Waking up with mask off after 2 hours

[skyuser37]

Hi all,

I have been a cpap/bipap user for the past 1 year (first used the Dreamstation, before switching to the ResMed VAuto before the recall happened). Was unable to fall asleep with the machine until the past month or so following a nasal surgery, it helped me to tolerate my bipap a little better I guess. Have been able to fall asleep within 1/2hr of putting on my mask for the past few weeks.

However, I am always waking up with my mask off, consistently at the 2h mark. Sometimes i can vaguely recall pulling it due to the air gushing from my mouth or into my cheek. 

I use an F&P Brevida with mouth tape, although sometimes I wake up noticing airflow through my mouth tape (it's porous).

Any idea what could be waking me up? Should I lower the pressure? My oscar screenshots are below.

Thanks for any input! Have been quite desperate to make this work since I've been so tired at work.

[attachment=36582][attachment=36583][attachment=36584]

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More screenshots from OSCAR:

[SarcasticDave94]

Welcome to Apnea Board,

It is probably your pressure of minimum of 4 is too low, causing air starvation and then the mask removal. It would also be helpful to redo the chart order when presenting as standard order is more convenient to see necessary info quickly.

[CorruptAlligator]

Welcome to Apnea Board,

It is probably your pressure of minimum of 4 is too low, causing air starvation and then the mask removal. It would also be helpful to redo the chart order when presenting as standard order is more convenient to see necessary info quickly.

Looking at his pressure response his minimum doesn't look low.  His minimum is 8.6 and his EPAP is around 4.  Exhaling at 4 isn't low right?

I don't see any patterns that would cause mask being taken off.  I would look into the leaking. I see parts that the therapy stops after a rise in leaks.

I would keep at using the device. It could just be matter of time until you get used to the equipment. If you have issue with breathing comfort with the mask, it's probably worthwhile to try out various mask to find one that you can breath comfortably.

[skyuser37]

Thank you all for the replies, I have attached my new OSCAR screenshots with lesser fields.

Yes I was thinking it might be the leaks as well as I notice the air going through the gap in my mouthtape. 

Would using a full face mask help to eliminate the leaks?



           

[CorruptAlligator]

I only recommend trying out various masks because I've noticed that masks can have different comfort levels in breathability. I found some to push air too aggressively when the machine calls for it. I personally think that non-full face masks perform better than FFMs.

As for tape, it should not have gaps for leakage. I use this tape, and it works well, no gaps.

https://www.amazon.com/gp/product/B01F9J...=UTF8&th=1

[skyuser37]

More screenshots:

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I only recommend trying out various masks because I've noticed that masks can have different comfort levels in breathability.  I found some to push air too aggressively when the machine calls for it.  I personally think that non-full face masks perform better than FFMs.  

As for tape, it should not have gaps for leakage.  I use this tape, and it works well, no gaps.  

Ok, will try this tape out! Thank you

[quiescence at last]

I think you'll find that nasal resistance is lower for nasal pillows versus nasal cup or FFM at same pressure X.  This is because there is just a bit more pressure inside of the nostrils than outside. on the FFM or nasal cup, there is air pressure on both sides.

If this were me, a would use a FFM, but other than that I would start my settings adjustment by increasing EPAP to something like 6.0 and make my PS lower (like 3) and don't need to vault the pressures up too far but allowing the EPAP to range from 6.0 to at least 9.0.  That translates to PS 3 over 9.0-12.0. Then I would look for evidence that the flow limitations are all but eliminated and CAs stay very low or eliminated.

QAL

maybe some form of chin strap would help and also starting to learn to seal mouth by pressing tongue against back of upper teeth.

[skyuser37]

Thank you for the suggestions, much appreciated.

An update, tried using my F30 last night but got a rise in OA. Tried reducing PS but got abit hard for me to sleep, I'll try other options and see how it goes

[CorruptAlligator]

Like I've said earlier, I do not recommend FFM. They cause clustering OA (as shown on your chart) which is referred to as 'positional apnea' and 'chin-tucking' in this board. This is why I wouldn't recommend FFM. Try out other types of nasal masks with tape. If pillows seems too aggressive, I recommend trying out N30i, Wisp, or DreamWisp masks.

With FFM, you have to wear a cervical collar to stop the clustering OAs.

[SarcasticDave94]

It might be for you the full face mask increases positional Apnea, but not for everyone. Myself, I use full face because I can't control mouth breathing.

Again, in some, a full face may increase Positional Apnea clusters. I think some comments from those that get them with certain masks, it gets traced back to the headgear and straps.

And yes, best practice is try pillows or nasal masks first.