I can't fight this feeling anymore

[riptideeast]

I'm a new user just set up with a CPAP 2 days ago. I intend to use this thing as best I can, but feel like I can't exhale against the airflow. I don't know if I'm a mouth breather or not and I also have a lot of problems keeping this mask sealed. I haven't found any good documentation on how to keep the cushion clean; it keeps creasing at the top of my nose and leaking air just below my eyes. I need some guidance and a lot of time to get used to this thing. Any recommendations would be greatly appreciated.

[Muse-Inc]

Welcome aboard! You've come to right place...great info, great folks
Please fill out your equipment details (click the User Control Panel link under the big blue bar above) with "text" not "icons" then we'll know how to make sensible suggestions. Please tell us your pressure too.

If you have a really dry mouth or sore throat upon awakening, it's a good sign you're likely breathing thru your mouth; on the other hand, your bed partner might already know if you are.

[tattooyu]

I've forgotten what I started fighting for...

(Sorry couldn't resist, I like REO Speedwagon)

In my experience, full face masks can be extremely leaky. I just got a Quattro (medium and large) as a backup from my DME, in case I get a cold, and have to return it because it will not seal. I get zero leaks from my Swift LT nasal pillows (and chinstrap).

For exhaling there are two things: Time and EPR.

Time — Give yourself ample time to get used to therapy. It took me a good 2 months to really settle in. You may get frustrated but stick with it. We'll help you try different things.

EPR — There is a setting on your machine that you should be able to change from the menu that allows some exhale relief (level 1-3). I started with EPR at 3 and now have it off after 6 months. It will lower your average pressure (on exhale), so try to use as little as necessary.

Hope that helps some.

[Pugsy]

Welcome to the forum.

I see you have a ResMed Escape showing in your profile. Since you just started you might want to see if you can upgrade this machine to the data capable CPAP. The Escape provides no useful data to you. It only will show the DME how many hours you are using the machine. You will have nothing to show you how bad the leaks are and if the pressures are optimal for you.

EPR exhalation relief. A setting of 3 will give you 3 cm of pressure reduction during exhalation which may help you get adjusted to the machine. Also, are you using the ramp? This feature provides a gradual increase up to your pressure setting. What pressure are you set at?

Cleaning the plastic parts of the mask with warm mild dish detergent is sufficient till you think of something else you like. I use Johnson's baby wash. Full face masks will need to be washed daily to remove the skin oils which if nothing else, will affect the sealing ability. I am referring to the cushion part that touches the skin.

I don't use a full face mask but it does require more effort to get the leaks taken care of simply because of the area of surface contact. Sometimes less is more when tightening the straps. Try adjusting it while laying down with the pressure on but not when you are rushed to get to bed. Do it when you have extra time.

[Sleep Nazzi]

Finally a subject matter I know something about... QUITTING!

DON'T DO IT! (huge 72 point font)...

I remember exactly what you are going through as I went through it five years ago. Long story short, my waking life is crap now. I'm tired. I'm cranky. I'm short with my loved ones. WHY? NOOOOOOOO SLEEEEEEEEEEEEEEEEEEEEEEP! (very dramatic huh)?

So now five years later, I'm starting over again and experiencing the exact same problems. Exhaling against gale forced winds! I'm back on CPAP now for an entire week (sound like a AA (Apnea Anonymous) meeting here). I still hate it, but you know what, I can compare it to the last five years of not sleeping. Although uncomfortable and awkward, I'm going to stick with it this time. I WAS SCARED STRAIGHT! I woke up behind the wheel with my son in the car going down a country road at 60 miles an hour. I'm just so glad there was no oncoming traffic.

So what are you fighting for?

1) Your sanity.
2) Your family.
3) Your friends.
4) Your life!


NO SLEEP FOR YOU!

[SleepNazzi]

Woops... forgot to log in! And I'm wide awake... I SWEAR!


NO SLEEP FOR YOU!

[PST]

I'm a new user just set up with a CPAP 2 days ago. I intend to use this thing as best I can, but feel like I can't exhale against the airflow. I don't know if I'm a mouth breather or not and I also have a lot of problems keeping this mask sealed. I haven't found any good documentation on how to keep the cushion clean; it keeps creasing at the top of my nose and leaking air just below my eyes. I need some guidance and a lot of time to get used to this thing. Any recommendations would be greatly appreciated.

