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PLEASE HELP! First night disaster.
#1
PLEASE HELP! First night disaster.
Hello.   I'm a complete  basket case this morning.    Last night was my first ever experience on a  machine and I'm totally depressed (and exhausted!!) 

I had such a positive "I can do this" attitude when I went to bed.    Maybe someone can help me because I really don't want to have to call the DME today.   I want to make this work IF POSSIBLE.

I have the  ResMed AirSense 10 Auto + Philips Resperonics Nuance Pro Nasal Pillow .   I had a choice of masks and told the respiratory therapist I'm not a mouth breather (or don't think I am anyway).   He recommended this mask based on how popular it where I live.    It seemed comfortable enough and I got the machine figured out with a trial run yesterday afternoon.   I'd been on oxygen already so was somewhat used to having a foreign object on my face at night. 

So, when I tried to go sleep I kept feeling like I wasn't getting enough air (my pressure is set at 6-12) based on the 12 AHI's from my home sleep study.   I don't like the hot air so I turned down the humidity to #2 and then 1.     After two hours I finally started to drift off but then I'd wake up gasping because my mouth would all of sudden be full of air and I had to exhale it from my mouth.   Does this make sense?   

I also wasn't sure if it was leaking because I could hear it - but then I'd look at the machine and the mask always had a happy face showing.   I don't know.   Is there supposed to be a little noise?   And why was my mouth filling with air and causing me to gasp?   


I finally ditched it at 2 am and hooked my oxygen up.    I feel awful.    I want this to work.   

Can anyone  please tell me if I'm doing something wrong?    Is this happening because I should have a full face mask?  (which I hope I don't have to switch to) 


  Thank you. 

Ps. I have MyAir and also downloaded Sleepyhead - but had 0% compliance.
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#2
RE: PLEASE HELP! First night disaster.
First, sit up with it on and running during the day. Watch tv, read, whatever. This will get your body and mind used to the sensations.

Second, as you are wearing it and it is on, play with your tongue. Move it so the air comes out your mouth then move it so the flow stops. Hold it there. It will become natural later. I don't open my mouth when I sleep but I do lip leak at times.

Third, it is okay. It will work out. Nearly all of us have been there done that. Those of us who put on the mask, turn on the machine, and fall asleep, never to have a problem is? I'm not sure they exist here or in the Real World.

Fourth, the Nuance is a good mask. It is what I use. Watch YouTube videos on how to adjust it. If nothing else, it will help you feel more in control of your own health. Coming here was the first step to that. Self empowerment.
PaulaO2
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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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#3
RE: PLEASE HELP! First night disaster.
THANK YOU PAULA02!    I will try the tongue thing.    It's comforting to know this air in the mouth thing is common and it can be overcome with practice.  Whew... you have helped me!   

Is there supposed to be air blowing out from the front of the mask too?    Like an exhaust?   The RS set it up for me.
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#4
RE: PLEASE HELP! First night disaster.
The venting from the front of the mask is normal for most masks. The vent rate is there to prevent re-breathing exhaled air. The Resmed Airfit P10 nasal pillows uses a diffuser that is quiet and does not appear to be venting. If the venting air becomes a distraction, keep that alternative mask in mind.
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#5
RE: PLEASE HELP! First night disaster.
Hi Suzi,
I was one of those basket cases too. I suffered from a lot of anxiety over this, simply because I hadn't yet found this forum and had no support from doctor or DME.

I would sit on the side of the bed, put on my mask, turn the machine on, and immediately (well within a few minutes) rip the mask off and turn off the machine. Then I would try to tell myself that I could do it. Took several tries. At one point, I unplugged my apap, took it out to the living room, set it up, put on my mask, grabbed a book and started reading. I couldn't believe that I had read several chapters and an hour later didn't noticed that I had anything on my face. It took me a few nights of doing this, but within the week, I was able to sleep most of the night in my own bed.

My point is.....don't freak out, relax and realize that it will take some time. Take it a day at a time.

