[CPAP] Need help - I'm getting even less sleep using CPAP than when I don't

[CjakApnea]

Thank you for that link, I have attached the new screenshot to this post.

OpalRose- I believe you may have gotten yourself into a “habit” of taking the mask off when you wake up.

As for that, I am not fully conscious when I wake up and do it most of the time. Occasionally I will even find that I have taken it half off and wake up to it blowing air out while laying on my pillow. I will try to figure out a way to keep it on.

[Sleeprider]

Cjak, according to your chart (good job), you are using 10 to 15 cm pressure with EPR 3 on your Resmed Airsense 10 Autoset. Based on the graph, you are using ramp from a pressure of 4.0 and reach therapeutic pressure after 10-15 minutes. During this ramp period your breathing appears erratic with some hypopnea or obstructive apnea. At about 01:03 you reach therapeutic pressure and breathing stabilizes. You have several apnea at 01:26 and the machine increases pressure to 14 cm. The apnea episode ends and your breathing appears normal to the end of the session 1:15 total time.

Your settings seem fine however you should disable ramp or increase the minimum pressure to what you can tolerate. The apnea events may have been positional, and may be relieved with a soft cervical collar or more pressure. Given the short time of the sample, I wouldn't recommend any changes other than ramp for now. Your biggest challenge is to break the habit of removing the mask in your sleep, and you may need to find a way to make it difficult to remove without waking up. Looks good, and you should feel a lot better when you sleep longer. The instability of your breathing during ramp serves as a reminder of what your breathing would be like without CPAP...you need this.

[OpalRose]

There have been many folk here that remove their mask without realizing it.  I’ve never experienced taking my mask off, so hopefully others will chime in with some advice on overcoming that.

I only mentioned habit, because that’s what it becomes if it’s repeated often enough.  When I first started, I would wake up around the same time every night.  So I would get up for a couple hours before trying to sleep again.  After awhile, I had started something that was hard to break.  Now, if I wake up, I just roll over and usually fall asleep pretty quickly.

I don’t see anything major going on with your therapy, but something is causing you to feel uncomfortable enough to remove your mask.  How does your mask fit?    

It could also be you need a slightly higher minimum pressure, but can’t really tell with looking at 1 hours sleep.  You could try turning the EPR down to 2.  Also turn ramp off.

If you can manage to get a longer stretch of sleep, post another chart.

[CjakApnea]

Cjak, according to your chart (good job), you are using 10 to 15 cm pressure with EPR 3 on your Resmed Airsense 10 Autoset.  Based on the graph, you are using ramp from a pressure of 4.0 and reach therapeutic pressure after 10-15 minutes. During this ramp period your breathing appears erratic with some hypopnea or obstructive apnea. At about 01:03 you reach therapeutic pressure and breathing stabilizes.  You have several apnea at 01:26 and the machine increases pressure to 14 cm.  The apnea episode ends and your breathing appears normal to the end of the session 1:15 total time.

Your settings seem fine however you should disable ramp or increase the minimum pressure to what you can tolerate.  The apnea events may have been positional, and may be relieved with a soft cervical collar or more pressure.  Given the short time of the sample, I wouldn't recommend any changes other than ramp for now.  Your biggest challenge is to break the habit of removing the mask in your sleep, and you may need to find a way to make it difficult to remove without waking up.  Looks good, and you should feel a lot better when you sleep longer.  The instability of your breathing during ramp serves as  a reminder of what your breathing would be like without CPAP...you need this.

I think the first 10-15 minute sporadic breathing is me actually falling asleep, rolling over, etc. I will turn off the ramp setting tonight and see how it does. I've always had an issue with the pressure being very low at the start so it's a little awkward falling asleep, but I've gotten used to falling asleep with it.

There have been many folk here that remove their mask without realizing it.  I’ve never experienced taking my mask off, so hopefully others will chime in with some advice on overcoming that.

I only mentioned habit, because that’s what it becomes if it’s repeated often enough.  When I first started, I would wake up around the same time every night.  So I would get up for a couple hours before trying to sleep again.  After awhile, I had started something that was hard to break.  Now, if I wake up, I just roll over and usually fall asleep pretty quickly.

I don’t see anything major going on with your therapy, but something is causing you to feel uncomfortable enough to remove your mask.  How does your mask fit?    

It could also be you need a slightly higher minimum pressure, but can’t really tell with looking at 1 hours sleep.  You could try turning the EPR down to 2.  Also turn ramp off.

If you can manage to get a longer stretch of sleep, post another chart.

I've tried both the nasal and the nasal pillows, I prefer the nasal mask. However since I guess I have an oddly sized nose(?), the medium is too small, and the large is just slightly too large. The medium makes it so that if it moves at all during the night, my nostrils are pretty much touching the plastic part of the mask, making it a lot harder to breath even when I'm awake. The large fits alright, but a few times I've woken up to the air coming out of the top right below my eye, so it's literally just a constant stream of air hitting me in the eye.

