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Introduction- and Journey
#61
RE: Introduction- and Journey
(02-25-2020, 09:46 PM)melodyknit0375 Wrote: So now mask question time. 

I’m mostly recovered from my crud (still have a tiny bit of cough), but more frequently when I use the N30i mask I’ve been taking it off in the middle of the night (not aware of doing so). Last night I only got about 5 hours of treatment because of this (and I noticed a difference today).  I struggle at times with severe nighttime stuffiness even when not fighting crud. It gets worse as things start to bloom, as they will here soon.  Due to my other conditions I cannot take decongestants.  

Have you consulted an allergist?  I'm getting pretty good symptomatic relief from a combination of Flonase and Azelastine sprays, plus Montelukast at night.  I'm also getting allergy shots (at 71!), though that's more of a long-term thing.

If the MAIN problem is taking the mask off without knowing it, people have tried some fixes you could consider.  They are all for short-term use, to train yourself to leave the mask on.  You could wear mittens to bed.  You could put a chin strap on over your mask straps.  You could fasten tape over a mask strap so that you wake yourself up with the tug on your skin if you remove the mask.  You could put a cap on your head over your gear and tie it under your chin.


I did pick up the P30i pillow and I am trying to see if there is a difference in keeping my mask on with it. I used it a couple of times when I was still sick with the crud, and it was able to blast through the congestion some. I am wondering if that would be better for me long term?

Things I do know I like after my first month of treatment:

1. I really like tube on the top styles, I get tangled otherwise.  I do too, and mine has a velcro loop you can use or not to route the short tube up over your head.  I need to stabilize with paper tape, but I don't mind.  If the short hose on a mask is flexible enough, you could jury-rig something like that yourself.  I also use a Hose Buddy, which keeps everything up and away from me.  You might take a look to see whether that might work for you even without a top-of-head mask design.  It worked fine with my ResMed P10, though the P10 had other issues that made me look elsewhere.

2. I don’t believe I have any large issues with mouth leaks. 

So I guess my questions are thus:

1. Is the F30i mask compatible with the N30i frame and the P30i frame, and would it be worth to pick one up to have “on hand”?  Sorry, don't know.

2. Might I have better luck with the Dreamwear nasal? I think part of my issue right now is when I roll to my side the hard plastic part of the N30i is possibly getting dislodged.  It might be just right for you.  Me, I found that I was very sensitive to the sound of the air moving through the tubes that go across the face.  

3. Do I try to get it through my DME or just buy one on my own?  Depends on your insurance.  Try asking your insurance company and the DME both.

4. Any other masks I should give a look?  It's so much a matter of the contours of your face and your sleep "style" you probably really need to try a few more yourself.  If you should happen to try the Aloha, do get the Pad-a-Cheek strap covers, and be prepared for a poorly diffused vent.  If you try the P10, get the fit pack of pillows and be prepared to size up.  The P10 vent can't be beat, nor its minimalist design.  The trade-off is that it can move around more than some other masks, depending on how much you move around at night, and if that creates leaks that wake you up, it's maybe not for you.  

Even through all of this my AHI’s have generally been under 1, with only one night during the worst of my crud that landed at a 1.2. What concerns me more is I want to keep my mask on, as I now really know the difference between when I do and don’t wear it. 

What are all of your thoughts?
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#62
RE: Introduction- and Journey
Thanks Dormeo! 

I did download my Oscar data from the last few nights and on Sunday I had a huge cluster of RERAS but nothing on Monday, and last night when I switched back to the P30i I had a way better night. 

I do have a P10 left from my titration study, and I have tried it a few nights, but either I or the cat get tangled in it and it comes off too easily for me. Therefore why I continue to really like the over the head styles. 

I have my hose out of the way with a hook above my head and I have a collapsible hose Buddy for travel which worked a charm when I was in Florida. 

I primarily side sleep (right side) but it’s also a half stomach thing where I lay my left arm out starfish like. Kinda hard to describe.

I will try calling my DME in the next few days and see what they have to say.

As for the allergist, maybe, this is now the year for me to see all the specialists, since I’ve pretty much maxed out my deductible already this year. 

I might buy a mask or two on my own just to try different things.  I also do want a FF mask around if my allergy congestion gets bad this spring. 

