Frustrated and Tired

[Trying2sleep]

I've been trying to adjust to my cpap off and on for years. I cannot get good results and end up getting frustrated and giving up. I know I need to get this resolved and become successful for my health. I found this site and it seems like a great place. Here's my current issue...
I don't have a very high pressure. It's 8 I think. I'm a small person, but I have some central and obstructive apnea. I have a small chin/jaw. I've been trying to use a nasal mask (after trying nasal pillows years ago and hating them). I was told I need a chin strap because I have jaw drop. I've been swallowing air and completely blowing up to where I am burping and passing gas while trying to sleep, and for hours after I wake. This happens with the chin strap. With AND without the chin strap my mouth opens and air leaks.
I'm considering trying the Hybrid mask, the one with the chin flap. I haven't slept with the cpap in months and I feel awful. Does anyone have experience with aerophagia, or advice on the type of mask that could help me? I am considering purchasing a new bed/frame so that I could elevate my head/torso, because sleeping on a mound of pillows isn't working. Would that help?

[Pugsy]

You may need a bilevel machine despite your relatively low pressure of 8 to reduce the aerophagia issues.
Have you seen this for possible ideas to help reduce the problem?
wiki/index.php/Aerophagia

Have you tried a lower pressure (say 6 cm) just to see if even a lower pressure might help reduce the symptoms?
Even if 6 cm wasn't optimal in terms of doing an optimal job preventing the apneas...it's still better to prevent some of them as opposed to sleeping without cpap and it might do a decent enough job.

Do you just have to use a full face mask because you just have to mouth breath to move enough air ....do you have chronic nasal issues that force you to mouth breathe?

Do you happen to have a history of a lot of heartburn or GERD type of issues which could maybe have damaged the LES (lower esophageal sphincter) which is allowing air to enter the stomach....if this is the case the type of mask you use probably won't help the aerophagia issues.

Bilevel pressure machines...while normally thought of when people have pressure needs in the teens it doesn't mean that it can't be indicated for people with lower pressure needs in some special circumstances.
I know one person whose RX'd pressure was 8 and they simply couldn't deal with the aerophagia symptoms at that pressure so she got a bilevel pressure machine and set it for minimum of 4 exhale and inhale was set to 6 cm but the machine could go to 8 inhale only if needed. This meant she could used lower pressures for most of the night and only have to use the 8 ish pressure for a short time during the night and thus allowed her to be able to tolerate cpap therapy without having the unwanted aerophagia symptoms which were pretty disturbing to her.

[Pugsy]

Another question...are you using the Flex exhale relief available on your machine? If you are, at what setting?

[R1200ST]

You have found the right place. Sorry it took so long.

I am a chronic mouth breather, but I found the nasal pillow mask with a chin strap works the best. You must train your tongue to stay at the roof of your mouth which helps with the mouth breathing, and for me, keeps me from swallowing air. I have GURD, with a partial upper herniated sphincter which has posed no issue, but mine is minor so like other experts here have said, get it checked out.

To me, if you work through one issue at a time, you should get it all worked out pretty quickly. My first hurdle was putting on the sinus pillow mask, getting the chin strap on, and sitting there watching TV for hours, while working to keep my tongue at the roof of my mouth.

ALSO don't forget to TREAT your sinus issue. Neti pot rinse, will clean you out and clear you up, so you are not FORCED to breath through your mouth.

Thanks to Cedar fever here in Texas, I had 4 days of ROUGH times trying to catch up with the swelling etc. But thanks to Neti and a nose spray the swelling is gone and I had a good night sleep last night.

[Julie]

Look into soft cervical collars - they keep your head up, so airway's more open, and help with leaks (tho' you may want to use tape as well). A lot of people find they help with your issues.

[Trying2sleep]

I do not know how to lower the pressure on my machine. I was told I wouldn't be able to (or allowed to?) do that. I suppose I can find some info on how to do this myself!

I do have reflux, and it seems to have gotten worse over the last year. I'll make an appointment to get it checked out. I hadn't realized reflux would affect my air movement in this way.

