Mask leakage, snoring, and now phlegm...argh!

[Shutterbugmc]

I first posted on the forum last August, and wanted to provide an update. I've been using a CPAP machine for 15 years. I started off with the RemStar Pro from Respironics in 2005, and have used the ResMed S9 machine since 2014. I stopped using the humidifier years ago. For years I used the full face mask (Comfort Gel Blue, Resmed Quatro), and then shifted to nasal, using the DreamWear Nasal mask and headgear for several years. The less intrusive style is nice

Fast forward to last fall, I did a virtual chat with my GP in October. I was issued a new SDcard for my ResMed S9 machine card and was fitted for the P30i shortly thereafter. I’ve been cleaning the mask daily, washing the nasal pillows, but there are issues. While I’ve gotten used to the nasal pillows of the P30i, there are still air leaks, and my wife complains about horrible noises coming from the mask some nights. Sometimes she resorts to kicking me in hopes I’ll wake up and adjust my breathing at night. I’ve been cleaning the mask daily, washing the nasal pillows.

In addition, the other thing that started after receiving the new headgear is a buildup of phlegm in the morning. I never experienced this before, and am unsure of the connection with my new equipment. In the past few weeks, I’ve also started experiencing a nighttime cough before bed on a couple of occasions, resulting in my going mask free. Post nasal drip, somehow related to the machine or mask? With our current climate of COVID and masking up, this cough has me thinking all sorts of things.

I’m eligible for new equipment this week and will try out the ResMed AirFit P10 nasal pillow mask. In addition, I wonder if getting the ResMed S10 AirSense unit would make more sense. That way my GP has the remote monitoring option. Either that or I need to do a new sleep study, start from square one.

Attached is one of my recent sleep readouts.

[Shutterbugmc]

I'm curious about these AHI numbers. How much they vary?

[zonker]

I'm curious about these AHI numbers. How much they vary?

wish i had more knowledge and could directly address your troubles. let's see what the new mask does for the long haul.

as to the screenshot you poste this time, i can only say that we don't sleep the same way every night. when you start looking at your numbers, you're going to see some differences from night to night.

the CA (centrals) in your second graph; i'n not sure if those are alarming or just a one off.

let it ride for another night or two and let's see how it goes.

good luck!

[Shutterbugmc]

Thanks Zonker,

I will do that. I hope to have a better sense of what's happening after my appointment tomorrow.

BTW, I see in your profile that you use the Airsense 10 Autoset unit and Airfit P10 mask. How do you like that mask and box?

[zonker]

Thanks Zonker,

I will do that. I hope to have a better sense of what's happening after my appointment tomorrow.

BTW, I see in your profile that you use the Airsense 10 Autoset unit and Airfit P10 mask. How do you like that mask and box?

i can say, without hyperbole, that i feel both saved my life. well, okay, not THAT! but both made a huge difference in my therapy.

the machine was important because the pressure can be raised or lowered by increments of .2 as opposed to .5 on philips machines. this helped a lot because i had(and to some extent, still have) the worst bouts of aerophagia i've ever heard anyone describe. i was stuck in my therapy with my philips machine because i'm so sensitive to pressure that a .5 was WAY too much and just made my aerophagia intolerable.

with the resmed, i could s-l-o-w-l-y raise my pressure to combat my hypopneas with a minimum of discomfort.

the p10 was an earlier "life saver". i'm a full bearded fellow. i had tried two full masks and one nasal mask. i couldn't get a seal due to my beard and i will NOT shave it off. but i had thought i was a mouth breather and needed the full mask or at least maybe a nasal.

turned out not to be so in my case. (thank goodness!) i use the p10 in conjunction with forum member jay aitchsee's trick of using scunci hairbands to keep my lips closed. that and a foam firm cervical collar allows me to breath very well indeed through my nose.

sorry if that's more than you wanted to know. but i wanted to get it all down because i firmly believe it what works for me may not work for thee. if i had just said yeah, bro, their good, wouldn't do YOU no good!

good luck!

[cyberdreamer]

For the phlegm, post nasal drip, sinus issues and etc, you should try the humidifier again and fine tune it. I need to find the perfect setting in order to not have sinus pain, congestion and the like (for me, it's 7 with regular hose in the Airsense 10).

I can't believe how people sleep without the humidifer. For me, it gets so dry without humidification that it felt like someone were pushing daggers through my nostrils!

[Miss Emerita]

I'm late to the party here, and you may already have had your appointment. But I did want to second Zonker by saying that the ResMed Airsense 10 Autoset (or the For Her version) is an excellent machine.

About the postnasal drip and phlegm. That may be what is responsible for your very active flow limitation graph and perhaps the relatively low tidal volume and minute ventilation numbers, also perhaps the relatively long inhalation time. (TV measures the volume of air you move in and out in one breath; MV measures ventilation over the course of a minute.)

