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Mofrosie's Therapy Thread
#11
Lack of sleep from fighting with the mask
In the 2 months that I've been on CPAP I switched from P10 (medium) to N30i (also medium) because the pillows hurt my nostrils and the mask moved around too much, leaked, and woke me. The N30i is very comfortable - when it stays put - but I'm still losing sleep to fuss with it. I wake up a few times a night to scratch an itchy nose, and even though I try to minimize disturbing the mask, it moves, I feel air leaking and I wake up to reset it. Once I fall back to sleep (usually left side sleeper), if I move my head at all I feel some air sneaking up through the center of the cushion, or hear hissing or a flat-out gust and I wake up again to reset the mask. If I sleep on my back (I try to avoid it) my mouth opens slightly, I get mouth leak, and it wakes me. (I'm trying to avoid tape and would rather just roll over. Chin strap was thrown across the room on the first night.) Needless to say, even though the machine says I got 6 or 7 hours of "sleep" I doubt it.  Oh yeah, I get up about twice to go to the bathroom. If I have the time I take the mask off at about 6 AM and sleep undisturbed for another hour or so. 

Your advice, please!  I attached a few reports with different leak patterns.  Should I try to ignore what feels like a small leak and stay asleep?  The mask doesn't seem loose, but should I tighten it as much as I can? That seems to control the leaking but sometimes it feels a little suffocating and I have to work harder to breathe.  I'd really like to stay with the N30i.

Am I getting the benefit of CPAP if I slept better before I used it?   (Resmed AS 11, pressure fixed at 6, EPR 1.) I still have brain fog (I'm 68 so is it age or lack of sleep, or both) and wake up feeling like I need a nap.   I'm still waiting for the fabulous sleep so many people talk about, though when there are no breezes on my face or hissing sounds I think I can actually experience it.

Another question -- sometimes it sounds like the machine is "breathing" but it's not in sync with my own pattern.  What causes that?

My sleep test score was 31, about 29 of which were OA and 2 were CA.  The OA is basically gone and CA averages somewhere between 1-3. A few times it's been <1.  There is sometimes hypopnea and rarely CSR.  I'd also appreciate any observations and suggestions for how to improve my numbers. 


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#12
RE: Lack of sleep from fighting with the mask
if you having problem with cradle and pillow mask and i am guessing you are not a mouth breather then try a proper nasal mask but i would recommend to buy a cheap nasal mask like bmc brand try it on for few months, if you like it then buy any nasal mask that's shoots you
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#13
RE: Lack of sleep from fighting with the mask
I'm also trying to find a good sleep with the N30i. Not completely there yet.
Allthough I don't need it for suppressing apneu, I've increased my pressure to a constant 8 cm H20 / EPR 2 or 3 (I'm trying to figure out)
For me it feels like that by making the pressure a bit higher, that the mask is better inflated.
Adjust the mask when you have the pressure on it. 
Try turning off the ramp. That way the pressure doesn't change once you've adjusted your mask as good as possible.
I know it's not much but I hope it helps you.

Goodluck.
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#14
RE: Lack of sleep from fighting with the mask

  1. Others with far more expertise with Oscar data I expect will comment, In your 3 reports all show in left col toward the top that Large Leak % is far less than 0.2% of the time. Based on the wiki on this forum Large Leaks in some cases >5% or even 10% by themselves do NOT mean ineffective therapy. Given your low AHI, I expect that the therapy e.g. ameliorating adverse events are doing just fine. However, clearly waking up numerous times is not restful sleep and needs to be addressed. From your numerous night awakenings beyond need for bathroom it certainly seems that the quality (depth and restorative power) of your sleep could be a lot better, so yes the brain fog and tiredness are not normal; and the cycle of poor quality sleep leading to frustration with equipment etc. can be a downward spiral that takes a lot of care to deal with and turn around.
  2. Some people take many months to adapt to mask and equipment and one's expectations and attitude are important factors. While easier to say than to do oneself ... take a breath and relax knowing that there will be frustrations (throwing chin strap across room) and improvements as you experiment and find what works for you. Perhaps start with whatever you are grateful for with equipment (AHI are reduced and that short term and long term is good for brain and body; ____; ___: etc.). Self observation is key with regard to technique experimenting with what others have found that works for them and modifying that if it shows promise and forget it if the cons outweigh the pros for you.
  3. I am predominantly a side sleeper and thanks to forum (OpalRose and others) ... have your head toward the edge of your pillow so that nasal pillows do not make contact with the pillow and float off to the side. Some like me find that slightly turning your head away from the pillow and slightly tipping the chin upward also helps to allow mask to stay in a stable place.
  4. Perhaps read if you have not done so already the Wiki on Masks and on Leaks. Newbies tend (incorrectly) to think that the solution to leaks is to tighten straps but counter intuitively that is often wrong. Too tight will deform the material and break the seal. If you feel that you are responding (waking up) due to the sound of air leaks then perhaps you might use ear plugs or just a soft cotton ball to reduce that factor. As long as you do not have any allergic reaction to the nasal pillows material then perhaps some kind of lotion, skin cream to soothe that area (fully washed off before sleep) will help heal that area and lead to less itching and then waking to scratch it. Some report on forum nose itch and you can do a search to find those threads and what they did.
  5. I too find a chin strap and even more so a cervical collar a bit confining and hard to get used to, but unlike you I have tried multiple times and not given up after only one night. It might not be a tool that you wish to use - that is fine. Figure out what motivates you to control your apnea and persevere. Hopefully comments from more experienced members will allow you to relax about some of the things you raised and being able to take things in stride and to the extent possible come to love the equipment, make jokes (at least to oneself), or ... could support you into relaxing into things while at the same time experimenting and using self observation to find what works for you. There might not be any one magic bullet e.g. the search for the perfect mask is often a dead end for some/many? 

