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Mask recommendations for chronic migraine sufferer?
#1
I’ve had chronic migraines for 14 years. I was diagnosed with sleep apnea 8 years ago and tried to use CPAP (pressure 10, don’t remember anything else) at that time. However, my migraines tend to hit in the middle of the night and the head gear exacerbated both the pain and frequency. I gave up after a couple months of treatment didn’t improve my migraines.

I’m now determined to use my CPAP again, for 3 reasons:
1) I’ve been suffering from major memory/cognitive issues over the past year - Please God, let CPAP be the answer!
2) My migraines have since worsened (22/month)
3) I’ve seen family members stop needing medications after CPAP usage, but it’s taken 6-8 months

I had a new titration study, which evaluated me for a BPAP 14/10 that I haven’t gotten the Rx for yet. I’m currently still using my old ResMed Elite S9 @ pressure 11 with a Respironics DreamWear Nasal CPAP Mask. I’m getting an AHI of less than 2 from this setup. I like how unobtrusive the DreamWear is and I really like the tube coming off the top of my head. The DreamWear is not as tight on my head as my previous mask was and it does not encircle as much of my head, so it doesn’t seem to be as bad for migraines, but it’s still not great and it tends to slip around on my long silky hair (a common problem for me with all mask straps) so I probably have it tightened more than it needs to be for that reason. I’m also waking up to adjust it fairly often, though SleepyHead doesn’t report any Major Leaks.

So I'm looking for any mask recommendations that:
1) Have good supportive headgear to keep the mask in place, but does not need to be tight to do that (I’m a side-sleeper and rotate throughout the night) and will work on silky hair
2) Work well for a woman with a small nose (I’m not a mouth breather, so that’s not a concern)
3) Allows the air tube to fall back behind the pillow

I should mention, I've read a lot of the Mask reviews here and elsewhere. I'm considering the Tap Pap and CPAP Pro II, but I tend to be "drooly" as it is, and I'm worried this will exacerbate drooling. It's so tempting to have no head gear though... I also have a very small mouth, so I'm concerned with the mouth piece being uncomfortable. So if you have experience with those, I'd like to know. And did you find yourself waking up often to adjust it?
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#2
Hi greenhousedc - Welcome
While waiting for your Bi-Level machine you could try setting your S9 to a pressure of 13 or 14 cm and turn on your EPR to a setting of 3.  Depending on the pressure that you set, it will produce a pressure setting equivalent to 13/10 or 14/11.

I'm going to let some other members jump in on your other questions.

I hope you feel better soon.
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#3
Try oxygen for migraines, get a $50 pure O2 bottle to test it on one of the nights. If it works I recommend Philips EverFlo Q, The Q is important and only $20 more expensive but shows you O2% quality so you know what you're actually getting.

I used to get dull headaches in the middle of the night too. EverFlo to the rescue.
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#4
Oh yeah, migraines and headgear do not mix. When I have to use the Simplus, which sits differently and tighter than my Nuance, I get a migraine after about the third night.

You are looking for a mask that has minimal headgear but works. One that can be on lightly but not leak.

I'd recommend the nuance if you do not open your mouth while you sleep. My pressure is high (15-20) and I don't have to keep the headgear tight to make it stay on. If your head is the right size, the P10 has overly-simplistic headgear but modifications may have to be made if it is too tight. Both of these are nasal pillows.

Using a CPAP decreased my headaches. Or, rather, it decreased a certain type.
PaulaO2
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www.ApneaBoard.com


Breathe deeply and count to zen.

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.




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#5
(05-23-2018, 03:51 PM)Crimson Nape Wrote: Hi greenhousedc - Welcome
While waiting for your Bi-Level machine you could try setting your S9 to a pressure of 13 or 14 cm and turn on your EPR to a setting of 3.  Depending on the pressure that you set, it will produce a pressure setting equivalent to 13/10 or 14/11.

I'm going to let some other members jump in on your other questions.

I hope you feel better soon.
That's a really good idea, I'm only using EPR on Ramp right now. The last 3 nights @ 11cm my AHI has been entirely Central Apneas, I don't think going higher will help at this point? I'm not sure how my titration study came up with 14cm.

(05-24-2018, 06:57 AM)crowtor Wrote: Try oxygen for migraines, get a $50 pure O2 bottle to test it on one of the nights. If it works I recommend Philips EverFlo Q, The Q is important and only $20 more expensive but shows you O2% quality so you know what you're actually getting.

