So close to success; last obstacle

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
drone1066
Posts: 5
Joined: Tue Feb 10, 2015 1:35 pm

So close to success; last obstacle

Post by drone1066 » Sat Feb 21, 2015 9:25 pm

Hi all,

Diagnosed with severe apnea three months ago and am now finishing 5th week of treatment on my APAP machine w/humidifer.
Mask is fine, although I still have bouts with nose twitches and tics but they disappear once sleep occurs. My problem is that I'm generally being woken up by phenomenal congestion--or at least, the sensation of congestion--and I can't get back to sleep. Both sides of nose and even sometimes in the throat.
I have the humidifer cranked up to 5 (max), take Claritin (which I also need for a skin issue), and weirdly enough, within about 5-10 minutes after wakeup, my nasal passages feel relatively clear again!

The last part leads me to believe that this might be a defensive reaction to the forced air, maybe slowing down the rate of flow?

I need to find a way past this so I can get to the finish line. I don't get to access a doctor regularly, so I won't be able to raise this issue with a specialist for at least 3-4 months. Would prefer to solve it well before then, if possible.

Any ideas? And has anyone had a similar tpe of congestion that might not really be congestion in the traditional sense?

Edit: Oh yeah, forgot to mention my pressure setup is ramping from 4cm per to a steady 8cm per with the occasional burst up to 16cm if needed, but I ain't awake for that part....

_________________
Mask

User avatar
LSAT
Posts: 13229
Joined: Sun Nov 16, 2008 10:11 am
Location: SE Wisconsin

Re: So close to success; last obstacle

Post by LSAT » Sat Feb 21, 2015 9:28 pm

Too much humidity can cause congestion.

_________________
Machine: ResMed AirSense™ 10 AutoSet™ CPAP Machine with HumidAir™ Heated Humidifier
Mask: Fisher & Paykel Vitera Full Face Mask with Headgear (S, M, or L Cushion)
Additional Comments: Back up is S9 Autoset...... Buckwheat hull pillow

User avatar
Pugsy
Posts: 63941
Joined: Thu May 14, 2009 9:31 am
Location: Missouri, USA

Re: So close to success; last obstacle

Post by Pugsy » Sat Feb 21, 2015 11:03 pm

Have you tried lowering the humidifier setting? Sometimes people need a lot and some people don't need as much as others and find that a lower humidifier setting lessens congestion.

Also..I found that the pressure of the mask itself across the bridge of my nose would cause pretty much immediate congestion (my sunglasses cause it also). So maybe you are like me in that regard. To test it out take your fingers and press gently on the sides of your nose up by the nasal bridge area where the mask rests...apply about as much pressure as you use with the mask.
See if your nose gets congested..mine does and pretty much will clear up as soon as I take the pressure off in about 5 minutes.

_________________
Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier
Additional Comments: Mask Bleep Eclipse https://bleepsleep.com/the-eclipse/
I may have to RISE but I refuse to SHINE.

If you want to try the Eclipse mask and want a special promo code to get a little off the price...send me a private message.

drone1066
Posts: 5
Joined: Tue Feb 10, 2015 1:35 pm

Re: So close to success; last obstacle

Post by drone1066 » Sat Feb 21, 2015 11:24 pm

thanks to you both for the replies. pugsy, I think you're on to something. I realized I'd been adusting the mask lower on the nose and it was pinching in a spot where my nasal passages are somewhat deformed, and voila, your test almost immediately clogged up the pipes. Also explains why it went away pretty quickly afterword, whereas if the congestion was "real" (as in LSAT's humidity response) i would not just leave like that (although I do need to keep tweaking my humidity for other reasons, but I live in Denver, and dried out sinuses up here can be a very bad thing).

If it helps others, I'll let you know how it turns out after a couple of sessions experimenting.

_________________
Mask

User avatar
Pugsy
Posts: 63941
Joined: Thu May 14, 2009 9:31 am
Location: Missouri, USA

Re: So close to success; last obstacle

Post by Pugsy » Sat Feb 21, 2015 11:58 pm

Now you know why I don't wear any mask that puts pressure on my nose. I am like the princess and the pea in that regard....just the least little pressure makes it so that I can't breathe through my nose but my nose clears up pretty much immediately once the pressure is removed. I had it happen the night of the sleep titration study with a nasal cushion mask and the idiot tech says "well you will have to use a full face mask so you can breathe through your mouth" and I replied..."how about preventing the congestion in the first place and I won't need to breathe through my mouth...give me a nasal pillow mask to use" and the rest is history.

This happens to a lot of people and they get told "reduce the humidity" or "increase the humidity" but sometimes the response should be "can you remove the pressure off your nose?"

_________________
Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier
Additional Comments: Mask Bleep Eclipse https://bleepsleep.com/the-eclipse/
I may have to RISE but I refuse to SHINE.

