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(09-04-2014, 04:19 AM)Popriv Wrote: I can't make it through the nite without taking the full mask off.
Sometimes I wake, it seems like a lot of pressure. Mouth is blown open like I have my head stuck out the car window with my mouth open and the mask is leaking. I end up taking mask off. ???

Use SleepyHead to figure out what pressure the machine is at when you feel like you have too much pressure.

Usually leaving the pressure range at 4-20 is the wrong choice. You may feel like you're suffocating at 4. After you fall asleep, it takes a while for the pressure to adjust upward enough to treat your apnea. As the pressure increases, you get uncomfortable because of the change. When you fit your mask at 4 cmH2O, it may leak when the pressure goes up.

Hopefully, your doctor will be adjusting your pressure settings, but you might have to do it yourself.

Tell yourself you're not going to take the mask off and go back to sleep. Turn the machine off and back on, and the pressure should drop back down for a while. If you have to take it off, get out of bed, then take the mask off and go into the other room until you are ready to face it again.

If necessary, you can reduce the maximum pressure setting of the auto CPAP. Don't do this willy nilly, though. If you reduce it below the level you need, you can screw up your therapy.

Re: Mouth breathing

It's better to breathe through the nose for several reasons. Treating your apnea may help you be less of a mouth breather. The chin strap may help. You can still open your mouth even with a chin strap (try it), but it makes you less likely to open the mouth.

When you go to bed, try deliberately closing your mouth. Then press your tongue against the roof of your mouth, and against the back of your front teeth. The proper way to keep air from leaking out of your mouth is to seal off the back of your mouth with your tongue. There should be no air pressure in your cheeks or on your lips. Easy to describe, hard to do in your sleep.

I make my own chin strap from a 3 inch non-adhesive Ace bandage. I loop it around my head 3 times and pin the ends together with safety pins. It's cheap and easy to try. It's somewhat springy, which may make it more comfortable, but may also make it less effective for some people.
Get the free SleepyHead software here.
Useful links.
Click here for information on the main alternative to CPAP.
If it's midnight and a DME tells you it's dark outside, go and check it yourself.
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(09-04-2014, 05:53 PM)retired_guy Wrote: Hi Steve,

I see your min/max pressure is set at 4 and 20. I also see your average pressure comes in around 11?

I believe that the default min/max's of 4 and 20 do a disservice to the patient. Generally it is done when a more specific range has not been established. But when things get goofy, the machine can dial it up to 20 which will cause you to think you just walked into a tornado, or down to 4 which will cause you to think you inadvertently went to bed with a plastic bag over your head.

What I would suggest you explore with your doc is setting the minimum pressure to something like 8, and the maximum to something like 14. Then run for awhile and see how your results look. Or, another nice thing to do is set the minimum to 10 and turn the EPR on with a value of 2. In theory that results in the same minimum pressure but I have noticed that it might tend to calm the waters a bit, particularly with the flow-limits.

Now, about that mouth breathing cause the nose doesn't work well thing? Yeah, me too. I was the poster child for "can't breath through my nose." I have a cabinet full of full face masks to help prove that I can't breath through my nose. Then I got a Resmed P10 pillows system, and by golly guess what? I can breath through my nose. As a matter of fact the air pressure keeps my airway open extremely well. As a matter of fact I find I even continue to breath through the nose thru-out the day. Who woulda thought? Well, ok, but I have to go back to the face mask when/if I have a sinus issue, or cold? Not even. Hasn't happened. If anything the pillows mask help me to defeat a coming sinus issue.

I do use a chinstrap to help encourage my mouth to stay shut. My wife would do that but she's usually asleep too. She does her best to help me keep my mouth shut during the day. But that's another story.

My hubby used a nose mask from 2003 (when he started with a CPAP) until 2 weeks ago when he switched to nasal pillows. He is VERY happy with them as he noted they help keep the nostrils open and even helps with his deviated septum.

I am currently waiting for MY CPAP and using his old CPAP and brand new nose mask while I am not-very-patiently waiting.
Evpraxia in the Pacific Northwest USA
Diagnosed: 44 AHI when supine, O2 down to 82%
Treated since 20 Sept 2014:: 0.7 AHI, Settings 7-15, EPR on Full Time at Level 3
Better living through CPAP/APAP machines!
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You are experiencing a lot of what I did.
I started this in April I think it was, of this year.