    My apologies if any of the above seems harsh or unsympathetic. I expect that you will find much support from the forum and improvement in your sleep and quality of life - that is certainly what I picture for you.
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#15
What's happening here?
My average AHI has been approx 2 for weeks and now I'm  in the 4s.  (Sleep test  28.5 Obstructive; 2.9 Centrals).

 The only difference is switching to Small-Wide N30i about a week ago.  Numbers were fine until 2 nights ago. Before the S-W I was using N30i Medium for a couple of weeks and it felt very constricting.  P10 pillows kept shifting and it was war all night to keep them in place.  So now my numbers are going up but, after 2 months, I'm finally sleeping.  I really don't want a larger mask if I don't have to.  Short of changing masks is there anything else I can do?

On 8/27 I was having a problem with leaks. Did that cause the higher numbers?  I don't know what was happening on 8/28 because I was having a rare decent night's sleep.

Could the hypopneas be from holding my breath when I switch positions?  

And why the OA and CA so close together?

Resmed AS 11

Thanks for your help.


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#16
RE: Mofrosie's Therapy Thread
Mofrosie,
I have combined several of your threads pertaining to therapy questions.

It's much easier for those that offer advice to be able to see your past history in one thread.  

Going forward, please post all your questions and charts here in this thread.

I also changed the Title to "Mofrosie's Therapy Thread".

Thanks! Smile
OpalRose
Apnea Board Administrator
www.apneaboard.com

_______________________
OSCAR Chart Organization
How to Attach Images and Files.
OSCAR - The Guide
Soft Cervical Collar
Optimizing therapy
OSCAR supported machines
Mask Primer



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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#17
RE: Mofrosie's Therapy Thread
Hello Mofrosie.

I have been reading your thread, I am no expert but I have found on my experience when I had used the Resmed N30i nasal mask wasn’t good.  I tried it for 3 weeks and had to stop using it. I felt like I wasn’t getting enough air from this mask. On the last night I used it, I had a bunch of CA’s in a one hour period that raised my AHI to over 3. I am usual under 1 AHI. I had heard from other posters that the N30i cushion design had been changed. I went back to my Dreamwear nasal mask, same design, tube goes other the head. I do hear the swishing noise but I am used to it. 

Also I used to use the ramp feature, and used the 45 minutes at 4cm. I realized once I started reading posts that was part of my issues falling asleep and also when you wake up you start over again at 4cm for another 45 minutes. I have ramp off now and start at my prescribed pressure. 4 cm feels like you can get enough air to me. While in ramp you will not know if you are having any events. 

Hopefully trying different masks will help you sleep better. I have used a Resmed N30 nasal mask,  for my travel machine and that is a nice mask to try. I also have tried various pillow masks in the past and for me I didn’t prefer them. Never tried FFM. 

Another idea, I now use a Wellue O2 ring to track my O2 levels during the night. I have found that useful to understand why I may have O2 drops. I have found if I don’t use my machine my O2 drops, And I can wake up in distress. You can enter the O2 readings in OSCAR, which is nice.

Pillow height also makes a difference. I have reduced to a low height pillow and bought one that you can remove the stuffing to the amount of fluff inside. 

Humidity setting will help with comfort, good to experiment with that as well. Even opening your window can be good as well. 

Advise would be to go back  to your sleep doctor with your concerns, maybe ask why the pressure is set so low? Can you go back to an autoset to let the machine work on your events? Hopefully someone more experienced will answer you.

Keep up on trying and you will succeed!
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