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Night 4 was TERRIBLE!
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SylviaT Offline

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Posts: 30
Joined: Jun 2016

Machine: Philips Respironics DreamStation Auto CPAP
Mask Type: Nasal mask
Mask Make & Model: Respironics Dreamwear
Humidifier: Heated
CPAP Pressure: 8
CPAP Software: SleepyHead

Other Comments:

Sex: Female
Location: Emerald Coast - Florida

Post: #1
Night 4 was TERRIBLE!
So after the first night not falling asleep for over 3 hours and then two following nights of better sleep, but "other" issues, night 4 was a nightmare!!!!! I woke up twice with the feeling of choking. Dry throat and coughing like I had a cold! Finally took the whole dang thing off and went back to sleep. So needless to say I probably have a bad "grade" for last night with regards to how long I had CPAP Therapy.

Going to speak with the Medical Place tomorrow to see about trying a new mask and hopefully they will not budge when asking for a nasal mask/pillow! I'm not liking the full face one and I really don't think I sleep with my mouth open anyway.

On to night 5 with hopes for a better night sleep and more energy the next morning...........
06-05-2016 09:13 AM
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Sleeprider Offline
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Posts: 3,390
Joined: Dec 2014

Machine: Resmed Aircurve 10 Vauto
Mask Type: Nasal pillows
Mask Make & Model: Resmed Airfit P10
Humidifier: Resmed Climateline
CPAP Pressure: Auto Bilevel 18/9, PS 3
CPAP Software: ResScan SleepyHead EncoreBasic

Other Comments:

Sex: Male
Location: Where they make Respironics

Post: #2
RE: Night 4 was TERRIBLE!
Most people get good results with nasal pillows like the Resmed Airfit P10, and the most common error is to select too small a pillows size. DMEs will repackage the nasal pillows mask "kit" to only have one size of pillows. They should come with 3-sizes. Don't let them remove the medium and large size as it is far more likely you will need them than the small.

Setbacks happen, and don't let it get you down. Humidity levels and other settings can resolve many of these discomfort issues. Which model Dreamstation do you use? (might want to add to profile). If you have an auto, you might find a pressure range more comfortable and effective.

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06-05-2016 09:32 AM
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green wings Online

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Posts: 553
Joined: Feb 2016

Machine: Respironics System One RemStar Pro (460)
Mask Type: Nasal pillows
Mask Make & Model: AirFit P10
Humidifier: integrated humidifier
CPAP Pressure: 13.0 cm
CPAP Software: SleepyHead

Other Comments: using CPAP since Jan. 2016

Sex: Undisclosed
Location: US

Post: #3
RE: Night 4 was TERRIBLE!
Sorry you had a bad night, Sylvia. Comfort issues like you are describing are totally normal in the early days of adapting to CPAP, though.

Dry throat sounds like not enough humidity unless you had something else going on last night that wasn't typical (took allergy meds or something).

Do you know what setting you are using for expiratory pressure relief? Probably called C-Flex+ or something like that on your machine.

I started off with my treatment pressure at 7.0 and C-Flex+ at 2 when I first started CPAP this past winter. That was fine for a while, then suddenly one night I felt like I couldn't exhale against the pressure. The RT at my DME told me to increase C-Flex+ to 3. I did that, and it was lots more comfortable.

I needed the C-Flex+ at 3 for a while. I eventually lowered it back to 2 and then to 1.

I thought at first that the C-Flex+ settings were for 1, 2, or 3 cm decrease in exhale pressure, but they're not.

My understanding now is that C-Flex+ settings give around the same amount of decrease in exhale pressure (1.5-2 cm-ish), but that a setting of 1 makes the machine pressure return to the inhale pressure setting more quickly than a setting of 3 does. (If that's not right, I hope someone will explain it correctly.)


Re changing masks, yay nasal pillows!

If your DME has someone good at helping with mask fittings, you can make an appointment with them to try a different mask.

I just switched from a nasal mask (Wisp) to nasal pillows last month (AirFit P10 For Her).

I made an appointment with the respiratory therapist at my DME for a mask fitting. She helped me select the right size nasal pillows.

(Small for me; I was surprised, because I think of my nose as being on the large side. Maybe it is, but apparently the openings to my nostrils are a size Small.)

When I am wearing the nasal pillows, I can feel a tiny but definite rim of plastic that extends outside the edge of my nostril openings. (called "nares" in the plural. I had only ever heard that term used before in birdwatching.)

I also tried on the XSmall and the Medium pillows for comparison.

We also connected the mask to a CPAP machine set at my therapy pressure, and I lay down to get a feeling of what it was like to breathe through the nasal pillows.

I tried on the AirFit P10 "For Her". I think the difference is that the headgear is gray & purple rather than gray/blue and the kit comes with smaller nasal pillows sizes (XS, S, & M). I'm not sure if the headgear is a smaller size.

I love the headgear! It's so small and stretchy. I am wondering how long it will stay that way, but for now, it's really comfortable and easy to adjust.


