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So, I went to the CPAP shop and they had far less masks than what I imagined. Out of the several masks that they had, I found the DreamWisp to be the most comfortable. I tested it out lying down on a bed, with pressure at 7, and the thickest pillow they had. No leaks at the top or sides and I could push my head into the pillow very comfortably. Unfortunately, it costs something like $380 because apparently it's "new" and "medical grade" (I just think Japan likes inflating the price, even the ResMed Airsense 10 they were selling cost a whopping $3000!). Said I'd think about it, went home, and ordered the headgear with "arms" for the Dreamwear nasal cushion from Amazon to see if I can't solve my issues with it that way. Would be great if I could, since replacing parts regularly ain't cheap.
I also found a DreamWisp, unopened, for sale in Japan at a much lower price and might just purchase that as well to actually test it out and compare the two. Only the regular Wisp is covered under insurance though and I'm a bit worried the DreamWisp is no longer even being sold because of the magnets, so if it does fit and I can't find replacement parts...
Good morning. I've been testing out the Dreamwear Nasal Cushion over the last couple of days and surprisingly, it seems to be going decently. I managed to loosen up the straps just enough so I don't get cheek or teeth pain or headaches, and though the strap does ride up, it's far less than with the P10 and something that the new headgear (arriving the 17th) might be able to solve. AHI has been decent, leaks actually haven't been too bad, SPO2 looks good. I still want to try the Bleep mask and DreamWisp at some point, and I think it's good to know what other styles of mask you can fit, but so far, I think this might be an alright mask for me. Shocking!
Thank you everyone for your advice and help. I'll probably post again to confirm if the new headgear with arms actually works, but otherwise, I think I'm in a decent place with treatment right now and just have to take things slow, especially regarding my body adjusting to CPAP therapy so I can eventually work up to more optimal settings.
02-27-2023, 07:49 PM (This post was last modified: 02-27-2023, 07:51 PM by Riayain.)
RE: New to CPAP, wondering how well it's going
Hello, it's been a while. I got the headgear with arms for the Dreamwear Nasal Cushion a while back and have continued using the mask. It's not perfect, as it leaks when I'm on my side, but nothing significant and SPO2 and pulse rate have remained fairly steady. I still don't feel the best, but at this point I don't think it has to do with the mask straps... it's as loose as it's going to get.
Today I come with a new issue. I started mouth taping two days ago to see if I was leaking through my mouth in any way. My leak rate looks about the same, so I don't think so... or it could just be mild, occasional mouth leaks. But I woke up both days feeling dizzy and very stiff on my left side, from the back of my ear to my left shoulder. I even woke up once yesterday night and found myself sleeping on my left for some odd reason. I will stop mouth taping today and see if my condition improves. I'm wondering why this is happening (aerophagia and sinus pressure?), if it means I am mouth leaking and would be better served with a full face mask for more therapeutic results (and relieve sinus pressure?), if I do indeed need to increase my EPR and minimum pressure to see a decrease in the aerophagia.
I forgot to put my SD card in my machine yesterday, so I don't have today's results (ResMed app says my AHI and leaks were well within normal range though), but I do have results from the night prior. This time, I'm attaching a zoomed in screenshot as well.
You may just be tensing and positioning yourself in new ways in response to the unfamiliar feel of the mouth tape. I wouldn't be surprised if the problems abate as you get used to the feel of the tape. For me, that is now a very comfortable and even comforting sensation -- my mouth is all taken care of and I know I won't be awakened by the sound of air leaking out of my mouth.
Do you now feel you have the latitude to fine-tuner your settings? If yes, I'd recommend doing what was suggested a while back and setting your pressure to 7 and your EPR to 3. If you get an increase in OAs, you will want to raise the pressure bit by bit until they settle down; if you get an increase in CAs, you will want to reduce EPR to 2 to see whether that helps.
But unless you have real problems with revised settings, give any changes at least 3 or 4 days before you decide whether to stick with them or not. And as always, feel free to get advice from people here!
02-27-2023, 10:50 PM (This post was last modified: 02-27-2023, 10:53 PM by Riayain.)
RE: New to CPAP, wondering how well it's going
Unfortunately the dizziness and nausea from the tension is so bad that it's difficult to go about by day to day, so I think I need to stop using the mouth tape. I have not once woken up due to air leaking from my mouth and OSCAR doesn't really show any difference between using the mouth tape and not (as far as I can see anyway), so I don't think the effects, even if temporary, are worth it...
As for fine tuning my settings, I'm actually thinking of changing doctors to someone who might look at my OSCAR results and be a bit more flexible. I went back to my current doctor to at least change over to the APAP settings, citing how I didn't feel as good at 6.2 as I did at 6.6, and he told me that I was imagining things and such a small difference wouldn't make such a big change in how I feel each morning. He also ignored that my average AHI went up as a result, saying that I was considered treated if I was... get this... not under 5, but under 10! He did change my settings over to APAP, but he put the range down as 4.0 - 6.6, and when I asked why the minimum wasn't 6.2 as we discussed the last time, he told me that he couldn't do it for one reason or another. I showed him my OSCAR results this time, pointing at the inhale vs exhale ratio and at my aerophagia, suggesting that it might be good to at least try a pressure of 7 and EPR of 2 to see if my aerophagia might improve. He wasn't having it, period! There was more that he said, about how I was imagining all my symptoms and all CPAP does is lower apnea events and not improve any symptoms besides sleepiness, but to cut it short, he is sounding more and more like an old doctor who needs a bit more education, and I will be reaching out for a second, third, and fourth opinion.