Also, good idea to practice the Tongue trick. It will work if you can master it.
OpalRose
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www.ApneaBoard.com

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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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#6
RE: PLEASE HELP! First night disaster.
Normal to have your mouth blown open,i grind myteeth so i never needed a chin strap, maybe you do.
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#7
RE: PLEASE HELP! First night disaster.
I thought I wasn't a mouth breather as well and opted for a nasal mask, the AirFit n20.  First night...yup, a horrible nightmare.  You're in good company, if I say so myself.  Big Grin

I would just fall asleep and awaken in seconds with my mouth open and a torrent of air rushing out of it.  Turns out I open my mouth.  My jaw goes slack and my lips get separated as a result.

I now tape my mouth.  I use just under four inches of NexCare 1" wide white tape on a spool made by 3M.  Place over the lips with lips pursed, press and smooth all over, place your mask on, and that is how I sleep.

I am unfamiliar with your mask, so if it covers your nose and mouth, a strap is what could work for you, or a cervical collar.  My advice is to try the collar a few days and see if you can tolerate the warmth.  My wife can't.

This is a period of adjustment and learning.  You don't get bicycle riding on the first try.  Maybe the second, but not the first.
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#8
RE: PLEASE HELP! First night disaster.
(05-15-2018, 01:39 PM)Sleeprider Wrote: The venting from the front of the mask is normal for most masks. The vent rate is there to prevent re-breathing exhaled air.  The Resmed Airfit P10 nasal pillows uses a diffuser that is quiet and does not appear to be venting.  If the venting air becomes a distraction, keep that alternative mask in mind.

Thanks Sleeprider.   Okay then.  I don't mind the the vent as long as it's normal.   Smile
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#9
RE: PLEASE HELP! First night disaster.
Hello, and don't panic.  It's quite likely that you'll be comfortable with the CPAP therapy soon.  It takes everyone a little while to get used to it; that's perfectly normal.  Really, you'll be surprised at how quickly you find that it's no big deal. And you have an excellent machine to help you along.

The most important thing is to give it a chance, give it time, don't expect miracles in the first few nights (the miracles will happen later!), and don't blame yourself or assume that you must be an oddball for not wanting to put up with it.  Just keep on using it, and if necessary give yourself a lecture about putting up with a kind of adversity that really, when you look at it objectively, is not all that adverse. (As Dr. John the Night Tripper said all those years ago, "Just got to give myself a good talkin' to this time." ... OK, maybe you had to be there.)

And it does help quite a bit to use the machine & mask for some time before sleeping every evening, while reading or watching or maybe using the computer, as others here have said.  The longer the better, actually.  Just look at using the machine & mask as a normal part of your daily routine now, because it definitely should be that from now on. (Oh yeah, I was forgetting: indulging in screens just before bedtime is a bad thing and could make it more difficult to get to sleep. OK, then never mind that part, and stick with the reading instead.)

In this forum, in the list of "Important Threads" at the top, is one titled "Your Personal CPAP Success Story", and doing some browsing & skimming there can help quite a bit.  The thread has been there for a long time and it has collected 88 pages of replies, so maybe it'd make sense to start at the end and work backward. Whatever.  I'm not suggesting that anyone should read the whole thing.  You will discover that just about every new CPAP patient goes through the same kinds of difficulties, and (what's far more important) that staying with the therapy and defeating the difficulties does work wonders.  It's amazing.  CPAP is a great invention, no doubt about it.

About the mouth-breathing, don't assume yet that in your case it needs some artificial help like a chin strap or (IMO this is a bad idea in general, a last resort) taping the mouth shut.  It's too early for that.  Countless numbers of people who use only nasal masks are able to subconsciously train themselves, gradually over some number of nights, to keep the mouth closed while wearing the mask.  And the tongue-placement trick is useful.  Occasional "venting" from the mouth is not a big deal; it doesn't zero out your score in the game or anything like that.  There are discussion threads here, going way back (years), about mouth-breathing and its remedies, and you can search for them and read them to get a lot of moral support and a lot of practical advice about what to do and not to do.  Of course, as you're seeing, the advice from two or more people is often contradictory.  So you just have to try (at least briefly) whatever sounds plausible and not potentially harmful (unlike mouth-taping, because what if you have gastric reflux with mouth taped shut while sleeping?), and see how it works for you, and if it doesn't work, move on to something else.  Eventually you'll have your personal, customized set of CPAP practices to go along with your choice of machine and settings and mask.