A lot of people, I believe, on this or other sleep apnea boards have completely forgotten how confusing it is for newbies and attempt to write short posts but they don't always fully sink in for us.
What might seem as common sense to old timers at this, to newbies, doesn't always make sense, especially since the 1-2 people making sense, get a bit frustrated if it doesn't seem you grasp it all quickly but they forget that you are also getting a lot of input from some people who perhaps should not be offering advice, beyond their own experiences, and that can really confuse you until one night it all clicks and you finally realize what it is YOU need to do to make it work. Until that point, you are so tired and so confused from so many different opinions you become overwhelmed from it all and no longer know WHERE to start .......at which point some people just give up. Especially if they are afraid of feeling that they are bothering people with their questions. I know this as several have come to me my PM to ask......so if you are overwhelmed, it happens to most of us......its common.

At least many do. Cant speak for you.

However, you say your doctor suggested your AHI was 60? You weren't sure.
Mine was about 57 and at that type of number, rather than lets say, a 6, we both have severe sleep apnea, if that 60 is the correct number you were given.

When I first began and wasn't yet getting it right, my AHIs were anywhere from 45-60 and at that rate, i appeared to stop breathing almost every 45 seconds for 10 seconds. Then I might have an hour or two of no apneas but then at some point i would go back to them each 45 seconds to every 1.5 minutes or so....I was shocked at how frequently I did this.

In my case i never felt tired though. I wasn't sent for a test due to being tired but for dental reasons so I couldn't understand why I had sleep apnea if i wasn't tired?
Now I have it figured out for the most part, I do feel better rested than I did before when I accepted I was fine. I guess it was so gradual the decline of restful sleep I had not noticed I was tired.

You mention late night TV etc....One thing I have noticed for like yourself, I would still be watching TV until 2am, my fave being WALKING DEAD or something else that wound me up..........and smoking ( gave that up 4 months ago and now only Vape) but I have found since getting the hang of this, ITS A MUST to get to bed by 11, TV off in the bedroom and at the most I might read a few pages on my phone via the Kindle App and then I am off to sleep or I conk out within seconds of putting my mask on and head on the pillow and I am out like a light.

IF I stay up late, doing what i was doing before, even though in the end I am still getting the same hours of sleep but just waking up a few hours earlier now, going to bed at 11 than I did at 2pm, I feel 100% more refreshed for having done so.
This is where the talk of sleep hygiene is very important I believe.

I used to rush to bed at 2am, brushing my teeth before i went which always woke me up again, I now make sure I do a final teeth brushing by 9 and i try not to drink anything after that point but if I must, I just reach for a small bottle of spring water and thats it.....otherwise you will likely wake up at least once in the night for washroom duty but go back to bed right after, OR WORSE you get through the night but wake up about 2 hours earlier than you should have with a raging need to go to the bathroom to urinate and because you are only 2 hours off, you then don't go back to bed but stay up, albeit a bit tired and over time you become tired that way...

I didn't catch which mask you were using but if a mouth breather, at least in the beginning, Id suggest a face mask. Unfortunately when I first began, someone here advised me NOT to use a face mask and actually suggested she felt the DMEs were too quick to give face masks for mouth breathers. Unfortunately I listened to her but then went through 2 months of sleeping hell with high APIs until i finally had my results explained to me properly and from someone I trust on this board, was directed back to a face mask and from that moment on it all worked perfectly.............but i did add nasal rinse once a day ( usually after dinner ) with that salt stuff........NEILMED SINUS RINSE as I kept taking my mask off every night and then falling asleep for 4-5 hours without the mask..........from the first night i used it, I stopped taking off my mask.

You are getting stuffed up in your nose as I was and when it happens in your sleep, its natural to reach and take your mask off, especially made worse if you are using a nasal mask........but if you are wearing a face mask, its easier for you can breathe through your mouth but still be compliant. Not if its a nasal mask.
So if you are wearing anything but a full face mask, I suspect that is half the reason why you are taking it off at night.

The other half? IF you are wearing a full face mask and still taking if off, I would too IF I WERENT using the sinus rinse at night.......actually, last night, having not used it 2 nights in a row, trying to see if i could now get away with not using it, I too took off my mask for 4 hours, the first time i have done that since May 28th when I started using a full face mask and nasal rinse.

Hope some of that might help you.
Good luck
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This post resonates really well with my own early experiences with CPAP. Stick with it Popriv. You are not alone in how you are thinking at the moment.
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