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Any advice?
#1
So on the forth night. I am using a full faced mask. I have slept terrible the last few night, fighting the mask and all. I downloaded SleepyHead last night to see if I could figure out why I feel so unrested. I felt way better before using the CPAP.

My reading from last night are: AHI 5.95, Hypopnea 2.14, Apnea 0, Obstructive 2.86, Clear Airway .95.
Pressure was as high as 19 with Med being 10.5 and 95% of 16.84.

About 3AM I took the mask off as it was blowing so hard I couldn't keep it from leaking around the edges, even with tightening the straps.

Maybe I should try using a different type of mask? Sad
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#2
Hi scubadown,
WELCOME! to the forum.!
The mask is the hardest part of this therapy so You might try a different mask.
Full-face masks, (FFMs,) can be proned to leaking.
Hang in there for more suggestions and best of luck to you with your CPAP therapy.
trish6hundred
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#3
(03-11-2014, 06:00 AM)scubadown Wrote: Maybe I should try using a different type of mask? Sad
I tried four masks before I found one that fit my face and eased my claustrophobic anxiety. So...don't be discouraged if it takes a few trials before you and your mask are happy together. Perhaps a detailed account of where the leaks are could help your DME or the more experienced members of this forum in suggesting a solution.

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#4
It seems the worst leaks are around my nose. It also seems the full face mask pushes back on my jaw, further restricting my airway. It may just be my hyper imagination while I'm tossing and turning.

On another note, can some one direct me to the definition of Clear Airway as noted on the Sleephead program?
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#5
Clear airway apneas are apneas where the machine's CA detection algorithm has determined that the airway is likely clear, or unblocked, even though there is no airflow detected going into or out of the lungs.

A few CAs now and then are pretty normal: On a sleep study, centrals that occur as part of the transition to sleep may not even be scored as real events. With a CAI = .95, you don't need to worry about them.

As to why you're feeling worse with PAP than you did before: There's a pretty steep learning curve for some of us when we start PAP. After all, sleeping with a six foot hose attached to your face and a mask on is not exactly normal. Add in the fact that you're fighting leaks and a mask that doesn't seem to be working, and you're bound to be getting sleep disruption.

It takes most people a couple of weeks to a couple of months to sort everything out and start sleeping well with the mask. It then takes most people a few more weeks to a few more months after learning to sleep reasonably well with the mask to start to feeling better in terms of daytime symptoms. So be patient and keep working on things.

As for the mask: You might want to swap the current one for a different one. The fact that you're feeling like the mask is putting too much pressure on your jaw is a good indicator that this is NOT the mask for you. Unless you know for a fact that you are a mouth breather, you might want to try a nasal mask since they are easier to seal for most people. You might also want to look into using mask liners since they can also help some people.

You can make yourself a temporary mask liner if you want: Take an old, worn out T-shirt and place the mask cushion on the shirt. Cut out a piece of fabric a bit bigger than the mask cushion. Then cut out an opening in the middle that is big enough to poke your nose through (and leave your mouth uncovered if you're using a FFM). Place the liner between the mask cushion and your face when using the mask.
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#6
@scubadown: The mask in my profile has an adjustment on the nose bridge. If I feel a leak near the bridge of my nose, I turn a dial to move the top of the mask cushion closer to the bridge of my nose. Everyone is different in what mask will make them comfortable. Getting comfortable is part of the process to successful, continued therapy.

Keep working on it 'til you find what works for you. Live long and prosper.
This Veteran is medicated for your protection.
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#7
Hey SCUBA, you are doing pretty well with an AHI of 5.9. The goal is have something less than 5 and you are very close.

Full face masks are necessary for some folks, but if there is any way you can use nasal pillows or nasal mask, your leakage will be significantly easier to control. Get with your DME and try one. Many, including myself, initially have mouth breathing problems. If you can get your nose clear, and mouth closed, the nasal pillows are wonderful.

I use a combination of saline rinse and RX nose spray to get myself open. Then I use a chin pad to keep my mouth closed, and with all this working properly my nasal pillows just work. I had hell for the first few months, but now my AHI is always less than 1.0. Don't get me wrong, I still have the occasional night from hell and just take the damn thing off for the rest of the night.