I used to get dull headaches in the middle of the night too. EverFlo to the rescue.
My husband uses O2 as an abortive for his cluster headaches. I've tried it when I had a migraine, but didn't do anything for me. Are you saying it's helpful as a preventative?

(05-24-2018, 01:05 PM)PaulaO2 Wrote: Oh yeah, migraines and headgear do not mix. When I have to use the Simplus, which sits differently and tighter than my Nuance, I get a migraine after about the third night.

You are looking for a mask that has minimal headgear but works. One that can be on lightly but not leak.

I'd recommend the nuance if you do not open your mouth while you sleep. My pressure is high (15-20) and I don't have to keep the headgear tight to make it stay on. If your head is the right size, the P10 has overly-simplistic headgear but modifications may have to be made if it is too tight. Both of these are nasal pillows.

Using a CPAP decreased my headaches. Or, rather, it decreased a certain type.
Thanks for the detailed info, good to know these masks work at a higher pressure w/o being tight. I'm curious if you find the straps on these keep the masks on your head without shifting? The only mask that ever felt truly stable on me also had the lower strap down behind the ears (like the Simplus), but as you said, headgear and migraines don't mix. My dad never has problems with shifting headgear, but he's nearly bald and the straps seem to stay put on his head. With my long hair, it all just shifts around, especially the thin straps. Any tips?
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#6
The Nuance straps work well for me. I have short-ish hair. I do move around a lot at night and do wake up once or twice to pull the back strap down.

I hated the P10. Only mask to give me nose a sore spot. It was far too tight for me. Others find it a wonderful mask because it is so quiet and the headgear is overly simplistic. It is basically a single strap split. But it has no adjustability unless it is too big (they now make clips to shorten the straps.
PaulaO2
Apnea Board Moderator
www.ApneaBoard.com


Breathe deeply and count to zen.

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.




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#7
Not a migraine sufferer, but do like minimalist masks that allow for movement.  The F&P Brevia is 2 thumbs up, and I think other Brevia users would probably agree.

The pillows (for me) just don't come off once the air is flowing, but it's not invasive at all.  I keep the straps pretty loose and it's not a problem. Possibly actually better that way.

Swivel hoop too, so you can route the thing over your head, BUT it doesn't come with headgear that would keep the hose over your head.  Need some other kind of hose holder I guess.

Good luck.
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#8
Hi greenhousedc and welcome to the forum!

Having been a migraine sufferer all my life I can relate to wearing ANYTHING on your head while having a migraine! Not good.

I actually with the help of reading this forum self diagnosed myself as when I went to the doctor complaining of early morning (4am ish) bad headaches (felt a bit different than my migraines but similar) he immediately said I probably had cluster migraines and was about to prescribe me a drug for that. I told him I had done some online research and thought maybe I had sleep apnea and thankfully he agreed to have me tested. So - I don't know if your migraines/headaches could be SA related or not, but worth considering.

I second (or third etc) the vote for the P10's. I take my hair and put it all through the middle of the two straps at the back of the head and that seems to keep them on fairly secure. Also P10's come in 2 sizes for the head straps. The 'for her' version is I believe about an inch shorter. That may help.

However, if you like the DreamWear which I also have, they now have gel nasal cushions that you can buy and you can just buy the nasal cushions and they will fit into your dreamwear mask and headgear without the need to purchase a whole mask again. BUT, bear in mind the gel nasal cushions come in sizes like S, M, L and you would need to know which size to get.

About sizes, the DreamWear mask frame does come in 3 sizes and there are 4 sizes of cushions, so there is possibly room for you to get a better fit with that mask but it may entail you purchasing another frame.

Hope you get all this sorted out quickly and find your solution.

Best of luck and keep us posted!
APNEABOARD - A great place to be if you're a hosehead!! Rolleyes

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#9
Thank you everyone, these are some really good ideas you've provided me with.
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#10
Hi! Welcome!

I'm so sorry to hear about your migraines. I, too, suffer from migraines, and have had to take them into consideration when deciding on a mask.

I use the P10. The headgear is the most minimal I've seen, and does not need to be "tight" to stay on. I spread the 2 straps out and wear it like a headband: 1) I put it over my head so 1 is at the base/back of my neck, and 1 is in front of my face/neck, 2) I pull all my hair up so the back strap is at my neck like a headband would be, 3) I pull the front strap up over my face to rest slightly past my top hair line (just like a headband). And that's it. The strap doesn't slip around my hair this way. And the straps don't put pressure on my head.

As far as the hose, I lay down, and then put the hose up on my pillow, and then tuck the hose behind my pillow to keep it in place and out of my way.
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