I'm currently wearing the large but have tightened it slightly so that the air doesn't leak out. It doesn't cause me pain, I have little leakage, and I don't have red marks on my nose, so I think the large is what I should be using, I may just have to mess with the straps it just a bit.

I'll turn off the ramp setting if it's still enabled tonight and post the results tomorrow. Thank you both!

[groggygirl]

Although I never took the mask off in my sleep, the first month or so I just HAD to take it off when I woke up after 90 minutes or so. I can't explain it either but I simply could not make myself keep it on. I wasn't seeing any subjective improvement in sleep quality either. I finally just quit using the APAP at all for a couple of months. When I restarted, I also started coming here more frequently. Something that helped me with the nasal pillows was when someone told me I probably had them on too tight, and they shouldn't be so tight they were forced into the nostrils, just tight enough to slip into the nostril. It took me a while to get there, and I still have to manually adjust them most nights, but it did eventually make a difference in my sleep duration. Someone (probably Sleeprider) gave me a link to a page on mask/pillow use, which of course I have misplaced - maybe someone who knows it can share the link so you can read it. It's been 9 months now, my duration has improved slowly but not my sleep quality, so I'm back looking for more advice.

[CjakApnea]

Hello again,

I turned ramp completely off last night, but still got little sleep with it. I did wake up once last night, but I rolled over and managed to fall back asleep. But then sometime after I took it off unconsciously while asleep. I had a lot of leaking last night for some reason, I will tighten the straps some more tonight and see if that reduces the leaking at least.

[mesenteria]

The leaks, by themselves, may be sufficiently intrusive that you partially awaken and remove your mask, just like we scratch ourselves without really awakening.  But the leaks also can affect how well we are treated while wearing the mask, and if it's a generally poor experience it's no wonder you have little benefit so far.

You may be on a journey of mask discovery, pressure settings tweaking, and in finding ways to ensure you don't inadvertently remove your mask during the night.

[Sleeprider]

It's possible the leaks are from your mouth rather than your mask. Over-tightening straps should not be needed I think you would benefit from a soft cervical collar to prevent the clusters of obstructive apnea, and to help put a little pressure on your jaw and prevent mouth leaks. Many members have found this solution both comfortable and effective, and it might help you to keep the mask on. There are many threads on the forum concerning selection and use of a soft collar or wedge.

[CjakApnea]

The leaks, by themselves, may be sufficiently intrusive that you partially awaken and remove your mask, just like we scratch ourselves without really awakening.  But the leaks also can affect how well we are treated while wearing the mask, and if it's a generally poor experience it's no wonder you have little benefit so far.

You may be on a journey of mask discovery, pressure settings tweaking, and in finding ways to ensure you don't inadvertently remove your mask during the night.

I can't get another mask for a few more weeks due to my insurance. One new mask every 3 months is what they will pay for. Right now I'm using the Nasal, but have also used the Pillows. According to the Myair.Resmed website that tracks my stats, I don't usually leak that much. Most previous nights I have minimal to zero leakage. I did notice last night that my pressure has been increased (I had talked to my doctor about it and he said he would look it over and see what he could do), from 10-15 to 13-16, so it's possible that I just had it too loose for the 16 but tight enough for the 15.

It's possible the leaks are from your mouth rather than your mask. Over-tightening straps should not be needed I think you would benefit from a soft cervical collar to prevent the clusters of obstructive apnea, and to help put a little pressure on your jaw and prevent mouth leaks. Many members have found this solution both comfortable and effective, and it might help you to keep the mask on. There are many threads on the forum concerning selection and use of a soft collar or wedge.

I have been wearing an anti-snore chin strap, it wraps around my head and under my chin to prevent my mouth from opening.

[CjakApnea]

Hello again,

I have been wearing the mask every night this week so far (Monday - Thursday night) and have had the same issue as usual, where I would take it off in the middle of the night. Attached are my charts from the past 4 nights.

I've been swapping different things up to try to get it to stay on or be more comfortable, here is what I've changed-

• Monday night- Nasal mask, Ramp On
  

• Tuesday night- Nasal Mask with Chin strap. Starting tonight, my Doctor increased my pressure from 10-15 to 13-16. Ramp Off.
  

• Wednesday night- Nasal Pillows, Ramp Off.
  

• Thursday night- Nasal Pillows with anti-snore chin strap, Ramp Off. The big gap is me taking it off, and then putting it back on shortly after. 
  

It's probably also important to note that I don't remember waking up at all BEFORE I take the mask off on any of the days. So it's keeping me asleep, and it's obviously helping with my sleep apnea looking at the graph. Then there is something that is waking me up randomly, enough that I know that I am waking up and enough that it is making me take the mask off unconsciously. 

I'm starting to get worried that I've just gotten into the habit of taking it off when I wake up, even though it's not intentional.

Any suggestions or things that you notice would be appreciated!