Any tips for the newbie phase?

[01i]

So, last night was night #1 of CPAP.

So I started off with my humidifier set to 3.0 and temperature set low (17 degrees I think). After an hour or so, being slightly irritated with the coolness of temperature I increased it, and then increased it again a second time later during the night.

I managed about 6 or so hours with the mask on before I reached the point where It was too irritating. I tried removing it and going back to sleep, but I guess my body had got used to breathing through the nose and I felt really bunged up. Ended up putting the mask and machine back on for another 30-45 mins, and then - as I failed to fall asleep again - just getting up. Feeling pretty tired today

Actually sleeping on the other hand, well that was an issue. I sleep somewhere between my front and lying on my right side (almost in the recovery position). My right arm goes under the pillow and my left arm usually runs in front of my face, with the palm of my hand resting on my forehead. I've experimented with changing position many times over the years as this isn't great for my arms, but I fail to sleep in any other position.

I could just about manage to find a comfortable spot with my head on the side, but the constant air blowing out of the mask on to my left wrist is serious irritating and I can't find a way of getting around having the air blow on my arm that doesn't end up blocking the co2 escape hole. The straps were occasionally annoying when they felt like they were pulling my hair, and I also feel like there is now a bruise that runs from the top of my nose, down the sides and along my top lip (which was very dry when I woke up, not too bad now).

As it currently stands, I like the feeling of the air blowing into my nose, buy dislike pretty much everything about the mask set-up. Do you think I'll just get used to the mask (it was the first night after all), or do you think that when 'everything' about it is irritating, it's worth trying a different type of mask? If I do end up going for a different mask, how long should I trial the original before requesting a different one?

[Julie]

Cut the foot off a wool sock and wear it over your arm. You will get used to the whole thing quickly as you seem to have done great for the first night.

[robysue]

welcome to the Hosehead club.

You write:

I sleep somewhere between my front and lying on my right side (almost in the recovery position). My right arm goes under the pillow and my left arm usually runs in front of my face, with the palm of my hand resting on my forehead. I've experimented with changing position many times over the years as this isn't great for my arms, but I fail to sleep in any other position.

You ought to google "Falcon sleep position". It's pretty close to what you describe as your natural sleep position and it is CPAP friendly:



It's important during the adjustment period to try to find a sleeping position that is as close as possible to your favorite pre-CPAP sleeping position as possible. And it does get easier with time.

I could just about manage to find a comfortable spot with my head on the side, but the constant air blowing out of the mask on to my left wrist is serious irritating and I can't find a way of getting around having the air blow on my arm that doesn't end up blocking the co2 escape hole.

Which mask are you using? There are some masks that have built in diffusers for the exhaust vent airflow. That might help. On the nasal pillows side, the Resmed AirFit P10 has really superb diffusion. The F&P Eson is a nasal mask that has an (optional) built in diffuser that works really well.

The straps were occasionally annoying when they felt like they were pulling my hair, and I also feel like there is now a bruise that runs from the top of my nose, down the sides and along my top lip (which was very dry when I woke up, not too bad now).

It can take a while to figure out how to properly adjust the headgear. If it's pulling your hair, it may be too tight. Headgear pads from Padacheek may help with certain mask models. (I use one of her full frame pads on my Swift FX---it's the only way I can keep the top silicone strap from getting tangled in my curly hair.) The bruise on the top of your nose and the soreness down the sides of the nose and onto your top lip is something that you do need to do something about. A mask pad/liner may help. Loosening the straps may help. Or swapping the mask out for a different one may help.

For the dry lip: Take this seriously. Use lots of lip balm during the daytime and find a non-petroleum lip balm to use at night. Seriously chapped lips (as in bright red, sore "clown lips") were one of my biggest issues back when I was a newbie. Once the chapping got started, it took a very long time for it to heal.

As it currently stands, I like the feeling of the air blowing into my nose, buy dislike pretty much everything about the mask set-up. Do you think I'll just get used to the mask (it was the first night after all), or do you think that when 'everything' about it is irritating, it's worth trying a different type of mask? If I do end up going for a different mask, how long should I trial the original before requesting a different one?

You need to contact the DME to find out what their policies are. Most DMEs allow you to swap the mask out at least once for free during the first 30 days. Some are a bit more generous with newbies. Personally I'd say you shouldn't stick with the particular mask you are using for more than about 7-10 days if it is clearly NOT getting any better in terms of comfort.

But before swapping the mask out, be sure you know how to adjust the mask properly. Many RTs who fit people with their first CPAP mask routinely over tighten the straps. And over tight straps lead to all kinds of discomfort and, ironically, usually increase the unintentional leaking. Try mask liners to see if that helps with the skin irritation. You can cut some do-it-yourself ones out of old worn out t-shirts. Or buy either permanent ones from Padacheek or disposable ones from Remzzzs. Some of the commercial mask liners will fit more than one mask model.

[01i]

So, having felt like a zombie for most of the day since getting up I took a nap for about an hour and a half and feel a lot better for it. Ended up with a big red mark on my forehead, and the full outline of the mask around my nose, so I guess it's still a bit tight.

Julie, thanks for the sock suggestion. When I had that nap I was able to lie in my normal sleeping position without noticing the air flow on my arm which was great.

robysue, thanks for the suggestions, the "Falcon" position looks interesting, I've tried it (or at least something very like it) naturally in my pre-cpap days of trying to find a position that was more comfortable for my arms in the morning. It's comfortable to lie in, but I couldn't fall asleep without reverting back, I'l bear it in mind if I do have to try and find a new position though. Fingers crossed the wrist-sock will continue to do the job.

