Any other suggestion?

a. Telling when one goes to sleep is not easy. But from a distance I think she may have fallen asleep at 23:50. We breath deeper and in a more irregular pattern then when we are sleeping. On the flow chart you may be able to see this if you expand out the scale. Put your cursor in the 23:50 area, and repeatedly press the up arrow key to expand the scale. You may have to left and right arrow to keep it in the right area. Keep expanding it until you can clearly see the wave pattern. Then look as I say for when the waves become very regular and perhaps of lower amplitude. The other clues are snore as people don't usually snore when they are awake. And flow limitation will be more likely to occur when sleeping because the airway becomes more relaxed. Thursday is harder to tell, but actual sleep may have started at 22:30.

b. Her mask leaks look very good. This is much better than I get with my P10 pillow type mask.

c. I have no experience with the collar and will leave that advice to others.

I think you have a reasonable setup based on those two nights, but I still think she could benefit from changing the mode to standard instead of For Her. And increasing the max pressure to 16 may help. It was not a limitation in those two days, but it could be especially if you switch to standard mode.

thank you Ron.
A. Do you mean when fell in sleep pattern is more regular wave? I see it started around 23: 46. Flow rate less then 25 (not sure this considers low amplitude)

Then 1st OA around 12: 54.  then a few irregular pattern at varied time. 

and not much snore. 

thanks

[Ron AKA]

Yes, the sleeping waveform should be more regular and consistent.

[luckydxx]

Hi everyone,

How would you monitor yourself? besides use myAir or get SD data load to sleephead?

Do you still monitor daily?

thanks

[Walla Walla]

Look at the machine summary and also by how I feel.

[luckydxx]

"Don't know what to prioritize now: 
a. change to nasal mask
b. change different pressure with full mask
c. Find out why she keep having certain high OA and try with soft collar (which could be hard to acceptable for her to sleep)"

I would try the higher pressure first with the F20 mask, to see if it is effective. Next I would try the collars to see if that helps. Then you will know what pressures you are dealing with and perhaps can make a better choice. I find the P10 works up to about 15 cm and about there I need the chin strap to help keep my mouth close. My wife uses the Mirage FX up to 15 cm and seems to have learned how to keep her mouth closed. I haven't.

Hi Ron, 
1. how does she learn not to mouth breath
2. Does the mask leak easily?
3. what does that mean "My wife uses the Mirage FX up to 15 cm" ? do you mean she just need to have pressure up to 15cm, or do you mean there is other issue if more than 15cm if use this mask?

thank you again.

[Ron AKA]

Hi Ron, 
1. how does she learn not to mouth breath
2. Does the mask leak easily?
3. what does that mean "My wife uses the Mirage FX up to 15 cm" ? do you mean she just need to have pressure up to 15cm, or do you mean there is other issue if more than 15cm if use this mask?

1. It can be difficult. One potential help is to use a chin strap. If you google CPAP Chin Strap you should find lots of hits. 


2. In my experience I don't find the AirFit P10 leaks easily, and you can sleep on your side without dislodging the mask. That said, it does leak from time to time, and if you open your mouth then that shows up as a leak. 

3. My wife gets minimal leakage at 15 cm and even above that. However, when I try to allow pressures above 15 cm she complains about discomfort. Fortunately for her she does not really need it. Her current settings are 10 cm min, 15 cm max, and EPR of 2 cm.

[luckydxx]

A 2” collar is plenty for her, or she will be uncomfortable.

I hope you find the right solutions for your mom.

Hi Opal,

2" measurement is the collar's narrowest part (in the middle), is it? I got mine but it is almost 2.5", and widest part more than 3 inch. (Amazon: Foam Cervical Collar Universal - 2", Black by core), not sure that's normal. 

Also there is curve in the middle, that is up side, is it? thanks a lot

[OpalRose]

Sorry, I don’t use that collar, but I believe 2” is the smallest height you can purchase, and the curve would be placed where the chin rests.

I thought your mom tried a collar and didn’t like the feel of it around the back of her neck.

That was why I recommended a small toddler size (crescent shaped) neck cushion (worn backwards) so that the opening is at the back of neck.  Others have suggested just rolling a small towel or washcloth and place under chin to help.

[luckydxx]

Sorry, I don’t use that collar, but I believe 2” is the smallest height you can purchase, and the curve would be placed where the chin rests.

I thought your mom tried a collar and didn’t like the feel of it around the back of her neck.

That was why I recommended a small toddler size (crescent shaped) neck cushion (worn backwards) so that the opening is at the back of neck.  Others have suggested just rolling a small towel or washcloth and place under chin to help.

thank you opal. I bought both at the same time, to try which would work out better.

[luckydxx]

Hello Everyone, I took mom to Visit primary Doc today and told her nose issue. She Checked nose there is swelling and congestion, not sure it is rhinitis, prescribed:

ciclesonide 37 mcg/actuation nasal HFA inhaler Commonly known as: ZETONNA.

Also the sleep tech told me if mom has nose congestion, then wear nasal mask could be issue as that force her mouth open. We can try use strap to see how it goes. What do you think?

Also I have requested to see ENT but may need to wait weeks.

Thank you again.