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Mask snoring / high pressure leaking
Hi all, I've been subscribed here for a while but this is my first post.
I have two things going on and am looking for opinions and advice. The first thing is mask snoring. My wife tells me that I am more frequently snoring into the mask if I am on my back. If I am on my side it sems les to her (although she may just fall asleep because I'm finally quiet). I will go to my RT (and I really like the guy) and ask, but practical answers from the field will help me too.
Secondly, I get what are sometimes long bursts at max power (20 cm in my case) and it blows the mask off of my face and basically inflates my cheeks, What's the deal with that? Sometimes it wakes me and I just cycle the machine so it settles again
I have a ResMed Autoset Spirit and the Mirage Quattro mask. Pressure starts at 8 cm and caps at 20. I can't stand ramp time and have heated humidity.
Jim
P.S.. With my head hung in shame I have to say that my last visit to my RT was two and a half years ago. I'm not having any troubles and have been happy with my therapy, but I know this is too long between office visits.
I have two things going on and am looking for opinions and advice. The first thing is mask snoring. My wife tells me that I am more frequently snoring into the mask if I am on my back. If I am on my side it sems les to her (although she may just fall asleep because I'm finally quiet). I will go to my RT (and I really like the guy) and ask, but practical answers from the field will help me too.
Secondly, I get what are sometimes long bursts at max power (20 cm in my case) and it blows the mask off of my face and basically inflates my cheeks, What's the deal with that? Sometimes it wakes me and I just cycle the machine so it settles again
I have a ResMed Autoset Spirit and the Mirage Quattro mask. Pressure starts at 8 cm and caps at 20. I can't stand ramp time and have heated humidity.
Jim
P.S.. With my head hung in shame I have to say that my last visit to my RT was two and a half years ago. I'm not having any troubles and have been happy with my therapy, but I know this is too long between office visits.
Views: 234
Replies to This Discussion
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Permalink Reply by RockRpsgt on
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How long have you been on PAP therapy? What are your auto settings? Has anything changed since you started therapy.
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Permalink Reply by Mary Z on
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No shame, Jim, if things have been going well, who likes to go to the doctor? My pressure is 18/22 and it's very hard to keep the seal from blowing off your face, or inflating your cheeks at a pressure of 20. This has been confirmed by RT DME and on another forum from actual experience. I love my quattro (have had to severely limit it's use due to poor skin and bad nasal bridge damage), but found I had to really tighten it down to keep it on my face. I only recently tried Macks silicone ear plugs shaped into a thin string, about pencil size around the edges of my FItLife and have found it helpful. Silly putty is supposed to do the same thing. I found the silicone worked better if I lightly scored it- seemed to give a better seal. I do believe at your pressure, from everything I have read, that the quattro is the best mask.
Good Luck,
Mary
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Permalink Reply by Jim Bayer on
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Hi Rock, I've been on PAP for 14 years now. My first machine was single pressure and non-titrating. I'm so glad I have this new machine. I went for a second sleep study about 4 years ago. My initial pressure was set for 11 cm and the RT bumped it to 12.5 on my first machine. The Spirit starts at 8 and goes to 20. I've had good luck so far.
It seems my experience with PAP is slowly diminishing. I don't know if it is the therapy or other issues, but my feeling of well-being and refresh after sleep is less and less. I've always had issues with the interface as well. I've slept on my stomach my whole life until PAP therapy (started at age 34) and the mask/nasal pillows, etc. are a pain. I have a deviated septum so the nasal pillows don't work well for me. The quattro so far is the best solution.
How do I find the Auto settings? I can find the clinicians menu (I never change anything) so if you can direct me to the menu item I'll be glad to let you know.
Jim
Rock Hinkle said:How long have you been on PAP therapy? What are your auto settings? Has anything changed since you started therapy.
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Thanks for the support and advice Mary! My doctor really wants me to come in about once a year and I've been averaging once every 2-3. When he looks at my sleep time average and sees about 6-7 hours he gets serious with me. He insists that I get 8 hours per day. I just can't seem to find time to sleep. Sad but true.
I'll try the other sealing methods you suggested. I could replace my mask too. It's been nearly 2 years on this one.
Jim
Mary Z said:No shame, Jim, if things have been going well, who likes to go to the doctor? My pressure is 18/22 and it's very hard to keep the seal from blowing off your face, or inflating your cheeks at a pressure of 20. This has been confirmed by RT DME and on another forum from actual experience. I love my quattro (have had to severely limit it's use due to poor skin and bad nasal bridge damage), but found I had to really tighten it down to keep it on my face. I only recently tried Macks silicone ear plugs shaped into a thin string, about pencil size around the edges of my FItLife and have found it helpful. Silly putty is supposed to do the same thing. I found the silicone worked better if I lightly scored it- seemed to give a better seal. I do believe at your pressure, from everything I have read, that the quattro is the best mask.
