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[Diagnosis] Hi, new here- Question Please
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robysue Offline
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Machine: PR Dreamstation BiPAP Auto
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Other Comments: Papping since September 2010

Sex: Female
Location: Buffalo, NY

Post: #81
RE: Hi, new here- Question Please
(02-22-2014 08:12 PM)ShelaghDB Wrote:  I just started my CPAP therapy in a half assed manner as I am waiting to go to the DE I think you call them, this week to change masks.
The one I have unfortunately is leaking too much and it keeps waking me up so I just haven't really got into the swing of this CPAP stuff yet.

...

But this leads me to my only concern and that is, losing interest in this therapy if i spend endless months being fitted for one mask or another and none work.
Attitude and commitment to therapy cannot be provided by the DME or the sleep doctor. They've got to come from you.

You are the only one who can make yourself use the machine every night as directed. And you are the only one who can prevent yourself from losing interest in making this crazy therapy work for you in your bed each and every night. If you expect CPAP therapy to fail, it most likely will fail. If you expect that with the necessary work, you can make CPAP work for you, you most likely will succeed in becoming a happy PAPer who is fully compliant with therapy.

Finding a mask that works is critical. And it's a shame that DMEs make that more difficult than it needs to be. But c'est la vie. Some folks do go through a dozen or more masks before finding one that works. Others get lucky and find the right mask right away.

One part of the puzzle of finding a mask is to NOT rely solely on the DME: Chances are the person fitting you for the mask has never worn a CPAP mask and has no idea what they are actually doing. (Sad, but true.)

If you think a mask is almost working for you, then it's worth the time and effort to try to figure out how to solve the issues rather than switch to yet another mask.

To start with: Exactly which FFM are you using? Is the mask comfortable before it starts leaking? Is there anything about the headgear that you really can't stand? Does it have a gel cushion or an air cushion for the seal? (Fitting air cushions is very different than fitting gel cushions.) Are you using the ramp feature, and if so, is the mask well sealed at the start of the night, and then it starts leaking later on when you are at full pressure?
02-23-2014 11:01 AM
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robysue Offline
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Posts: 1,240
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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: #82
RE: Hi, new here- Question Please
(02-22-2014 08:12 PM)ShelaghDB Wrote:  Sorry, another question.......I keep seeing people saying that on CPAP they no longer wake up for washroom breaks?

Um, is it normal to sleep right through the night without waking up at least once?
It is NOT normal to wake up needing multiple washroom breaks and most successful PAPers who had nocturnia pre-CPAP report that with CPAP they no longer wake up needing to go to the washroom. Many PAPers say that's the first positive thing they notice about PAP.

Whether it's normal or not to sleep right through without waking up at least once for any reason is a different question altogether. It's not uncommon for normal folks to wake up very briefly at the end of each REM cycle. But most normal people don't remember these post-REM wakes in the morning because they are very brief as in less than 5 minutes in length. And these post-REM wakes are not numerous enough to be considered detrimental to the overall quality of sleep.
02-23-2014 11:09 AM
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PaytonA Offline
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Post: #83
RE: Hi, new here- Question Please
(02-23-2014 10:48 AM)robysue Wrote:  But some people are mouth breathers out of habit, rather than necessity. And some people find that with CPAP, they don't do anywhere near as much mouth breathing at night as they did pre-CPAP. Still, the only way to tell is to have a machine that records full efficacy data, including leak data, and to look at the leak lines every day for a while to see just how often you have significant mouth leaks.

robysue or anyone,

Is there a way to determine from the data that the leaks being experienced are actually mouth leaks?

PaytonA
(This post was last modified: 02-23-2014 01:40 PM by PaytonA.)
02-23-2014 01:39 PM
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zonk Offline

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Post: #84
RE: Hi, new here- Question Please
(02-23-2014 01:39 PM)PaytonA Wrote:  robysue or anyone,

Is there a way to determine from the data that the leaks being experienced are actually mouth leaks?

PaytonA
Not from the leak number on the screen, mouth breathing gives you dry mouth but not if you don,t consistently mouth breathe
If you only mouth breathe some times and at not at other times so the leak line (graph) look flattish for most of times and few spikes here and there, the spikes might indicate mouth breathing
ResScan guide shows something like that, I,ll try find find it for you when had my tea, just waken up ... 6 am Sydney time
02-23-2014 02:10 PM
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me50 Offline

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Post: #85
RE: Hi, new here- Question Please
PaytonA

do you have dry mouth when you wake up? Any other symptoms or things you notice?

If you have dry mouth, you are most likely breathing through your mouth. Which leaks are caused by mouth breathing, not sure you can sift those out from the other leaks. Someone else will probably have better help for you
02-23-2014 02:15 PM
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robysue Offline
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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: #86
RE: Hi, new here- Question Please
(02-23-2014 01:39 PM)PaytonA Wrote:  
(02-23-2014 10:48 AM)robysue Wrote:  But some people are mouth breathers out of habit, rather than necessity. And some people find that with CPAP, they don't do anywhere near as much mouth breathing at night as they did pre-CPAP. Still, the only way to tell is to have a machine that records full efficacy data, including leak data, and to look at the leak lines every day for a while to see just how often you have significant mouth leaks.

robysue or anyone,

Is there a way to determine from the data that the leaks being experienced are actually mouth leaks?

