Suffocated while side sleeping on P30i

[chunkyfrog]

Using an unscented baby wipe on the pillows and any skin close by
stops itching caused by irritants.
Still, some itching simply occurs because we can't get to it.
No other reason, except the nerves do what they do.
Surprisingly, meditating on that type of itch itself can help.
Weird, but it works.

[samurai3005]

Using an unscented baby wipe on the pillows and any skin close by
stops itching caused by irritants.
Still, some itching simply occurs because we can't get to it.
No other reason, except the nerves do what they do.
Surprisingly, meditating on that type of itch itself can help.
Weird, but it works.

Since you're a long-term user of the P10, I think I may need a few advice. Has the pillow cushion ever cause itchiness (particularly the skin on the nostrils where the pillows go in)? If yes, how did you fix that?

lanolin cream. brand name of Lansinoh. works a treat and helps prolong the pillows life span, in my experience.

pardon me, but i've forgotten if you are in the united states or not. it's available in the states, in the infant care section of grocery or drugstore.

it's used by nursing mothers to sooth sore nipples.

Really great advice here. I'd definitely apply.
No I'm not in the U.S. I'm from Viet Nam. U.S-only products usually take a month to get here. Quite troublesome but if it's worth the wait then I don't mind the trouble.
Thanks alot!

So this is last night's result. Once again, my dad failed to use it from ~2am - 4am (which I believe is the REM time, where the OA events tend to happen the most). I just hope that the following nights will be better. He no longer complained of suffocated feelings but he just straight off removed it, unconsciously, I think. Had to put it back on for him all of those times.

I have a couple of things to ask:

1/ Also he told me that he felt "more comfortable" (he did not say less suffocated) when he had to double up his pillow to raise his neck a bit. This wasn't necessary with the P30i but with this new mask he felt like he had to. Has this occured to any of you P10 users? Was it because the flow is "more direct" with the P10 (I know the mask he's using is not exactly the P10 but a very similar one like I explained in the previous post) than the P30i?

2/ I notice that the times when he just straight off pulled the mask off at midnight were when the pressure was "relatively high" for him (usually 10-12 cmH2o). I know this increase is necessary to maintain his airway (the machine has done its math right?). He did not tell me but I speculated it could be this raise in pressure that irritated him and woke him up and made him feel like he should remove the mask. Say, if at that exact moment when he was woken up by the pressure and consciously breathed in & out with a normal rhythm, will this cause the machine to decrease the pressure?

[samurai3005]

Another day, another let down...

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Looks to me that the situation won't get any better . I don't think the treatment is working for my dad with this kind of habit of removing the mask. I'm really tired!! He said at nights he wanted to go to the bathroom (which, if true, means that the treatment isn't working because cpap therapy is supposed to reduce nocturia symptoms), hence why he took it off. But I stayed up late watching over him and it wasn't like he went to the bathroom after he removed the mask, it was only a couple of hours after that!! (we have a sleep cam as well so I could veriry things).

At this point I'm serious about taping up his mask so that he won't straight off remove it since the suffocation thing is out of the way. And also make him serious about finally get this treatment work. I've read some posts on here that people didn't want to remove the mask yet woke up with the mask out of the way and seeked help here. Some of them tried taping up to stop them from subsconsciously removing the mask. Should I do the same to my dad?

For what it's worth, he usually get a good straight afternoon nap without removing the mask (usually 1-2 hours, it was 3 hours straight yesterday) but he usually sleeps inclinced for his naps.

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[khauser]

Some of them tried taping up to stop them from subsconsciously removing the mask. Should I do the same to my dad?

For what it's worth, he usually get a good straight afternoon nap without removing the mask (usually 1-2 hours, it was 3 hours straight yesterday) but he usually sleeps inclinced for his naps.
21 aug afternoon nap.png

Nocturia can be helped by cpap, but that's not a given. But it certainly won't help if it isn't used. Given your observation, his nocturia probably is related to him pulling off the mask though.
Honestly, you may have a big problem here if he's willingly resistant to therapy (I'm not saying that's the case, just a vibe I am getting). It is very hard to force someone else to do something they don't want to do. Taping might work but the idea behind taping is to make the person more aware they are removing the mask so they can stop. It's a retraining concept. It can only help if he wants it to.