Good Luck,
Mary
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Rock,
BTW, my doctor is not an RT but a "Sleep Pathologist". Not sure what the difference is,
Jim
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Jim, Unfortunately I can not direct you to that menu. I enjoy my job way to much. Given your time and experience on PAP someone here may be able to do that for you. I would advise you to speak with your physician on this matter. Talk to him about tightening the auto-settings as I believe this would help. Also research Bipap. I have found that patients who tend to need higher pressures do better on this type of machine.
When was the last time you replaced your mask?
Jim Bayer said:Rock,
BTW, my doctor is not an RT but a "Sleep Pathologist". Not sure what the difference is,
Jim
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Jim, for sure replace that mask. My optima medicare allows me a new mask every three months and a new cushion every month. After two years that mask ought to be used up.
Mary Z.
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I'll try the other sealing methods you suggested. I could replace my mask too. It's been nearly 2 years on this one.
Jim
Mary Z said:
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Permalink Reply by Rose Marie Holt on
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I am AT 20 with a full face ResMed Ultramirage. I dont ramp bc I want to know the seal is OK right off. It seals OK - partly bc it inflates my mouth pretty good. I keep the silicone clean - that helps a lot. I hear those cloth "washers" help with the seal. I must reposition it in my sleep bc i know it will unseal without much encouragement. Snoring isnt nec. apnea. Another RT visit seems appropriate. how is your daytime sleepiness? Maybe you can adjust the mask at 20? will it stay in place?
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Permalink Reply by Samuel Kaplan on
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Jim
Just like your wife, your CPAP probably "hears" your snoring and automatically raises the pressure to overcome it. If 20 is blowing your mask off and inflating your cheeks it is too high - especially if is doing exactly the opposite of what its supposed to do and wakes you up in the middle of the night.
So, (a) Don't sleep on your back. Use the old "tennis ball attached to the back of your PJs" trick, or something else that would prevent you from rolling on to your back while asleep. (b) See your RT. Maybe he can reset your machine's high setting a little lower. And, (c) your condition may have changed a bit so maybe its time for a new sleep study for you.
Good luck, and a good night's sleep.
Sam Kaplan
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I've only been using the CPAP for two months but what you have is what I had, blowing so much air it blew the mask off my face, nearly. I went back and talked to the store where I got mine and she reset it. Mine was set at 5 and then at 45 minutes ramped up to 18. Then she changed it to go from 5 to 14. Using the ramp button, I was constantly ramping it back to 5. That didn't help that much either, so I knew that there is a "titration" CPAP and you can get it with heated humidity so I asked if I could get that and I'd be willing to pay for it out of pocket. Well, they actually switched it out for me and now I have the auto-matic titration where you get only the amount of air that you need at the moment you need it.
The funny part about it was that I thought I was getting too much air but as it turns out, I actually get that higher number of 18.9 several times throughout the night for for a duration of about 1 minute or less. Sometimes I wake up during the night and look at the pressure and it's only 7 or 8.9 or 11 and one time I saw 18.1.
If you haven't had a sleep study repeated since you've been on it, you might want to have that done or ask for the "auto-titration" CPAP. Losing or gaining weight can change your needed pressure amount too.
I don't know why they don't just make them ALL auto-matic. Seems to me it would beneftit the patient a lot more.
Hope this will help you.
Pat
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Well, not an expert myself, but do you put the mask on and bring the cap up to 20 before you use the step up? That way you can adjust for all leaks at maximum pressure and different sleeping positions. I sometimes move my machine to another room for a few days to test and adjust my mask without disturbing my wife.
Sammy
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Nearly anyone with a pressure of over 20 is going to have trouble with masks blowing out. There are only certain masks that will do the job- a task for your RT/DME. Certainly you can see if your mask pressure could be lowered, but just because you have trouble with a mask leaking doesn't mean the pressure is too high.
Rose, the RemZzzs may help, or I use macks silicone earplugs rolled into a thin string (about pencil size) and placed along the perimeter of the mask. I find I have to take the silicone off each morning- I roll it into a ball and string it out again the next night. That way I can use it longer. I use the mirror to place it on my face, strap it down and then go get hooked up, check the seal and make adjustments as necessary. I use the FItLIfe Total Face Mask and was having terrible leaks until I started getting the hang of the silicone. It takes patience and practice. The RemZzzs did not help me, but I understand they are coming out with a new model.
Good Luck,
Mary Z.
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