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[CPAP] OSCAR confusing me with leaks/apneas
#21
RE: OSCAR confusing me with leaks/apneas
Thanks, I guess I will post a detailed analysis of what has been making therapy difficult.

Questions are underlined.

Mask Wise
  1. Blisters have formed on the bottom edges of my nostrils, a large one forming on the left side of the septum. They're present in both nostrils, moreso on the left side. I believe that the nasal pillows are too small for my nose and I need to get larger ones.
  2. The pain from the blisters makes it difficult to sleep, eventually, I manage to ignore it and I will oftentimes wake up in the morning with more soreness. I started applying Lanolin to address this. Is it possible that I am tucking in response to pain?
  3. Upon extension of my neck upwards, the TOP of the pillows start to leak and when I notice this I notice that I subconsciously put my neck downwards in response. I imagine this could also be playing a part in the issue?
I wasn't able to find much in the mask primer on nasal pillows, only found out about the nasal pillow size issue through digging through the forum.

Some of the clusters occur whenever my mask is leaking excessively, however, I imagine that pain or mask tightness could still cause the same type of positional response?

[Image: 5bf42db49e1617e5a7f87c314eee2e28.png][Image: 3c3e9ea4802ed76c727e0574eabad393.png]


Collar-Wise
  1. I purchased the 3M Futuro Neck Collar at a pharmacy in response to being informed about positional issues, however, after my first night, the side of my neck that I slept opposite of (right side with left neck pain) was in a lot of pain. I assume this is because of my pillow being too low or high?
  2. The distance between my throat and my chin is 2 inches, this collar is only one inch thick, would that still stop me from tucking my chin? I don't have any issues whilst awake tucking my chin it seems, there's some minor resistance but it's hardly noticeable. Sometimes I worry that I'm tucking subconsciously because I can't tell if I'm getting any resistance or not.
  3. The collar doesn't seem to stop me from pulling my neck forward as I often do while awake, I assume this would probably contribute to positional apnea?
Is collar thickness important? Is it supposed to support my entire jaw or? I couldn't find much on the Wiki regarding it.
Do they even make thicker collars?

Position-Wise & Next Steps
  1. Neck-tucking is the commonly cited issue for positional apnea, yet are there other types of positional apnea I should be aware of?
  2. I've always had a habit of tucking my chin, I could only imagine that I will do it subconsciously in my sleep?
  3. If the collars fail, what other options are there to keep my airway straight and open?
  4. Should I get a new mask and/or collar?
---

Most of my apnea issues are from these positional clusters that are cited, and I keep waking up every day feeling like the CPAP has done nothing. I'm fatigued, foggy beyond belief, and my short-term memory is essentially non-existent. I feel terrible and I've been fighting these symptoms for years, most of the time unknowingly. I don't even know/remember what it feels like to NOT be tired.

It's just very frustrating that you solve one problem (initially I was diagnosed with UARS) seemingly and you have another one come up.

---

Attached is last night's sleep log, not any different than the last few nights on the collar; clusters, and nothing more. I'm extremely thankful for all the help I've gotten so far, but I guess my case is beyond conventional and I just need more and more help regarding it.


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#22
RE: OSCAR confusing me with leaks/apneas
My story so you can see where I fell off the path...

I used a Wisp mask for quite a while. I got a sore that I ignored. I eventually got it cut off...not fun.

Suggest you get another type of mask
DaveL
Compliant for over 30 years

I'm just a cpap user like you. I don't give medical advice. I hope to learn from you, and share my experiences with you. 
Seek the advice of a physician before seeking treatment for medical conditions including sleep apnea. Sleep-well

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#23
RE: OSCAR confusing me with leaks/apneas
I got a DreamWear Nasal Mask at my DME that was a free sample. I go to this DME because a personal friend started working there, so this might be some inside info -- she told me that the phillips sales rep drops off a box of samples every month because they want to encourage people to try the mask. She refers to it as a "bar style" in that unlike pillows it doesn't go in your nose.

So start with your DME and tell them your problem -- that you need to try a different style of mask because the one you have doesn't work, and specifically ask them if they have any manufacturer's samples. If they can't help you, it might be worthwhile to circle around to various DMEs in your neck of the woods -- if you find one willing to help you this might be a way to find a new DME that you like!
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#24
RE: OSCAR confusing me with leaks/apneas
(04-30-2021, 02:24 PM)cathyf Wrote: I got a DreamWear Nasal Mask at my DME that was a free sample. I go to this DME because a personal friend started working there, so this might be some inside info -- she told me that the phillips sales rep drops off a box of samples every month because they want to encourage people to try the mask. She refers to it as a "bar style" in that unlike pillows it doesn't go in your nose.

So start with your DME and tell them your problem -- that you need to try a different style of mask because the one you have doesn't work, and specifically ask them if they have any manufacturer's samples. If they can't help you, it might be worthwhile to circle around to various DMEs in your neck of the woods -- if you find one willing to help you this might be a way to find a new DME that you like!

I just went out and bought a N20, so hopefully, that would also do the trick? No idea how the nasal masks work, I hope there isn't a certain pressure requirement.

If the N20 proves to be fruitless, I will try the DreamWear Nasal Mask. Beating myself up for not looking into that because that's actually a much better than getting a nasal mask I'd imagine...

Unfortunately, I don't have a specific DME but I believe the one I bought the N20 from is going to become my regular DME. I don't have insurance coverage for this (long story involving another DME lying to my insurance company) so I will have to pay another $100 if I want to try the DreamWear Nasal Mask.