Have you tried Flonase, and over-the-counter nasal spray? It can take a week or two to kick in, so you'd want to give it some time to see whether it helped. My allergist also recommended using NeilMed nasal rinse. It's a weird sensation, but regular use seems helpful. You might also see whether you could have a remote consultation with an ENT or allergist and then try some prescription medications. For what it's worth, the two I'm finding quite helpful are a spray called Azalastine and a pill at bedtime called Singulair (montelukast).

[joeljjk11]

I am definitely no expert but I know I would feel horrific without humidity. No clue how anyone could sleep without it, just my opinion. I think I would try the humidifier and experiment with a setting that works for you. Also typically snoring is because your pressure is too low. Just my two cents.

Joel

[cyberdreamer]

I'm late to the party here, and you may already have had your appointment. But I did want to second Zonker by saying that the ResMed Airsense 10 Autoset (or the For Her version) is an excellent machine.

About the postnasal drip and phlegm. That may be what is responsible for your very active flow limitation graph and perhaps the relatively low tidal volume and minute ventilation numbers, also perhaps the relatively long inhalation time. (TV measures the volume of air you move in and out in one breath; MV measures ventilation over the course of a minute.)

Have you tried Flonase, and over-the-counter nasal spray? It can take a week or two to kick in, so you'd want to give it some time to see whether it helped. My allergist also recommended using NeilMed nasal rinse. It's a weird sensation, but regular use seems helpful. You might also see whether you could have a remote consultation with an ENT or allergist and then try some prescription medications. For what it's worth, the two I'm finding quite helpful are a spray called Azalastine and a pill at bedtime called Singulair (montelukast).

Miss Emerita, are you aware of the possible side effects of Singulair? It can cause mood changes and suicidal idealization. It messed with my mood and made me depressed whenever I took it! I later found out a bunch of warnings about it. Several people have committed suicide because of Singular apparently. Here's a warning from FDA: https://www.fda.gov/drugs/drug-safety-a ... lergy-drug

[Miss Emerita]

Thanks for your concern, and I’m sorry to hear about its effects on you. I haven’t had any side effects at all. I recently tried discontinuing Singular, only to find that my drip worsened. So for me, it’s a clear plus. As with all drugs, though, susceptibility to side-effects will surely vary from person to person.

[Shutterbugmc]

Hello and thanks for all the replies peeps!

I was beginning to lose hope, frustrated by my appt cancelled until 2/18, and the whole nasal thing. I've actually gone without wearing the mask all together for the past 7-10 days.

I find it odd that when I first switched to the DreamWear Nasal mask a few years back, there was never a nasal issue until I switched to the P30 last December. They don't seem to be all that different in design, but maybe I'm missing something. I received a new SD card along with the mask, and some settings were adjusted as well.

I did try a CPAP chin strap, but its design didn't seem like a good match with the mask itself. It felt constricting, and my wife was like "you're still making a lot of noise!" Any recommendation on a comfortable foam firm cervical collar?

I can't remember when I stopped using the humidifier portion. It was years ago, back with I had my RemStar Pro from Respironics. I never had an issue being dried out, but could revisit that. Another question for the doc when I go in.

"Using scunci hairbands to keep my lips closed"...interesting Zonker. I'll have to look at that on the forum, as I can't picture it at the moment. Is that a solution better suited to folks with a beard?

My wife recommended using NeilMed nasal rinse too, so that's a good first step for now, before my appointment.

Matt

[zonker]

Any recommendation on a comfortable foam firm cervical collar?

well, i use a 4" collar. i don't know if that would be too tall for you. it also comes in 3". like this-
https://www.amazon.com/Coreline-Cervica ... 883&sr=8-4

or you can pop down to the drugstore and see what they have. over in the section where they keep bedpans and braces and such.

"Using scunci hairbands to keep my lips closed"...interesting Zonker. I'll have to look at that on the forum, as I can't picture it at the moment. Is that a solution better suited to folks with a beard?

dunno. works a treat for me. mind you, scunics nor collars last forever. i get about three months out of the collar before it's gone too soft to be effective. i'm not sure on the lifetime of the scuncis. regular washing snaps them back, but that only goes so far before it just won't anymore. but they are a buck each, which i'm okay with.

[Shutterbugmc]

So I didn't buy a collar yet, but decided the Scunics idea could be a good fit for me. I like the non-invasive look, that it could pair well with the nasal mask.

I used the machine the past few nights, to see how I felt in the morning, while at the same time taking your guys' feedback into account. Once again waking up with the phlegm issue, especially on the night when I had a LOWER AHI number. While I still don't understand the connection, I'm open to getting a humidifier and seeing if that makes a difference. Considering I have the older Resmed 9, I'm wondering if I can pic one up from my doc, or just online somewhere.

[Shutterbugmc]

Hey Zonker, last night was my first night using the Scunci method you mentioned. One of my best AHI readings yet! Hoping for more consistent success!

[zonker]

Hey Zonker, last night was my first night using the Scunci method you mentioned. One of my best AHI readings yet! Hoping for more consistent success!

yay, scuncis!!

fingers crossed, you can stay the course and have continued success.

give us another chart tomorrow so's we can see.