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[CPAP] Blocked nose and face mask, how to adjust?
#11
RE: Blocked nose and face mask, how to adjust?
I do have some suggestions for settings that may be more effective at comfortable sleep. But, first, just know that I have never switched from full face mask. When I started treatment, I had the same or similar issues with nasal blockage, nearly a constant congestion for 10+ years, sometimes breaking clear for a couple minutes on only one of the nostrils. So, I mouth breathed through the day. I was a chronic user of decongestant and antihistimine, trying to scrape a few brief minutes of comfort.

Once I started using the CPAP, and stopped choking myself, my congestion reduced greatly, and after 8 years of treatment, I generally breathe through my nose while sleeping, and even most the time during the day. I did not stop using medicine.

The way I explain the cycle of breathing while congested is that I would start out mouth breathing, and when I transitioned to sleep, my body would naturally switch to nasal breathing (or at least it would try). As soon as that happened, the lack of air flow would either prevent passage and therefore would cause long apneas or there would be enough airflow to suck phlegm into or towards my lungs leading to either coughing to clear, or at very least jolt me back awake enough to switch back to mouth breathing. Of course, the brain continued to switch back to nasal breathing the moment I sank back toward sleep. It was a vicious cycle.

Alot of my congestion went away, as apneas themselves reduced which were definitely fueling the congestion.

A real transformation occurred when I noticed that I could breathe through my nose enough stop the rattle jack awakenings, but only if I tilted my head just right so I could get some air flow through both nostrils. For me that means positioning my head about 15 degrees left of vertical face up. Surely everyone has a different best position. For me it is lying on my left side, and head cocked to the right and upward, a travel pillow to support the chin. It seems like that would not work, because head up generally leads to "tongue slides down" air blockage. Somehow it does not cause obstruction.

I wish you the best of luck as you try new things.

QAL
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#12
RE: Blocked nose and face mask, how to adjust?
setting suggestions - As sleeprider suggests, setting min pressure at 7 cmH2O, and EPR of 2 may make trasitioning to sleep easier, and staying asleep more. I would note that the most recent chart shows that you have an EPR set for Ramp-only.  This should be changed to Full Time.

QAL
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#13
RE: Blocked nose and face mask, how to adjust?
(01-04-2023, 01:26 AM)quiescence at last Wrote: Welcome. I like to review individual breaths, so that clip means a bunch to me.  There is nothing I see in it that makes me think you were asleep,  at least, not deep enough for any restorative sleep.  While awake, you use your muscles to inhale and to exhale.  When  asleep you  only use your muscles to inhale. The body just exhausts the inhaled air by equalizing pressure inside and outside.

Your assessment would be correct! Whenever I finally fall asleep, it's immediately interrupted by a ton of OA/CAs until I wake up in a panic and take several long, deep anxious breaths. Not very restful indeed :p

As for the EPR and others, you're correct, I didn't realize. I'll set it up now, thanks Smile
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#14
RE: Blocked nose and face mask, how to adjust?
Lyandra, your recent charts clearly show the pattern we associate with positional apnea (chin-tucking). Until you are able to get back to sleeping in bed, you will need to use a soft cervical collar to counter the chin-tucking an upright sleep position causes. I thought we were already clear on that and you were recently able to get back to normal sleep position.
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#15
RE: Blocked nose and face mask, how to adjust?
(01-04-2023, 09:24 AM)Sleeprider Wrote: Lyandra, your recent charts clearly show the pattern we associate with positional apnea (chin-tucking). Until you are able to get back to sleeping in bed, you will need to use a soft cervical collar to counter the chin-tucking an upright sleep position causes.  I thought we were already clear on that and you were recently able to get back to normal sleep position.

Indeed! Using a collar helped a fair bit, thanks again for that Smile
The chart posted here is from afterwards. Makes for interesting nights as you can see  Too-funny
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#16
RE: Blocked nose and face mask, how to adjust?
(01-04-2023, 04:28 AM)quiescence at last Wrote: The way I explain the cycle of breathing while congested is that I would start out mouth breathing, and when I transitioned to sleep, my body would naturally switch to nasal breathing (or at least it would try).  As soon as that happened, the lack of air flow would either prevent passage and therefore would cause long apneas or there would be enough airflow to suck phlegm into or towards my lungs leading to either coughing to clear, or at very least jolt me back awake enough to switch back to mouth breathing. Of course, the brain continued to switch back to nasal breathing the moment I sank back toward sleep.  It was a vicious cycle.

Alot of my congestion went away, as apneas themselves reduced which were definitely fueling the congestion.

A real transformation occurred when I noticed that I could breathe through my nose enough stop the rattle jack awakenings, but only if I tilted my head just right so I could get some air flow through both nostrils.  For me that means positioning my head about 15 degrees left of vertical face up.  Surely everyone has a different best position.  For me it is lying on my left side, and head cocked to the right and upward, a travel pillow to support the chin.  It seems like that would not work, because head up generally leads to "tongue slides down" air blockage.  Somehow it does not cause obstruction.

Hey QAL Smile 


What you described there ("Switch back to nose breathing vicious cycle") is EXACTLY the issue I was encountering! And... your last paragraph made me realize that before the surgery, I was indeed sleeping like that: on the left side, with my arm below the pillow, propping my head up ~15 degrees. 

I would have gone back to this position, but I saw both my ENT and surgeon, who both recommended against sleeping on the side, and against resuming CPAP for now. The reasons are first the blocked nose, but also the fact that a piece of bone was removed from my skull (frontal sinus), and put back in place with titanium screws. Both agree applying constant pressure may hold some risk, until the bone is settled, so I'll stop my experiments for now.

However, thanks a lot for your mention of the 15 degrees thing! While it didn't make my nights amazing, it stopped me from waking up in a panic every 2 minutes. Nights are short and unrestful, but at least I sleep 4-5 hours a night, which is more than the previous 30 minutes I had. So I'm really REALLY thankful for that Big Grin

I have a facial scanner next month to see if the bone is properly settled, we'll see there & then if I can resume CPAP use. Once that's done I'm sure we'll have a lot of cool data to look at Big Grin
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