Need to Vent and get words of wisdom

[tootiredtocare]

Well, I could use a few words of wisdom. I have been diagnosed with sleep apnea for about 3 weeks now. I have used two different masks, the Mirage Micro and the Swift LT. The Mirage Micro leaked alot, and I have trouble keeping the Swift LT in place because I am a stomach sleeper. Honestly, this whole process has been a little overwhelming for me. My doctor and the sleep center I went to for my sleep studies said that everyone feels so much better when they start using a bipap machine. I was really excited about sleeping soundly through the night. Unfortunately, that hasn't happened.

I have severe allergy problems and sinus trouble - my nose stays either stopped up alot or is running. I have been using a heated humidifier at night but am not sure that it is working properly because it doesn't ever feel very warm. And, I am having trouble sleeping on my back or side. I would love to be one of those people who could sleep on his back because I didn't need to sleep on my stomach anymore, but I haven't found that to be true. Of course when I try to sleep on my stomach, my mask either comes off or slips out of my nose, and I wind up breathing through my mouth. I don't now how people afford to continue to buy masks because my insurance just started over and they are fairly expensive. My DME hasn't been the most helpful; I actually question how competent they are. They don't offer suggestions on the best mask for me - it is basically, "what mask do you want?"

The air is so cold going up into my nose at night that it freezes me. I could really just use some good advice. Like I said, I am currently using the Swift LT mask, the ResMed VPAP S bipap macihine and the H4i heated humidifier. To make the story complete, I am a very large guy who just isn't used to sleeping on his back. There is so much trial and error involved in this, I just had no idea. Thanks for any support you may provide and for letting me vent.

[Sleeprider]

Can't help with the stomach sleeping, although there are some special pillows available that make room for a mask to fit in a cavity in the pillow. The cold air can be solved by using a Sleepzone heated hose (your cost $140), or a 15 amp heated cord for reptiles that apparently can be purchased from pet supply. As far as the DME saying "what mask do you want?" Well it sounds like you have free-run of the place. Find something that works.

Its a lot for someone starting out. Just realize that as you tackle the problems and solve them one at at time, that eventually this will all settle out and become routine. We've all been there. My suggestion is to focus on solving the problem that bothers you most first, then move on to the next one. As you start getting more benefit out of your sleep with therapy, this will seem a lot less overwhelming.

[ozij]

Welcome to the forum, TTTC (tootiredtocare is soooooo long...).
I hope it helps when I tell you the most of us got here out of the same frustration and disappointment. Most of those who slept happily with their first mask probably didn't go looking for an internet forum the next day (or later...).

Getting the right mask can be a problem -- but I as far as I know, DME's should give you a chance to try and return masks-- the companies reimburse them -- however other know more about this than me. Don't assume the DME's know which mask is right for you, or how to fit it. They might, but they might not. You'll find the tips tricks and secret way of making masks your friends right here.

Cold air: I found it terribly annoying. The first step is to buy or make a hose cover -- you can get good hose covers from http://www.padacheeks.com . If a hose cover isn't enough (it wasn't for me) there's a heated hose available -- I think its sold from the US too nowadays, but the source is http://www.sleepzone.com.au.

You don't have to sleep on your back. I was a stomach sleeper before my OSA was treated -- it's the best position to keep breathing -- and managed a few nights on my stomach with my nasal pillows mask (the Breeze then) -- but eventually reverted to my original side sleeping.

Some of us (many, I think) find that routing the hose so it comes form above your head makes mask management much easier. And tummy sleeping too.
LINKS to Hose hangers and methods of managing the air hose
viewtopic.php?t=10640

Allergy and sinus problems: Are you aware of nasal irrigation -- that is, rinsing out your nasal passages with a warm saline solution? Take a look here http://www.neilmed.com to see the techniques, and here: http://sleeptreatment.com/allergy-video-series to learn about how to handle some of the allergy problems that impact sleep and cpap therapy.

It's as you say -- there's a lot of trial an error involved in this, I remember the my shock when I understood it was not going to be as simple as I imagined. But things can be solved -- and we're here to help you.

O.

