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I've got my 6 week follow-up on thursday and I need to know what I should be asking them. As it stands I can't manage a full night's sleep with my mask. I'm using a full-face and as I'm just about falling asleep my jaw relaxes so much it drops back a little and a leak occurs along the bottom of the mask. MY mouth doesn't really open when I sleep but that action makes a leak which wakes me up. On the few occasions I do get to sleep I normally wakes up after an hour or so and take the mask off.

So what should I be saying to the sleep study people?

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What mask are you using Russ? The Resmed Quattro FFM is designed to help with the problem that you have described. Sometimes it will , sometimes it won't.

Russ if I were you I would tell them about all of the problems that not having a proper titration and PAP education has caused. How it has probably set your therapy back months. Tell them about the importance of proper PAP education and support. Tell them how dificult it has been for you to self titrate without proper guidance.
Ok that sounds good, what am I to tell them should have happened with my titration?
I would go with TushyGalore's self-defined simplistic solution. Simulate your jaw-drop position and adjust (tighten the mask). If it seems too tight, I would say, accept it as a compromise. I only know one other person personally that I have discussed the following side affect of the full face mask: when we wake up, we have lines on our faces where the mask was. These lines go away after a while. I just took off the mask about 25 minutes ago. I just looked in the mirror and I still have two long faint curved lines on either side of my mouth and nose. If you don't experience this then I would guess that your mask is not on as tight as the masks of my friend and I. My personal feeling is I would rather do what I have to to have the mask not leak than risk annoying my heart by periodic stopped breathing all night.

Your second complaint, I'm not sure. You said you wake up with the mask off. You didn't say why. In the first case you said the mask leak wakes you up. If you don't know why, then I personally don't have a suggestion. I can share with you that I wake up with my mask off sometimes and I don't know why. One possibility could be that perhaps it's somewhat unnatural to have a tight piece of silicone crammed against your face while air blasts your skin. If I had a choice, I would not have sleep apnea and would prefer to sleep naturally with out any kind of mask. I also have a nasal pillow mask which I use occasionally when I am having leak problems with the full facial mask and am too tired to take the silicone and rubber out to make sure they are positioned correctly within the plastic. I have allergies and if too stuffy, I won't want to use the nasal pillow mask. Generally speaking, I don't like having something crammed up my nose. They don't seem all that pillowy to me. I do like the idea of having at least a couple of different styles of mask so that when I hate one kind, I can use a second kind for a while until I hate the second kind also and then switch back to the first. I now use the full face mask the most and I think I have less incident of waking up with the mask off with the full face mask. When my insurance allows, I want to try another mask. I fits OVER the nose only and has a Gel interface and is called a Sleep Net I-Q. One last thought. When I started, I tended to be more attracted to masks that seemed less claustrophobic. Now, I think it's more important to to have a mask that gives a secure fit and is going to stay on all night with the least trouble. Well, good luck, Russ. Here are a couple of links on the subject of mask options:

http://www.advanscpap.com/apnea-masks/
p://www.sleepapnea.org/resources/pubs/mask.htm
Have you tried a chin strap? They are simple to use and often add just enough support to keep the mouth closed.
Maybe try a dental appliance instead of the CPAP. I did not have success staying asleep with my mask. I could sleep with the dental appliance. I have a friend that goes back and forth between the two. It's especially helpful for travel. Good luck.
Ok last night I tightened the mask with my jaw loose and that seemed to help but something else has been happening only over the last few nights - it's like my apnoea has been happening with my mask on. I was regularly waking up with a snort - this has never happened before with the mask on, what's happening?
I can only assume, but it sounds like either you have a leak or your pressure is to low.

Russ Burt said:
Ok last night I tightened the mask with my jaw loose and that seemed to help but something else has been happening only over the last few nights - it's like my apnoea has been happening with my mask on. I was regularly waking up with a snort - this has never happened before with the mask on, what's happening?
have you gained weight? ,Even if the answer to that is no. Your Pressure needs to be higher. That is after you're sure that there's no leakage. Sounds like your in need of a check up?

Russ Burt said:
Ok last night I tightened the mask with my jaw loose and that seemed to help but something else has been happening only over the last few nights - it's like my apnoea has been happening with my mask on. I was regularly waking up with a snort - this has never happened before with the mask on, what's happening?
Tell them that you would like an in lab titration done in combination with a psg.

Russ Burt said:
Ok that sounds good, what am I to tell them should have happened with my titration?
I have finally found a solution for the dreaded and embarassing creases caused by sleeping with the CPAP mask. I simply cut strips of fleece as long as the straps on the sides, and about 4 inches. I slip the pieces of fleece under the straps after I put my mask on. This was a very inexpensive solution too, (50 cents!). Try it, you'll be glad you did.

Crabby Appleton said:
Hi Russ,
I have exactly the same problem. My mouth does fall open and depending on what position I'm in, the mask can slip and leak. It also does help that I have a goatee that messes with the sealing. I was told to use the larger mask with hopes it would "catch" under my chin and give a better fit. I refused to wear the mask for several years because of the claustrophobic problems. I finally gave in and wear it every night. I still feel rotten every morning. I'm sure it's because my breathing is messed up. Because the "levels" a OK, my doc doesn't seem to think I know what I'm talking about. I've been using it for 4-5 years now. I'm about ready to chuck it. That, coupled with the great creases I have all over my neck every morning, make the CPAP a delight. Hope you can get some relief.
Kenny
You can get a chin strap ...and also try the new gel saline...rub on th einside of yournose to keep membranes moist.....get a humidifier attachment if you don't aqlready have one....if not thay get a room mister to put moisture in the air so you dont dry out
I dont know what position you are sleeping in or if this would be helpful to you. But due to back problems I can not sleep on my back. When I started wearing the cpap I thought this would be a problem but I have found it to be very helpful. I have a full face mask because I breathe through my mouth. I sleep on my side. I started just curling my arm up over my pillow so my arm is actually holding the mask against my face. I do not have any leaks! And I am very comfortable

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