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Struggling with CPAP issues
#1
Struggling with CPAP issues
I’m struggling with two interrelated issues. 

I started in March with a DreamStation 2 using an F30 mask. It went great for a few weeks but the I’ve found it difficult to tolerate the silicone in the mask. My skin gets clammy and sensitive, while the silicone edge tends to cut into my skin. I’ve tried a Wisp, but it’s clear I start mouth breathing. 

The second issue is that after my first followup with the clinician a couple of weeks ago, she observed that I’m getting more central apneas. These were negligible during my sleep study, but I’m seeing half my apneas as central and my AHI has been running between 8 and 12 on the nights I can tolerate the mask. 

As a result, my clinician set me up for a non-venting mask. The respiratory therapist from the DME gave me a 1 foot extension with an exhaust valve at the end, and told me to tape over the vents on the F30. The extension goes between the mask and the regular hose, so I assume the idea is to just move the CO2 away from my face. 

But now I want to try a gel mask to see if that will improve my comfort. I’m willing to pay out of pocket and order online. But I have no idea if this nonventing strategy will work with other mask brands.  I don’t have that much confide me in the respiratory therapist because he kept saying latex instead of silicone and didn’t have any interest in addressing that issue first. 

Any suggestions on whether a gel mask might improve my comfort?  Or maybe one that actually covers my nose instead of the F30?  And if so, will it be safe to cover its vents and use with my extension vent?

Thanks for any help!
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#2
RE: Struggling with CPAP issues
(05-24-2022, 12:24 PM)K2write Wrote: I started in March with a DreamStation 2 using an F30 mask. It went great for a few weeks but the I’ve found it difficult to tolerate the silicone in the mask. My skin gets clammy and sensitive, while the silicone edge tends to cut into my skin. I’ve tried a Wisp, but it’s clear I start mouth breathing. 

Try something like Lansinoh, which is a lanolin cream. You can find it in baby aisle of the drug store, sold as a salve for nursing mothers.

Quote:The second issue is that after my first followup with the clinician a couple of weeks ago, she observed that I’m getting more central apneas. These were negligible during my sleep study, but I’m seeing half my apneas as central and my AHI has been running between 8 and 12 on the nights I can tolerate the mask. 

It's likely that those central apneas will go away as you adapt to CPAP therapy. The more you use it, the faster and better you'll adapt.

Quote:As a result, my clinician set me up for a non-venting mask. The respiratory therapist from the DME gave me a 1 foot extension with an exhaust valve at the end, and told me to tape over the vents on the F30. The extension goes between the mask and the regular hose, so I assume the idea is to just move the CO2 away from my face. 

I've never heard of such a device. The purpose of the vents on the F30 is to keep the tubing purged of exhaled air. Taping them over seems stupid and is contrary to the manufacturer's warning, for a very good reason.

Plus I don't see how a "non-venting" mask will treat central apneas.

Quote:But now I want to try a gel mask to see if that will improve my comfort. I’m willing to pay out of pocket and order online. But I have no idea if this nonventing strategy will work with other mask brands.  I don’t have that much confide me in the respiratory therapist because he kept saying latex instead of silicone and didn’t have any interest in addressing that issue first. 

I would try the gel mask. Get it from your equipment provider. Your insurance will cover extra masks during your adaptation period. It's quite common to have to try several masks before finding one that works best for you. Meanwhile, try the lanolin cream. I wouldn't tape over the vents on either mask, or use that 1 foot extension thingie until we find out what it is. Your best strategy for fighting the centrals is to get a comfortable fitting mask and that you use it as much as possible. Whenever you're sleeping, is my advice.
Sleepster

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: Struggling with CPAP issues
Also, contact your doctor's office and ask just which mask they're prescribing. It sounds like your equipment provider is trying to pull a fast one on you by having you tape over the vent holes on your existing mask. They've entered into a contract with your insurance company to provide you with the right equipment, even if it cuts into their profits.
Sleepster

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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#4
RE: Struggling with CPAP issues
What he did was increase the amount of CO2 that you rebreathe to increase your blood CO2 concentration to remain above your apneic threshold.

