New to CPAP, wondering how well it's going

[Riayain]

I didn't even think about supplemental oxygen and it wasn't brought up after the sleep study or the titration night. I think that's because my O2 levels looked good and stable during the titration night. I might get a recording oximeter though, and if it does bring up worrying results, I'll ask for it in my next doctor appointment. Thanks a lot!

[Riayain]

Hi, sorry to make another post, but a couple more nights into the CPAP therapy and I kept getting bothered by leaks, so I changed to an AirFit N20 Small (from a Medium). Unfortunately, I think the mask keeps shifting in bed and so I have to tighten the straps a lot to reduce leaks when that happens. Since I've started tightening the straps, I started experiencing headaches on just the left side of my face even though I have both straps adjusted fairly evenly. Is this normal or is there another reason? They're not so tight that I'm getting marks and I can sleep with them, but the headaches make me think they're too tight...

[Dormeo]

Wish I knew the answer to your question! I'm posting just to ask you never to apologize for posting. This community is here to try to help, which we can't do unless you ask!

[Riayain]

It might help if I post some OSCAR screenshots, so here you go.

I didn't start experiencing the headaches until I tightened my straps to reduce air leaks when I move around in bed (I sleep on my side and wake up on my back). They're pretty much tightened all the way and they leave no marks, but the mask is definitely not floating like people say it should be... People say that the mask straps should be tightened just enough, but what even is just enough?

(Haven't adjusted the settings the previous posters suggested... yet. I wanted to discuss with my doctor once before making the decision.)

[Brazen]

I agree with Dormeo, no need to apologize for asking for help. That's why this board is here.

Have you read the mask primer article?

Masks are very individual and it can take a few trials to find one that works for your facial structure and your sleep.

What works for me, but may not for you...  is to hold the mask against my face, just with my hand, turn on the machine, and then small movements until most leaks are gone. Then I try to adjust straps for that same feeling.
I also make sure the straps are equal on both sides.

Once I have the mask on, with straps, turn the machine on again and lift the mask off my face a tiny bit to sort of re-seat it.  That re-seating is usually enough to get rid of leaks.

I also sleep with my head on the edge of the pillow so the mask is hanging in the air without pressure from the pillow.
Some nights are better than others.

Hope that is helpful.

[Riayain]

Thank you for both of your kind words.

I did indeed read the mask primer article and followed it. Unfortunately, I experienced leaks... I'm guessing that the N20 just doesn't suit my facial structure and how I sleep. It's a shame because otherwise I found it quite pleasant.

Luckily, the clinic I go to was open today. I called them and told them the situation and I'm now on an AirFit P10. This time I made sure to lie down at the clinic and put my head into all kinds of positions, including the chin tuck and smashing my cheek onto a bunched up coat. No leaks... that I could feel, anyway. And the straps didn't feel too tight. Then went home and turned on the mask fitting thing and tried again. No leaks, and this time I shook my head like a dog and went full smash-face-onto-pillow.

I guess we'll see tonight if the straps really were the problem! I'm now on the For Her head gear, near loosest it can get, and it's mighty nice to not have a lot of pressure against my cheek...

[Riayain]

Good morning from Japan. The headache continued to plague me all of yesterday, so I went to bed very early with my new AirFit P10. I woke up once maybe 2-3 hours in for reasons unknown, then slept all the way until the next morning.

I'm attaching my OSCAR results, but they honestly look pretty decent to me. A bit of leaking here and there, but nothing noticeable in my sleep and even when I woke up. I haven't implemented the other settings people have kindly advised yet.

The headache is gone, so that's nice. I'm a bit worried that the head gear is actually a bit too small, since I have a bit of a big head for a woman and it feels rather... snug, even at its loosest. I don't have a headache now, but I can sort of feel where the little adjustment clip is on my head, if that makes sense. No marks on my face. I'll see throughout the rest of today and the next couple of days, maybe ask my doctor in my next appointment if I can't try out a standard head gear size with the XS pillows.

I do have just a bit of irritation around the nostril openings. I hear there are nasal moisturizers and gels, and will head out to the pharmacy and try some out tonight. I already use a neti pot and nasal spray every day for allergies, so it's not a huge extra step for me.

What do you all think? If you have any advice, maybe even a mask type to try out if the pillows don't work out, I'd love to hear it. Thank you.

[Dormeo]

So glad you had a good night. Yes, ask about trying a standard size for the head gear. That might be just right for you. In the US there’s a product called Lansinoh that can be soothing to sore nostrils. (It’s made for nursing mothers.). It’s 100% lanolin. Maybe you can find something similar?

Your chart looks good. I would suggest you try EPR of 2. If you do, compensate by raising your pressure to 7.6. The additional EPR might reduce you flow limitations some. They may actually not be bothering you at all, but in case they are, the additional EPR could be a boon.

[Riayain]

So, I managed to find something similar that's 100% lanolin and I have to say, it does make a difference and lasts for surprisingly long. Wonderful, thank you for the recommendation!

Noted on the EPR and pressure change up 1. I do want to wait for the weekend since if I don't feel well after that change, I have two full days to recover. I'm surprisingly sensitive to this kind of thing... I was still dealing with the side effects of the tight N20 mask straps, for example, on Sunday!

Switching to nasal pillows seems to have given me a bit of aerophagia again. I'm guessing it's because the air is entering a lot more "directly" now and my body just needs to get used to it. I'll keep monitoring everything...

I also noticed last night that they did actually leak a bit when I pressed my head on my side. Not the top, thankfully, the bottom, and not both at once. I might try out S sized pillows in my next doctor appointment along with the standard sized head gear and see if that makes a difference. If not, I surprisingly don't care all too much since my AHI is looking good and I do feel somewhat rested. It's all a case of trial and error, is what I'm coming to find out...

[Dormeo]

Yes, trial and error -- or the experimental method, if we want to dress it up a bit! I'm glad you got some good goop for your nose, and do let us know how it goes with the revised settings.