I also tried on Nuance Pro nasal pillows. The pillows themselves felt softer to my nose than the ones with the P10, but the headgear didn't fit me very well, and the P10 is much lighter. The short section of hose that extends from the P10 nasal pillows feels downright flimsy, but the low total weight is a huge factor in comfort.

I actually brought the Nuance Pro home first (those gel nasal pillows are SO comfy), but because I couldn't seem to get the headgear adjusted to fit well, by night 3 the whole feeling had changed to not-so-comfy. I had an awful time with the velcro straps on the sides of the Nuance. They need to be adjusted just right to keep the pillows from rubbing the nostril openings. I just could not get them adjusted right. I might have kept trying if I hadn't known the P10 was there as the other option.

I read the reviews for the Nuance Pro in the Product Reviews section on this forum, and they have some really great reviews. They just didn't work for me.

Re the mouth breathing thing, I can see from my breathing flow rate graph in SleepyHead that I am leaking air from my lips at times during the night, but it never shows up as "large leak" so I've been ignoring it. (I don't really understand how it could NOT cause a large leak. Maybe it's just a tiny "puff"?)

I will probably try a chin strap at some point. I have been putting that off, because they look like they are one of those items that are really individual in what fits best and works best for each person.



(06-05-2016 09:13 AM)SylviaT Wrote:  So after the first night not falling asleep for over 3 hours and then two following nights of better sleep, but "other" issues, night 4 was a nightmare!!!!! I woke up twice with the feeling of choking. Dry throat and coughing like I had a cold! Finally took the whole dang thing off and went back to sleep. So needless to say I probably have a bad "grade" for last night with regards to how long I had CPAP Therapy.

Going to speak with the Medical Place tomorrow to see about trying a new mask and hopefully they will not budge when asking for a nasal mask/pillow! I'm not liking the full face one and I really don't think I sleep with my mouth open anyway.

On to night 5 with hopes for a better night sleep and more energy the next morning...........
06-05-2016 11:21 AM
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pupcamper Online

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Posts: 404
Joined: Nov 2015

Machine: PR DreamStation CPAP Pro
Mask Type: Nasal pillows
Mask Make & Model: AirFit P10 Pillows; Quatro Air FFM
Humidifier: DreamStation Heated Humidifier
CPAP Pressure: 10.5 cmH2O; no ramp; no C-Flex
CPAP Software: SleepyHead EncorePro

Other Comments: Lung cancer survivor since 11/2004; CPAP since 11/2015

Sex: Male
Location: Van Buren, Arkansas, USA.

Post: #4
RE: Night 4 was TERRIBLE!
(06-05-2016 09:32 AM)Sleeprider Wrote:  Most people get good results with nasal pillows like the Resmed Airfit P10, and the most common error is to select too small a pillows size. DMEs will repackage the nasal pillows mask "kit" to only have one size of pillows. They should come with 3-sizes. Don't let them remove the medium and large size as it is far more likely you will need them than the small.

Setbacks happen, and don't let it get you down. Humidity levels and other settings can resolve many of these discomfort issues. Which model Dreamstation do you use? (might want to add to profile). If you have an auto, you might find a pressure range more comfortable and effective.

I agree with sleeprider.

(06-05-2016 09:13 AM)SylviaT Wrote:  So after the first night not falling asleep for over 3 hours and then two following nights of better sleep, but "other" issues, night 4 was a nightmare!!!!! I woke up twice with the feeling of choking. Dry throat and coughing like I had a cold! Finally took the whole dang thing off and went back to sleep. So needless to say I probably have a bad "grade" for last night with regards to how long I had CPAP Therapy.\

On to night 5 with hopes for a better night sleep and more energy the next morning...........

Those are all signs of mouth leaks/breathing and can occur with a FFM as well as nasal masks and nasal pillows, especially if your humidity is set too low. You can control the mouth leaks by sealing your mouth from your throat with the back of your tongue. If that doesn't work you may have to use a chin strap, which is the case for me even with a FFM. It may be a good idea to pick up a chin strap while at the Medical Place, just in case. The Ruby chin strap works well for me, although your mileage may vary.

"....respiration,—a troublesome practice, but one which custom has rendered necessary to our easy existence...." Oliver Twist, Charles Dickens- 1837

I use FlashPAP to load data from a FlashAir III wifi sd card in my machine to my computer and display it with SleepyHead .
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06-05-2016 11:23 AM
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PoolQ Offline

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Posts: 986
Joined: Jul 2015

Machine: AirCurve 10 VAUTO
Mask Type: Full face mask
Mask Make & Model: Amara View
Humidifier: Integrated
CPAP Pressure: 6.2, 15, PS4.0
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Sillicon Valley

Post: #5
RE: Night 4 was TERRIBLE!
I see you are using the Amara View, me also, and for a reason-I have trouble exhaling into pressure. I tried the P10 and could not handle it even one night, DME said "well of course, you have trouble exhaling into pressure".

