"please keep me updated about oximeters "
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Chipmunk Cheeks
The head RRT at my DME provider's called me today. Their "mask man" suggested that he contact me since I had been talking to the "mask man" about mask issues and mentioned that I was scheduled for a bi-level re-titration.
We discussed the various masks I've tried and which I've liked, what I didn't like about some, etc. One thing we discussed was the pressure sometimes causing what some call "chipmunk cheeks" where the air builds up in our mouth and then escapes thru our lips.
He said that is almost always caused by not being able to exhale all the air. That is not a pressure setting so much as it is the need for pressure relief only on exhalation. Rather than adjusting pressure we should FIRST increase our EPR or C-Flex expiration pressure relief so that there is LESS PRESSURE TO BREATHE OUT AGAINST.
We discussed the various masks I've tried and which I've liked, what I didn't like about some, etc. One thing we discussed was the pressure sometimes causing what some call "chipmunk cheeks" where the air builds up in our mouth and then escapes thru our lips.
He said that is almost always caused by not being able to exhale all the air. That is not a pressure setting so much as it is the need for pressure relief only on exhalation. Rather than adjusting pressure we should FIRST increase our EPR or C-Flex expiration pressure relief so that there is LESS PRESSURE TO BREATHE OUT AGAINST.
Views: 1795
Replies to This Discussion
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Permalink Reply by susan mccord on
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Judy, I found out about this accidentally. I used to have that happen all the time. Had never even looked at the C-flex #s on my CPAP awhile back, changed them, and promptly forgot about 'em. I just now realized I DON'T have the cheek/lip problem anymore. At least not that I'm aware of.
God, technology is a wonderful thing. Too bad some people (like me) are so slow and/or reluctant to mess with it.....
Thanks for the reminder that I did, in fact, do something with my equipment that made a difference!
The fact that I forgot about it till now is another conversation entirely!!!
Susan McCord :-D
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Permalink Reply by R. Barnes on
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Im having the same problem. My sleep doc asked if my mouth is open and I kept telling him no,just putt-putts thru corner of mouth. I know I dont have any epr set on my machine. What would I try it at for starters, any help would be appreciated. I like my nasal mask
except for the mouth thing. Having trouble with all other mask i have tried, dont have enough "bridge" on nose and get constant leaks at eyes. 407 mask is only one that have decent for me.
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1 would be the minimum amount of expiration pressure relief and 3 would be the maximum amount of pressure relief.
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Permalink Reply by RockRpsgt on
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When is your re-titration scheduled for? I have not seen your name on any of my orders.
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I had hoped, Rock Hinkle!!! I really had hoped. But - that drive in winter is NOT my cuppa tea any more. Too many years of driving winter roads, I've lost my nerve. I/we planned on this spring when the roads and weather could be relied upon. But this opportunity came up .....
Sorry I've been neglecting everyone ... the gut took offense to something I ate. Well, I cheated, I ate some raw broccoli, cauliflour and celery w/vegetable dip ..... which don't always agree w/my partial obstruction. USUALLY I can get by cheating IN MODERATION and I only ate one piece of each ..... but ..... this wasn't one of those times.
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Deal, Rock Hinkle, my very favorite PSGT!!!!!
Rock Hinkle said:I will let it slide this time, but I get the next one.