Exhaling against pressure is one of the things people seem to react to the most individually. In addition to using EPR, just give it some time. For some people the sensation simply becomes less intense. I would never have believed on night two how little it would bother me by week two. I admit that this is not true for everyone.

I've got the same mask, and I have gradually reduced the size and frequency of leaks, although occasionally I still have a bad night. These things work for me:

1. Squeaky clean mask and face. I have oily skin, so maybe this doesn't matter as much to others. I've started popping the cushion out for cleaning, because it's easier to wash and rinse the surface that touches the face that way. I use a mild liquid soap, and rub it slowly over the outer cushion all the way around, making sure I've soaped all the oils off, then rinse well. In the end the material squeaks when you rub it between thumb and forefinger, the way freshly shampooed hair does. Face and mask need enough time to dry before going to bed. This is a bore, but a rush job means leaks for me.

2. I tighten the lower straps pretty tight but keep the upper ones a little loose. The cushion doesn't crease around the nose when I do it right. It fills with air and seals tighter as the pressure goes up. In theory. Much of the time. I admit the cushion doesn't always seat right.

3. Make sure the mask isn't too big. I'm a big guy, and I assumed I'd be a large. Why not, I'm XXL for most things. But a medium fit best. Too big, and the mask sits high on the nose and leaks where the bone start to fall back into the eye sockets. ResMed has a template at its site you can print and cut out and use to estimate what size ought to fit best, but actual use is the acid test.

[Rustyolddude]

Bottom lefthand corner is a video on fitting & cleaning. http://www.resmed.com/us/products/mirag ... s&sec=true

[jdm2857]

I'll repeat the advice to talk to your supplier about upgrading to an efficacy data capable machine. If you do it during the first 30 days, it may not cost you a cent. And it will give you the ability to monitor and adjust your therapy.

The EPR feature mentioned above may or may not be available on the patient menu, depending on how the machine was set up by the supplier. But if you sent me a personal message (the PM button in the left margin of this post) with an email address, I can send you instruction to access all of the functions of your machine.

[DoriC]

If you're a side sleeper, you might need a special bed pillow that will allow for that especially with a FF. I'm not too savvy about copy/paste but you can do a search for SleePaPillow, Chiroflow or Regeneris. Maybe someone else can lead you to them. And welcome to the forum!

[BeanMeScot]

As said, turn on the EPR and give it time. When I started, I had an APAP set to 5. That was too low and I felt like I was suffocating. I turned it to 6 (titrated pressure 7) and it felt like a gail. So 5.5 was just right. Months later, it feels like nothing and I have it set to 7. It still feels like nothing. You will get used to it. The human brain is very adaptable.

[riptideeast]

I took some of your advice and cleaned the mask cushion. I had only worn it one night, and took it off after two hours. I hadn't cleaned it having only worn it for only 2 hours, so I took it apart and wiped the mask out and let it dry. Then, last night I didn't get to bed until around 3 am. (I own and operate a computer repair shop, and spend most of my time there.) I put the mask on and adjusted the straps and tightened the knob at my forehead, and surprisingly it stayed sealed most of the night with just minor air leaks around the mouth. I got about 5 hours of sleep with it with no problems. I'm not sure that I got the rest I need. Maybe this won't be so bad. I set my pressure to ramp over 5 minutes. By the time it gets up to 16, breathing isn't as hard. My EPR is set at max (3). I guess it might work for me. I woke with a very dry throat. I am using the humidifier. Does the H4i provide humidification without it being heated?? I had it on but couldn't tell that it was working.

[PST]

Heat is used to adjust the amount of humidity. The humidifier works, up to a point, unheated. This is sometimes referred to as passover humidification, as the air has a chance to pass over the water and pick up some moisture. The more the water is warmed, the more evaporation will occur and the moister the air will be. Too much and it can condense back into water in the hose. So if your throat still feels dry, turn up the heat one more click.

I find it best not to think of the knob on the Quattro as something to tighten or loosen. It is more of a way of adjusting the shape of the mask to conform to your face. You want the forehead pad to bear the pressure of the upper strap. The knob lets you position the pad so nothing hard touches the bridge of your nose, but the mask stays close enough to the bridge for the cushion to form a seal. There is numbered scale on the screw mechanism, so when you find the sweet spot, you can make sure you return it there after mask maintenance. Out too far, and the seal breaks. In too close, and you find that you are "breeding a scab on your nose," as my father used to say. That was only a metaphor when he said it, but it can be literally true with this mask.