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Trying to find the right settings
#11
RE: Trying to find the right settings
(11-10-2021, 11:11 AM)SarcasticDave94 Wrote: I'm just commenting on mask removal. I did this myself when starting my ASV therapy in 2017. I'd get a few hours logged then I'd somehow end up with the mask off. To break the habit, I had to consciously put the mask back on the moment I realized it was off. For myself, not putting it back on was training myself to remove the mask after a few hours.

So the key is when you see the mask is off, put it back on immediately. Do not scrap the session. Make yourself put the mask on.


Thank you for the advice.  I actually tried this last night, but couldnt control my breathing and relax for whatever reason.  Ended up waking up completely, and took a while to relax then fall asleep.  But you're right, I have to get in the mindset of putting it back on immediately.
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#12
RE: Trying to find the right settings
Hang in there OP! I’m still tweaking after 2 yrs. Always experimenting and wondering if there is a better mask.
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#13
RE: Trying to find the right settings
I am not advocating this, but I do often awaken after a couple hours (usually at conclusion of a sleep cycle with REM or at least dreaming just ending). I usually feel like I need to get up and move around.  Wide awake, I will do stuff for 30 to 90 minutes before moving back to the bedroom for another restart.  It is not, for me, any concern and actually I am more pleased having gotten up cuz otherwise I squirm for a while if not the whole period.  I am satisfied with segmented sleep.

QAL
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#14
RE: Trying to find the right settings
Since Ive been trying 14cm Ive noticed the mask leaking more.  Ive tightened the straps to compensate and its affected my comfort.  I did really well Friday night, but awoke to a leak on the side next to my mouth.  Ive been tightening the chin straps to fix the leaks, yet more keep happening.  However, if I loosen the chin straps the bottom part feels really loose and a deep exhale causes it to move.  Do I need to see about getting another mask or headgear, or both? My mask has a S in the front so I've assumed its a small Smile
Ive been working on breathing through my nose more, so maybe could move to trying nasal pillows, definitely with a chinstrap.  It seems my therapy will get better one night then goes back to the normal for the next few days.  

I tried what the above poster said over the weekend.  Trying segmented sessions and it did help Friday night.  That was the longest I ever used the machine.  My issue is I have to be up at 5:30 every weekday for work, so its harder to practice that during the week.
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#15
RE: Trying to find the right settings
So a really short night.  Airsense recorded 1.2 AHI whereas you can see OSCAR data.  I tried to put the mask back on later and struggled to control my breathing.  Pulled it up a little bit then dozed off immediately Sad.  The flow limits in this concern me along with all the snores it registered.  I zonked out pretty quickly after putting the mask on last night and of course, dont remember removing it and putting it on the nightstand.  It still had the chin straps connected when I tried to go again.  Just odd and frustrating night.

I zoomed in on the RERA event.  Its likely the flow limitations caused me to wake up?


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#16
RE: Trying to find the right settings
Just an update,

Ive still been struggling with my therapy, but I have been consistent with using it every night and ensuring I put the mask back on after realizing its removed.  I cant seem to get totally comfortable in a sleeping position, and I find myself waking up at least every hour.  Even wearing the mask for over 6 hours like this night, I still woke up 5 to 6 times.  It has been the same every night.  Using EPR at 3, I started having more CAs, so I turned it to down to 2.  Then my Flow Limit rose a lot higher.  I changed it back to 3 and the CAs came back, but giving it time to see if they start to happen less freqeuently.  

Im pretty much at a loss for what to do.  I had this past week off work and tried my hardest to get used to the mask and ensuring I used it all night.  I didnt have one positive night other than the amount of usage.  I still feel completely exhausted.  I have an appointment with my sleep doctor in the next week and curious as to the next steps from their side.  I can tell my SA is getting worse, I barely sleep for an hour at a time anymore.  

Ive also had a leak as shown in the attachments.  I had LL several nights which Im sure didnt help my therapy and I corrected it, however they keep coming back.  I got a new mask and still the same leak out of the side of my FF mask.  I tightened the straps to compensate yet it comes back.  It only happens if I breath through my nose and not my mouth.


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#17
RE: Trying to find the right settings
Update from the last few weeks.  Ive been very consistent with my therapy and wearing the mask all night.  However,  I still wake up 5-7 times (maybe more) every night and feel the exact same.  Ive noticed my late night/early morning bathroom trips have reduced to 1 and sometimes 0.  I do not wake up to any rush sensation where my heart is beating super fast. I open my eyes and realize I am awake and drift back to sleep.  Sometimes.  Others, I stay awake for a little bit which is part of my insomnia.  I have yet to sleep an entire night straight through.  I fiddled with the pressure using fixed at 12, 13, 14 and even 15 last night. 

I struggle with some leaks at the higher pressures as youll see in the attached pictures.  Im not sure if the cpap is necessarily doing its job and I have insomnia and/or something else that needs to be treated, or if Im missing something or doing something wrong.  I do have issues getting fully comfortable and in a comfortable sleeping position.  I usually end up sleeping on my stomach and with my head resting on my left hand.  Very awkward position but it helps me fall asleep.  

Im still using my FF mask but notice leaks later through the night on the side of the mask. Depending on which side I turn to side sleep, it leaks out the other.  Resetting the mask usually corrects it, but it comes back after some time.  I have an appointment with my sleep doctor next week and plan to explain what Ive just written out here.  I hope someone can see my snippets and possibly notice something that maybe Im doing wrong.  .

one more post as I could only attach 3 screenshots  Smile


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#18
RE: Trying to find the right settings
The data doesn't look bad except the occasional leaks. It didn't appear to be constant, so it's probably like other mask situations. It comes down to finding the right brand, form factor (full face, nasal, pillows), cushion size, correct adjusting of straps. This entire group needs balanced to be right for you, and it always represents the hardest part of PAP therapy.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#19
RE: Trying to find the right settings
May I put in a comment about the Brevida pillow mask?

Some folks seem to think they NEED a full face mask, just because. No real reason. FFM has to seal a much larger area, creating a larger potential for leaks. Also, I have read that the #1 problem with masks is having the straps too tight -- preventing the mask from floating on the face and instead distorting the seal to the point of leaking.


I struggled with several mask types until finding the Brevida nasal pillow mask. Nothing over the nose. Little tiny tubes sit just inside the nostrils, and the rest of the mask seals around the nostrils. Brevida has a much smaller area to seal versus a FFM, thus less tendency to leak. Be sure to get the "fit pack" which includes both pillow sizes; just because a user is a "medium" in one mask does NOT mean they are a "medium" in all masks.

FWIW, I'm not the only one who thinks this way. As I recall, SarcasticDave has made similar comments in the past -- namely that pillow masks in general do a better job of sealing because they only need to seal a small area and there are academic studies with similar conclusions. Also SarcasticDave has opined that Fisher & Paykel has some of the the best sealing technology available.

Bottom line - Do some googling on the Brevida. Read the marketing materials, which IMO are not hype.
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#20
RE: Trying to find the right settings
Funny you recommended the Brevida nasal pillows because my DME did too and I picked it up the other day. You’re absolutely right as this covers a much smaller area. I’m going to try out the different sizes (mine came with 3).
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