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Permalink Reply by Judy on June 16, 2009 at 2:45pm

The Respironics REMstar M Series Plus is limited in its data capability and can only provide compliance data. How many hours you've used it IS part of your compliance data tho. Before we go any further, IF you would prefer to have a fully data capable CPAP (which I HIGHLY recommend), if you have had this Plus less than 30 days, take it back and tell the local DME supplier that it is not acceptable and that you will only accept a fully data capable Respironics REMstar M Series Pro w/C-Flex.

The first thing I would do is call my insurance company and ask them what local DME CPAP suppliers they are contracted with. Hopefully you will have the option of more than one as the will give you more bargaining/negotiating room.
Almost all insurance pay for CPAPs by insurance (HCPCS) code NOT by brand and model. Whilst the Pro will cost the local DME supplier a FEW dollar more than the Plus, the insurance reimburses for either model at the same contracted rate. Thus the supplier would prefer to pawn the Plus off on unsuspecting new clients rather than the Pro. And understand that compliance data is of benefit to NO ONE EXCEPT the local DME supplier to get their reimbursement from your insurance. It provides no data of value to you or your sleep doctor if you have any problems acclimating to your CPAP therapy at all. Any changes that may be needed to your therapy will have to be made by your sleep doctor "by guess and by gosh" or via another, expensive, in-lab PSG titration. Whereas w/a fully data capable CPAP the data will be there to indicate to you and your doctor not only what problems you may be having but also what changes might relieve those problems. Just because a CPAP has a data card is absolutely no indication that it is fully data capable.

Now, as to the problem of keeping the mask on all night. You can become more comfortable w/having a mask on your face whilst sleeping by taking time during the day or early evening to take your CPAP into the living or family room, donning your mask, turning your CPAP on and reading a book or magazine, work a crossword or jigsaw puzzle, knit or crochet, watch TV, whatever it takes to occupy your mind w/something OTHER THAN "I've GOT to get to sleep". Just be sure to remove the humidifer tank whilst moving your CPAP so you don't accidentally spill water into your CPAP.

As far as accessing your compliance data: I'm not as conversant w/the Respironics' as I am w/the Resmeds. Try this:

http://www.cpap-supply.com/Articles.asp?ID=130">

Keep in mind that YOU are the one paying for this equipment. Whether thru insurance is out of pocket or thru insurance is totally immaterial. If you don't agree to accept it that is a sale and money LOST to the local DME supplier. YOU are the one to endure the benefits OR consequences of CPAP therapy, NOT the local DME suppier and NOT your sleep doctor or the local DME supplier. "You get what you pay for" does NOT hold true w/local DME suppliers and insurance companies!

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Permalink Reply by Robert Woods Mann on June 16, 2009 at 3:41pm

When I was first getting used to the CPAP, perhaps 5 years ago, I sometimes removed the mask at night, probably when it felt uncomfortable for some reason. For me it was just a phase. A strong desire to get the full benefit of the CPAP helped -- maybe autosuggestion came into play. ("I really don't want to pull off my mask at night!") Also the newer masks are more comfortable.

Also, I had a bit of a claustrophic reaction at first, which was perhaps contributing to pulling off the mask while asleep. I have known people who never could get used to it. For me a rational approach ("consider the alternative to keeping the airway open") worked. Also a bit of autosuggestion. ("I really love the CPAP and am deeply greatful to to doctor who came up with the idea!")

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Permalink Reply by Melinda Hertel on June 16, 2009 at 5:01pm

It is very common for people to pull the mask off while asleep. Sometimes we never know the reason. But most often the causes are: 1. your body is still getting used to having a mask attached, 2. the pressure is not correct for you--too high or too low, 3. the mask is leaking, causing a disturbance that wakes you enough to pull it off, 4. you have a REM disorder where you move during REM sleep.

I pulled my mask off a couple of times when I first started therapy. I still don't know why. I have patients that do it because of leaks or pressure issues. The REM disorder has to be diagnosed in the lab. When someone is in REM sleep, the body is paralyzed. There should be no body movements. I have a patient that has this disorder and he is treated with klonopin.

There really is no way to tell how long you slept with the mask on unless your machine monitors mask leaks or turns off automatically when it detects the mask has been removed.

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Permalink Reply by sleepycarol on June 16, 2009 at 10:32pm

Another suggestion might be to try a piece of tape on one of the straps, taping it to your cheek or face. When you go remove the mask, hopefully the tape will pull enough to wake you up.

Judy had some very good suggestions, please follow up with her suggestions and ideas.

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Permalink Reply by Rock Conner RRT on June 23, 2009 at 2:36pm

Be patient with yourself. You'll probably stop taking it off. Meanwhile, make it harder to remove by adding a chin strap -- Rock

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Permalink Reply by Adriann on June 23, 2009 at 3:51pm

Thanks for the encouragement!

Rock Conner RRT said:

Be patient with yourself. You'll probably stop taking it off. Meanwhile, make it harder to remove by adding a chin strap -- Rock

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Permalink Reply by SleepyEm on June 23, 2009 at 9:19pm

It took me months to stop pulling it off. At first it was after a few hours, then gradually I'd sleep longer and longer with it until now I sleep the entire night (most of the time) with it. Hang in there!

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Permalink Reply by Mike on June 26, 2009 at 2:44pm

There are nights every once in a blue moon when even now, I wake up having pulled the cpap mask off, and without any idea why. it was much much more common when i first started treatment though.

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Permalink Reply by Henning on November 9, 2009 at 4:49pm

I think most new CPAP machines have a built-in leak alarm which can be activated. This is often done from the medical menu. The alarm will go off if you pull your mask off when you sleep.

Some also have that problem, that they fall asleep before they get the mask on. This can be solved by putting an alarm clock to ring one hour after you have gone to bed. When you turn on your CPAP then remember to stop your alarm clock.

Henning

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Permalink Reply by Andy on November 9, 2009 at 8:01pm

Hi all,

I've been using my CPAP for about three weeks. So far, in the first week, I've woken in the morning with the mask off, neatly placed on the bedside table, and the CPAP turned off.

I don't recall doing that, but obviously I did. I don't think of this as "pulling it off" though.

More like carefully removing it!

In any case, I haven't done it since that first week, so no big thing at this point...

.

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