I’ll figure it out eventually.
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#63
RE: Introduction- and Journey
Alright Everyone! I've been doing well with treatment, especially since I have been home now two weeks with the state of the world right now. It's been about two weeks since I last took off my mask in the middle of the night without realizing it. Generally I am doing well, and feeling good considering everything right now.

My follow up appointment with my sleep doctor is on for Wednesday, mostly because even in these times, insurance still has its rules and regulations. They have asked me to bring my SD card, which I will, even though it is the one I provided for the machine myself. I'm glad I only have to take that, as I did not want to take my entire machine into a germ area if I didn't have to.

I have done some searching, but I also want to be somewhat reassured and y'all's feelings on if I should be up front with him that I adjusted the settings, or let him come to me. My AHI's have generally been under .5 (usually .1 or .2 range) and I have been really compliant on number of hours (The last time I was under 7hrs usage was early this month). I've been feeling really good, and I plan on sharing that. Just for reference, I have settled on an 8cm-14cm auto with 3EPR, where he had me on 11cm of fixed pressure. I don't use the ramp function.

I just don't want to be labeled a non-compliant patient. I feel I have been very compliant, just with some help and support from all of you, and I honestly can't imagine I would be very compliant with 11cm fixed blowing up my nose every night.
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#64
RE: Introduction- and Journey
Upload your SD card to OSCAR prior to visiting your doctor.
Let your doctor know you changed your settings something like this, "I did change the settings because the 11 just wasn't comfortable and I couldn't keep it up, I see my AHI is down, did I do ok?" The last is to get him to agree that you are doing fine. EPR is considered to be a comfort setting.
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#65
RE: Introduction- and Journey
Congratulations on all your terrific adaptation! Your sleep doctor will be so dazzled by your results that he/she will probably respond well to the kind of approach Bonjour suggests. And if not -- you will just keep on keepin' on.
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#66
RE: Introduction- and Journey
Thanks for the advice. I'm just hoping that they are really looking to "check the boxes" so to speak right now and not looking to scrutinize me. As it is they were up front that I will be getting a temp check before entering the office.

I will make sure to download my data to Oscar on Wednesday morning before leaving. As it is we are on a stay at home order in Ohio so this is really my only outing for the week.
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#67
RE: Introduction- and Journey
Congrats on doing well with the therapy. I agree with how bonjour wants you to discuss the setting edits you've done. I've done that myself with my pulmonary doc. When settings are mentioned, I'd say I had to adjust to obtain better feel, better results on OSCAR, better compliance, etc. Results look good don't they, doc?

Response is needed two-fold as per reason: he's confirming the results are good, and secondly, it keeps him in the loop and reduces ruffled feathers. He's not cut out entirely, and has some input.
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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#68
RE: Introduction- and Journey
Exactly, it's letting the doc feel that you are trying to follow his direction, that you need him for validation, that he is part of the team.
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#69
RE: Introduction- and Journey
Doc appointment went really well. Maybe its all the COVID precautions, or the fact that this one appointment was one not to risk on Telemedicine (they just changes the rules last week, but he preferred this face to face just in case something went wrong).

Doc didn't even bring up that I changed my pressures, or that he prescribed 11cm. He said 8cm-14cm was perfect, as I am averaging about 9cm-10cm most nights and 14cm gives me the support I need if I need it.

He was very happy with my AHI- I've averaged (.2 the last 30 days), I'm 100% compliant (8hrs average usage a night), and says not to worry about occasionally tearing my mask off, he sometimes tears his off himself.

I got put on a once a year check in, with the caveat that if I run into issues, give them a call. He did recommend that I maybe pick up a full face mask to have on hand, but that he was happy with my leak rates etc. He says as long as I check in once a year, I shouldn't need any further sleep studies, unless I notice issues again, he did say to call back if I notice waking up due to my PLM again, as that was the primary issue he was hoping would go away with the CPAP, he did say that it could re-emerge, but chances of that are low.

Obviously, I will check in here if I have issues, but as for right now, I'm going to keep on vibing with what I am doing.
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#70
RE: Introduction- and Journey
Couldn't have gone better! I wonder whether part of his good attitude comes from his being a cpap user himself.
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