Picking up on something else you said, maybe he should try sleeping inclined at night, at least until he gets more used to the mask and machine.

[Pugsy]

While sleep apnea is a common cause for nocturia....there is another common cause for the male of the species and that would be the old prostate gland being enlarged. Might want to have that checked out.

There are ways of getting up to pee that don't involve removing the mask but old habits are hard to break.

If you think that it is the pressure going up causing the problem....which BTW I have my doubts but that's a different story....how about just putting him on fixed pressure and see what happens. Something maybe around 9 cm and see what happens.
If he needed 10 or 11 for some reason and an apnea event slipped past the defenses it would still be preferable than 2 hours of untreated apnea sleep because he took the mask off. Might be worth trying.

[samurai3005]

Some of them tried taping up to stop them from subsconsciously removing the mask. Should I do the same to my dad?

For what it's worth, he usually get a good straight afternoon nap without removing the mask (usually 1-2 hours, it was 3 hours straight yesterday) but he usually sleeps inclinced for his naps.
21 aug afternoon nap.png

Nocturia can be helped by cpap, but that's not a given. But it certainly won't help if it isn't used. Given your observation, his nocturia probably is related to him pulling off the mask though.
Honestly, you may have a big problem here if he's willingly resistant to therapy (I'm not saying that's the case, just a vibe I am getting). It is very hard to force someone else to do something they don't want to do. Taping might work but the idea behind taping is to make the person more aware they are removing the mask so they can stop. It's a retraining concept. It can only help if he wants it to.

Picking up on something else you said, maybe he should try sleeping inclined at night, at least until he gets more used to the mask and machine.

Yes I understand. He really believes in the treatment though he just needs to understand that this is the only good way forward now, and the CPAP will stay. Althought it can never be as comfortable as breathing without it, he has to adapt to it for his health's sake.

While sleep apnea is a common cause for nocturia....there is another common cause for the male of the species and that would be the old prostate gland being enlarged. Might want to have that checked out.

There are ways of getting up to pee that don't involve removing the mask but old habits are hard to break.

If you think that it is the pressure going up causing the problem....which BTW I have my doubts but that's a different story....how about just putting him on fixed pressure and see what happens. Something maybe around 9 cm and see what happens.
If he needed 10 or 11 for some reason and an apnea event slipped past the defenses it would still be preferable than 2 hours of untreated apnea sleep because he took the mask off. Might be worth trying.

He doesn't have enlarged prostate gland, Pugsy. We're pretty sure of that.

So I tried the Lansinoh cream like zonker's suggestion and he no longer complained of nose irritation! However, a new problem arises!! Dry mouth (particularly the tongue and the upper oral cavity). He slept with the ResMed Sullivan Chinstrap last night (tried a few chinstraps already and this one works) but the leaks were still awful. I think he might need some taping as well. We'll try taping with Urgopore tonight and see if we can eliminate the leaks.

And because of that feeling of dry throat, he said he had to wake up to drink a few glasses of water, which he did. But nevertheless, he still pulled the mask off at 2am (he didn't wake up to drink water this time) and the thing is, he didn't even remember doing it. I also changed the maximum pressure to 9 like Pugsy suggested (but only from midnight on ward).

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I think my problem right now is the leaks and the dry mouth issue. If we can eliminate that then we can continue to work on making him restrain from subsconsciously pulling off the mask. This has been one hell of a CPAP journey. I really hope it'll come good in the end!!

[samurai3005]

I believe until now my "CPAP quest" has become "elimination of mask leak and mouth breathing" in order to get rid of the whole dry mouth thing.

This is his afternoon nap.

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He woke up still complaining of a dry mouth, particularly the soft palate and the tongue. Air must have been flowing out through his lips somehow! (he was wearing a chinstrap which successfully prevents his jaw from dropping). I notice that, even though the "large leak" on the OSCAR report is only 2%, the most part of his nap had >15L/min leak rate. These must have been blown out through his mouth, right?

