New to forum and losing battle with CPAP

[sleepkaos]

Hello All,
I am new to this board and the CPAP. I fought with it a year ago and quit, but I don't have the choice whether to use it or not anymore. So I have set out to take control of my health and my first stop is this forum. I downloaded my SD card today on SleepyHead to checkout and understand my results. My Intellipap showed a 14.9AHI last night but sleepyHead shows 6.89. I don't understand the difference. Is there different criteria?

I have a great deal of trouble with mask leak. I have been fitted a couple of times and I am convinced that after 3 to 4 hours of sleep something changes which does not allow my mask to seal properly. I have used the Res-Med Quatro full face mask and more recently a Res-Med Mirage Liberty which is a nasal pillow with mouth mask. Should I consider a nasal pillow without the mask?

I had the CPAP prescribed and have been back several times. They always blame the mask for the issues and try something different. About 2 weeks ago I unlocked the CPAP and adjusted the pressure settings from 4-15 to 8-12. This seemed to help the amount of sleep I was getting and some of the leak issue, but my AHI is still high and i'm tired. There is a great deal of information here and I am trying to educate myself, but I dont fully understand all of the settings and statistics.

Any advice would be greatly appreciated. Thanks!

DeVilbiss/ Intellipap/ DV54D

[Sleepster]

Hello sleepkaos and welcome to the forum. It's difficult getting started, but you have come to the right place.

SleepyHead (SH) has bugs, so likely that's the reason for the unreliable AHI it's reporting. Likely a pressure higher than 12 is needed, and that's why your AHI is so high.

But before you worry about AHI you have to get your leaks under control. And before that, you have to learn to sleep with the machine attached to your face -- it sounds like you're making progress there so you should celebrate that success -- many people can't get that far.

Trying different masks really is the right thing to do to get the leaks under control. It could be that the mask cushion is getting coated with skin oils after a few hours and that's why it starts leaking worse in the middle of the night. Keep some wipes handy so you can clean it off, clean off your face, and put it back on for the rest of the night. After a while, as you adapt, this step will no longer be needed. At least that was my experience. You have to try adjusting the straps, too. You don't want them too tight or too loose. Again, this is something that's a bother only for a while, until you adapt.

[sleepkaos]

Thanks Sleepster! I figured my face thinned in the middle of the night, I didn't think about oils. I will try that tonight.

[PoolQ]

the mask seals to your face with a "friction" fit, the air pressure is trying to push the seal out and the friction stops that. Face oil will lube this area of the mask and make it easier to push out.

Typically once you get close, the straps are adjusted 1/8" at a time. They are quite sensitive. Once you put the mask on, turn the air pressure on, typically you need to slightly pull the mask away from your face to let the silicon seal "inflate" then let the mask settle back.

If you are a side sleeper, I find it useful to sleep on the end of the pillow so that the mask hangs over the edge of the pillow.

Do you have a "hose hanger" to keep the hose up and out of your way while sleeping, you can do home made with a rubber band or something attached to your headboard, or buy one-there are many low cost solutions on the web.

You will se many posts about wearing the mask while reading or watching tv to help get used to it and also adjusting it without the pressure of also trying to go to sleep. Mask, CPAP on, tv.

[sleepkaos]

Thanks PoolQ!
I don't seem to have a problem with the mask itself. I can get to sleep fairly quickly and the mask gives me few problems. I purchased one of the buckwheat pillows and do sleep on the end of it.
But man, 3 or 4 hours in and I am suddenly in a wind tunnel. I have sat there in bed playing with the mask and trying to make it work for 15 min while it continues to blow copious amounts of air and the mask leaks badly.

[Sleepster]

Since you are wearing a nasal mask, one place you may be leaking is through your mouth. Look at your leak rate graph and see if there are extened periods of time where the leak rate is higher than at other times. This is the usual sign that you are mouth-leaking. You may also find yourself waking up with air hissing out of your mouth. A chin strap is the first step. It can be used as a training device, and once trained you no longer need it. Others find it a permanent part of their gear. Still others, like me, find that a full face mask is needed when the chin strap doesn't work for them.

Like you, the face oils were an issue with my original nasal mask. So I switched to nasal pillows as a remedy. Then, a couple years later, I had to switch to a full face mask because of mouth-leaking. I dreaded that, thinking the skin oils would be an issue, but it wasn't. Apparently I adapted, was less stressed out of having to use a CPAP machine, and didn't produce as much face oil. I do have to wash the mask in warm soapy water daily, though, to maintain a good seal.

[shewhorn]

Re: the oil... After around 6 hours my full face mask starts... umm.... farting! PFFFPFPFPFPFTPTTFTFTFTFT! It's due to the oil buildup. My DME said this was common and suggested buying a product called REMzzz. She said they usually take care of the problem for most. It's a thin cloth liner that goes between your face and your mask. As my insurance doesn't cover them she suggested buying them online. They're not terribly expensive but... they're not terribly inexpensive either. If that ended up being a good solution, I would just make a template out of wood and buy some fabric and cut my own.

[sleepkaos]

Thanks Shewhorn!

[PaytonA]

One of the things that typically happens during the night is that the muscles in your face relax so the mask actually gets looser as the night goes on assuming that you stay asleep. I make my final mask adjustments in the morning when I wake up if I get leakage then.

I do agree that you may be encountering mouth leakage and like Sleepster said you may want to take action to solve that problem. Can you feel the leakage and, if so, where is it leaking from?

Beswt REgards,

PaytonA

[trish6hundred]

Hi sleepkaos,
WELCOME! to the forum.!
I know CPAP can be difficult to get used to, but I want to encourage you to keep trying and don't give up.
Don't be shy about trying as many different masks as you need to 'till you find the one that works well for you. I was one of those that a chinstrap just wouldn't work and therefore, I had to go to a full-face mask, (FFM.) I was dreading that for a long time because I was chlostriphobic, but I managed to work through it and have never looked back.
I wish you much success with your CPAP therapy and hang in there for more responses to your post.