MY FIRST PROBLEM:TAKING THE MASK OFF..

Hello everyone,

I am newbie here and as you can see this is my first post. The forum is really cool, thanks to you, it seems to be the best interactive source about sleep apnea and CPAP devices. I'm also a CPAP newbie too. I have been using it for only 10 days or so.

The problem is, I take the mask off unconsciously during sleep, almost every night Could only wake up twice with my mask on in this period. Checking my therapy data, I see that it happens about 1.5 hrs after I go to bed. In the morning, I see the mask taken off and put aside, often ripped off wildly, without opening the clips. And I never remember anything about it at all.

I don't know why that happens. I CAN sleep with the mask. I don't have any nasal problems or drying mouth issues etc. in the morning.

I can't get any therapy in this case. Any help will be greatly appeciated.

One of my first thoughts when new is it is low end of the ramping that makes you uncomfortable. In your case you have the data to prove thats not the case as you remove it well past the ramping stage.

Something other than that must be making you react to the mask to take it off. It could be the straps are too tight making you feel uncomfortable? You could be getting mask leaks that create noise and wake you up. if so you need to make adjustments. Rain out was driving me crazy at first. It would gurgle and make noises that woke me up. You did not mention any issues along those lines.

It is not unusual to have problems adjusting to the gear on your face.

I hope you get to the bottom of why you are removing it. As you said you are not benefitting from the therapy until you can wear the equipment.

BTW welcome to the group. There have been others that have had this problem. Hopefully they can steer you in the right direction.

Thank you pdean44. Well yes, my ramp period is 20 min. and this thing happens after 1.5 hrs. But I'm sure it happens during the REM phase.

I feel comfortable with the mask and the S9, moreover, I do not feel psychologically reactive to the gear. On the contrary, I actually like them, knowing they can really improve my life quality. So I guess it's not also related to some discomfort hidden deep under, which comes to surface when I'm totally unconscious.

I do the device's automatic mask fit test, and even at high pressure, there's no disturbing noise or leak, etc. The device also does not make any disturbing noise. In fact, it is quite silent.

There's no apparent reason for me to take the mask off, so I don't know what to do yet. I'm planning to start a video recording of myself when I go to bed, and try to understand what happens before I take the mask off.

Another solution is to have polysomnography again with my own CPAP unit. But you have to wait a long long time to get an appointment at the sleep center here.

The steps you are outlining will be sure to help you get to the bottom of it.
Hopefully it is just a passing phase as you adjust to the gear. i also felt like the gear is here to help so did not have an aversion to wearing it. I did rip it off several times when i had nasal congestion when i had allergies and then later a head cold. I worked on making sure my passages could stay clear and worked on the humidity settings. Pretty disconcerting to feel like you cant get enough air

I also hope it's a phase and it goes away at once. Including last night,

I've been able to complete last night with the mask on. But even after such nights of full treatment, I still feel sleepy and disoriented throughout the day, even worse than before.

I feel like there's something wrong, I hope I'm mistaken.

what was your titrated pressure? your low end is set at 4cm, i can't even breath awake on my machine at 6cm. Are you using EPR?

I sent you a PM

Are you SURE you're ok with cpap? Why do you call yourself resistance? Seriously, many of us rip the mask off our faces in the beginning. It takes a while to get used to this new habit. Stick with it. Soon your subconscious will accept it!

Uncle_Bob wrote:what was your titrated pressure? your low end is set at 4cm, i can't even breath awake on my machine at 6cm. Are you using EPR? I sent you a PM

Bob, got the PM, thank you for your help.

My doctor told me to get the S9 set between 4-12. As I've seen so far, 4 cm is applied only during ramp period. Then it increases. I don't have any difficulties breathing at 4 cm though. I use EPR at 3. Average pressure goes 9-10 cm during sleep and seldom rises up to 12.

SleepyT wrote:Are you SURE you're ok with cpap? Why do you call yourself resistance?

