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[Treatment] Can't tolerate CPAP for more than 4h
#1
Can't tolerate CPAP for more than 4h
Hello everybody,

i got my Löwenstein Medical Prisma20a CPAP machine last november, after spending 3 days at a sleep lab. My initial treatment was set to 8 hPa at a continuous pressure with a nose only mask. Actually i felt that this pressure was way too low for me and i felt like not getting enough air like this (even when still awake) so i changed the settings, which now feel better for me to APAP 11 - 15.5 hPA and i got a full face mask, because at night i woke up because of air hissing out of my mouth with the nose only mask. For a few weeks I also experimented with a soft cervical collar, which i read here about and tried a backpack like device that was supposed to prevent me sleeping on my back. But whatever i tried i still hardly can get above 4.5 hours of CPAP treatment per night. I usually wake up after around 4 hours sleeping with the CPAP on and then feel like i have to take it off, because i can't breathe properly anymore through my nose. After taking it off i fall asleep quickly, but probably will have even more apnea events without the CPAP on.  I also tried taping my mouth, because initially i had problems with air getting pressed into my stomach as i started with the full face mask. Actually the time i tolerated the CPAP went down because of this even further. I recently figured out, that i seem to have an allergic reaction to the tape which leads to my nose swelling up and making it hard for me to breathe. Since i don't tape my mouth anymore the time i tolerate the CPAP treatment went up again to around 4 hours and i don't seem to get air pressed into my stomach anymore. Maybe my body adjusted to that somehow. I attach some of last nights data from the PrismaTS application as screenshots, since as far as i know Löwenstein Medical is not compatible with Oscar. I hope i can get here some hints what i can try or what i am doing wrong to improve my CPAP treatment, thanks in advance! Smile

   

   
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#2
RE: Can't tolerate CPAP for more than 4h
It looks like you've figured some things out for yourself concerning leaks, taping and wearing a full face mask.

The Obstructives are clumped together and suggests a positional sleep problem.  If you are sleeping on your back, you could be tucking your chin into your chest, which cuts off your air supply.  

Try sleeping on your side as much as possible.  Other than that, use one thinner sleep pillow, instead of thick puffy pillows.  This will keep your neck from falling forward.

Keep trying to adapt to the use of a soft cervical collar to support your chin/jaw from falling forward.

I can't really say why you might be waking up after 4 hours.
OpalRose
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#3
RE: Can't tolerate CPAP for more than 4h
Hey, you are in a similar situation in which I was until a week and a half ago. I spent 3 months trying out different things and the most I could manage was a couple of hours of sleep before I wake up and then I simply couldnt fall back asleep with the mask anymore. When I took of the mask I fell asleep almost instantly.

It took me 3 months to find the right combination of stuff that works for me. I tried 6-7 masks before I found one that I actually found comfortable ( Dreamwear nasal cradle mask ) - but I still couldnt sleep that well on the side with it since it kept getting moved a bit and I had air going in my eyes.

Then I tried buying a CPAP pillow ( Contour CPAPmax 2.0 pillow ) because I was hoping that it would help with side sleeping and tossing and turning. It was a big improvement but I still wasnt fully comfortable and the mask would still move a bit or hurt my nose in the morning ( I had to make it fairly tight to avoid leaks and also had a nose surgery last September, so bad combo ).

Then I decided to try the Airfit n30i mask which is almost identical to the Dreamwear I had but I was lucky and this one fits my face better and I have no leaks with it and its more comfortable when sleeping on the sides.

Then I also had to get a chin strap because I tend to talk in my sleep from time to time.

After getting this combo, I started sleeping a lot more with the mask. I still wake up after a couple of hours but because I find my mask comfortable now, I manage to keep on sleeping.

My point is : you need to keep experimenting, try different masks, pillows, cervical collars, chin straps etc. I was honestly absolutely desperate to the point where I got badly depressed due to the lack of sleep/energy. But I kept trying things until I found the magic combo. For me it had nothing to do with just using it until I got used to it, I had to keep trying different things until I found the right combo.


ps. I also have a Prisma device and I cant seem to install their stupid software on my laptop, annoying.
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#4
RE: Can't tolerate CPAP for more than 4h
(06-02-2020, 04:54 PM)OpalRose Wrote: Keep trying to adapt to the use of a soft cervical collar to support your chin/jaw from falling forward.  

I can't really say why you might be waking up after 4 hours.

Thanks for your reply. You motivated me to give the soft cervical collar another try. Smile I dont actually think i have a pillow problem because i rarely ever lie with my head on the pillow, rather on the mattress or on a small and thin pillow.

My assumption why i can't tolerate the CPAP longer than 4 hours is, that because of the clustered apnea events my body gets into a lot of stress and this causes me to wake up and feeling like i have to get rid of the mask. I also usually feel then that i don't get enough air through the mask, which is only after wearing it a few hours, not at the beginning. Maybe also the CPAP pressure is too low to keep my airway open. I will try and raise the upper limit a bit.
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#5
RE: Can't tolerate CPAP for more than 4h
(06-03-2020, 08:08 AM)vrapche03 Wrote: My point is : you need to keep experimenting, try different masks, pillows, cervical collars, chin straps etc. I was honestly absolutely desperate to the point where I got badly depressed due to the lack of sleep/energy. But I kept trying things until I found the magic combo. For me it had nothing to do with just using it until I got used to it, I had to keep trying different things until I found the right combo.


ps. I also have a Prisma device and I cant seem to install their stupid software on my laptop, annoying.

Hi, thanks for your reply. Interesting to hear from someone with a similar problem! Actually i have the same nasal pillow mask from Resmed AirFit N30i. I find it very comfortable. The reason why i don't wear it anymore is that i have severe leakage through my mouth. Either i wake up from the hissing sound and / or i wake up with a very dry mouth. I got myself the Philips Dreamwear Full Face mask and now don't have problems with leakage anymore or waking up because of it. It takes of course some days to get used to the larger mask, but i think for a full face mask it's still comfortable to wear. Concerning the Prisma software, did you try the 4.1 version, which is linked here somewhere in the forum? I had no difficulty installing it on my Windows 10 desktop.
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