So now all that's left to do is keeping his lips sealed because once they are closed and sealed, there's no way the air going in can just play around at the oral cavity (hence, drying his mouth) but have to go straight down to his lung.

I did some digging and found a lot of helpful articles in here, especially some from Mr. Jay HC. I'm ordering an 3M tape now but for the time being, I'm asking him to practice placing the tip of his toungue behind the 2 upper front teeth. I also read that some people had success in using the Scunci method, but sadly we don't have Scunci in our country (I wouldn't want to take risk using any other regular headbands anyway).
So my question to other P10 users out there, how did you fix the mouth leaks?

[chunkyfrog]

Scunci is not that special. it is just a brand name.
The word is used generically . . .
Women's stretchy knit headbands large enough to be comfortable should work.
Little girls' stuff is too small for most adults.

[zonker]

Scunci is not that special. it is just a brand name.
The word is used generically . . .
Women's stretchy knit headbands large enough to be comfortable should work.
Little girls' stuff is too small for most adults.

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absolutely.

samurai. chunky speaks the truth. it's just that scunic is the brand you'll most likely see in a north american store.

any such hairband should work.

[chunkyfrog]

Dollar stores in the US commonly sell mostly kid sizes--not always labeled as such.
Even a child's hairband should work, but piecing two together, or adding a length of elastic will help.

[samurai3005]

So after a few nights with chinstrap + "rooftop tongue" technique, he no longer complained of dry mouth, however he still removed his mask here and there and didn't remember doing it. The leaks were relatively high though, around 24L/min even though he didn't feel a dry mouth/throat anymore. But the most important thing is that we couldn't get a full night sleep with the CPAP on.

Then it hit me, my dad is the kind of person that is sensitive as hell when it comes to things touching his face... So I gave "mouth taping" a shot in order not to use the chinstrap! I didn't put his chinstrap on last night but I taped his mouth (after a very long talk about how this is only going to help you, that I'm actually not trying to shut you up or anything cynical thing that you think I'm trying to do to you...) with the 3M Nexcare for sensitive skin (the blue one) and wow, so far so good!

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(FYI: the initial pressure setting was 7 - 13 but Pugsy suggested I should lower the maximum threshold a bit so that my dad could feel more comfortable at late night and not remove the mask, whether consciously or not)

The leak was beginning to raise at around 2am so I figured that the tape must have come off a bit at the lower edge, I'll see to it tonight if it could be improved or not, as he said he woke up with a bit of drooling on the sides of his mouth, though the whole tape still stayed on.

About his nocturia: I guess it's like biological clock for him now. He will have to pee after going to sleep for 3-4 hours.

[zonker]

Then it hit me, my dad is the kind of person that is sensitive as hell when it comes to things touching his face... So I gave "mouth taping" a shot in order not to use the chinstrap! I didn't put his chinstrap on last night but I taped his mouth (after a very long talk about how this is only going to help you, that I'm actually not trying to shut you up or anything cynical thing that you think I'm trying to do to you...) with the 3M Nexcare for sensitive skin (the blue one) and wow, so far so good!
27 aug.png

good work!!

About his nocturia: I guess it's like biological clock for him now. He will have to pee after going to sleep for 3-4 hours.

i don't know how on earth you could ask him this. it's getting very personal. BUT, does he get up to pee because he HAS to or because he's awake and figures he may as well go?

either way, i don't think it's a big deal. my night time toilet visits cut back from 4 -5 during the night pre-cpap to once a night now. and truly, for me, it's because i'm awake at 4 and figure if i get up and get it over with, i can sleep more comfortably for a longer period of time.

either way, i am offering you all kinds of praise for what you have done for him. this is going to extend his life and make him feel better.

at least, he'll feel better once he's used to it.

[Lucyhere]

Zonker, who are those cute guys? I'm thinking only old people would know.

.

[zonker]

Zonker, who are those cute guys? I'm thinking only old people would know.

.

frank sinatra on the left and gene kelly on the right.

and who you calling old?