[tootiredtocare]

Thanks for the words of encouragement. I really appreciate it. I am sure everyone know that when you are exhausted, you are desperate for a good nights sleep. I can't get over how expensive sleep apnea is. I mean, masks, hoses, humidifiers, chin straps, tape... It seems like it goes on and on. Do you know if most insurance companies cover the cost of say a heated hose or new masks, at least to defer some of the cost. It just seems like it can get expensive if you can't find a good mask soon after being diagnosed.

By the way, I do use nasal irrigation. However, sometimes, my nose is so stopped up that I can't get the irrigation to work. My sinus trouble actually seems worse since I have been on the sleep apnea machine, if that makes sense.

[DreamOn]

Hello and welcome to the forum, tootiredtocare!

We all need to vent sometimes. This therapy certainly isn't always easy! Especially in the beginning, there can be a lot of troubleshooting that needs to be done. In regards to your mask slipping, I suggest that you check out the "Lab Rat" mask/strap modifications here: viewtopic.php?t=15104. Scroll down to "Swift LT". Perhaps there's information there that will lead to a solution and keep your mask in place. It's also possible that the nasal pillows you have are the wrong size for you. That may be your problem with the Mirage Micro too. You may have to use a full face mask, since you can't breathe well through your nose.

Your DME should be taking the time to fit your mask properly. Each mask comes in different sizes. Ideally, you should be taught how to properly adjust the mask, and test it under full pressure at the DME while laying down and moving around. If they're not doing that, in my opinion they're not doing their job correctly. Sadly, we hear that all too often around here.

Some people use the special bed pillows made for CPAP. Also, there are buckwheat hull pillows, down pillows, and other types to consider. I use a soft latex pillow that I purchased at Sears, and it works very well for me. I do sleep on my side most of the time, though. It may help to hang the mask over the side of the pillow.

Finding the best level of humidification can take some experimentation. Having too much may actually make you feel more congested. Everyone's preferences are different and the correct setting can vary, depending on the conditions in your bedroom. I have the same humidifier as you do, and I keep mine set at either 1.5 or 2.0. You may want to buy or make an insulating cover for the small hose on the Swift LT. Pad A Cheek has covers for both the large and small hoses/tubing here: http://padacheek.com/PAC_Hosecover.html (small ones are at the bottom of the page). Even if your larger hose is covered, that small hose is long enough that the air may cool when passing through it. Insulating it may keep the air a bit warmer for you.

I believe most insurance companies go by the Medicare replacement schedule for supplies, including masks. You should check with your insurance company, but most will pay for a new mask every 3 months. Also, most DME suppliers allow you to exchange masks at no cost within 30 days, so take advantage of that if what you have isn't working for you. I know what you mean about the cost! It certainly does add up.

I know how frustrating this can be. You do have to just tackle one challenge at a time until everything falls into place. The results will be worth it once your therapy is optimized!

~ DreamOn

[LoneStar]

Hi TTTC,

Welcome to the forum. We've all been where you are and survived. But getting used to using your CPAP machine and solving all your problems with it and the mask make take time. Hang in there.

One thing about your humidifier; not all of us do well with it turned on and actively "humidifying." I actually found that I do better with less nasal stuffiness when I just use it in "passover" mode. In other words, I don't turn on the heating element, but the CPAP air does move through the water chamber picking up moisture as it passes over.

I do use the Aussie heated hose, but I mainly use it to prevent "rain out" which is when water condensates in your hose/mask and you end up breathing it in unexpectedly - not a good thing. Some folks use a hose cover, but it didn't work for me in solving the rain out problems.

And don't expect heated and humidified air to be really warm; it is just warm enough to not be cold.

Lisa

[LoneStar]

Hi TTTC,

Welcome to the forum. We've all been where you are and survived. But getting used to using your CPAP machine and solving all your problems with it and the mask make take time. Hang in there.

One thing about your humidifier; not all of us do well with it turned on and actively "humidifying." I actually found that I do better with less nasal stuffiness when I just use it in "passover" mode. In other words, I don't turn on the heating element, but the CPAP air does move through the water chamber picking up moisture as it passes over.