If you want to try the Eclipse mask and want a special promo code to get a little off the price...send me a private message.

drone1066
Posts: 5
Joined: Tue Feb 10, 2015 1:35 pm

Re: So close to success; last obstacle

Post by drone1066 » Sun Feb 22, 2015 5:41 pm

turns out my mask is a little too tight, which is a natural outcome of a fear of leaks. Well, I have no leaks, but it's because the facemask was so tight it was putting unnecessary pressure almost everywhere. I'm a chronic pain patient, so with my meds, pressure can be hard to discern. But after logging this stuff for a few days, turns out the big factor for my waking up was simply the expiration of pain medication.
This is probably going to take more alchemy than I thought it would, which is a shame, because for the most part, the APAP has been a godsend. But it can't fix everything, right?

Thanks again for everything, and for what you do for this community.

_________________
Mask

yaconsult
Posts: 1099
Joined: Fri Nov 14, 2014 10:43 pm
Location: "Silicon Valley", CA

Re: So close to success; last obstacle

Post by yaconsult » Mon Feb 23, 2015 1:01 am

It's such a process - no wonder so many people never make it over the hill to a successful outcome. If you get the chance, you might want to try some other types of masks. I have to run high pressure for my severe apnea - 12.5-20 and at those pressures the only thing that seems to work for me is nasal pillows. Everything else leaks too much for me unless I really tighten it down and then I start having skin breakdown. There are many different kinds of nasal pillows and ways to hold them in place. Again, for me, the Breeze nasal works the best of the ones I've been able to try. It all depends on you, your skin, your bone structure, your pressure, etc. etc. etc. It's no wonder so many people give up.

_________________
Mask: AirFit™ P10 Nasal Pillow CPAP Mask with Headgear
Additional Comments: January 2015 Sleep Study Results: Apnea/Hypopnea Index (AHI): 80.2, Sleepyhead

User avatar
LadyWolf79
Posts: 14
Joined: Wed Dec 31, 2014 10:30 am

Re: So close to success; last obstacle

Post by LadyWolf79 » Mon Feb 23, 2015 2:08 pm

Drone1066;

I have the same issue with congestion as Pugsy, but did not catch it until I was at least a month into therapy. Any pressure, what-so-ever, on or around my nose causes immediate congestion. During my titration, they slapped a full face on me, and did not try anything else. After a month, I decided on my own to change from a full face to a hybrid. That worked great. My average AHI with a full face was 4.0 to 9.0 (which, by the way, was considered managable by my sleep doctor). On the hybrid, it lowered to 2.5 -4.5 AHI on a good night. I was breathing much better. Lately (about 4 weeks ago) I switched to the P10 for her...my AHI has now moved from 2.5-4.5 with the hybrid, down to 1.0 to 1.6 (Yippee, hope to be at 0.0 soon). The difference was between night and day. I admit I am prepared for mouth-drop and wear a chin strap to keep my mouth closed, but to me, that was a minor adjustment and I have only had limited problems with too much tension on the chin strap. Now I consider pillows the best approach to treat my apnea. I never would have considered changing from the full face mask if I had not been following the forum here with expert recommendations and opinions. Taking responsibility for my own treatment limited my apprehension regarding the trial of various masks. I see a pulmonologist that is very supportive when dealing with comfort, so I do not believe she will have any problems with my experimenting with various masks when I see her next month. My own brother could never get used to a full mask and now does not use the therapy that has been needed for many years.

Best of luck to you...and stay vigilant. I was willing to try a variety of masks until I found one that worked well.

LadyWolf

_________________
Machine: ResMed AirSense™ 10 AutoSet™ CPAP Machine with HumidAir™ Heated Humidifier
Mask: AirFit™ P10 For Her Nasal Pillow CPAP Mask with Headgear
Additional Comments: Also use a ResMed Liberty Mirage hybrid mask

drone1066
Posts: 5
Joined: Tue Feb 10, 2015 1:35 pm

Re: So close to success; last obstacle

Post by drone1066 » Sun Mar 01, 2015 2:42 pm

thanks all.

I'm doing nicely now. Traded a little strap pressure for about a 1-2% leak rate and that's helped a lot. My apnea is only one issue with me, since I have a severe degenerative spinal condition, so my life depends on this working (makes me highly, highly motivated). Full face mask is fine with me since I'm used to having things cover my face, and I've already adapted a solid sleeping position to work with it. Got the humidity about where it works best (not ideal, but good enough to sleep), and now it's basically retraining myself to not catnap so much so I can be truly tired when I lay down, which I think is an underrated key for a lot of people. AHI went from 37 to just under 1 now on average so that's good. All in all, so far so good. Just need to catch up on a phenomenal amount of missed sleep the last 4 years.... Get some energy back!

_________________
Mask