Removing mask in my sleep!

[Marianoz]

Hi, I am new to the board but a long time user of my REMstar Auto M series. It was set between 4 to 22 and I use a hybrid mask. When I first started therapy it took me a WHOLE year to get used to and not remove my mask in the middle of the night. After that difficult first year I loved every minute of therapy...I would dream in what I describe HD quality every night! However, about two months ago I started having issues (congestion, nose bleeds, etc.). I went to an ear, nose, throat doctor and I was told that I have one of the most common conditions developed by CPAP users, rhinitis and sinusitis. I was given medication and was told not to use the machine until I was feeling okay.

After a full month of I felt okay to start using the machine again; however, in 30 days I have only spent a full night without removing my mask. I usually only keep the mask for 2 hours. Sometimes I wake up feeling like I am not getting enough air and remove it, and sometimes when I wake up in the morning I see the mask in the night stand and I don't remember removing it.

Do I have to get used to wearing it again after only not using it for a month? One thing I did was to increase from the initial setting of 4 to 5, to see if the added pressure makes a difference. Has anyone experienced removing their mask in their sleep?

[Tez62]

Marianoz, I think most people remove it at some time, I have been on CPAP for two years and have never gone off it but some nights will go to the toilet and half dazed think I'll put it on in a minute and fall asleep without it or in warm weather I struggle with it more than winter. Although it is extremely import that we try to be 100% compliant we also can't feel guity about not wearing it 100% of the time. It could be taking you time to get used to it again, remember our faces aren't used to having something covering them so just do your best to get back in the habit of wearing it as long as you can.

[Marianoz]

Thanks for your reply, the thing is, I have been using the CPAP for years without removing it at night. I did at the beginning, but after a year I started to stick to it. It has now been a full month of removing it! I am exhausted and doing things like starting sentences that are incoherent and right after I finish speaking not remembering what I said -- could be I am going crazy too :-)

Something I forgot to mention...I have never used the humidifier, not sure if I should start using it now!

I see most existing threads about removing one's mask are people starting treatment, not longtime users. That is why I am reaching out to longtime users to see if they had a similar experience.

[zonk]

Sometimes I wake up feeling like I am not getting enough air and remove it, and sometimes when I wake up in the morning I see the mask in the night stand and I don't remember removing it.

I would rip the mask off if my pressure start at 4, would feel suffocating and as you said not get enough air

Have you had a followup with your sleep doctor

[PaulaO2]

There's a few tricks you can try.

Take a string or velcro or tape and make a loop on the hose, not far from the mask. Then pin or attach this to your shirt or pillow case. When you take the mask off, it will make noise and will, hopefully, wake you up.

Another is to make the headgear harder to take off. An extra strap around your chin or something.

Is your machine data capable? If so, take a look at the data at the time you take the mask off. What is the pressure at that point? It is possible the pressure is at 4 which is way low. Like zonk, I'd feel suffocated at that pressure. Or it could be higher and you are reacting to that in your sleep.

And I cannot believe the doc said for you to not use the machine! That's just not right! To heal from anything, even sinusitis, you need to take care of yourself. Having adequate oxygen at night is a huge part of that!

[trish6hundred]

Hi Marianoz,
WELCOME! to the forum.!
You might try a little humidity and see how you do with it. You might also try a different mask.
Have you had a sleep study recently? Maybe something has changed a bit.
Good luck to you on getting this straightened out and hang in there for more suggestions.

[Marianoz]

Sometimes I wake up feeling like I am not getting enough air and remove it, and sometimes when I wake up in the morning I see the mask in the night stand and I don't remember removing it.

I would rip the mask off if my pressure start at 4, would feel suffocating and as you said not get enough air

Have you had a followup with your sleep doctor

No f/u with doctor. I moved to Costa Rica from USA, I need to find out if there are any sleep centers in the country -- most people unfamiliar with CPAP unlike the US where almost anyone knows someone that uses one.

As i said in my last post, I raised the pressure to 5. It might not make much difference but I will find out tonight. My average per night is 7.5; however I am reluctant to raise pressure too quickly.

[Marianoz]

There's a few tricks you can try.

Take a string or velcro or tape and make a loop on the hose, not far from the mask. Then pin or attach this to your shirt or pillow case. When you take the mask off, it will make noise and will, hopefully, wake you up.

Another is to make the headgear harder to take off. An extra strap around your chin or something.

Is your machine data capable? If so, take a look at the data at the time you take the mask off. What is the pressure at that point? It is possible the pressure is at 4 which is way low. Like zonk, I'd feel suffocated at that pressure. Or it could be higher and you are reacting to that in your sleep.

And I cannot believe the doc said for you to not use the machine! That's just not right! To heal from anything, even sinusitis, you need to take care of yourself. Having adequate oxygen at night is a huge part of that!

Great suggestions, thank you all!!! Like I said, not everyone is familiar / experienced with CPAP therapy in Costa Rica. Doc said that If I continued using CPAP before sinusitis is cured that I would just make my condition worse and never fully heal. I think the doctor is familiar with CPAP but maybe not a lot of people have them so he is not that experienced with them.

My CPAP is data capable, I got the card reader...but the software did not work in my Mac. Without getting too technical I ran it using windows in my Mac and it still did not work. Something about not having a x386 processor. I will look at the screen next time I take it off. I think I did look once and it was around 8.

[Shastzi]

I'm with the pressure crowd.
4-5 cm does not produce enough airflow through the mask / hose circuit to purge all the CO2 with each exhale cycle.
Not harmful but it gets stifling after awhile. Been there, done that.

Point #2. You need to get some live data collecting going on because you cant tell how well your therapy is going except for the daily AHI of 7.5 (too high, by the way. You need to be below 5.0 )
But without the full suite of flow/pressure data you and your doctor may never figure out what really needs to be done to get your AHI down lower. In this day and age there is no need to guess.
***
If you can get going with Sleepyhead software (or equivalent) that will tell you what's happening every night.

Cheers!

[davidrreid]

I have been on CPAP now since 1999 and the mask removal thing started about 6 months after I started.

Initially I seemed to just pull it off but eventually developed the unconscious ability to undo the little catch at the bottom, remove the mask and then hang it up on the bedhead.

I have been using the humidifier right from the start due to a deviated septum and now find that unless I sleep on my left side I start getting a blocked nose.

In winter I increase the minimum pressure from 6 to 7.5 and that helps keep things clear.

Diagnosed with Type 2 Diabetes, a heart murmur and a leaky heart valve back in February so now on a big weight reduction drive which I hope will also reduce the sleep aopnea severity. So far lost 25 KG.

David