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Pulling off nasal pillow while sleeping
#1
I just found this forum and really need help. I have had this machine for about 6 weeks and will probably not be able to keep it because I cant get more than 3.5 hours average use (I need at least 4 for Medicare to pay for it.) My AHI jumps all around from 1.3 to 8.5. Setting is 7 lbs/3.5 humidity. My problem is that while I am using the machine and sleeping on my back, I wake up suddenly and "rip" the thing off my head after 2 to 3 hours of sleep. I then lay on my side and sleep for a couple of more hours. Laying on my side has caused degeneration of my disks in my neck and my physical therapist says that I have to sleep on my back. I don't know what to do! My doctor only wants to see me after 30 days of use with a readout of the card, but I want to solve this problem and show some improvement before having the card read. Has anyone had this issue? What did you do to solve it? (I know that each person is "different," but I need some ideas. Thank you for your response.
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#2
The first thing I would suggest is to download sleepyhead and/or rescan and take a look at the data to see if you find anything that would cause you to take the mask off. If you are using a set pressure then it won't be because the pressure was too high. You can post your data and we can look at it to see if we see anything that would cause a problem. Can you tell us exactly what S9 you have? Is it an Elite, Autoset, etc. (you can see this information by the button on your machine)

Don't give up. We will do our best to help you.
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#3
First thing is some "tough love" -- you are doing 3.5 hours which means you can JUST DO THE OTHER 1/2 hour, even if you just wear it watching TV.

Get your 4 hours, however you must, then you "earn" your machine and you can work out the other problems as soon as practical.

You are getting more or less effective therapy (AHI 1.3 to 8.5). While 5 is the "official OSA limit", you at close, at or below that so presuming you had moderate to severe (or worse) apnea you are already miles ahead.

The most important thing for your therapy is to WEAR THE MASK.

So ask yourself WHY you rip it off? Is this due to noise, air blowing on you, claustrophobia, alien invasion, or what?

You then try to mitigate that -- starting with a conscious commitment to STOP, get out of bed if necessary, re-don the mask and use it to sleep, including on your side or on your back. Use it ALWAYS.

Now that can be easy to say and harder to do, so you might consider making it harder to remove. Put some tape over the straps, around your chin or wherever you must to make it HARD to just push it off without meaning to do so and without being mostly awake.

Wear a chin strap OVER the headgear maybe, but find a way to force yourself to either wear it or to WAKE UP and straighten things out.

This might lose you a little sleep now but will pay off in months and even YEARS to come as you get better and better sleep and treatment.

You might consider a new mask as well. Maybe you don't like THIS mask.

Most people go through something like 5 to 8 masks before finding "The One". (While you are at it, fill out your profile fully with the EXACT machine MODEL, not just S9, there are 3 S9s with wildly different capabilities.)

We'll help as much as we can so hang in there and just keep doing it better.

You are already part way there. Wearing the mask some of the time is good. Wearing it ALL of the time is much better, and eventually necessary for fully effective therapy.

Also note, as much trouble as you are having now, most everyone who STICKS WITH IT eventually finds it at least tolerable or more commonly VERY COMFORTABLE.
Sweet Dreams,

HerbM
Sleep study AHI: 49 RDI: 60 -- APAP 10-11 w/AHI: 1.5 avg for 7-days (up due likely to hip replacement recovery)

"We can all breathe together or we will all suffocate alone."
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#4
While I agree with everything that herbm has said, the real issue is "mind over mask". You need to convince yourself that you really need to wear the mask every time you lie down. I normally sleep on my back, unless the cats start driving me crazy, then I try to discourage them by sleeping on my side.
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#5
I used adhesive tape to keep the mask on my face. It made enough of a mess, pulling the mask off, that I woke up and gradually learned to stop pulling it. I only needed to use the tape for a week or so.
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#6
You're pressure is at 7 (not pounds by the way) so that's high enough that you shouldn't be having trouble getting enough air. So I think ME50's suggestion of downloading and installing the software so you can see where you're apnea events are taking place is the best idea for openers. Very often when sleeping on our back we need higher pressures to keep the airways open. So for instance if you titrated at 7, you might actually need 9 to successfully sleep on your back.

