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Difficulty adjusting
#1
Question 
My sleep specialist has me using Phillips Respironics Dream Station with the Nuance Pro Nasal pillow. I started using it at the end of July, 2016 so it's been about a month. I finally settled on using the small nasal pillow. The medium would pop off at night. I've only worn the mask for more than a six hour period 4 times during the month, only two that were consecutive. The rest have been 3 to 4 hours before I remove it. The mask seems to fit comfortably when I go to sleep. Am I doing something incorrectly or is this normal during the first couple months? I'm not feeling refreshed.

I also have noticed in the past week that the skin at the entry of my nostrils where the pillow contacts is sore in the morning. Is this normal? If so is there something I can do about the soreness?

I was really looking forward to this working. I'm actually more tired during the day than when I started.
Sad
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#2
Hi 89Lou31. Welcome to the Apnea Board forum. You have run headlong into our most common problem: getting the right mask and mask fit. My first suggestion is to try a nasal mask. That is what I switched to when I couldn't adjust to the nasal pillows. Talk to your supplier or sleep center about trying a different mask. You might be able to go in for a mask fitting. Don't give up. You are just getting started. My next suggestion is to install the Sleepyhead software and look at the "shape" of your treatment waveforms.

Rich
Apnea Board Member RobySue has posted a Beginners Guide to Sleepyhead Software here:  http://www.apneaboard.com/wiki/index.php...SleepyHead

Download Sleepyhead
Organize your Sleepyhead Charts
Post from Imgur


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#3
Since you are using your CPAP only a few hours per night, and likely have very high leak rates, your lack of feeling refreshed is understandable. If you were issued this equipment by a supplier, you should talk to them about your difficulty, and look at a different mask option. Even other brands of nasal pillows are going to fit and feel different. If you're not leaking through your mouth, then that may be an option. The Dreamwear nasal masks use a different attachment and secure differently, so that might also be something to try. Work with your supplier, as you probably have a return policy when a mask does not work.
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#4
Hi 89Lou31,
WELCOME! to the forum.!
The mask can be the most challenging part of this therapy, so don't be shy about asking to try different ones
till you find one that works well for you.
Hang in there and don't give up, you're just getting started.
Good luck to you on your CPAP journey, stick around for more responses to your post.
trish6hundred
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#5
Welcome to the forum 89Lou31..

+1 for what richb said.

I'm a relatively new user, the first two months where crap.. trying to get used to wearing the stupid thing in the first place, then trying to work out the mask issue as well.

I was fortunate that the clinic supplying my test equipment was very good, they set me up with a Dreamstation set on auto to get pressure measurements for my respiratory specialist to assess.
The original mask they loaned me was a Fisher & Paykel Eson mask, then they swapped me over to a nose pillow mask after a couple of weeks to see how I went with that..... oh what crap that was, so back to the Eson nose pillow after a week.

It is trial and error for some aspects, but if you have a good clinician they should have you set up close to what you need from the start, it will just require fine tuning to get fully comfortable with it all.

I ended up buying a brand new Dreamstation, complete with the F&P Eson nose mask, all set up identical to the loan machine and mask originally supplied for the trial period.
The clinic gave me a good discount on it all, and they set up the new unit to all the same settings I was using on the loaner.

I need reports cleared by my specialist now on a 12 monthly basis to keep my commercial/truck driving licence.
The clinic is going to access my Dreamstation remotely to download data when I call and ask them to, then they will send the report to my specialist for him to assess and sign off on.

You will get your set up sorted out, it may be frustrating during doing so, but with advice from here I'm sure you will get it figured out in conjunction with your specialist and your CPAP supplier.
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#6
Finding the right mask and learning how to adjust it for your particular face and therapy pressure is a major hurdle. Try several and get it the best it can be.

The next hurdle is to accept the fact that you must start with a lower pressure than you will eventually need. Abruptly starting with a pressure that is going to cause you to lose sleep and suffer with mask leaks is counter productive, so react accordingly. I hate analogies but I will say this is like going to the gym to get in shape. you don't get it done all that quickly. Likewise, you have to stick with it to maintain your gains. Patience, patience and more patients then perseverance, perseverance and more perseverance. It get better, believe me.

Most importantly, avail yourself of all the help you can get from your doctor and DME supplier. Mask trials are free at most DME's so find one you can stand. Many time a doctor will have the DME hand a patient a cpap unit that is set to pressures that are intolerable so discuss that with your doctor. The DME is pretty well stuck with whatever your doctor prescribed so you will have to advocate with him for any changes unless you want to take them on yourself. Many people do that.

Lastly, and equally important, keep posting here since there are some very experienced people here who can help you along the way. They are much more accessible than most doctors and often give better advice. I'm not saying to ignore your doctor or DME's advice but feel free to get a second opinion here when you have trouble.

Dude
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#7
Thank you for the input. I was dismayed that there was no advice other than changing the mask style. I contacted Phillips and they suggested I go to a Wisp. It's a better fit. The machine is louder. I've adapted to the noise but my partner has not. Guess we'll get soft ear plugs. I'm still trying to adapt to the harness that holds the mask and I think I've finally found the correct fit.

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#8
(09-08-2016, 01:51 PM)89Lou31 Wrote: Thank you for the input. I was dismayed that there was no advice other than changing the mask style. I contacted Phillips and they suggested I go to a Wisp. It's a better fit. The machine is louder. I've adapted to the noise but my partner has not. Guess we'll get soft ear plugs. I'm still trying to adapt to the harness that holds the mask and I think I've finally found the correct fit.

It is difficult to provide additional suggestions when we can't see what is going on with your treatment. Try installing the Sleepyhead software and then post some screenshots of your nights treatment. We could give you some feedback about the efficacy of your treatment and your settings. Straight 7 CM H2O is a fairly low pressure. You should find out if it is actually working. Keep posting.

Rich
Apnea Board Member RobySue has posted a Beginners Guide to Sleepyhead Software here:  http://www.apneaboard.com/wiki/index.php...SleepyHead

Download Sleepyhead
Organize your Sleepyhead Charts
Post from Imgur


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