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I am have been newly diagnosed 3 months ago with sleep apnea. My pressure is 12 but I have been unable to adjust to the CPAP. I have made it maybe 1 night with the mask still on my face in the morning. I have tried, full face and the nasal pillows with chin strap and mouth piece.
Any thoughts on whether Auto-CPAP would be helpful or any mask suggestions? I am a side sleeper and start out breathing through my nose but think I mouth breath after I am sleeping.
Thanks for any help.
Views: 545
Replies to This Discussion
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Permalink Reply by Mary Z on
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What you might talk to your doc about a BiPAP machine which delivers your 12 inhale pressure and a lower (by about four points usually) exhale pressure . That makes it easier to deal with so you don't have that straight 12 pressure blowing at you constantly. I don't know what machine you have so I don't know if it's got any EPR (exhalation relief) or C or A flex. Don't even know if those come on straight CPAP. They would do the same thing if enabled. Tell us what machine you have, exactly as possible. Call your DME/Doc about the problems you're having. Tell them just what you told us. Good Luck, keep trying.
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Permalink Reply by Jon on
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You should discuss this with the physician who prescribed your current machine. If you feel you can not/do not want to talk to this physician, you need to change docs.
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I don't know your level of severity but it doesn't sound like this is improving the quality of your sleep and after all, the point of treatment is to be able to breath while you sleep. You might consider an oral appliance, specfically a mandibular advancement device. It fits in your mouth like a set of acrylic retainers and advances the jaw forward to open the airway. Many studies show them to be as effective as CPAP in treating mild to maoderate sleep apnea. Best news: Patients go to sleep with it and wake up with it having breathed fully all night long.
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Permalink Reply by Jan vanNiekerk t SnoringElephant on
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Jeffrey
There are several options available. I think it is a combination of a few things.
1. The mask could be intimidating, and is something you have to get used to. If you are an open mouth sleeper you have the option of an oral mask. (I know Fisher and Paykel supply them)
2. It could also be a combination of cold air continiously blowing in your airways. A heated humidifier can help. With the cold air blowing in your airways you could have swollen nostrils, due to blood flowing to your nose, to assist in the heating of the air.
3. A heated tube just make it easier because the air is warm already entering your nostrils and there is no condensation.
4. An APAP is comfortable as it is reacting to your apneas and decrease pressure when awake.
I sleep with a nose mask, some call it a full face, but it fits over the nose, on the upper lip. the full face cover the mouth and the nose. I can believe that will be uncomfortable.
The oral mask has been designed for people sleeping with an open mouth.
I also take a cheap antihistamin.
The combination of my air temperature being adjusted (F&P Icon) together with the heated tubing does make a difference.
The snoringelephant website describe the different options fairly well.
I hope that you will find the correct combination. The combination above is the best I could find after 13 years on the CPAP machine. The Icon Auto is now my 3rd machine and offers the Auto, heated humidifier and heated tube.
Jan
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It is REALLY aggravating thats for sure. I hope you can get the answers you need. My machine, I am not happy with it, it blows the air so hard, even on 7, and with the humidifier up to 4 still dries out my mouth, and I am not a mouth breather.
Some things it just seems can't be fixed. (that sure does sound pessimistic doesn't it :( )
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Permalink Reply by CPAP Library on
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An auto set could be helpful because it adjusts only when you need the pressure so it ends up being at a lower pressure through most of the night. I have some good videos about the Resmed S9 autoset at www.sleepnation.tv
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Permalink Reply by Kathleen Rentel on
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I love my Bipap. My settings are 12/6 It allows me to exhale at my own pace. You could talk to your Dr. about changing to a bilevel.
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There are several things that could be an issue. I will discuss three of the most common.
First, you are you providing enough humidity? Is your mouth or nose dry? If so you don't have adequate humidity. The drying and subsequent swelling of the membranes will make it so uncomfortable that you will pull any interface off. The swelling of the membranes reduces the size of the passages and results in pressure loss in the passages, resulting in obstructions, and may times causes the person to pull the mask off. Be sure that you are providing enough humidity. If this works, but you have rainout, you will need to deal with the rainout. Lowering the humidifier heat is usually not the way to deal with rainout.
Second, you may have become used to the pressure found during the titration and now that you are becoming more relaxed, partial obstructions. The obstructions that you may be experiencing may be causing you to pull off the masks. Third, you may not have gotten a complete titration. Not the thing that any patient wants to hear, but it happens. You may not have gotten a good titration for several reasons. 1 - Many times a split study just plain old runs out of time. 2 - Being sensitive to pressure changes, prolonging the time it takes to be titrated appropriately. In these cases, a second titration is needed. 3 - Just a bad night. 4 - Another thing that happens is that the titration was ok, but you are becoming more comfortable with the CPAP.
Third, as you get used to CPAP and you relax more, the obstructions may start to happen again. Again, a retitration will be necessary. Humidity deficit and a reoccurance of obstructions either from a bad titration or getting used to the CPAP are the most common.
You didn't mention your weight, or other possible complications, respiratory or cardiac, or PLMS being the more important ones.
A simple change to auto CPAP or BiPAP might make it easier, but you will have difficulty with those therapies as well, if lack of humidity, mouth leak and mask leaks are a problem. I would suggest you be sure that mask fit with minimal mask and mouth leak is taken care of first. Adequate humidity can be addressed the next time you apply CPAP. Turn the humidifer up. Full face masks usually require more humidity. The other things mentioned above should be considered with a very frank discussion with your doctor.
In my experience, humidity deficit, mask fit, mask leak, and need for a different pressure because of an incomplete titration or getting used to the therapy as discussed above are probably the most common causes what you are experiencing considering the time you have had CPAP.
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Peggy McGalliard said:It is REALLY aggravating thats for sure. I hope you can get the answers you need. My machine, I am not happy with it, it blows the air so hard, even on 7, and with the humidifier up to 4 still dries out my mouth, and I am not a mouth breather.
Some things it just seems can't be fixed. (that sure does sound pessimistic doesn't it :( )
Peggy,
Sounds like you have a leak, either mouth or mask. When the machine blows so hard, it's trying to make up for a leak. That alone will dry you out. A careful mask fit with the CPAP turned on is my suggestion. If that doesn't work, holler back. Most things can be fixed. It's getting the right help, and applying it that matters.
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Thank you so much for all your responses. In an answer to some of your questions
I am currently using a CPAP Fisher and Paykel Sleepstyle 200. It does have a water container with heated moisture.
I am overweight but as most of you know its not easy to lose weight when you don't sleep, I am trying and go to the gym but its slow going. I don't have any other health problems as of my last physical.
I have a doctor's appointment tomorrow to discuss machine options and we shall see what happens.
Thanks again all.
Jeff
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Jeffrey Baskin said:
Thank you so much for all your responses. In an answer to some of your questions
I am currently using a CPAP Fisher and Paykel Sleepstyle 200. It does have a water container with heated moisture.
I am overweight but as most of you know its not easy to lose weight when you don't sleep, I am trying and go to the gym but its slow going. I don't have any other health problems as of my last physical.
I have a doctor's appointment tomorrow to discuss machine options and we shall see what happens.
Thanks again all.
Jeff
Jeff,
Be sure to discuss mask issues, mouth leak and possible retitration. Good luck,
John
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With a full face mask and not being able to take the pressure, then perhaps their is nasal congestion? The air has to go somewhere and that is out through the sides of the masks and of course thru the small portal in the mask.
So then you start mouth breathing? Nasal pillows or full mask, check your nasal congestion not nasal obstruction.
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