I do use the Aussie heated hose, but I mainly use it to prevent "rain out" which is when water condensates in your hose/mask and you end up breathing it in unexpectedly - not a good thing. Some folks use a hose cover, but it didn't work for me in solving the rain out problems.

And don't expect heated and humidified air to be really warm; it is just warm enough to not be cold.

Lisa

[SleepingUgly]

I'm no expert here, but it seems if your nose is stopped up, you will have trouble using a nasal-only mask of any sort.

I have severe allergy problems and sinus trouble - my nose stays either stopped up alot or is running.

[BlackSpinner]

I'm no expert here, but it seems if your nose is stopped up, you will have trouble using a nasal-only mask of any sort.

I have severe allergy problems and sinus trouble - my nose stays either stopped up alot or is running.

Yes that was my first thought too - get rid of that nasal mask and go for a full face mask!
Any RT who gives someone like that a nasal mask is an idiot

[Muse-Inc]

Welcome aboard! Rants and questions encouraged here, we're on this sleep-disordered breathing 'ship' together,

OK, you've got sleeping position, mask, cold air, congestion, and cost issues. Search here for Falcon position for sleeping. Rooster, who sleeps in this position, wears the RespCare Hybrid mask...here's his suggestions for fit that might help ypu viewtopic.php?t=14422&highlight=. There must be thousands of posts about congestion, many of us use a combination of nasal steriod sprays, nasal irrigation, saline spray, allergy meds, antihistamine nasal sprays (Astepro or Astelin), or go to an ENT for possible surgery. Humidification: some do better with more, some with less...experiment and see which helps. Cold air...using high humidity might help but if the temp is cold, that might not help...a heated hose is supposed to eliminate cold air and not affect level of humidification (got one on my wish list). Cost...yeah, it's a challenge.

Meanwhile start logging your daily data from the LED: leak, pressure, AHI, AI, HI, hrs slept, etc. This will help for reviewing trends and identifying treatment issues.

[tootiredtocare]

Thanks so much for your wonderful comments. I definitely appreciate all of your information. Someone had mentioned using a full face mask and my question is, do all men who use a full face mask have to shave? I have a goatee on my chin that I would like to keep and have had forever, but don't know if that is possible with a full face mask. I keep the rest of my face shaved. I understand that some of you also have bad sinus problems yet you appear to be able to use nasal masks. Did you start out using a full face and decided to go to a nasal mask? I'm just trying to figure out how you made it work for you - just the nasal irrigation, nose sprays, etc...? And no, my DME did not take the time to show me how it would feel lying down, or tightness against my face, etc. I think that is why I have so many unanswered questions. Thanks to everyone for the warm welcome and all of the knowledge.

[Ramma2]

I started out with a nasal mask as well, and it just did not work for me. My nose is almost always 75% plugged, so breathing only through my nose was not an option. The Dr at first suggested nasal sprays, flushes, etc, but none of that worked. Once I switched to the full face mask things got greatly better.

Being on vacation I get sort of lazy and don't shave, so last night when I went to bed I was sporting a 6 day growth and I had no problems with the mask sealing (just make sure its clean and oil free). The bottom edge of my mask sits in the valley between my bottom lip and chin, so if your goatee is like how I am picturing it I do not think it would give you troubles. But it is at least worth a try.

[Judy R]

Welcome to the group. As you can see we've all had troubles at first, I know it's a pain in the neck, but like some said, take it one problem at a time. I understand that they didn't take the time with you to fit you properly, I had that same problem. So, I came here to learn how a mask should fit. Not everyone can use the nasal pillows, I know I couldn't and fought with it for six months, then I got a comfort gel nasal mask, I thought I was in heaven. I'm a tummy sleeper too, and I didn't have an ounce of trouble sleeping on my tummy with the comfort gel mask. But, due to all of my allergies, sinus issues, bronchitis, etc. I've just moved up to a full face mask {Quattro} and I'm loving it! It's the first time I've actually slept soundly in I can't remember when. So, hang in there, ask tons of questions, and we're all here to help you.