Post Reply 
Any advice?
Author Message
scubadown Offline

Members

Posts: 11
Joined: Mar 2014

Machine: ResMed S9 AutoSet
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: H5i
CPAP Pressure: auto
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Merritt Island, FL

Post: #1
Any advice?
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
(This post was last modified: 03-11-2014 06:01 AM by scubadown.)
03-11-2014 06:00 AM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
trish6hundred Offline

Advisory Members

Posts: 6,449
Joined: May 2012

Machine: Resmed S9 AutoSet for Her
Mask Type: Full face mask
Mask Make & Model: Fisher & Paykel Simplus
Humidifier: H5i Heated Humidifier
CPAP Pressure: 10 - 7-20 Cm H2O
CPAP Software: Not using software

Other Comments: I started CPAP in 2008. Totally blind since birth.

Sex: Female
Location: Missouri, USA

Post: #2
RE: Any advice?
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
03-11-2014 06:09 AM
Find all posts by this user Post Reply Quote this message in a reply
JimZZZ Offline

Advisory Members

Posts: 370
Joined: Dec 2013

Machine: ResMed S9 AutoSet
Mask Type: Full face mask
Mask Make & Model: Fisher & Paykel Simplus
Humidifier: ResMed H5i (not using)
CPAP Pressure: 9 - 14
CPAP Software: ResScan SleepyHead

Other Comments: CareFusion PureSom Ultra Chinstrap

Sex: Male
Location: Western North Carolina

Post: #3
RE: Any advice?
(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.
03-11-2014 06:21 AM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
scubadown Offline

Members

Posts: 11
Joined: Mar 2014

Machine: ResMed S9 AutoSet
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: H5i
CPAP Pressure: auto
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Merritt Island, FL

Post: #4
RE: Any advice?
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?
(This post was last modified: 03-11-2014 06:50 AM by scubadown.)
03-11-2014 06:50 AM
Find all posts by this user Post Reply Quote this message in a reply
robysue Online
Wiki Editor
Advisory Members

Posts: 1,233
Joined: Oct 2013

Machine: PR Dreamstation BiPAP Auto
Mask Type: Nasal pillows
Mask Make & Model: Swift FX
Humidifier: PR Dreamstation humidfier
CPAP Pressure: min EPAP = 4; max IPAP = 9;
CPAP Software: SleepyHead EncoreBasic EncorePro

Other Comments: Papping since September 2010

Sex: Female
Location: Buffalo, NY

Post: #5
RE: Any advice?
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.
03-11-2014 08:30 AM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
justMongo Offline

Monitors

Posts: 3,853
Joined: Sep 2013

Machine: ResMed VPAP Auto (S9)
Mask Type: Full face mask
Mask Make & Model: ResMed Mirage Quattro
Humidifier: ResMed H5i
CPAP Pressure: 18 IPAPmax - 11 EPAPmin, PS=5
CPAP Software: Other Software

Other Comments: μολὼν λαβέ

Sex: Male
Location: Калифорния

Post: #6
RE: Any advice?
@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.

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
03-11-2014 08:41 AM
Find all posts by this user Post Reply Quote this message in a reply
drgrimes Offline

Preferred Members-2

Posts: 235
Joined: Sep 2013

Machine: S9 Resmed Autoset
Mask Type: Nasal pillows
Mask Make & Model: Philips Dreamwear
Humidifier: resmed
CPAP Pressure: 5-15
CPAP Software: ResScan

Other Comments:

Sex: Male
Location: Texas

Post: #7
RE: Any advice?
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.
(This post was last modified: 03-11-2014 09:09 AM by drgrimes.)
03-11-2014 09:07 AM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
herbm Offline

Preferred Members-2

Posts: 852
Joined: Jan 2014

Machine: ResMed AutoSet S9
Mask Type: Oral
Mask Make & Model: ResMed Airfit P10 Nasal Pillow
Humidifier: ResMed H5i
CPAP Pressure: 11-16
CPAP Software: ResScan SleepyHead

Other Comments: Backup Mask: Innomed Hybrid FFM -- Oral+Nasal Pillows

Sex: Male
Location: Austin, TX

Post: #8
RE: Any advice?
"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."
03-11-2014 09:33 AM
Find all posts by this user Post Reply Quote this message in a reply
scubadown Offline

Members

Posts: 11
Joined: Mar 2014

Machine: ResMed S9 AutoSet
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: H5i
CPAP Pressure: auto
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Merritt Island, FL

Post: #9
RE: Any advice?
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.
03-11-2014 03:39 PM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
herbm Offline

Preferred Members-2

Posts: 852
Joined: Jan 2014

Machine: ResMed AutoSet S9
Mask Type: Oral
Mask Make & Model: ResMed Airfit P10 Nasal Pillow
Humidifier: ResMed H5i
CPAP Pressure: 11-16
CPAP Software: ResScan SleepyHead

Other Comments: Backup Mask: Innomed Hybrid FFM -- Oral+Nasal Pillows

Sex: Male
Location: Austin, TX

Post: #10
RE: Any advice?
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."
03-11-2014 03:45 PM
Find all posts by this user Post Reply Quote this message in a reply
Post Reply 


Possibly Related Threads...
Thread: Author Replies: Views: Last Post
  Newbie - need advice on settings and machine tmc712 18 364 Yesterday 09:04 PM
Last Post: tmc712
  Need full face mask advice Bob32256 12 654 Yesterday 04:37 PM
Last Post: Zippo
  advice for diagnosis steps to take odoyle 14 540 12-05-2016 08:44 PM
Last Post: Sleeprider
  [Equipment] Advice on transitioning from pillows to FFM? Strat0caster 8 236 12-02-2016 10:58 PM
Last Post: PaulaO2
  ADVICE ON THIS DATA Gazz 3 259 11-21-2016 11:13 AM
Last Post: OpalRose
  new user wants advice Gazz 3 235 11-19-2016 11:06 AM
Last Post: trish6hundred
  Advice needed for struggling CPAP user Fubblin 35 1,980 11-18-2016 07:18 PM
Last Post: Sleeprider

Forum Jump:

Who's Online (Complete List)