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Partner is struggling with CPAP
#1
Partner is struggling with CPAP
Tired partner here…who is not giving up, I need help understanding everything.

Husband received his machine (Resmed 10 Autoset) two weeks and has only worn it for 2 full nights. Both were an awful experience.
 
Thanks to everyone else’s post, he continues wearing it during the day or for a few hours before bed. He loosened the straps of his mask (nasal pillows). He stopped using his chin strap and ordered a new mask (Airfit20 full face mask, it’s not here yet).

When the mask was too tight, while wearing the chin strap - he felt too claustrophobic and it was hard to breath out.

After ditching the chin strap, he still struggled with breathing out.

Is this issue common for mouth breathers and nasal pillow masks in general? His sleep clinic tried to talk him out of trying a new mask, and didn’t offer much help to stay in it other than “keep trying”. How do nasal masks work for mouth breathers. I am concerned he will experience the same thing with the new mask, is there anything we are missing?
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#2
RE: Partner is struggling with CPAP
If he is a mouth breather, then either a nasal pillow or nasal mask is not going to work. There are hybrid masks available that would have a better chance of providing the needed therapy. All of them have a nasal sealing area and a mouth enclosure. The masks are, (off the top of my head) Resmed F30 and F30i, Philips DreamWear, and the F&P Evora. The difference between the Resmed models is where the hose attaches. The "i" model attaches to the top of the head, as opposed to the front of the mask. For me, I'm an F&P fan. F&P masks overall seem to require less strap tension to obtain a good seal. . . But that's just me talking.

I wish him good luck in succeeding.

- Red
Crimson Nape
Apnea Board Moderator
www.ApneaBoard.com
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#3
RE: Partner is struggling with CPAP
Couchpartner12,

Unfortunately it is trial and error.

I knew that for some people the hardest aspect of being compliant was the mask. I told myself I will stay with it because I waited decades to figure out what was wrong with me.

I was not prepared for the panic attack in the DME office when a nasal mask had something that went in front of my face. I have a bump on my nose. The nasal cushion masks I tried did not seal. I knew enough to lay down while trying on the masks.

I settled on a nasal pillow mask with a tube up the side (the pillows go in the nose). I realized my mouth opened not an issue before CPAP. My sleep became worse, woke up more but not from leaks.

Went back to DME, got a different nasal pillow/prong mask with tubing going up the two sides of my head behind the ears and in front of below my chin. I woke up less often so stuck with it. I taped my mouth. Got a sore in my nose, got it cauterized so I can continue wearing the mask whenever laid down for naps, reading and for sleep.

Winter was approaching, like now, so I decided to get a full face mask incase I get a cold. I got HYBRID Universal mask made by Innomed, later RespCare. I decided to try this full lace because it had the same nasal pillows/prongs, it came with all the sizes and it had a built in chin strap.

I found I got deeper sleep. I was still waking up. I never went back to the nasal pillows. I have had the same for 15 plus years. A few years ago I tried some other company hybrid masks at the DME. Bought the same one. This year my face has changed a bit the new ones I just got do not seem to fit as well but I am still using the same one. I always wore the medium cushion, now that is big on me and the small is small. So I go between the two sizes depending on my face.

I woke up many times with the mask off.

The only thing I can say to your husband is "I needed the attitude sleeping without my machine was not an option. No matter how many times the mask came off it went back on. I did not blame myself for taking the mask off while asleep, half asleep or just waking up. It would have been to easy to blame the mask and everything else. It would have been easy to get negative but I knew I did not have the physical or emotional energy to waste on negativity. You are not alone. I wish you success."

Other thoughts.

- With a full face mask the minimum pressure should be 7cm.
- If you use Exhale Pressure Relief (EPR) increase the pressure if feeling like you need air..

It takes time to figure out if you need more/less humidity, higher/lower tube temperature.

It is an adventure/road trip or whatever keeps you positive and at it.
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#4
RE: Partner is struggling with CPAP
Here is a link - Mask Primer

http://www.apneaboard.com/wiki/index.php/Mask_Primer

There is a section on Mouth Breathing and a tongue trick. I have not tried it but I have seen it recommended.
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#5
RE: Partner is struggling with CPAP
CPAP is awful. Most people stop using it in the first year. I gave up after 3 months of being totally unable to fall asleep without being drugged.

Has your husband tried an oral appliance? I am getting fitted for one next month. We will see if that gives me insomnia or not.

Have you looked into the Inspire implant? I had wanted to get that but my AHI is too low to qualify for it (I had a 6.4, so the health risks of not treating my apnea are fairly low.)
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#6
RE: Partner is struggling with CPAP
joepublic23,

Look up Sleep apnea and Heart health.

Your statement, [(I had a 6.4, so the health risks of not treating my apnea are fairly low.)], is so misleading. RERA do not show up in the AHI calculation, they are still detrimental because of the wake ups. There are different issues that cause Sleep Apnea and sleep issues, they are not good for the health.

I am sorry to hear that you stopped.
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#7
RE: Partner is struggling with CPAP
Two different MDs confirmed that for me personally, the health risks of not treating my apnea were low, provided I don’t gain weight (I am fairly thin) or have my apnea get any worse.

The first MD agreed that the insomnia being caused by the CPAP was a bigger problem.

The second one said he would never have put me on CPAP as a first step given how mild my apnea is and my well founded concerns about insomnia.

It is misleading to stay that I stopped CPAP since I was completely unable to fall asleep with it- in reality I was unable to start.
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#8
RE: Partner is struggling with CPAP
Hang in there! I too struggled to find a mask that consistently worked for me. I am now a fan of the hybrid masks. But I started with an F20, and I think of it as a good "starter" mask as it is relatively easy to adjust to minimize leaks. My feeling is that starting with the FF masks is a plus, as you can optimize the pressure first without struggling with leak or nasal congestion issues. Then you can move on to see which style works best for you. With the CPAP settings optimized he should literally not feel the pressure and have less, not more, resistance to exhales.
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#9
RE: Partner is struggling with CPAP
Rainbowfish,

“My feeling is that starting with the FF masks is a plus, as you can optimize the pressure first without struggling with leak or nasal congestion issues.”




Thanks for the reply! Could you clarify what optimizing the pressure means exactly?
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#10
RE: Partner is struggling with CPAP
The initial settings from the results of your sleep study will almost certainly not be what you end up with.  

For instance, my own experience is below:
I knew going in I was a mouth breather so I asked for a FF mask and was given an F20.  With it I almost immediately had no leaks. When EPAP pressure is set too high, it is hard to breathe out, if it is too low, it was hard to breathe in and the EPR does not effectively facilitate exhales (nix the ramp setting if the last is an issue).  I lost my provider in the middle of all these adjustments and the great people here helped me stay on track.

Once I had comfortable settings with the F20, I started playing around with different styles of masks (some of the online sellers offer a "come on" price for initial purchase).  With the CPAP pressure I can breathe through my nose, so I tried pillow and nasal masks.  But after 60 years of mouth breathing, it just did not feel natural, and I had lots of mouth leaks.  So, I ended up with a hybrid mask where the CPAP pressures are equal over my nose and mouth, and there is no pressure over the nasal bridge (and you can use it with glasses on).  For me, an F30i plus fuzzy strap covers (from Amazon or the vender list), is comfy with virtually no leaks, and no strap lines.

This website has true experts on how the settings work, but they will need your OSCAR results.  And I would also recommend getting a O2 sat recorder like a Wellue ring (Amazon or the vender list) as the whole point is to keep your heart and brain getting oxygen.
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