Newbie in need of help

[Osiris357]

From my experience the times where the mask ended up on the floor without realizing I did it happened because of 2 reasons. 

1) I couldn’t exhale properly even with EPR 3 or,

2) it was uncomfortable 

If you can afford it purchasing another mask and giving it a try might solve that problem. If you want to stick with pillows I suggest the ResMed AirFit P30i. If you would like to try full face I suggest the ResMed AirFit F30.

The F30 can be tricky to get right since the strap on top of your head is adjustable but once you get that adjusted correctly so the nasal cushion is sitting right under your nose without any tension on the other straps are relatively easy to get tensioned properly using the mask fit function.

Good luck to ya and remember patience is the key to getting this right

[zoraa]

Thank you all so much for your responses! This is all really great feedback

Honestly it is hard for me to tell if I'm not breathing well enough through my nose, or if I'm just not used to nasal breathing at night and it's taking some adjusting (as I've been breathing through my mouth for so long)

Im hoping it's the latter and I just need to get used to it. I hope the fact I'm able to fall asleep and stay asleep for two hours with nasal pillows and mouth tape means that I am capable of breathing nasally at night, but that I may just need to adjust

I will definitely try the suggested chin strap instead of mouth tape as well, though I worry I'd find a way to get my mouth open lol. Tape has actually been doing a good job with keeping things closed, but the chin strap might be more comfortable and I may be more compliant with it

Definitely going to give the nasal pillows a fair shot, at least to see if over time I'm able to wear them longer. Will report back when I get some more data!

Thanks again everyone

[jaswilliams]

Also putting socks on you hands might help prevent you taking the mask off

[JoeyWallaby]

Once I got flow limitations under control with BiLevel... I stopped taking off mask during night. You have some moderate flow limitation... wouldn't be surprised if you're taking it off at night because of the flow limitations and subconsciously finding it hard to exhale against the incoming pressure.

[zoraa]

Thanks again everyone for the info. JoeyWallaby I have to agree, I do think I'm finding it a bit of a challenge to breathe comfortably. Partially from breathing out against the exhale pressure, but also, I think I may just not be able to breathe nasally at night. I've been trying to force it but I'm just not sure I have the physical capacity to do it without surgery (right nasal airway is VERY narrow). I also know surgery is not a guarantee

I am going in to my supplier tomorrow to get a full face mask to see how that goes. I figured it couldn't hurt to see if it does help me breathe easier, stay compliant, and if I see improvements in my data. If I'm still not seeing improvements, thinking bilevel is the next step

I was able to get a couple hours of data, I attached two images to this post, first one has the recommended chart organization (without snores, I barely had any), second one has some additional charts. My AHI actually increased from before, but again, I think a big part of that might be that I'm forcing myself to try to breathe nasally. I had a couple of apneas as well, which I have a suspicion are largely positional. I've tried positional therapy in the past without much luck... I sleep supine for like 85% to 90% of the night, and it actually made me physically ill and extremely sore when I tried to force myself to sleep on my side instead (I also have some autoimmune issues, very sensitive to big physical changes). I would absolutely like to give it another try eventually, but right now I'm focusing on figuring out all this PAP stuff... oof lol

Feel free to let me know if you all have any thoughts, feedback, etc! Thank you again for all of your help

[Osiris357]

If you have nose breathing problems without cpap you definitely need a full face mask until that is fixed. You should be able to sleep a little longer with a full face. 

I’m wondering if those flow limitations aren’t from the air having difficulty getting through your nasal passage? Can you breath through your nose during the day without needing to open your mouth while just walking around? If not I’m surprised (sort of) that the doctor would prescribe a nasal mask.

I would wait till you have data from a night or 2 with a full face mask before changing settings. If I’m wrong others will correct me.

[zoraa]

If you have nose breathing problems without cpap you definitely need a full face mask until that is fixed. You should be able to sleep a little longer with a full face. 

I’m wondering if those flow limitations aren’t from the air having difficulty getting through your nasal passage? Can you breath through your nose during the day without needing to open your mouth while just walking around? If not I’m surprised (sort of) that the doctor would prescribe a nasal mask.

I would wait till you have data from a night or 2 with a full face mask before changing settings. If I’m wrong others will correct me.

Hmm that is a really good point. What is usually the culprit for flow limitations? As I mentioned I sleep on my back, and my jaw definitely has a tendency to fall back, so I'm wondering if that could be the issue?

I do have a custom made oral appliance to help with bruxism and it holds my jaw forward. But it's soooo uncomfortable, I have such a hard time wearing it. But maybe I should see if I can at least sleep with it for like 2 hours, with the nasal pillows, and see if that helps with the flow limitations. Also considering the soft collar route maybe?

They just pushed my appointment back to Friday for the FFM so I have a few more nights anyway to experiment with the nasal pillows. I can definitely breathe through my nose during the day, but really only through my left nostril, and I'm a full on mouth breather at night. Sometimes intra-nasal dilators can help a little but difficult to wear with nasal pillows.

Honestly I'm kind of self treating. The respiratory therapist recommended FFM but I wanted to see if I could force myself to breathe nasally so gave the pillows a chance, knowing it could be a total bust

Definitely going to experiment a bit more, thanks for your feedback . Im also currently halfway through your thread and have learned a lot from it!

[harrywr2]

If you have nose breathing problems without cpap you definitely need a full face mask until that is fixed. 

I was a life long mouth breather until I started on CPAP and my sleep doctor insisted I at least make an attempt at using a nasal mask.
At the moment a daily dose of Flonase(physician recommended), humidity at 5 and temp at 81 and the nasal pillows are workable .

[Gideon]

I am a big proponent of nasal masks, I use the P10 and used to be a "full-on" mouth breather. BUT I don't have any major structural issues with any part of the airway.

BUT the right mask is always the one that works for you. With an FFM, when side sleeping try to position the pillow so that your masks hang over it so the pillow itself doesn't dislodge it.. Also use a CPAP Hose clip to attach your hose to your pillow or PJs so you do not have the full weight of the hose trying to dislodge it.

Try the masks under pressure (bring your machine) while you are relaxed as possible and lying down in a sleeping position, for you try both sides and on your back.

[Osiris357]

Harrywr2 that was if it was the nasal passages themselves were restricting airflow due to being narrow without being stuffed up.

For me personally I wish I could use my pillows. The air always ends up in my mouth and of course right out of it. I can’t get the tape to stick past a couple hours. It always comes up in random spots and out comes the air. Thankfully I’ve been able to get my full face to be just as effective by adjusting settings