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#7
Thank you. I appreciate your help.

It is a ResMed S9 Autoset (36005)
Summary is for the past 6 weeks
Avg Hrs 3.33
AHI Avg 2.46
Leak Rate .48
Pressure 7
(10-15-2014, 09:20 AM)me50 Wrote: The first thing I would suggest is to download sleepyhead and/or rescan and take a look at the data to see if you find anything that would cause you to take the mask off. If you are using a set pressure then it won't be because the pressure was too high. You can post your data and we can look at it to see if we see anything that would cause a problem. Can you tell us exactly what S9 you have? Is it an Elite, Autoset, etc. (you can see this information by the button on your machine)

Don't give up. We will do our best to help you.

Thank you. I appreciate your help.

It is a ResMed S9 Autoset (36005)
Summary is for the past 6 weeks
Avg Hrs 3.33
AHI Avg 2.46
Leak Rate .48
Pressure 7
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#8
That is too little data to make any firm conclusion, but with an AHI of 2.46 I do suspect a small increase in your pressure would be helpful to you.

The Autoset is capable of support a range of pressures, not just a set pressure. If this were my machine, I think I would like to see a minimum pressure of 6 and a maximum pressure of 9 or 10. I would also turn on the EPR setting at level 2. That would allow your exhale to be 2 less than the inhale. So if your pressure was 8 for instance, it would drop to 6 on exhale to make things a little easier for you.

Call the Doc. Tell them that you know they want you to tough it out for a month before they do anything, but you really feel you need the machine set a little differently because you are not able to comply with therapy where you're at.


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#9
Hi Istopbreathing,
WELCOME! to the forum.!
I know CPAP therapy can take some getting used to but just stick with it; it will get better.
Call your doc and tell him/her about the problem you are having with your therapy.
Best of luck to you as you settle into using your CPAP mask and machine.
trish6hundred
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#10
(10-15-2014, 10:59 AM)PollCat Wrote: While I agree with everything that herbm has said, the real issue is "mind over mask". You need to convince yourself that you really need to wear the mask every time you lie down. I normally sleep on my back, unless the cats start driving me crazy, then I try to discourage them by sleeping on my side.

I actually agree with PollCat (agreeing with me), on his emphasis of "mind over mask" though I was trying to be 'gentle'. Smile

There are other ways to do it perhaps but the best plan I know is to just commit to wearing the darn thing 100% of the time and change what you must (including yourself) to make that happen.

Juanito has always tried -- successfully -- the "tape it on" trick, and only had to do that a week or so.

For most people a low of 7 is sufficient, but some of us aren't really happy until we get above 8.

We still need to know what you know or feel about WHY you rip the mask off?

Is it mere sleep ripping, or do you do it for some perceived discomfort?

Seriously, almost every one of us (even me) has had a mask they just can't stand to wear.

We might be able to help you wear your current mask better or to find a different ones that eliminates you main issues.

As retired_guy said we (and you) really need to see your full data (over multiple nights) to fully help....

For instance, something as simple as "avg hrs" of 3.33 could be 3 nights of wearing it 4+ hours followed by a night of (almost) not wearing it at all.

In this first case (3 of 4 over 4 hours) you would actually get enough credit with most insurance companies to KEEP the mask, but in the case where you wored it exactly for 3.33 hours each night you would get ZERO credit.

Averages kind hide important detail.

Sweet Dreams,

HerbM
Sleep study AHI: 49 RDI: 60 -- APAP 10-11 w/AHI: 1.5 avg for 7-days (up due likely to hip replacement recovery)

"We can all breathe together or we will all suffocate alone."
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