There are also other masks that you can try, both the nasal-pillows type similar to your Nuance (but also different!) and then nasal without pillows (covering the nose) and full-face (covering nostrils and mouth), so if you find that your initial choice of mask has a few problems that seem serious, some kind of deal-killer, then don't give up; instead, try another mask, possibly one of those other types. Read in the "Mask Reviews" forum if you have time.  If you have to buy a mask yourself, it's relatively expensive (generally $75 to $100) but well worth it, seriously. It can make all the difference in making CPAP not only bearable but something that you'll look forward to.  Even staying with the nasal-pillows type, as Sleeprider said, the Resmed Airfit P10 has a diffuser to reduce the vent's noise & air blast, and another one with a diffuser, also very comfortable and lightweight, is the Fisher & Paykel Brevida.  Both of those are definitely worth trying.  If you were to take a poll here, you would find that the long-timers who have put years on their machines (and who wouldn't consider ever sleeping without them) have entire collections of masks, some of which they use, many of which they don't any more.  That's because with masks, unlike machines, there's really no way to find out what is right for you without trying it.

So hang in there, and do read some of those success stories, because doing that should give you a bit of a boost emotionally.
"I wanted to be a Boy Scout, but I had all the wrong qualities.  They were looking for kids who were trustworthy, loyal, helpful, friendly, courteous, kind, obedient, cheerful, thrifty, brave, clean, and reverent.  Whereas I tended to be devious, fickle, obstructive, hostile, rude, mean, defiant, glum, extravagant, cowardly, dirty, and sacrilegious."  (George Carlin)
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#10
RE: PLEASE HELP! First night disaster.
(05-15-2018, 03:09 PM)OpalRose Wrote: Hi Suzi,
I was one of those basket cases too.  I suffered from a lot of anxiety over this, simply because I hadn't yet found this forum and had no support from doctor or DME.  

I would sit on the side of the bed, put on my mask, turn the machine on, and immediately (well within a few minutes) rip the mask off and turn off the machine.  Then I would try to tell myself that I could do it.  Took several tries.  At one point, I unplugged my apap, took it out to the living room, set it up, put on my mask, grabbed a book and started reading.  I couldn't believe that I had read several chapters and an hour later didn't noticed that I had anything on my face.  It took me a few nights of doing this, but within the week, I was able to sleep  most of the night in my own bed.  

My point is.....don't freak out, relax and realize that it will take some time.  Take it a day at a time.

Also, good idea to practice the Tongue trick.  It will work if you can master it.
-
OpalRose - Thanks so much.   I will have to soldier through this.   I've been practicing today and it feels like I'm suffocating!    I was worried I'm not getting enough oxygen so I put on my finger oxygen/pulseomoter to see and Yep!  My oxygen is at least 95 - but it sure feels like I'm being smothered. ha!   
 
Like Paula said,  I need to get used to the sensations it gives.

(05-15-2018, 03:19 PM)mesenteria Wrote: I thought I wasn't a mouth breather as well and opted for a nasal mask, the AirFit n20.  First night...yup, a horrible nightmare.  You're in good company, if I say so myself.  Big Grin

I would just fall asleep and awaken in seconds with my mouth open and a torrent of air rushing out of it.  Turns out I open my mouth.  My jaw goes slack and my lips get separated as a result.

I now tape my mouth.  I use just under four inches of NexCare 1" wide white tape on a spool made by 3M.  Place over the lips with lips pursed, press and smooth all over, place your mask on, and that is how I sleep.

I am unfamiliar with your mask, so if it covers your nose and mouth, a strap is what could work for you, or a cervical collar.  My advice is to try the collar a few days and see if you can tolerate the warmth.  My wife can't.

This is a period of adjustment and learning.  You don't get bicycle riding on the first try.  Maybe the second, but not the first.

Yikes!  Tape!  (my husband probably wouldn't mind....hahaha!)    I'll keep that idea in mind.  
Thanks!
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