Here's a nice thing, since using CPAP for a while, when I take the mask off in the middle of the night, I breathe the rest of the night snore free.
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#8
"slept terrible the last few night, fighting the mask and all. I downloaded SleepyHead last night to see if I could figure out why I feel so unrested."

You feel terrible because of that "fighting the mask and all". What is the "and all"?

Is this leaks? Or are leaks just part of fighting the mask?

You are doing really well, as you have your AHI down and you ARE wearing the mask and doing the therapy. That puts you miles ahead of many people.

What everyone else said about finding a new mask is likely good advice (and I love recommending the Airfit P10 to those who can breath through nose alone), but first let's talk about the leaks.

FWIW: I have a seen polls on other forums that suggest people try about 7 or 8 masks before "finding the one" and "getting really good therapy".

Is it leaking when you put it on? Can you tell where it is leaking and fit it to your face with HAND PRESSURE, then get the straps to simulate that EXACT pressure (and result)?

Have you looked at any videos of fitting your mask on YouTube etc? (Search for videos on your mask and DO THAT.)

Have you re-read the manual on how to fit your mask? Most of us get them on at first, with or without the manual, and then forget the manual has specific instructions....

Those instructions in the manual MAY be worthless but at least go back and read them again to make sure there are no hints you missed before you became familiar with the alien on your face.

What is your mask? If you post that (and add to your profile) there might be someone here who "knows the tricks" for that mask.

So re-read the actual instructions, watch the videos, and try it when AWAKE and you don't mind focusing on the "procedure and technique". That way you aren't tired and impatient to get to sleep at the same time.

Also try to figure out if you problems with leaks are only or mostly at the higher pressures.

Is your machine wide open or nearly so? Your median is 10.5 while you 95% is 16.85 so that means you were above 16.85 some of the time too.

Post your SleepyHead charts so we all can compare, pressure, AHI, and leaks.

Also, what's your range AND EPR?

You may need your top pressure reduced just to keep your machine from going nuts when you don't need more pressure, or you may need your bottom pressure increased to just get STARTED near your real pressure so you can better fit the mask before sleeping. Or you may need something else.

Finally, try to determine if your mask fit is the MAIN problem, or are YOU disturbing the mask either by fiddling with it or by the way you sleep (on your pillow etc.)?

For myself, I found that once I got a mask correct, it was best to LEAVE IT ALONE, but at other times or once the leaks started then there was nothing to do but get up, turn off the machine, go to the mirror and reset the darn thing.

BTW, I really believe in the practice of "don't take off the mask" but rather GO REFIT IT and come back to bed, turn it one, test it, and THEN go back to sleep.

If you need to go to bed earlier to get enough sleep for that, then do so.

It is much more efficient to "get it right" early on and just do it, than to spend weeks almost getting it right and pulling off the mask -- that trains your unconscious to believe it can get rid of the mask.

However, the mask you have may not ever really work for you so be prepared to find another.
Sweet Dreams,

HerbM
Sleep study AHI: 49 RDI: 60 -- APAP 10-11 w/AHI: 1.5 avg for 7-days (up due likely to hip replacement recovery)

"We can all breathe together or we will all suffocate alone."
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#9
Thanks for all the suggestions and advise. I updated my profile and my mask is a Fisher & Paykel Simplus. The directions are are pretty basic and not of much value.

Can some one point me in the right direction to find the guideline values or goals for the different terms in Sleepyhead such as Hypopnea, Apnea, Obstructive, Clear Airway, Leaks, etc? For instance, last night my "leaks" 95% = 13.2 and Max was 20.4, but I have no idea what that means.

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#10
Here you go, this is both general to CPAP and Specific to SleepyHead, written by the person who wrote (most of) the HELP for SleepyHead:

Check this glossary for definitions
http://sourceforge.net/apps/mediawiki/sl...r_Glossary



[link to DME-owned website removed per Apnea Board rules]
Sweet Dreams,

HerbM
Sleep study AHI: 49 RDI: 60 -- APAP 10-11 w/AHI: 1.5 avg for 7-days (up due likely to hip replacement recovery)

"We can all breathe together or we will all suffocate alone."
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