Hopefully changing the mask will help... I'm going to set up a camera with a timestamp and see what position I am moving into that's causing positionals...
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#25
RE: OSCAR confusing me with leaks/apneas
I'm glad you have a new mask.

The N20 box has a fit gauge in it. You hold it under your nose and it tells you what size insert you need.

I have a big head....first one I got was a Large. It apparently only comes with a Large insert. When I finally checked with the gauge I bought a Medium insert.


I use my N20 with a Knightsbridge Dual Strap chin strap. Most of the time. That's because I mouth breath. I don't wear a Full Face Mask because of leaks and claustrophobia.


the N20 has magnetic clips on the bottom straps. Careful if you have a pacemaker. Just saying, just in case.
DaveL
Compliant for over 30 years

I'm just a cpap user like you. I don't give medical advice. I hope to learn from you, and share my experiences with you. 
Seek the advice of a physician before seeking treatment for medical conditions including sleep apnea. Sleep-well

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#26
RE: OSCAR confusing me with leaks/apneas
A pointer to help you become clued in on whether this (or any other) mask is right for you, if you cannot control leaks to a reasonable and manageable level unless you make the straps so tight it hurts, then chalk it up as wrong. Either the cushion or headgear are wrong sized or some other aspects are making it wrong for you. Never tighten any mask till it hurts.

Second thing about CPAP masks, every mask made for CPAP are good up to Max PAP pressures of 25-30. In fact I was told by my Lincare RT that if I'd gotten the Astral NIV that goes up to 50 cmH2O, I could have used my same full face Vitera as I've been using on my ASV. It goes back to proper fit and adjusting.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#27
RE: OSCAR confusing me with leaks/apneas
@CathyF

For me, the N20 is very comfortable and produces a good seal. HOWEVER there is a very large exhaust that comes out the elbow in front. I have asked and asked, and have no solution. Just wanted to alert you to this.

FWIW, the F30 has a different style of elbow that routes the exhaust air toward your left shoulder and your right shoulder, not straight out the front. The two elbows are different sizes and not interchangeable. Don't I wish - - -
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#28
RE: OSCAR confusing me with leaks/apneas
Good comment.

Made me smile.  I was doing my KD Strap up so tight my jaw hurt until noon after a night's sleep. So the caution about doing up a mask so tight should apply to an adjustable chin strap too. Smile
DaveL
Compliant for over 30 years

I'm just a cpap user like you. I don't give medical advice. I hope to learn from you, and share my experiences with you. 
Seek the advice of a physician before seeking treatment for medical conditions including sleep apnea. Sleep-well

Post Reply Post Reply
#29
RE: OSCAR confusing me with leaks/apneas
(04-30-2021, 09:39 PM)DaveL Wrote: I'm glad you have a new mask.

The N20 box has a fit gauge in it.  You hold it under your nose and it tells you what size insert you need.

I have a big head....first one I got was a Large.  It apparently only comes with a Large insert.  When I finally checked with the gauge I bought a Medium insert.


I use my N20 with a Knightsbridge Dual Strap chin strap. Most of the time.  That's because I mouth breath. I don't wear a Full Face Mask because of leaks and claustrophobia.


the N20 has magnetic clips on the bottom straps. Careful if you have a pacemaker.  Just saying, just in case.

Thanks for pointing this out, looks like I bought a medium when a small would've been more appropriate for me.
Hopefully the medium will be somewhat effective until the 3rd when business hours open up again?

Thanks for all the help guys.

(04-30-2021, 10:10 PM)SarcasticDave94 Wrote: A pointer to help you become clued in on whether this (or any other) mask is right for you, if you cannot control leaks to a reasonable and manageable level unless you make the straps so tight it hurts, then chalk it up as wrong. Either the cushion or headgear are wrong sized or some other aspects are making it wrong for you. Never tighten any mask till it hurts.

Second thing about CPAP masks, every mask made for CPAP are good up to Max PAP pressures of 25-30. In fact I was told by my Lincare RT that if I'd gotten the Astral NIV that goes up to 50 cmH2O, I could have used my same full face Vitera as I've been using on my ASV. It goes back to proper fit and adjusting.

Have you ever seen a mask worsen someone's positional apneas, in your experience on the forum? I guess that is my working, albeit flawed, theory so far.
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#30
RE: OSCAR confusing me with leaks/apneas
(04-30-2021, 10:38 PM)godletmeslee Wrote: Have you ever seen a mask worsen someone's positional apneas, in your experience on the forum? I guess that is my working, albeit flawed, theory so far.

Yes, I have very recently come to believe that's what was happening with me. Until 5 weeks ago when the brilliant folks here clued me in with positional apnea and chin tucking and wearing a cervical collar, I wore a full face mask because I could not breathe through my nose once I got drowsy. I started oh so long ago with an F20 mask, which eventually gave me a nasty pressure sore on the bridge of my nose. I moved on to the Amara View, and then the Dreamwear when it came out. These are both minimal-contact masks, and they are not particularly forgiving fit-wise. And I have a very small face and head (why I have apnea!) so I fought leaks pretty much constantly.

Now that I'm wearing a cervical collar and a nasal mask, I realize that I'm remembering all of those times when I woke up because the mask was leaking and I would wiggle my face to try to get it to settle back down.

Except that I just realized that I was also tucking my chin because I was wiggling my whole head! Oh-jeez

It explains why I have some many instances when the data shows simultaneous nasty leaks along with flow limitations and OAs and Hypopneas...
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