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Permalink Reply by Heather on February 10, 2009 at 4:40pm

Daniel:

Last night I tried the Comfortlite2 again, this time with the cushion, and the humidifier at 1. Slept well for about 5hours, then woke with a start when I inhaled a bit of water: there was a pool in the bottom of the cushion! Maybe because it was so cold last night? Ick. Question: When I tried 0 setting, no water was used. I didn't realize that to humidify the air it has to be warm. Why can't some moisture be added at room temp? I am concerned that with this dry winter air I will cause more problems in my nose. Maybe I'll have to heat my bedroom tonight.

Also, what do you think of the Simplicity Simple Nasal Cushion Judy likes?

Daniel Levy said:

If you nap for two hours and have two major apnea events and no other events, by definition you have and AHI of 1.0, which is considered normal breathing. You idea to increase the pressure during a nap is an interesting one and may have merit, as long as the higher pressure doesn't disturb your sleep.

Condensation at the OptiLife nasal pillows can be from the moisture of your exhalation, I'm not sure if that would be the cause of your leak woes, but if it is, a quick wipe with a tissue should solve it. You could try reducing the heat even more. Some people turn off the heat completely. As long as you don't feel too dry as a result, that could take care of the problem. You just have to experiment. And remember, spring is on the way soon...

As for setting the CPAP lower than the mattress, I think people make way too much of that. It only makes a difference if you have condensation in the tube and it is dripping into your mask or nose. It will still make noise, even if the water rolls back into the chamber. Doesn't it make more sense to eliminate the condensation, by either reduce the heat level, increasing the temperature in the bedroom, or insulating the tube from the cooler bedroom air?

Daniel


Heather said:

Thanks Daniel. It may be that a 20 minute nap is not enough time for the auto pap to adjust like you said. Maybe I should set it at a continuous pressure of 10 for my nap?

Also, my AHI says 1.5. And it didn't change after the nap with the three "episodes." That could be because it is averaging over the whole time my card has been recording, right? So 2-3 events may not change that average. I guess when I am falling asleep at night, I only have 1-2 "events."

Last night I tried the Optilife with nasal cushion. It was ok, I fell asleep, but woke up at 4 AM to hissing and tried and tried to adjust the cushion but couldn't get it to seal again. It was moist from condensation. Is that why I couldn't get it to seal? This is an on-going problem; I had the same thing happen with the ComfortLite II and my Swift LT. I do have a snuggle hose, and the dial is only set to 2 on the humidifier. Our room is about 60 degrees and I really don't want to have to heat the room every night to avoid condensation.

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Permalink Reply by Judy on February 10, 2009 at 5:50pm

If you opt to try the Simplicity simple nasal cushion (I use the Small) you will find the headgear very large. I had to put a fold in the center of the center strap and use a strip of velcro to hold the fold in place until I got it to fit just right. When I was sure I had the length right I used scissors to cut out the fold and put the two cut ends back together w/a velcro strip. That velcro strip will hold for MONTHS.

Also the velcro ends of the two lower straps were as wide as the headgear strap so that if you weren't VERY careful when you fitted the straps the velco could rub your neck raw. I just used my trusty ole scissors to taper the velcro ends to avoid that problem.

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Permalink Reply by Heather on February 10, 2009 at 6:47pm

good to know, thanks Judy.

Judy said:

If you opt to try the Simplicity simple nasal cushion (I use the Small) you will find the headgear very large. I had to put a fold in the center of the center strap and use a strip of velcro to hold the fold in place until I got it to fit just right. When I was sure I had the length right I used scissors to cut out the fold and put the two cut ends back together w/a velcro strip. That velcro strip will hold for MONTHS.

Also the velcro ends of the two lower straps were as wide as the headgear strap so that if you weren't VERY careful when you fitted the straps the velco could rub your neck raw. I just used my trusty ole scissors to taper the velcro ends to avoid that problem.