Ok, maybe I have some "resistance" against that mask and hose in my subconscious, but at the consciousness level, I really like them

Your mask removal is a common thing to do at the start, i used to do it as did many others and i actually got as far as unplugging the machine during the night

a good step one is to build up the hours on the machine during the night and not hope for or expect an instant fix.

once you can build the hours up to around 5 then look you can look at your leak rate. Good luck

I think your best move is to set the low end at 8-cm and leave the upper end at 12-cm....for a week or so. Your machine has to work too hard to figure out what pressure you actually need....and that's disturbing your sleep.

If you can get your hands on software that'll run on your machine, get it quick. "You can't manage...what you can't measure".

Finally, sit down and give your subconscious a good "talking-to"....it has to agree that CPAP therapy is absolutely vital. Your subconscious is "in charge" while you're asleep....and if it isn't absolutely convinced that you're gonna die early without successful therapy, it'll subvert the process by ordering that the mask be removed..... while you're asleep.

One of the quickest ways to convince the subconscious of the need for CPAP therapy is to wear a recording oximeter for a couple of weeks....and see you far below the minimum O2 saturation levels (93%) you're falling to during the night.

Get smart.....and don't give up.

You can try wearing the mask during the day(with the machine on) while awake. Read or watch TV while wearing it to help keep your mind off of the mask. Do this daily, a few times a day if possible. This may help your brain realize that the mask is OK and that you will do this.

Brenda

At 7 APR 3 (means the low pressure was 4 cm), I felt like I was suffocating -
this feeling came and went - but at times I *wanted* to rip the mask off,
and the feeling increased as time passed (like an hour or so), so I wonder
if this might be your problem.

I was using APAP set from 7-11 with EPR3, and it spent most of its time at the low pressure.

I traced it to not enough pressure to exhaust the CO2, so I upped the pressure,
with particular attention to raising the low pressure (when EPR was active).

At 9 EPR 2 I was ok, and was noticably better at 10 EPR 2 (my AHI dropped to half,
although it was quite good at 9). What really surprised me was that my centrals
went down when I upped it to 10cm.

Others have reported sleeping better at 10cm than 8, even though their stats
(like mine) were fine at the lower pressure. I suspect they too had an O2 issue.

For this reason I never use ramp. The S9 has a 5-second ramp when you turn it on
and that is all I need or want.

Your body can compensate for prolonged lack of O2,
you grow more red blood cells, and those cells can enlarge themselves too.
So an oximeter won't pick this up except at the beginning before your
compensation mechanisms kick in. Olympic ahletes use this all the time,
they train at high altitudes to stimulate those mechanisms.

Personally I think we all adapt to CPAP in ways like that. But no studies on such things
have been done that I know of. Maybe cyclists should train while wearing CPAP machines.

Thank you for the valuable information. I have to talk to my doctor about changing the pressure values, and I'm going to see him in a week.

This morning, I woke up with my mask off again:( I have taken it off at about 06.00. I wonder if the electricity goes off at late night and early morning hours.. Power outage is a known issue around here. That wouldn't surprise me. I'll try to test and make sure if it is so.

Sometimes I wake up at night with my mask on and I realize how comfortable and easy I feel with it. Then I go right back to sleep again. I'd be surprised if my subconscious has problems with the mask or airflow, etc.

I also want to buy an an oximeter in any case. I believe it will provide valuable data for understanding better what happens while I'm asleep. Contec CMS 50 E looks perfect, but unfortunately it isn't available here. If you recommend other brands, I want to buy one at once.

I wish the S9 had a built in oximeter.. Or at least a reasonably priced optional one to plug in. Sometimes I see other CPAP machines with built in oximeter, mask-off alert or even back up power..and feel confused about my Resmed decision.

UPDATE: I just ordered Contec CMS 50E via this website:
http://door2doorshop.com/wholesale/CMS- ... ter-5.html

I hope it arrives at once, I'll be looking forward to it:)

Resistance.........

You're going to be just fine. You have good equipment....and good software. Your oximeter and cpap software will look at the problem from different directions...thereby giving you a great depth of understanding.

In no time at all, you'll be doing well....and helping others.