Not having seen your charts I don't know if this is appropriate for you but I and others on this forum have coached a few members on this direction. Search both our wiki and forum for EERS, Enhanced Expiratory Rebreatheing System. http://www.apneaboard.com/wiki/index.php...Eers&go=Go

There is a form of central apnea that occurs because too much CO2 is flushed from your system. It is the need to remove this CO2 that provides our main drive to breathe.
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#5
RE: Struggling with CPAP issues
(05-24-2022, 02:21 PM)Sleepster Wrote: Try something like Lansinoh, which is a lanolin cream. You can find it in baby aisle of the drug store, sold as a salve for nursing mothers.

Thanks, I’ll try that.

(05-24-2022, 02:35 PM)Gideon Wrote: Not having seen your charts I don't know if this is appropriate for you but I and others on this forum have coached a few members on this direction.  Search both our wiki and forum for EERS, Enhanced Expiratory Rebreatheing System. http://www.apneaboard.com/wiki/index.php...Eers&go=Go

I can post OSCAR images if that would help, but I wouldn’t know which days to post. I’m still learning how to work with OSCAR.   In the meantime, I’ll follow that link about EERS.  


I’ll also give my DME another call.  When I went for the venting change, I asked about gel mask but he didn’t have any for me to try. If they don’t stock them, I’ll look elsewhere.
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#6
Inconsistent results with same setup
I've been getting very inconsistent results from day to day, and I'd like help to understand why.

My setup is a DS2 with an AirTouch F20.  I'm currently using a plain hose, as my heated hoses tore again and I'm waiting for a replacement.  I'm using an EERS setup, meaning I've taped over the vents on the F20 elbow and have a vent device on a hose extension about a foot from the mask.  (Thanks to Gideon for pointing me at the wiki page on EERS.) 

I'm attaching last night's OSCAR with an AHI of 9.63 (the highest it's been this week) plus the report from a few nights earlier, with an AHI of 3.99:

   

   
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#7
RE: Inconsistent results with same setup
Always keep posts on your therapy in the same thread.  I'm on my phone and I don't see it.  

In your profile indicate you are using EERS, 12 in extension.  It is important for us to realize that you are using nonstandard setup.  Nothing wrong with EERS  but as we provide data driven advice it helps to know what your setup is.

On your inconsistencies.  It is a form of positional apnea that we often refer to as chin tucking.  You have shown one bad night but one night does not make a trend.  On the second night you still had some positional, but not enough that I would aggressively try to eliminate.  So how much do you get over time?
Read about  soft cervical collar in my signature to learn more on it.

I'm going to request a moderator merge your threads.
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#8
RE: Struggling with CPAP issues
As per Gideon's request, I have merged the two threads. Since the original thread title still seems appropriate, I didn't change it.

- Red
Crimson Nape
Apnea Board Moderator
www.ApneaBoard.com
___________________________________
Useful Links -or- When All Else Fails:
The Guide to Understanding OSCAR
OSCAR Chart Organization
Attaching Images and Files on Apnea Board
Apnea Helpful Tips

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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#9
RE: Struggling with CPAP issues
Try the Resmed N20 or F20. The mask is lined with memory foam instead of silicone. Much more comfortable for me.
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#10
RE: Struggling with CPAP issues
(07-27-2022, 05:39 PM)Gideon Wrote: Always keep posts on your therapy in the same thread.  I'm on my phone and I don't see it.  

In your profile indicate you are using EERS, 12 in extension.  It is important for us to realize that you are using nonstandard setup.  Nothing wrong with EERS  but as we provide data driven advice it helps to know what your setup is.

On your inconsistencies.  It is a form of positional apnea that we often refer to as chin tucking.  You have shown one bad night but one night does not make a trend.  On the second night you still had some positional, but not enough that I would aggressively try to eliminate.  So how much do you get over time?
Read about  soft cervical collar in my signature to learn more on it.

I'm going to request a moderator merge your threads.

Sorry about that. 

Looking at chin tucking I’m wondering if it’s something related. My mask fits fine when I go to sleep, still in ramp mode. But I find I get annoying leakage in the middle of the night when the pressure is raises.  And one of the things I’ve noticed is that the silicone part, between the rigid plastic and the foam, tends to become inflated by the pressure, causing the mask to become tighter. This not only cause leakage between the foam and my skin but also puts pressure on my jaw, pushing it back. 

If that’s the problem, I don’t know how to fix it. 

(07-27-2022, 09:09 PM)Cpalms Wrote: Try the Resmed N20 or F20. The mask is lined with memory foam instead of silicone.  Much more comfortable for me.
I’m already using the AirTouch F20. It’s much more comfortable than the silicone, but also much more expensive.
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