What is your biggest CPAP struggle?

[ChicagoGranny]

Since, I've tried a few of the center hose masks, and I can never keep the weight of the hose from pulling the pillow against my nose and making my nose hurt.

There are some newer models available that have the hose attached to the headgear on top of the head. When the hose pulls, it pulls on the headgear and does not disturb the mask. The hose is up and away from the face. If you are interested in trying one, start a new thread, and someone will give you the model names.

[chunkyfrog]

Cpap hose management.
Numerous devices are sold by various sellers, or can be rigged up DIY.
They all work.
When caught out of town without my travel hose hanger,
a visit to the dollar store for duck tape and hair scrunchies solved the problem.
The tape peeled off the motel headboard with no damage.

[Sova]

I know this is a few months old, but thought I would chime in in case the doc comes back to read!

Agree with everyone that mask fit and the return policy are both key.

Something I haven't seen yet though- letting the patient know that there is a definite adjustment period and to plan for this in advance. I had some HORRIBLE nights during the first few weeks where I was only able to sleep for a couple of hours because I was not used to the feeling of air from my CPAP. I felt like I couldn't breathe out, it was weird to feel the mask on my face, etc. I think it's important to tell the patient about this and also let them know it WILL get better. I now sleep like a baby with my CPAP, better than ever before, but I was unprepared for the adjustment and can see why people might up and quit after 1-2 weeks of miserable sleep.

Another thing- working with the patient to make sure pressure is set correctly once they have their mask fit perfected and have gotten used to the machine. Especially when they have mild sleep apnea. My machine improved my AHI on the default setting set by the doctor, they were like "ok great that's acceptable" when I was still getting AHI of 5 all night and not feeling much of an improvement. I had to do my own research to figure out how to set the pressure myself, download the software, etc. and was able to get my AHI down to 2 to 0.3 depending on the night. I felt so much better after this!! Even if the patient isn't as tech/data savvy, if you're able to set pressure remotely, work with the patient to do a trial period where you test different pressure settings for a week each and see what gives the best AHI.