Should I be snoring during treatment?

mikej · Post by **mikej** » Wed Jan 02, 2008 12:43 pm

Hi,

New to the forum. I got my CPAP on Dec 14. I have used it all but 3 nights. My wife says that I am snoring with the mask on most nights that I use it. I thought that the treatment would eliminate the snoring? Also, I find myself taking off the mask after 3-4 hours on most nights due to comfort issues. Alot of times it feels like it is leaking, but I'm not sure if it is. On some nights, like last night, it felt real wet in the mask and I had the humidifier setting on 1. My pressure is 7, but most times I have to use the ramp button to be comfortable, otherwise I find it hard to breathe. I would appreciate any advice that I can get because I want this to work, but I don't feel it is.

Thanks,
Mike

tangents · Post by **tangents** » Wed Jan 02, 2008 1:31 pm

Hi Mike,

Welcome to the forum! Snoring is considered a type of breathing (flow) limitation, and is not desirable. If you could fill in your profile (found at the top of the page) it will help us give you suggestions to the problem areas you mentioned. I will offer some general ideas, just based on my own experiences and what I have read on this forum.

First, your mask comfort. Have you checked the yellow light bulb "our collective wisdom"? It has many suggestions for altering masks to make them more comfortable and seal better. Also, if you fill out your profile, and/or post a topic with the mask name in the title, the users of that mask will jump right in.

Next, the ramp. Quite a few of us feel suffocated with a pressure lower than 6, but this doesn't seem to bother you. Using the ramp is just a matter of choice. Getting used to breathing on CPAP takes a little time - it's hard to relax at first. For me, I didn't like the ramp because I kept anticipating the pressure increase, and would stay awake because of the anticipation!

I'm not suggesting that you change your pressure because I'm not medically trained, but if it were me, I would try a small increase to see if my snoring stopped.

Good luck, and take care,
Cathy

RipVW · Post by **RipVW** » Wed Jan 02, 2008 1:38 pm

Hello Mike & Welcome to the forum! You've found a great place for ideas and suggestions from many experienced xPAP'ers! Like you, I would expect CPAP to eliminate the snoring while you're using your machine--I might let my doc know about that (maybe your machine pressure is set too low?). And, many of us (including me!) removed our masks in our sleep during initial use, just a reflex action to get that "thing" off the face. With time, that should stop happening. The moisture in your mask is what CPAP'ers call "rainout," condensation from the warmer, moist air on the inside of the hose & mask caused by the colder air on the outside of the hose/mask. A hose cover is the standard fix for this--depending on how cool you keep your bedroom AND how high you set your heated humidifier, you might later need to add a heated hose cover as many of us have had to do.

I'm sure our "old timers" will join in here to provide more help!

P.S. Do be sure to start reading the "Collective Wisdom" (yellow lightbulb) to learn much valuable information about CPAP and sleep apnea.

ratkinson · Post by **ratkinson** » Wed Jan 02, 2008 7:08 pm

mikej,
Funny you should post this. My wife has been complaining that I have been snoring also. I have played with my pressures, slowly over the past week and a half. Evidently I am still snoring. I will continue to try to find the pressure that stops it , but, I am already quite a bit higher than my titrated 12. Let me know how you make out. I would appreciste the tips as well.

Richard

mikej · Post by **mikej** » Wed Jan 02, 2008 10:20 pm

Thanks for the responses everyone. I had an appointment with my doctor on the 29th, but I moved it to the 15th. My concern is that since I have Cigna, they will not cover a different mask if it turns out I need a new one. I had to buy the machine outright when I picked it up....Cigna doesn't rent them. Anyway, worst case, I will buy a full face mask from cpap.com if the doctor recommends one to help stop the snoring. In the meantime, I will give it a few more weeks and welcome any other tips from others.

Mike

kteague · Post by **kteague** » Thu Jan 03, 2008 1:30 am

Hi Mike. I see you're using a nasal mask. Are you snoring due to mouth breathing? Maybe your wife can tell you that. A full face mask would address that, but there are other ways to address mouth breathing if you like nasal masks or pillow style masks. Some masks are returnable within 30 days, don't know about yours, but if it's not working for you, I'd be at someone's door asking them to help you either make it work or replace it. Best wishes.
Kathy

Snoredog · Post by **Snoredog** » Thu Jan 03, 2008 2:07 am

There is nothing wrong with using the Ramp button to fall asleep, but you can run into problems IF the Ramp starting pressure is set too low, in fact most patients will starve for air to breathe if left at the default 4 cm pressure.

Most masks on the market today require 6.0 to 6.5 cm pressure to fully exhaust your exhaled CO2 effectively.

You have a Plus machine with Cflex, don't know what setting you are using, but I would suggest position #2 at that pressure. However it could also be that 7 cm is actually too low for you (reason you find it hard to breathe). 7 cm pressure is not high at all, just allow yourself more time getting used to wearing the mask.

For most people that takes 4-6 weeks.

Snoring: depends on where the snoring is, sometimes you cannot eliminate snores no matter the pressure used. If they stopped at 7 cm to avoid triggering CA events which interrupt your sleep they may have stopped at 7 cm, then that can allow you to continue to snore (ask your doctor WHY they stopped at 7 cm pressure).

However, if you are snoring with a nasal mask that can be an indicator of mouth breathing, if that is the case your therapy pressure is lost and will leave you as if there is no therapy at all.

Yes you can use a Full Face mask, but if you are a chronic snorer you will most likely snore with it also, but more of your therapy may be applied if you are now mouth breathing.