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At 6:10pm on January 10, 2010, raymond parastino said…
when I try to sleep my cheeks puff out. this happens weather I am using a nasal mask( resmed) or a full facial mask. ( resmed). When I first started using cpap I had all the hope in the world that this was going to make a major difference in my life. IT HASN"T!! Infact my life is worse than ever. I've had to buy all my own equipment because of changes in insurance. I am so tired of people telling me what they think is wrong and all the time the aren't even listening to what the problem is! I just want to sleep like a regular person. I don't want my cheeks Ohstrained out painfully, waking me up every hour or so. I can,t afford to purchase any more masks at $150.00 or more. I've heard from a few people who say I'm not exhaling all the way. Well if I'm not exhaling all the way by now I never will. Isn't there anyone out there who has had this problem and found a solution that worked. I am so frustrated at my situation that I am alienating my wife and family. My doctor has no answers for me. He says you just have to work it out , buy another mask ,have another $1700.00 sleep study. Buy a more expensive machine. I am out of money and patients. I haven't had a good nights sleep in over twenty years. I was promised by everyone and their brother that this was the answer to all my problems. and with in a month I would be a new man. Well it has been three months and things are getting worse not better. I'm willing to listen to any ones idea or solution. I was on another forum and all I got was two post by people who agreed with each other. Funny thing each one of them had made over 2,000 posts each. Seemed to me that they like to see their names in type because they sure hadn't any answers. And please no poems. I just want to get a good night sleep so I can stop being such a jerk! I have tried using the c-flex in every position with out a bit of difference. I have used chin straps nasal masks, full face masks . Lying on my side, my back, my other side. HELP!!! Oh my pressure is 10 cmh2o and 3 liters of O2. I have a resperonics Remstar auto with A flex,( and c-flex) It is both an auto machine or a regular cpap machine. I have the right humidifier and an Everflo Q O2 concentrator. I've tried the auto position the cpap position everything I can think of. I know I'm coming off as a jerk but I am at my whits end. I am hoping some one can help me return to sleep and sanity.
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Permalink Reply by 99 on
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i am plain guessing here
if your intake is xx amount say 10
and your o2 xx amount say 5
that is 15 to me the o2 should stay the same but the air should be trimed so the total is 10
i may be talking rubbish can some one dive in
with a more professinal answer based on facts
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Do you know how to access the data from your Respironics M Series Auto w/A-Flex??? Have you or anyone else done a full download of ALL the data, not just the compliance data? Were YOU given a copy of the full download?? Your APAP is a fully data capable device and the data from it should be able to give some clues as to what is going on.
I'd take a guess that even just a 0.5 cm drop in pressure could reduce or eliminate the chipmunk cheeks but you may need a full 1 cm drop. Do you have the A-Flex set to the maximum 3 expiration pressure relief??.
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Permalink Reply by Andy on
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Hi Raymond,
Sorry to hear about your sleep and CPAP problems. I've been n CPAP for just about three months, and the people here have been a huge help to me, by supplying both information and encouragement.
For some people, it seems that it takes a few months to even a year before they're used to using CPAP, start getting good results, and train their brains and body to adjust to this new therapy.
As for the financial part of things, I have a few suggestions. There is a warranty on the masks, and I've been able to exchange one for a new and different one if it doesn't work and feel right to me.
The sleep center I went to gives the mask used in a sleep study to the patient, or just throws it away. They use "sample" masks purchased from the CPAP company. Maybe you can get a "used-once" mask at your sleep center, or sweet-talk them into giving you one of their sample masks.
Unfortunately, as you've probably read in this forum, many doctors and equipment suppliers don't take the necessary time to work with patients, and don't follow up.
Before buying any more equipment, I'd insist on seeing your doctor, and getting specific, detailed info on what can be done to make this better. In my case, I showed up at the doctor's office one afternoon, and told them I needed to see the doctor ASAP, and that I wasn't going to take "no" for an answer!
I believe that part of the issue for us CPAP patients is that we don't get the follow-up that we need and deserve from our medical providers, and we end up getting frustrated.
I decided early on that I would take an active part in my therapy, and act as the "general contractor" between myself, the doctor(s), the sleep center, and the equipment providers. By knowing in advance what the plan was, and by following up with all concerned, I've been able to manage things successfully, and get good results.
For me, information is key. I have the email addresses of the sleep center and equipment provider, so I can, and do, ask questions whenever they come up, and get good answers. The providers don't feel that I'm pestering them, and they can answer whenever they have time, so I usually get quick replies.
As for insurance-- don't get me started. But, I'd make very sure that your insurance company is paying for whatever they're supposed to, and I would not let up on them until they do. You've probably already checked with your state health department, but there may be some other program available to supplement your insurance plan, so that you can get the tests, equipment, and supplies you need.
If all else fails, I'd even track down the manufacturer's rep for your brand of equipment, and beg him/her to help you get the mask you need.
Good luck with all of this, and please stay in touch. We all know what you're going through, and there are lots of informative and caring people here that want you to feel better!
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