Twilight NP Arrives Tomorrow - Any Suggestions?

tangents · Post by **tangents** » Thu Mar 22, 2007 8:35 am

I've been on CPAP for two full weeks now! Mostly good nights, some not so good. Wishing I felt more rested, trying to be patient, all the usual stuff. I've been using the ComfortGel so far, with OK success. My main problems are getting a sore on the bridge of my nose and keeping the seal as I switch from side, to back, to other side during the night. For the nose, I've tried adjusting the angle of the headpiece, but can't get a seal if it's more than one notch up from straight. I use a bandaid with good success, just cut all but 1/8 inch off the sides so that it comes off easy in the morning. To try to keep the seal while I switch positions, last night I finally rigged up a hose holder so that the hose will stay above my head, and got lots of rain out during the night. So tonight I will make myself a hose insulation sleeve, and assume that'll fix the problem. (It's just a tube of fleece over the hose, right?)

I ordered a Twilight NP to try, figuring that I will like not having the straps on my face. Are there any hints you can offer me? I'd really appreciate them. Thanks for your help with this forum!! This is such a caring group of people, and I would be very stressed out by now if I hadn't found so many suggestions here.

Again, thanks for your help.
Cathy

DreamStalker · Post by **DreamStalker** » Thu Mar 22, 2007 9:25 am

Hi Cathy -

You are correct about the hose cover being a simple tube of fleece material. My mom made me some long tubes of fleece that I just cut to length.

Chances are that your Twilight NP is going to have rainout problems also. Although I do not have one myself (maybe this summer?), I think becuase it has the greatest surface area of plastic tubing exposed between the pillows and the exhaust ... its design suffers from the rainout issue more so than others. Most users of the Twilight NP seem to have the Aussie heated hose in order to keep rainout under control. It is a hose fitted with electrical resistance in the form of a copper wire embedded in the hose which heats it to prevent condensation.

Masks are indeed the most problematic issue in getting our treatment to work ... but not give up on it as you will eventually find the right mask for you. Good luck

tangents · Post by **tangents** » Thu Mar 22, 2007 10:03 am

Thanks, Dreamstalker!

So, the length of tubing from the nose to the top of your head is where the condensation is occurring? Has anybody tried to wrap that with insulating material?

I'm so glad you told me that, or I would have assumed that I made the hose cover wrong!

DreamStalker · Post by **DreamStalker** » Thu Mar 22, 2007 2:27 pm

Condensation or rainout will occur wherever warm moist air comes into contact with a surface cool enough to condense it … that usually happens somewhere along the plastic hose between the humidifier reservoir and the mask (including the mask itself). The air exhaled will often have more moisture than the air you breathe in.

While most other nasal pillow interfaces have the port(s) located much closer to the pillows, the Twilight NP is designed with a separate tube for each pillow and the exhalation port(s) is located near the top where the two separate tubes become one with the connection hose. This design forces the warm moist exhalation air to have to travel the length of those two tubes to the exhalation port(s) which are generally exposed to the cooler room temperature air. In addition, by having two tubes (even though they are smaller in diameter) instead of one, the surface area is greater with two and thus this also increases the potential for condensation even more so.

Many tout the Twilight NP/Aura as a great mask … but they also note having to deal with rainout. I think those who live in warmer climates may be less susceptible to rainout issues in general but more especially for this mask. In any case, you need to make sure you don’t cover up the exhaust ports trying to insulate it with a cover. Hope it all works out for you.

bdp522 · Post by **bdp522** » Thu Mar 22, 2007 5:41 pm

If you run into any problems when you get the mask, here are Rested Gals links to the mask;

viewtopic.php?t=3098

It might be a good idea to check them out before the mask arrives.

Brenda

blarg · Post by **blarg** » Thu Mar 22, 2007 8:23 pm

I fleece covered even the spot on mine that goes on either side of the nose, and then from above the exhaust all the way back to the machine. Now that I'm in Sydney I'm not having any rainout on 4, but back in Oregon I needed a heated hose to stop rainout on anything above 2. Depends on how warm your room is etc.

It's a great mask, just be ready to face some rainout issues.

tangents · Post by **tangents** » Fri Mar 23, 2007 7:46 am

Thanks, everybody! My Twilight NP arrived a day early, and like an IDIOT I used it last night without reading the late afternoon/evening posts. I looked at the clock at 12:30 AM thinking I had been fighting with the headgear all blasted night. Stayed awake until 1:30 trying to get comfortable, then - RAINOUT - right into my nose. YUK. Switched to my ComfortGel to get through the rest of the night.

I made a nine foot sleeve out of fleece for my hose yesterday, and cut off about 12" for the hose coming off the Twilight. Didn't realize that this section of hose is kind of flimsy - ended up stretching the plastic at one end so that while it still seals, it's really fragile now. Covered it with duct tape for added structure. Tonight I will make covers for the hose sections down to the nasal pillows. I like my humidifier on 3, and live in Cleveland, need I say more... :>) ?

So, my biggest question is this: am I wasting time trying to get the headgear to fit my apparently small head? Should I just deconstruct and go from there?

Thanks for your advice, I had/have high hopes for this interface.

Cathy

Gerald · Post by **Gerald** » Fri Mar 23, 2007 9:25 am

Cathy.....About a month ago, I switched from a CL-2 to the Aura (your new mask) and it's doing a better job for me.

I use lanolin (for breastfeeding mothers) on my nares every night. After a few minutes the lubrication helps me to hardly feel the mask....and I achieve a better air seal too.

I have a swinging arm mounted over my head to suspend the hose over my pillow. Rested Gal has shortened the hose on her Aura....and her posts will tell you how to do it if you feel the need. Read them all....and you'll be "sitting at the knee of the master".

I find that my M-series Auto is doing a better job of determining my correct pressure with the Aura (as compared with the CL-2). I have my pressures set at 9 cm on the low end....and 13cm on the high end. During the night the M-series ranges between those pressures very nicely. I set my ramp to start at 7cm and ramp up to 9cm in 15 minutes. I'm nearly always asleep before the end of ramp time.

I have a hose cover.....the room is about 73F....and the humidity in the room is about 40%. I have my M-series humidifier set on (1) (lowest setting) and I am not experiencing any significant rainout. In the morning, I do see a few droplets of condensed water inside the nosepiece....so, I must be just on the edge of a "rainout" problem....I'm getting enough moisture......but not so much as to cause annoyance. Every now and then, I'll feel a little "tickle" inside one of my nares as I change head positions during the night....and I suspect one of those droplets finally "decided" to be a "rainout"....but the problem is so slight that I don't pay any attention to it.

Finally, if your machine has card reading capability, I urge you to get a card reader and software so that you can chart your progress every day. Download a copy of jskinner's "analyzer" program to go along with Encore....it's a good program. Send Skinner a few bucks if you like it.

You're on your way to success!

Gerald