New Member, need help please!

[chigirl]

Hi,

I've been lurking for about a month now, but could use some help. APAP has been going okay, but I find I'm waking up to a large amount of pressure/airflow that I can't stop. (Well without turning the machine off.) Once I wake up, it's difficult to go back to sleep and often times end up taking my mask off and sleeping without it.

Insurance wouldn't pay for a titration study, so I was set up on APAP with a wide pressure range which I tweeked slightly. (I moved it from 5-15 to 7-15 maybe a week or so ago.) I was also unable to try multiple masks to see which might work best for me so I'm experimenting with them one at a time through my DME. I started with the P10, but was unable to breathe, even with adjusting the airflow. I'm now using the Dreamwear mask, but I'm a side sleeper and I have difficulty keeping it sealed-or at least from making such a racket through the vent on the nose piece. (Plus it blows cold air on me through that vent, which I think wakes me up.) I've contemplated blocking the vent on the nose piece, but not sure if that's a good idea or not.

So my questions are, is there anything from the data that might indicate why I'm waking up? And how could I adjust to minimize that chance?

Short of turning the machine off (Resmed Autosense 10) is there any way to get it to return to a lower pressure once I've woken up? Right now it just keeps blasting away.

I read somewhere that the Dreamwear nose piece used to come without a vent. What are thoughts on blocking it? (Which I think would solve a lot of my issues--well unless I started re-breathing my air.)

Last's nights sleep data is attached. There is a stop towards the end of the session where I turned the machine off and restarted it. I'm sure I took the mask off or at least away from my nose to try to get it to stop and seal better-and I suspect there's a big leak there. I wasn't asleep for at least the first hour-ish because I was fidgeting with the mask. I made the mistake of trying a small frame, which didn't work, and then had to work to get the medium adjusted again. Mask adjusting for me is like the princess and the pea. It takes me forever to get it to where I think it's okay.

Thanks in advance for all your help!

[OpalRose]

First off...DO NOT BLOCK THE AIR VENTS IN THE MASK, unless you don't want to wake up in the morning.

Interesting that the three times the machine was turned off was early on in the night when the pressure was the lowest. That suggests you are not getting enough air.

You have a high snore rate and a high flow limitation rate which the apap will respond to by raising pressure, and this suggests that you need to raise minimum pressure.

I would move the minimum pressure to 8.5 cm and bring the maximum down to 13.5cm and see how it goes.

Now the real problem will be the mask. It may be hard to make the DreamWare mask work if you are a side sleeper. Its just too easy to dislodge it and that will cause the leak blips on your graph, and this can definitely wake you.

[Gideon]

Your pressure is increasing because of snoring, and you have very little in regards to events that would drive your pressure up. Your chart shows that without snoring your base support is 11-12 cmH2O. When you woke up pressure was around your max set of 15. So lower your Max to 12cmH2O, this is slightly above what your body is demanding and should not make a difference in your therapy. Just to keep you in Auto for now also raise the minimum to 10cmH2O. This is slightly below where your body is saying I need at least this much air.

So set a range of 10-12 cmH2O, and let's see what happens.

Fred

[chigirl]

I appreciate your help! Thanks. Yeah didn't want to block the air vents until I got advice on that.

The three on and off's in the beginning were me fidgeting with the mask. I kept trying to get it adjusted properly. Long story short, I have very fine, silky hair and none of the straps from the masks I've tried, stay in place. I have been experimenting with pony tails, head caps/coverings and bobby pins in the hopes of getting things to stay "put." I was hoping the smaller frame would keep the Dreamware mask from slipping, but it just gave me a headache. So I was back to the medium frame, with a cap and a pony tail. But it took some adjusting to get it back to where I wanted it.

As far as side sleeping with the Dreamware, I've found that when I turn over, I can pull the side of the mask tight under my cheek and that helps with the leaks. It's kinda hard to explain what I'm doing but I use my pillow and my face to pull the side of the frame towards the back of my head. The only issue is that I have to do that whenever I turn, so it does wake me up. Unless I can learn to do it automatically.

The DME has suggested a nasal mask next, but I'm concerned about side-sleeping with one of those as well. I'm really a stomach sleeper, so side-sleeping is somewhat of a compromise as it is. (And I'm claustrophobic to boot...so I'm limited.)

All I want for Christmas is a mask that:
1) Doesn't blow cold air on my nose, in my eyes or on my arm.
2) One that doesn't make me feel claustrophobic.
3) One that lets me sleep on my side or stomach.
4) One where the straps stay put and don't slide around.
5) One that is quiet.
6) One that lets me breathe.
7) One that doesn't leak enough to wake me up.

Anyone know of a mask like that?

[Rcgop]

I use the P10 system with chin strap. And, I quickly learned to sleep on my back. After a couple months of trial and error on the pillow size, I learned to control leaks and comfort. Now I am on my stomach, side, back, whatever. It took a while but I will never change to anything else

[Gideon]

Ho Ho Ho!
I have 51 weeks to work on that one.

All I want for Christmas is a mask that:
1) Doesn't blow cold air on my nose, in my eyes or on my arm.
2) One that doesn't make me feel claustrophobic.
3) One that lets me sleep on my side or stomach.
4) One where the straps stay put and don't slide around.
5) One that is quiet.
6) One that lets me breathe.
7) One that doesn't leak enough to wake me up.

Anyone know of a mask like that?

[chigirl]

I tried the P10, but I couldn't breathe (primarily exhale) with it on. I tried scrubbing the vent with a toothbrush, but it still didn't let much air out.

I also found it to be loud when I was exhaling--probably because I was forcing the air out? I found it really difficult to get to sleep with the mask on. The straps never stayed in place either--I had to bobby pin them to my hair and they still shifted around.

There was one night where I could breathe with it on and I was like "wow, this is great! This is what everyone's talking about." But it lasted only one night. I don't know what was different that night from all the other nights.

I tried the medium pillows, and I could exhale with those, but it felt like it was stretching out my nostrils--it was definitely too big.

I thought about making the holes slightly bigger on the small pillows, but I wasn't certain they would seal if I messed with them, so I left it alone. I may try it at some point--not like I have anything to lose. And I suppose best case I have a mask that works. Worse case I buy new small pillows-if I go back to the P10.

[OpalRose]

Try the P10 again. Use a larger size pillow than what was suggested. You may have to pin it in place or use a chin strap.

I used to pull my hair in a ponytail and place the second strap under that right on the occipital area and the top strap at the top of my head.

[Gideon]

When I was using a P10 I had my best results when I wore a chinstrap OVER the P10 (I am a Mouth Breather, chinstrap didn't solve that)

I was able to sleep on my back and side and maintain the mask seal. Nothing has stopped me from opening my mouth.

[chigirl]

Does the chin strap help keep the straps in place? If so, which ones are people using? Thankfully the first blast of air into my nostrils when I opened my mouth cured me of being a mouth breather, but if it keeps the straps in place, I'd be willing to try. At this point I'll try anything to keep the blasted straps (whichever mask) from moving around. Using a cap works fairly well, but even that moves around on my head.