I don't know what a DME is. Assume it's some sort of American insurance thing? Luckily I live in the land of the National Health Service, and the sleep clinic at my local hospital has a big shelf showing loads of different ResMed products. My treatment is free, so I can swap to something that'll work better for free too. As long as it's ResMed.

I have a new question.

I know that I am supposed to clean out the mask and empty the water from the humidifier every morning. If I have an hours nap, do I need to clean everything then too, or is an hour or two ok to leave until the next scheduled morning cleaning session?

[Wulfman...]

So, having felt like a zombie for most of the day since getting up I took a nap for about an hour and a half and feel a lot better for it. Ended up with a big red mark on my forehead, and the full outline of the mask around my nose, so I guess it's still a bit tight.

Julie, thanks for the sock suggestion. When I had that nap I was able to lie in my normal sleeping position without noticing the air flow on my arm which was great.

robysue, thanks for the suggestions, the "Falcon" position looks interesting, I've tried it (or at least something very like it) naturally in my pre-cpap days of trying to find a position that was more comfortable for my arms in the morning. It's comfortable to lie in, but I couldn't fall asleep without reverting back, I'l bear it in mind if I do have to try and find a new position though. Fingers crossed the wrist-sock will continue to do the job.

I don't know what a DME is. Assume it's some sort of American insurance thing? Luckily I live in the land of the National Health Service, and the sleep clinic at my local hospital has a big shelf showing loads of different ResMed products. My treatment is free, so I can swap to something that'll work better for free too. As long as it's ResMed.

I have a new question.

I know that I am supposed to clean out the mask and empty the water from the humidifier every morning. If I have an hours nap, do I need to clean everything then too, or is an hour or two ok to leave until the next scheduled morning cleaning session?

A little light reading on "cleaning".
The only people who say you're SUPPOSED to clean this stuff often are those who are eager to sell you more "stuff".

viewtopic.php?p=567264#p567264

My take......don't be obsessive about it. Most of the users lose their OCD tendencies after a very short time.
Use distilled water and clean/replace your machine air intake filters regularly.
In your normal daily living, you're not breathing filtered air anyway.


Den

.

[Julie]

DME = Durable Medical Equipment - Dealer, shop, etc.

[Wulfman...]

So, having felt like a zombie for most of the day since getting up I took a nap for about an hour and a half and feel a lot better for it. Ended up with a big red mark on my forehead, and the full outline of the mask around my nose, so I guess it's still a bit tight.

Julie, thanks for the sock suggestion. When I had that nap I was able to lie in my normal sleeping position without noticing the air flow on my arm which was great.

robysue, thanks for the suggestions, the "Falcon" position looks interesting, I've tried it (or at least something very like it) naturally in my pre-cpap days of trying to find a position that was more comfortable for my arms in the morning. It's comfortable to lie in, but I couldn't fall asleep without reverting back, I'l bear it in mind if I do have to try and find a new position though. Fingers crossed the wrist-sock will continue to do the job.

I don't know what a DME is. Assume it's some sort of American insurance thing? Luckily I live in the land of the National Health Service, and the sleep clinic at my local hospital has a big shelf showing loads of different ResMed products. My treatment is free, so I can swap to something that'll work better for free too. As long as it's ResMed.

I have a new question.

I know that I am supposed to clean out the mask and empty the water from the humidifier every morning. If I have an hours nap, do I need to clean everything then too, or is an hour or two ok to leave until the next scheduled morning cleaning session?

Since you don't have your location in your profile, is your wording an indication that you live in Oz (Australia)?


Den

.

[01i]

England

[spmccord]

The best advice I can give is PATIENCE!

It's a big change. It's takes a while to get used to the change in sleeping habits, not to mention having a alien strapped to your face!

Good luck, and don't be afraid to ask questions. We're all in this together!

[01i]

Well, night #2 was significantly better than night #1. I managed to keep it on from start to finish again, but this time went to bed and got up at what would have been my normal times.

Rooster's pillow position in the Falcon thread is useful, I'll be using that. It's sort of similar in ways to a pillow position I adopted naturally (but that didn't work with the cpap at all).

I had 2 or 3 awakenings during the night, the first one after a couple of hours with a high level of mask irritation. I took the mask off for a few mins to give my face a little chance to recover and then put it back on and went back to sleep. That's going to be my new process I think, taking the mask off for a couple of mins if I wake up. The cpap technician suggested that if I wake up (for the toilet or whatever), to disconnect the hose but leave the mask on. But I think that Psychologically, giving my body a little break if I wake up, will work for me better in this introductory period.

I also boosted the humidity from 3.0 to 4.5, and changed the ramp to 5 mins.

I noticed a lot less insomnia last night than I'm usually used to. I've always read that slowing down your breathing is a good way to help you fall asleep, but have never been able to do it. Previously, slowing down my breathing deliberately to mimic sleep just seemed to make me feel like I wasn't getting enough oxygen, however, with the cpap it's actually really easy to do

I definitely think a nasal pillow will be a lot more comfortable than my nasal mask, but I think I'm going to get used to this pretty quickly

[OkyDoky]

My pre Cpap sleeping position was the same as yours. I even slept this way during testing because I couldn't fall asleep any other way. I had no problem sleeping this way with my P10 nasal pillows. After getting used to sleeping with Cpap I started getting comfortable sleeping in other positions and now sleep mostly on my side. As you said sleeping with my arm up and under my pillow did start to give me shoulder discomfort, so it was a good thing that Cpap treatment allowed me to find new comfortable positions.

[Michelle-OH]

I think you'd really like the P10 due to your sleep position and the fact that it's exhaust air is very minimal.