Best thing to do is to ASK your wife to observe you more closely the next time she hears you snore, have her check your mouth to see if you are mouth breathing/snoring. Then the Full Face mask would be warranted.

mikej · Post by **mikej** » Thu Jan 03, 2008 5:41 pm

Today I received a call from Apria doing a checkup asking me how I was doing. I pretty much told her what I posted here and she agreed that the pressure may be too low to be effective. She recommended that I ask the doctor to see if it needed to be raised, also she recommended I use C Flex setting 2 (like Snoredog recommended), it was on 3. I will try that tonight. I elevated the hose as well and did not have the "rainout" last night, but last night was my worse night yet as I have been falling asleep practically all day today. Hopefully the new c-flex setting helps tonight, but the Apria rep also suggested that I might want to ask the doctor for the full face mask also and I will do that. She also recommended that since my machine doesn't have the smartcard, to have my doctor write a script for one that does and they will issue a loaner with a smartcard for 2 weeks free of charge so my data can be captured for the doctor. Thanks to everyone for their help so far. Everything the Apria rep told me was already relayed to me here based on your help. I'm glad the forum is here for us new people!

Mike

roster · Post by **roster** » Thu Jan 03, 2008 6:12 pm

[quote="mikej"]...... My concern is that since I have Cigna, they will not cover a different mask if it turns out I need a new one. .......

Mike

Sundown · Post by **Sundown** » Fri Jan 04, 2008 11:36 am

My husband wanted a Nasal mask, but is a mouth-breather, so we had to go with a Mirage Quattro FF mask. His snoring is rare now.

I initially was on 4 for ramp, and thank goodness one of the members here told me that was the default setting and I should either up the ramp myself or try without ramp at all. I now use no ramp.. and go right to sleep.. but my pressure is 9, so it was a piece of cake.

yardbird · Post by **yardbird** » Fri Jan 04, 2008 1:43 pm

I've said it before and I'll say it again... the mask is the key to this therapy. If your mask leaks into your eyes and wakes you up, or if it has a bridge piece that makes a sore spot on your nose, or if it .... whatever.... if it doesn't WORK for you, then you can have the latest greatest, whizz-bang, cutting edge cpap machine.... and still not feel any better.

This does take a little getting used to. I used to toss my mask off at night... "Get this ALIEN OFF MY FACE!"....

Now if I fall asleep watching TV without my mask, I wake up all panicky and get it on ... hehehe... like a pressurized security blanket for my face. or.... a HOSE JUNKIE!

So work on getting the mask that fits and that you're comfy with. Don't be afraid to tell your doctor or Apria or whoever... that something isn't right. This is MEDICAL treatment. And it's up to the medical professionals to make proper adjustment to obtain effective therapy. And whether they'll admit it or not... they really do need your help and input to accomplish that. So learn as much as you can. Don't be a know-it-all, but DO put yourself in a position to make relevant and meaningful observations and/or requests.

You can do that by hangin out here.

_________________

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mikej · Post by **mikej** » Wed Jan 23, 2008 3:09 pm

Ok, so I got a loaner Resmed auto titrating machine for a week and I got a new full face mask. My problem now is the last 2 nights on the loaner machine, after about two hours, the pressure is so intense that the mask is coming away from my face making squealing sounds as it does. The menu appears to be locked down so I can only see hours used on it. I have tightened the mask and it still seems to be too much. Any thoughts?

Mike

TossinNTurnin · Post by **TossinNTurnin** » Wed Jan 23, 2008 4:35 pm

tangents wrote:
Next, the ramp. Quite a few of us feel suffocated with a pressure lower than 6, but this doesn't seem to bother you. Using the ramp is just a matter of choice. Getting used to breathing on CPAP takes a little time - it's hard to relax at first. For me, I didn't like the ramp because I kept anticipating the pressure increase, and would stay awake because of the anticipation!

That was my exact experience.

bigk · Post by **bigk** » Wed Jan 23, 2008 4:58 pm

To get more info from the Resmed, you should be able to press the left and right buttons together for 3 seconds.

rested gal · Post by **rested gal** » Thu Jan 24, 2008 7:26 am

mikej wrote:Ok, so I got a loaner Resmed auto titrating machine for a week and I got a new full face mask. My problem now is the last 2 nights on the loaner machine, after about two hours, the pressure is so intense that the mask is coming away from my face making squealing sounds as it does. The menu appears to be locked down so I can only see hours used on it. I have tightened the mask and it still seems to be too much. Any thoughts?

Mike

It was good that they gave you a loaner auto-titrating machine, BUT.... in my opinion, the brand (ResMed) they chose to give you was an extremely poor choice on their part since breathing out against pressure could be part of your problem.

The ResMed autopap gives NO relief whatsoever against pressure when you exhale. ResMed's advertised "EPR" for pressure relief while exhaling CANNOT even be turned on when the machine is operating in auto-titrating mode.

An autotitrating trial might go a lot better for you if you can get them to switch that resmed autopap for a Respironics autopap...

Specifically, I'd suggest the Respironics REMstar Auto A-flex M series. Not just "C-flex." Make sure they (or the doctor who will be prescribing it) understands you are saying A-flex.

The ease in breathing out while using A-Flex is quite amazing. Could make all the difference in the world to some people (you, perhaps) in being able to do this kind of therapy comfortably enough to get a good auto-titration trial.

That machine is worth pushing for.

All that said, I agree absolutely with yardbird:

yardbird wrote:I've said it before and I'll say it again... the mask is the key to this therapy. If your mask leaks into your eyes and wakes you up, or if it has a bridge piece that makes a sore spot on your nose, or if it .... whatever.... if it doesn't WORK for you, then you can have the latest greatest, whizz-bang, cutting edge cpap machine.... and still not feel any better.

Mask	Humidifier

Additional Comments: S9 Autoset, H5i, Resmed Swift FX, Resscan 3.10