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Newbe with Chipmunk Cheeks
#11
Hi Sandyelle,
WELCOME! to the forum.!
Good luck with CPAP therapy and also with getting it dialed in to meet your needs.
!

Hang in there for more responses to your post, and you've come to the right place for guidance.
trish6hundred
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#12
I’ve got chipmunk cheeks too  Laugh-a-lot(never heard anyone else say that before) 
Anyway I’ve found nasal pillows to be the best bet for fitting without leaks. Our cheeks can cause leaks with full face masks that has nothing to do with your mouth being open. I suggest trying nasal pillows
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#13
(10-10-2017, 06:56 PM)LisaH Wrote: I’ve got chipmunk cheeks too  Laugh-a-lot(never heard anyone else say that before) 
Anyway I’ve found nasal pillows to be the best bet for fitting without leaks. Our cheeks can cause leaks with full face masks that has nothing to do with your mouth being open. I suggest trying nasal pillows

Unless your mouth flops open with a nasal mask like mine does. The only way to stop air shooting through my lips is to tape.
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#14
I tried a chin strap last night.  I'm going to try it again before making an opinion.  My teeth and jaw felt funny, but maybe I'll get used to it.  Not thrilled about trying the cervical collar.  I had neck surgery years ago and wore a collar for a long time.  

I have shoulder surgery scheduled for tomorrow.  When the hospital called to go over my info, she said that they would discuss using the CPAP after surgery when I get there tomorrow, but it was important to continue using it after the surgery.  
I was told to sleep in a recliner for a little while.   

Thanks for all your help.
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#15
A lot has changed over the past month.  
I had surgery for a rotaor cuff tear  on 11/11 and I am still recovering from that.  I have to sleep
in a sling with little movement in my arm.  
I am still plugging along with with CPAP therapy. 

Current settings are
9 to 16.  
Ramp off 
My humidiity level is at 6 but I use almost a tank of water each night and still have try mouth.  
I have been using a chin strap but am still struggling to keep my mouth closed. 
I switched this week to an Amara View full face mask.  I think it is helping.  
I am sleeping more each night but also take a strong sleep medicine, but find I still
wake up often.  

Last night I had my best numbers yet.  AHI 2.57

I wake up several times a night and I adjust the mask, put on or take off the chin strap and drink water for my dry mouth.  

Any suggestions.  I am still exhausted, which may be partially due to the shoulder surgery.  I sleep in a adjustable bed at 30 to 45  degree for my shoulder.  Would turning the humidity level down help?  

[Image: 4uuIbZW.png]
thanks  for much for your help.
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#16
I have a feeling you are waking up several times due to your shoulder surgery. That can’t be very comfortable to try and sleep with your arm in a sling. Sad

I do feel that your minimum pressure to too low, especially since you spend most of your night at max pressure.

I would start to inch up the minimum pressure. I believe you need to be at 12min and 18max. You don’t need to move it to 12 all at once. Try 10, wait a few days, then raise it again. The minimum pressure should be closer to your 90% pressure reading or at median pressure reading which is 12cm.

As long as you don’t experience a whole bunch of Clear airways, the EPR setting of 2 seems to be ok.

Right now, comfort is important, so if you need to use ramp, set it closer to minimum pressure.

As far as dry mouth, try a mouth rinse before bed, like Biotene.
OpalRose
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#17
Thanks for the suggestion.  I'll increase the pressure tonight.  [Image: u7qfeFI.png]

This is night before last.
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#18
I’m not sure I understand the rationale for a chin strap if you have a full face mask. With an FFM, you can breathe all you want through your mouth (the goal of a chin strap is to stop mouth breathing).

Consider using Xylimelts and/or Biotene products for dry mouth. Dry mouth used to worry me more than it does now (although I’m still a newbie). When I get up to go to the bathroom in the night, I pour half a pint of water down my gullet. The dry mouth seems to correct itself very quickly in the am.

IME the humidifier doesn’t really help with dry mouth. Then I had to turn mine down because it makes me wheezy.

You can simply use a pillow (some folks swear by buckwheat) or a towel roll to organize your head in the right position. You likely know some of these tricks from having neck issues. Experiment with these while you’re awake? You could even try a series of methods and then check your SleepyHead chart to see the effect on flow limit.

I’m with you in not wanting to use a cervical collar.

Using a recliner can put your head in a non-optimal position for keeping airway clear.
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#19
Hi Sandyelle. You obviously had a big problem with leaks (22% of the night over the red line) and the great majority of your apneas occurred during the leak period. The problem here is that the machine can't accurately diagnose events during a large leak. So your numbers don't mean a great deal in that respect. The following night without the leaks you did much better.

Do you have a heated hose? If so, you could try setting the humidity to automatic climate control and see if that is better for your dry mouth. Just set the temperature to whatever is comfortable - I use 27 deg in summer and 30 in winter, as I like the air nice and warm.

I suspect you're not going to get consistent results until your shoulder is healed and you can come off the pain meds. Don't give up, but just realise you are in a difficult situation which will improve greatly with time.
DeepBreathing
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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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#20
(11-05-2017, 08:56 AM)Sandyelle Wrote: Thanks for the suggestion.  I'll increase the pressure tonight.  [Image: u7qfeFI.png]

This is night before last.


It’s hard to advise on humidity.  Try turning it down a notch.  Sometimes too much humidity is not any better than too little humidity.

I noticed the leak, which looks to be mouth breathing.

I know a lot of folk say a full face mask takes care of mouth breathing and it doesn’t matter.  I don’t necessarily agree with that.
If you are breathing through your mouth with a full face mask for a good part of the night, the result will be very dry mouth.

This shouldn’t be taken lightly, as that can have a negative effect on your teeth and gums over time.

If you feel that a chin strap helps, then it doesn’t hurt to try even with a full face mask.

Many of us have mastered the “tongue seal” method:
Place your tongue to the roof of your mouth with the tip of tongue behind front teeth, then suck upwards lightly.  Your tongue will find it's natural place and makes a seal at the back of your throat so that no air will escape should you open your mouth.  This takes time and practice.

For me, it was worth mastering.  I didn’t like a chin strap, but used it for awhile, and didn’t want to give up on nasal pillows, so I practiced, it took a couple months, then it became natural.

But for now, I think you need to give yourself time to heal and recover from your surgery.  Things will fall into place in time.
OpalRose
Apnea Board Moderator
www.ApneaBoard.com

How to Organize and Post ScreenShots

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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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