I can't edit the above post anymore, so I'll make a new one.
I made an appointment for tomorrow to get a second opinion, and I called one more clinic who didn't do second opinions, but listened very closely to my issues and said that even 0.1 change in pressure does make a difference, EPR can help my aerophagia, and I do seem to understand what's going on given I know the terminology and seem to have been tracking my results closely. They absolutely don't understand why my doctor isn't willing to be a bit more flexible, and are more than happy to have me transfer over to them to see if I can get more optimal treatment.
I'll still go to the appointment tomorrow, but the call went so well that I honestly might just call my current clinic afterwards, politely request the transferal documents, and make an appointment at the place I called for later this week. It's very nice talking to someone who isn't so dismissive of how I feel on the treatment. I even teared up during the call because of how frustrated I was. I've been suffering from the symptoms for months, unable to work at one point, and finally saw a little improvement on the CPAP and just want to stay on it with less aerophagia and other "side effects" of the treatment, all to have my doctor tell me that these symptoms are irrelevant and I just have some kind of anxiety disorder...
Thank you everyone for your kind words up until now, and hopefully within another two weeks I'll have more positive news to share.
02-28-2023, 05:40 PM (This post was last modified: 02-28-2023, 06:15 PM by Riayain.)
RE: New to CPAP, wondering how well it's going
Good morning from Japan. I slept without the mouth tape last night and propped my arms on pillows to try to relieve some neck and shoulder pain.
Unfortunately, I woke up still feeling lightheaded (less, though!), with neck and shoulder tightness (especially behind the ears), and even a little short of breath. I think my settings do need to be changed to reduce aerophagia and pressure on the sinuses and ears, but perhaps my current mask is also to blame, as it pulls at the top and leaks slightly when I'm on my sides, causing me to tense up to remain in a position where it doesn't leak overnight. This is just a theory, but the best one I've got since I didn't experience this with the N20 or P10 masks. (Nope, instead the N20 unfortunately leaked at the top no matter what and the P10 just gave me a headache and made my aerophagia worse...)
Tonight, I think I'll finally make the effort to put on and adjust the Bleep mask. Do you have it set as a pillow or nasal mask?
I'm going to try and expedite my transferal documents to this morning and see the clinic I called this afternoon. They seem to be a lot more thorough and might do a better job at mask fitting, even. Let's see.
I transferred doctors and I'm already glad I did. They're far more willing to make adjustments to my CPAP therapy. I'm now on APAP, going from 4.0 to 7.0 with an EPR of 2. Yes, finally, my EPR was changed! They want to wait and see the results of this before making any adjustments to the minimum pressure. They also said they want to revisit my first mask to see where the problem really lies - how I put it on or the actual shape of the mask. But that'll be for my next appointment - they taught me a way to manage my hose with my current mask so that my body hopefully doesn't tense up at night. I'll give it a try and see.
Either way, they said I'm overall doing very good with the treatment, I just need to give myself more time and grace. Which, well. I guess I will. I have to.
I'll see how I do in the next few days with these new settings, maybe post a screenshot of OSCAR tomorrow with a zoom in on the flow rate now that my EPR is on 2.
The hose management trick my new doctor showed me seems to be helping, because I woke up with significantly less tense neck and shoulder muscles and was even able to sleep on my sides without worrying about leaks!
I won't lie, I do feel a bit lightheaded, but it feels more like the initial type I had in the beginning when my pressure was set at a fixed 6.60. Almost as if I'm a bit high. I guess it's because of my new settings? It took a few days to die down back then, so I'm assuming it'll take a few days now, too.
Ear pressure and sinus pain has reduced. I do have a bit of aerophagia, but so far it's manageable. We'll see in the next couple of days.
Yawned a few times when I got up. I got less than 6 hours of sleep, so it could be that. Yawned a lot yesterday though and I slept more. We'll see if the yawning dissipates in the next few days.
Attached a couple of OSCAR screenshots. I do seem to spend a lot of time 7.0. Wondering if that means there's a stronger case for raising my minimum next time. As for the flow rate, CAs look fairly normal, flow limits appear to be around the same, wondering if a switch to EPR 3 might be better but also not even sure if a switch to EPR 2 has made a difference. Might need a few more nights' data.
Update: Never mind the "a bit of aerophagia" sentence. It's a lot. Burping, farting, weird stomach and chest pains, the works. I was told by the new clinic that possibly I need to change my pillow, because I currently use a Tempurpedic pillow and my head actually tilts back a bit, possibly causing my mouth to open a bit when I sleep. I'm trying out a different pillow tonight. Sigh...