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Permalink Reply by Daniel on February 10, 2009 at 8:18pm

You can put water in while the heat is set to zero. That's called "passover" or "cool" humidification. Up until about seven years ago, cool humidification was the standard, because many doctors were concerned that patients wouldn't clean their heated humidifiers regularly and wind up with a Petrie Dish full of bacteria blowing up their noses.

You might try wrapping a washcloth or something around the short tube section of the ComfortLite II. That might help out since the Snugglehose doesn't cover that section.

As far as the Simplicity goes, I personally can't stand it. It's been around for a very long time. The silicone is thick with a single wall construction. I find the headgear so tangled and confusing that the mask should be called the "Complexity." I've tried it with several female patients with small noses, and none of them could get a good seal. Still, the fact that they still make it means that there must still be some people who like it. After all, everyone's face is a little different.

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Permalink Reply by Judy on February 10, 2009 at 9:27pm

The Simplicity's silicone cushion is what I like. The edges aren't so sharp and cutting as, for instance, the thin outer cover on the Quattro or the Micro. The cushion is similar to the simple nasal cushion of the CL2.

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Permalink Reply by sleepycarol on February 10, 2009 at 10:26pm

I have been using my humidifier in pass over mode most of the winter. I live in Missouri and so of course we have to have the house heated. Some of the water does get picked up by the blowing air and I find it is just the right amount of humidity for me. I have asthma and too much humidity sets off attackes and I feel as though I can't breathe. When I had a bad cold a few weeks ago I set the humidifier to 1 and was good to go and then when I felt better turned it off.

Last summer I didn't use the humidifier at all -- didn't see a need and didn't feel like I needed it.

Each of us is different and you will need to experiment to see what feels best to you.

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Permalink Reply by Daniel on February 10, 2009 at 10:39pm

Judy's right. I now remember my Respironics rep telling me that the Simple Cushion on the Comfort Lite II is the direct descendent of the Simplicity. If you like the Comfort Lite II's cushion, the Simplicity may be a good choice for you. Don't be afraid to make your own customization with the headgear, though.

Judy said:

The Simplicity's silicone cushion is what I like. The edges aren't so sharp and cutting as, for instance, the thin outer cover on the Quattro or the Micro. The cushion is similar to the simple nasal cushion of the CL2.

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Permalink Reply by Heather on February 11, 2009 at 1:46am

I am learning so much from this discussion and this website. I have been trying for almost a year to understand how all the CPAP equipment works. Just knowing I can try a 0 setting without risking extreme nasal problems is a relief. And to try wrapping that short tube section to help eliminate condensation. And to know the CL2 cushion is similar to the Simplicity makes me more likely to go through the trouble of trying it. THANK YOU ALL!

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Permalink Reply by Judy on February 11, 2009 at 10:09am

Live and learn, Daniel!!! I didn't realize that the CL2 cushion was a direct descendent of the Simplicity!!! Since I tried the CL2 first and it was only after I switched from the CL2's nasal pillows to the simple nasal cushion that I eventually stumbled on to the Simplicity and was immediately interested in tryng it!

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Permalink Reply by Heather on February 11, 2009 at 3:09pm

Last night I set the humidifier to 0 and wrapped the short part of the hose on the CL2 with nasal cushion, and I had no water problem. Yeah!

Two nights without the nasal pillows and my nostrils are feeling better. The only painful spot with the nasal cushion is where it hits right below the bridge of my nose, which is weird because the cushion is so soft. Hard to believe when the CPAP is on, there is enough pressure to cause soreness.

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Permalink Reply by sleepycarol on February 11, 2009 at 5:49pm

Heather to try to toughen up your nares use some Ayr Gel Nasal Gel or some lanolin. This will help some with the soreness and help the pillows to seal. It will take several days of use before your nose will toughen up and no more so nose!!

All of us (at least the majority of us) have had to go through this in order to use the nasal pillows. Take extra care of your nose and it will love you for it!!

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