PaytonA
If you have the leak graph (as opposed to just the summary numbers) you can look for extended periods of times at relatively high leak rates, together with dry mouth symptoms. I don't do much mouth breathing so I don't have a good example at my fingertips. Hubby and I will soon be going skiing for the afternoon and evening, but once I get back I'll see if I can find a decent example.
02-23-2014 02:23 PM
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zonk Offline

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Post: #87
RE: Hi, new here- Question Please
(02-23-2014 02:10 PM)zonk Wrote:  ResScan guide shows something like that, I,ll try find find it for you when had my tea, just waken up ... 6 am Sydney time
I can show you heaps of examples of mouth breathing from my charts but only if I knew how, does not seem "you can teach an old dog new tricks"


ResScan guide .... page 57 http://www.apneaboard.com/ResScan_Interpretation-Guide.pdf
detailed leak graph shows significant leak episodes in some periods and none at all in other periods

The high level of leaks (> 24 L/min) and their characteristic plateau shape (steep rise, flattening off then returning to the base line) indicate the presence of significant and variable leaks, most likely mouth leaks
02-23-2014 03:13 PM
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PaytonA Offline
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Post: #88
RE: Hi, new here- Question Please
(02-23-2014 02:23 PM)robysue Wrote:  If you have the leak graph (as opposed to just the summary numbers) you can look for extended periods of times at relatively high leak rates, together with dry mouth symptoms. I don't do much mouth breathing so I don't have a good example at my fingertips. Hubby and I will soon be going skiing for the afternoon and evening, but once I get back I'll see if I can find a decent example.

I have the leak graphs. I just need to figure out how to increase the Y axis scale.

PaytonA
02-24-2014 12:54 PM
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PaytonA Offline
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Machine: ResMed S9 VPAP Auto
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CPAP Pressure: VAuto MinE14.0 MaxI 20.6 PS4.0
CPAP Software: ResScan SleepyHead

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Location: Orange County,California

Post: #89
RE: Hi, new here- Question Please
I figured out how to increase the scale. I am going to post an image of my leak graph in a new thread called "Leak graph Interpretation".

PaytonA
02-24-2014 01:33 PM
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ImaSurvivor Offline

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Post: #90
RE: Hi, new here- Question Please
(02-22-2014 08:12 PM)ShelaghDB Wrote:  [quote]
Sorry to ask so many questions but the doctor and the DE seem better suited at filling out papers.
Its only just now I realized that I didn't have to set my machine for pressure and that the DE must have done it when i took home the machine so all I have to concern myself with is changing humidity level and time for it to start up after I put on my mask, and thats all...nothing was explained to me so its just by reading here that i am grasping it all......and the first while i was posting but I really didnt have any sort of feel for what i had been handed.........
Sorry, another question.......I keep seeing people saying that on CPAP they no longer wake up for washroom breaks?

Um, is it normal to sleep right through the night without waking up at least once?

I titrated with a full face mask and a nasal mask that had a plastic piece that rested on my forehead. I was told those were very generic, non full-time masks that were only used during the titration sleep study. I was told they were the only ones available to try during the titration and that I could try more when the respiratory therapist came in the next morning. Neither of those masks were a hit with me to even get through a few minutes with them. There was no way I would get through titration with either of them. Finally the technician told me they had a few samples of the Wisp Nasal Mask. It made a big difference in comfort. I still wasn't comfortable with the feeling of the CPAP at that point and the pressures but the mask itself was so much better with softer headgear, smaller cone over my nose and no extra apparatus on my forehead.

The next morning the respiratory therapist commented on a red mark on the bridge of my nose. It didn't bother me but maybe over time it would have. I only used it that one night for titration. I keep it now as a spare mask. The therapist asked/suggested I try the Swift Nasal Pillows. I liked that solution even better with so much less equipment on my face. Just the little cushions beneath my nostrils. It was only just a couple minutes I tried them though. I didn't know how it would be full time until I went home and tried them and have been using them since November. I have a hard time imagining having to use something else.

As robysue mentioned, if you find something that works 'quite well' it is worth working through the little problems and trying to solve them to make the mask work.

Just in the last couple weeks I have developed some irritation on the edge of my nose and a sore on the inside of my nostril. I didn't realize I could replace the cushions every month in between replacing the whole mask every 6 months. I am thinking that may be the reason my nose became sore. Seems it would have shown up earlier if it was a problem with the design of the mask/pillows. Also it seemed I had to fidget with the pillows to keep them sealed and working well after a period of time. Now I have new cushions and I could see an instant improvement with comfort and seal. I am still working on healing sores on my nose. The nose is tender but after experiencing some of the other masks, I know I really want to stick with the pillows and willing to work at it. I am using medicinal ointment during the day to heal and put some Lanolin ointment on to buffer the sores at night. Linsoh HPA Lanolin is considered safe to use at night without harming the silicone cuishons. My nose seems to be taking longer to heal than I would like but I am allowing it may take longer when I have the pillows rubbing on it each night.

As robysue pointed out, some PAPers notice instantly not having to get up multiple times a night for the washroom. I was averaging 2-3 time/nightly and sometimes even 4-5 times a night. Since beginning therapy, I do not wake up at all to go to the washroom. That is the most significant improvement for me as of right now. I rarely wake up for any reason once I am asleep. I didn't even know nocturia was a condition of sleep apnea. So much can be learned on this forum!

Good luck with your therapy!
02-24-2014 02:18 PM
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