Pokey49 - Therapy Thread

[Sleeprider]

You're doing very good with 7-hours of therapy. The mask issue might resolve with a slightly different mask style like the Resmed Airfit F-40.  Instead of having air-tubes along the side of your face and pulling up on your nose, the F-40 uses conventional adjustable straps on your head and the tube comes out of the front.  Mask liners are worth a try as an inexpensive alternative.

I previously covered the need for a new mask.

[Pokey49]

Lately I’ve not been getting 7 hours of therapy. Been more like 4-5 lately. I have another health issue that’s not helping with my sleep either. You mentioned the F40 mask. That was offered as a choice to try by my DBE. I declined thinking the hose coming off the front would be a constant problem with rolling from side to side getting tangled in the covers????

[Sleeprider]

I have never been able to use the masks that have the air inlet on top of my head. The use of air tubes as a main suspension for the mask is a non-starter and pulls up on my nose, makes noise or dislodges easily. I use the P10 which also comes off the front, but suspend the tube using a lanyard and command hook above the bed. Has not generally been a problem except the head gear for the P10 is particularly weak and slips. Back to the subject at hand; if you can try the P40, that seems like a low risk option. If it works, you solve your problem, it not then you move on the next best option or resume using your previous mask.

[ejbpesca]

It is quite common that one mask style/version does not work due to leaks and another must be found to mitigate the problem

After X nights with unacceptable leaks, it is time to try another mask style.  There are many versions and sizes called full face.  Hybrids do not have the size range choices of other full face masks.

Finding the right mask can be a long process.  During my 2nd sleep test before hybrid masks, I was wakened and given a full face mask due to mouth breathing, then went through 6 masks over a period of weeks trying to find one that would not leak.  Some find larger full-face masks than the F30i to work better.  Take a look at the F20, Mirage, and other designs/brands/sizes. Some of those have a different headgear configuration that spreads the grip of the headgear more evenly. Hybrids like your mask may not be large enough for some faces.

If you are using a local DME they will allow you to come back in with a mask you're trying and exchange it for another until you find one that works with fitting help.  Online DMEs allow exchanges by shipping. Some online retailers (no insurance) allow exchanges within 30 days.

I not only do not like chin straps/collars/taping to keep my mouth shut, but they failed to do it.  My F40 has been the best mask yet to keep a seal as I mouth breathe due to its flexibility.  I test it during mask fit by opening my mouth wide and breathing. By week 2 the cushion of the mask is leaking and I have to tighten the straps.  By week 4 it's time for another cushion to keep leaks down or tighten the straps so much it is irritating.  Some get many more hours out of a mask cushion than I do.

Still with all that, if I move enough the mask will lose its seal, leak, and my AHI will go up.  In movement, I have knocked the mask off its seal.  This may wake me due to air blowing out the sides but sometimes I move again and the mask regains its seal.

I have masks and cushions sitting in bags I will never use due to trying so many and moving to others that work better.

[Pokey49]

I have a Fitbit watch that tracks my sleep. Ever since I have started CPAP, I have been on it for 10 nights now, my sleep has gone to hell in a hand basket. I'm getting very little REM or deep sleep. My watch said I slept 6.5hrs last night but got only 58 minutes of REM and 38 minutes of deep sleep and that I was awake over an hour. I'm exhausted. I kept having mask leaks last night which I think is waking me up. I tried to download todays OSCAR report but it said that minimal data was available. So far CPAP is not helping me feel more rested.

[super7pilot]

Yes, For most folks it is very disruptive at first for several reasons.

First our bodies are not normally breathing in pressurized air. It's the same effect as moving from the coast to a mountain town in the Rockies. You are out of breath doing normal things. But your body adapts, but it does take time. And that disrupts our sleep.

Secondly is the pressure settings on our machines. Sadly, Most Dr's send us out the door at 4-20cm. An average adult at 4cm will feel like they are at high altitude (not enough air) And that disrupts our sleep. I feel horrible for the folks who have the machines set that way and have not found a forum like this that can help. I bet a large percentage of cpap machines end up in the back of the closet because of lazy Dr's setting them at 4-20

Then there is the average apnea patients median therapy pressure. Looking at all the charts people post. One can see that the median pressure to stop apnea's is well above 4cm. So having the pressure jump from 4 to say 12 (my pressure) is a 200% increase in air pressure. And can disrupt our sleep. The pressure changes sure effected my sleep.
For ME. I found that getting my minimum pressure close to my therapeutic pressure, then using EPR for comfort provided the best experience. Which for ME is EPR2.

Then add in the mask, mask head gear, chins straps, mouth leaks, mask leaks.

The good news is that with the help of all the fine folks here. One can get their pressures dialed in fairly closely to effect treatment and minimizing disruptions in sleep.

But it does take time perseverance. It is the rare person that just straps on a mask and all is golden and they feel great.

[Pokey49]

Thanks for the truth of the matter. I have enough trouble sleeping on a good day. For sure the cpap has not been helpful thus far. I may forgo it tonight to see if I can get rested. I’m so tired today I don’t think it’s even safe for me to drive. 

Regarding pressures mine is set at 8-20 with EPR 3. Your right about what my doctor prescribed: 4-20 and my DBE the same. My RT was upset I changed the pressure to 8. I personally didn’t care she was upset. My body, not hers. But this morning when I woke I didn’t feel like any air was flowing except the leaks I could feel on the side of my face. I assume air leaks decrease the pressure available at your nose and starves you of O2. 

For sure I’ve not figured out the mask issue yet. I started with a nasal mask & chin strap. I mouth breath.  But did not like the chin strap. Now trying a ResMed F30i hybrid full face. I seem to consistently get leaks later in the night. Not sure what to try next?  Any advice?

[Pokey49]

Dave (I hope it’s ok to address you as Dave)??

I went to pull up my OSCAR data this morning and there was not much of anything there. The message I got was “there is no data to graph”. Any idea what happened??

[SarcasticDave94]

There's been some feedback of ResMed 11s having issues with the SD card and recognizing the card was inserted. It may have been corrected with disconnecting and reconnecting power I think.

[Pokey49]

Ok. I will power it down and back up tonight and let you know what transpired. Thanks