I love the Amara View and have to admit that it takes quite a bit of practice getting it set up correctly.
1. it is very sensitive to strap pressure, 1/8" at a time for adjustments
2. that little strap of silicon near the breathing port should sit flat against your upper lip and not up under you nose
3. the mask seals around your nose from the sides inflating inwards and not from upward pressure from the straps
4. your nose should sit in the "cup" with the end of the cup just covering the tip of you nose
5. I like to put my nose into position first and then set the mouth part in place, others do it the other way around (mouth first)
6. if it's leaking pull it away from your face a little to let the gasket inflate and set it back down- this take practice and even after months of use sometimes I have to do this several times before it sits correctly

Good luck!
06-05-2016 11:47 AM
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PoolQ Offline

Advisory Members

Posts: 986
Joined: Jul 2015

Machine: AirCurve 10 VAUTO
Mask Type: Full face mask
Mask Make & Model: Amara View
Humidifier: Integrated
CPAP Pressure: 6.2, 15, PS4.0
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Sillicon Valley

Post: #6
RE: Night 4 was TERRIBLE!
I just took a look at your other post (3 nights in) and you are leaking a lot. play with 1-6 above when you are not trying to go to sleep so you have time to adjust things, sitting up and laying down.

Also you seem to be spending a lot of time right at your max pressure. If the machine would like to go higher and is stuck at the max this could be letting you go or stay at almost an apnea level and feel like you are not getting enough air. Could tell better with a post of the waveforms
06-05-2016 11:55 AM
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sdb7802 Offline

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Posts: 199
Joined: Jan 2016

Machine: PR DreamStation Auto
Mask Type: Nasal pillows
Mask Make & Model: ResMed AirFit P10
Humidifier: built-in with heated hose
CPAP Pressure: 9.5-14 C-Flex 3
CPAP Software: SleepyHead

Other Comments: Retired Electrical Engineer; began using cpap in 2001; FlashAir wifi card and FlashPAP app

Sex: Male
Location: Georgia, USA (The Margravate of Azilia)

Post: #7
RE: Night 4 was TERRIBLE!
The P10 is definitely worth a try.

As PoolQ said, you might be more comfortable with a little higher minimum pressure.

I also use C-Flex = 3 and it makes a difference.

For me less humidity is better; I use humidifier = 1, tubing heater = 1, mode = adaptive.

I use sugar-free wild cherry cough drops for a dry throat.

Good luck and post some graphs when you can.

Just my personal opinion. My posts are not medical advice or a statement of fact. Please consult a qualified physician or other qualified medical personnel. Please comply with all applicable laws, codes, regulations, and protocols.
06-05-2016 12:30 PM
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SaldusMiegas Offline

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Posts: 228
Joined: Apr 2015

Machine: ResMed AirSense 10 AutoSet
Mask Type: Nasal pillows
Mask Make & Model: P-10, F&P Simplus
Humidifier: integrated
CPAP Pressure: Rx:14, Set:Auto 8.0-15.0
CPAP Software: ResScan SleepyHead

Other Comments: Woot! P-10 pillows plus Ruby chinstrap for side-sleeping mouth breathers

Sex: Male
Location: Virginia

Post: #8
RE: Night 4 was TERRIBLE!
Dry mouth, dry teeth, dry tongue, dry throat ... all symptoms of air leaks. Sometimes the air will go in through your nose and come back out through your mouth. If you are seeing air leaks in your data then the dry throat might be associated with the air leak.

Saldus Miegas
06-05-2016 05:27 PM
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SylviaT Offline

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Posts: 30
Joined: Jun 2016

Machine: Philips Respironics DreamStation Auto CPAP
Mask Type: Nasal mask
Mask Make & Model: Respironics Dreamwear
Humidifier: Heated
CPAP Pressure: 8
CPAP Software: SleepyHead

Other Comments:

Sex: Female
Location: Emerald Coast - Florida

Post: #9
RE: Night 4 was TERRIBLE!
(06-05-2016 12:30 PM)sdb7802 Wrote:  The P10 is definitely worth a try.

As PoolQ said, you might be more comfortable with a little higher minimum pressure.

I also use C-Flex = 3 and it makes a difference.

For me less humidity is better; I use humidifier = 1, tubing heater = 1, mode = adaptive.

I use sugar-free wild cherry cough drops for a dry throat.

Good luck and post some graphs when you can.


Here is a graph from last night. All of this is still completely greek to me, so hope this helps! Thank you!!!


Attached File(s)
.pdf  Day 4.pdf (Size: 231.09 KB / Downloads: 33)
06-05-2016 06:42 PM
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trish6hundred Offline

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Posts: 6,452
Joined: May 2012

Machine: Resmed S9 AutoSet for Her
Mask Type: Full face mask
Mask Make & Model: Fisher & Paykel Simplus
Humidifier: H5i Heated Humidifier
CPAP Pressure: 10 - 7-20 Cm H2O
CPAP Software: Not using software

Other Comments: I started CPAP in 2008. Totally blind since birth.

Sex: Female
Location: Missouri, USA

Post: #10
RE: Night 4 was TERRIBLE!
Hi SylviaT,
I know you are having a bit of a rough time right now with your CPAP therapy, but I encourage you to just stick with it. Don't be shy about asking to try different masks, 'till you find one that works for you.
All of this can take time to get used to but just hang in there, it does get better over time.
Good luck.

trish6hundred
06-05-2016 08:11 PM
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