Help?

I'm usually pretty good about reading pages worth of posts before I pop off with a question but after a couple of weeks of trying to make heads or tales out of all of this Ive decided to swallow my pride and risk sounding like an imbecile.

I had my sleep study back in early Febuary and by early March I was the owner of a Respironics REMstar Plus M Series with C-Flex and a Mirage Quattro. The diagnosis was moderate to severe OSA but Ive never actually seen the study results.

Since I got the equipment I have been faithful in putting on the mask when I go to bed but in the 3 months that Ive been using it I think Ive gone 4+ hours with it twice. Sometimes I remember waking up and taking the mask off within a couple hours of going to sleep but increasingly I just wake up in the morning with the mask on the floor and the machine blowing air.

I thought for a while it was the full face mask so I bought an Opus 360 Nasal Pillow but that didn't improve my usage. Ive adjusted the pressure up and down but that didn't help either (Im back at the prescribed level now). Ive changed the ramp time out to the max to no avail and tried it without the ramp at all.

I remember feeling great on the 2 occasions I slept through the night with it but the last time that happened was well over a month ago at this point.

Are there any tips/tricks to getting compliance up to a point that the equipment becomes more than the $1000 dollar bedside art that it currently is?

Welcome to the forum.

No need to have waited so long to post.......you're not sounding like an imbecile. Far too many people have the same problems and unfortunately give up on their therapy.

Sorry to hear you don't have a data-capable machine to help figure out the problem, but we can try to go from what you DO have.

What is the pressure you were prescribed?

Have you tried the "Teflon tape fix" with the Quattro? The elbow in the front of it typically leaks like a sieve and that COULD be what's waking you.
Does it also seem to be the right size? That's another "issue" with that mask that some have had.

Do you use the Ramp feature? If so, what's the starting pressure and the length of time?

Are you on a rental plan?.......just in case there's a chance of upgrading.....you also might check with your insurance provider to see if it might be a possibility to upgrade from the Plus to the Pro model.


Den

I have not heard of the Teflon tape fix but my mask does in fact leak and whistle from that joint. Ive almost figured out how to secure the hose to keep it from making noise while I try to get to sleep but of course that only lasts until I get to sleep. As far as the size is concerned, it does seem to fit well. The respiratory tech at the medical supply company went through a couple of masks with me and I think we got the size right. It took a little adjusting of the forehead support but overall its pretty comfortable. If I have any issue with the fit its that sometimes when I'm on my side it leaks along the side of my nose and blows air on my eyelid.

I was prescribed a 12.5 pressure. In trying to get it "dialed in" Ive had it as low as 6 and as high as 14. I first lowered it when I got the nasal pillow and it felt like the sides of my nose might pop open and it was uncomfortable to try and keep my mouth closed against the pressure. I stayed with the nasal pillow for about 5 weeks and went back to the full mask to try higher pressures.

Ive gone both ways with the ramp from a timer of 20 to 45 minutes to not using it at all. I have not adjusted its staring pressure because it feels like its not even on at 4.5. Currently I'm not using it at all.

Unfortunately I own the equipment. I think though that I can charge off part of a new equipment purchase to my medical FSA.

Den's so right about your questions! Don't worry about asking - we've all been there.

There are a number of ways to approach this - and they don't exclude each other.

1. Keeping the mask from leaking.
2. Keeping you from taking the mask off - can you wear mittens to bed? Find way to tape you thumb to your hand (right of you're right handed, left if you're left handed) hand, so you can't use it easily to remove the mask?
   Set the mask off alarm on your machine?
3. Making sure you're not suffering from nasal congestion - you can use a sinus rinses for that, e.g. NeilMed's.
4. Do you use a humidifier? If not, get one. If yes, try to change to change the temp. - some need more warmth and humidity, others need less warmth - some even no heat at all.
5. Figuring out why you take the mask off - that's the difficult part.

Start out by spending one whole week at whatever setting you're using. Make only one change at a time, and track it.

And get a copy of your PSG report, and your Rx.

While you're at it - tell the doctor's office of your mask problem - that is sometimes an indication that your pressure is too high, and you need a bi-level machine with exhale pressure much lower, or even an indication of complex sleep disordered breathing - a kind of OSA that appears only when you're on cpap.

Whatever you do, however you continue - don't give up. Your machine is almost the simplest around, and you many need a more sophisticated one. By complaining to the Dr. you're making it clear that even if it's not registering enough compliance for the insurance, you want the therapy and therefore the Dr. has to try something else.

O.

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