I have a heart condition, its a small open flap between the top chambers of my heart. I also have mild pulmonary hypertension, and my cardiologist isn't sure if its from the heart or caused by the sleep apnea. Throughout the day, I often feel like I cannot move enough air and need to take big breaths through my mouth. Maybe I do this while sleeping? I know that after I've used the cpap my lungs feel like I can breathe through the day. My nose is chronically stuffy, also causing the mouth-breathing. I love the Neil-Med Sinus Rinse. It definitely helps when my allergies or a cold are blocking my air, but not totally. I've never tried the Neti-Pot. The ENT said I have a large tongue which is also interfering. My tonsils and adenoids were removed years ago.

The machine I have is set to recognize my exhalations...I think. I'll try searching for a manual to make sure it's set. I wasn't given much info about the machine when they gave it to me. They wanted me to use it however they set it up in the office.

Years ago when I tried the nasal pillow, it would shift all over my face (I move around a lot) and hurt my nostrils...I would wake up a lot. I've been trying the Eson nasal mask with the chin strap, but my lips keep opening...and the whole aerophagia thing is unbearable.

Do dental mouthpieces help align the jaw or tongue, and help when used in conjunction with the cpap? I'm looking into cervical collars now.

Thank you so much

[Pugsy]

Go here and request the clinical manual for your machine. The directions are down near the bottom of the page. Make sure to request the correct manual.
http://www.apneaboard.com/adjust-cpap-p ... tup-manual
In that manual you will find instructions on how to get into the clinical setup menu.
At the moment I am not saying go change the pressure unless you want to but if you want to try lower that is where you go to change it. It's not hard to do.
In the setup menu is also where you would find information on what exhale (Flex) relief you are using...if you are using a lower setting perhaps just increasing the exhale relief would afford you some relief.

[Enchanter]

You might want to look into other options. The problem is majority of people here are not doctors. They themselves aren't doing very well health wise in life for the most part. They don't care about helping people's health, in my opinion, they are more just a CPAP cult. They will defend it to their graves. They don't care about you.

[palerider]

You might want to look into other options. The problem is majority of people here are not doctors. They themselves aren't doing very well health wise in life for the most part. They don't care about helping people's health, in my opinion, they are more just a CPAP cult. They will defend it to their graves. They don't care about you.

you're confusing yourself with humans...

[Enchanter]

You're one pathetic old man. Witty sure, but nonetheless an old man Keyboard Warrior with no life.

[LSAT]

You might want to look into other options. The problem is majority of people here are not doctors. They themselves aren't doing very well health wise in life for the most part. They don't care about helping people's health, in my opinion, they are more just a CPAP cult. They will defend it to their graves. They don't care about you.

Or you Enchanter.....There were people that tried to help you months ago. They now realize that you're a lost cause.

[palerider]

Witty sure

well, I've certainly got that over you

[Trying2sleep]

I know that most people with sleep apnea have medical issues. I was suggesting that mine might be contributing to the mouth-breathing. But Wow....I dont know what that's about, so I'll move on.

I downloaded Sleepyhead. What a great program! I'm glad I found out about it here! It's encouraging to be able to see all of my data. My results don't show any leaks. Mostly Hypopnea, Obstructive, and RERA. Some Cheyne Stokes.

Pugsy- Right now my machine is set to ramp for 10 min and its on the C-Flex setting of 1.

[Pugsy]

Ignore Enchanter...that's a long story that doesn't need to be dredged up again.

You might try CFlex at 3...I don't know if it will help much but worth a try. It will enable you to maximize the exhale relief which still might not be enough in your situation especially if you tend to breathe more shallowly.

Respironics exhale relief is flow based (based on the force of your breathing) and even at a setting of 3 the most reduction a person with rather forceful breathing can get is 2 cm drop. So even with your setting of 1 you may not be getting a 1 cm drop during exhale. Sometimes a reduction during exhale will help with aerophagia symptoms and that's why bilevel helps so much...you can get more of a drop with bilevel than you can with regular Flex exhale relief.

A small amount of time in CSR/Periodic Breathing doesn't mean anything horrible is going on so unless you start seeing a lot of it I wouldn't worry about it.

[Trying2sleep]

Ok, I will change it to C-Flex level 3 and try it tonight. Thank you!

I'm going to schedule an appt with my pulmonologist and ask him about the GERD situation. And I'm looking for cervical collars and better ways to raise the head of my bed.

What about the masks I was thinking about trying? Does the Hybrid type or FFM type work well for people who mouth-breathe/jaw drop? The chin strap with Eson nasal mask isn't working for me.