New nasal pillow giving nose bridge lump? + more

[VYoung]

Hi! I'm new to therapy and I'm having some issues. I've read and researched and can't find similar experiences so I thought I'd jump in here and ask - looks like a fantastic board!

I'm in Canada, where our healthcare isn't so supportive of cpap machines but I was given an Elite II to use. I didn't go through a typical overnight sleep trial to get it, instead I was given an auto adjust machine to take home for a week with an O2 meter attached to it, and they used these results, whatever they were, to recommend a constant pressure of 9 for my machine as it apparently doesn't adjust. I've been using it faithfully for almost two weeks now. I am still waking occasionally to the sound of hissing air leaks in my nose, especially when I lay on my side and I'm occasionally getting rained out as I'm figuring out the humidifier settings (we've been traveling) but otherwise, I am starting to slowly adjust to sleeping with it. However, I do have the following issues and I'm hoping to find some advice!

1. I'm using nasal pillows so nothing is really touching my face much. It's comfortable enough, especially if I lay on my back, and doesn't leak at all if I'm not squishing it against the pillow. However, along the bridge of my nose where nothing is touching, I'm developing a small pointy lump in my cartilage and it's getting quite tender. It doesn't hurt in the evenings usually, mostly in the mornings so I believe it is due to my mask. I don't feel it at much throughout the day unless I wiggle my eyebrows and then it aches. If I push on it, it reminds me where the boundaries of my brain lie (though in both cases it's much more sensitive in the morning than in the evening). It is slightly pink, but it isn't like the red rubbed raw sores I keep hearing about from mask rubbing. It seems to be a semiflexible piece of cartilage. I don't think my mask is too tight, it's comfortable even with the bump and it isn't putting pressure on my nose when I lay on my back. Is this something I should expect? I'm willing to live with it if it doesn't get worse, and I'm hoping it will go away on it's own. I live in a rural area so I can't easily pop over to the place I purchased my mask for a fitting.

2. If I sleep on my back and stay there I'm reasonably comfortable and the mask doesn't bother me much beyond the typical adjustment things like noise or awkwardness. Except due to back issues from a car accident, I can't sleep on my back for long unless I take a muscle relaxant. I'd never previously considered taking a muscle relaxant for obvious safety issues but I figured since I'll be having oxygen shoved into my nose I was willing to try it. In the last two weeks, I've used them twice and both nights I slept amazingly well until they wore off (about 5-6 hours) and felt remarkably well rested. However, I just can't bring myself to use them with any frequency so I'm trying to figure out a better solution. Any brilliant ideas? It's been proving difficult to find a position I can comfortably sleep in on my side while wearing the mask and usually I only sleep one cycle on my side before I get woken up by the sound of a broken seal.

3. I don't think my machine is set at a reasonable pressure. It feels comfortable if I'm on my back, perhaps a bit light on pressure if anything, but nothing I'd ever complain about - I've grown quite accustomed to the pressure . If I lay on my side, I feel my breathing is more constricted, like I would require more pressure to sleep comfortably in that position. Is this normal? When I did my test, I took an auto adjust machine home for a week - the first 5 nights I wore it I slept like a log, flat on my back, never moved at all but by the end of the trial, I was beginning to have the same issues as above. I really don't know how I managed to lay like that for 5 days because I can't seem to do it for a whole night anymore! I can't change any of the settings on the machine I have to test this theory though but, from what I've read, I may need to consider buying an auto adjust machine. I sincerely hope not since they want $1400 here to buy the S8, and I just don't have that. Will this constant pressure machine meet my needs if I bring it back to the hospital and have them adjust it or should I start saving for an adjustable one?

Thank you very much for the amazing amount of wisdom on this board, I was feeling a bit overwhelmed before I found you guys!

[BleepingBeauty]

Hi! I'm new to therapy and I'm having some issues. I've read and researched and can't find similar experiences so I thought I'd jump in here and ask - looks like a fantastic board!

Hi, VYoung, and welcome aboard. This IS a fantastic forum.

I'm in Canada, where our healthcare isn't so supportive of cpap machines but I was given an Elite II to use. I didn't go through a typical overnight sleep trial to get it, instead I was given an auto adjust machine to take home for a week with an O2 meter attached to it, and they used these results, whatever they were, to recommend a constant pressure of 9 for my machine as it apparently doesn't adjust. I've been using it faithfully for almost two weeks now. I am still waking occasionally to the sound of hissing air leaks in my nose, especially when I lay on my side and I'm occasionally getting rained out as I'm figuring out the humidifier settings (we've been traveling) but otherwise, I am starting to slowly adjust to sleeping with it.

Sounds like a fairly typical experience, so far.

However, I do have the following issues and I'm hoping to find some advice!

1. I'm using nasal pillows so nothing is really touching my face much. It's comfortable enough, especially if I lay on my back, and doesn't leak at all if I'm not squishing it against the pillow. However, along the bridge of my nose where nothing is touching, I'm developing a small pointy lump in my cartilage and it's getting quite tender. It doesn't hurt in the evenings usually, mostly in the mornings so I believe it is due to my mask. I don't feel it at much throughout the day unless I wiggle my eyebrows and then it aches. If I push on it, it reminds me where the boundaries of my brain lie (though in both cases it's much more sensitive in the morning than in the evening). It is slightly pink, but it isn't like the red rubbed raw sores I keep hearing about from mask rubbing. It seems to be a semiflexible piece of cartilage. I don't think my mask is too tight, it's comfortable even with the bump and it isn't putting pressure on my nose when I lay on my back. Is this something I should expect? I'm willing to live with it if it doesn't get worse, and I'm hoping it will go away on it's own. I live in a rural area so I can't easily pop over to the place I purchased my mask for a fitting.

I've yet to see this problem mentioned here. My first thought was there's too much upward pressure from the mask, but you say the mask isn't tight and is comfortable. I confess, I'm stumped. Maybe someone else will have an idea to share.

2. If I sleep on my back and stay there I'm reasonably comfortable and the mask doesn't bother me much beyond the typical adjustment things like noise or awkwardness. Except due to back issues from a car accident, I can't sleep on my back for long unless I take a muscle relaxant. I'd never previously considered taking a muscle relaxant for obvious safety issues but I figured since I'll be having oxygen shoved into my nose I was willing to try it. In the last two weeks, I've used them twice and both nights I slept amazingly well until they wore off (about 5-6 hours) and felt remarkably well rested. However, I just can't bring myself to use them with any frequency so I'm trying to figure out a better solution. Any brilliant ideas? It's been proving difficult to find a position I can comfortably sleep in on my side while wearing the mask and usually I only sleep one cycle on my side before I get woken up by the sound of a broken seal.

You may need to consider a new bed (or more supportive topper), a new pillow, some comfort feature that will help you sleep more soundly. I think searching for a solution that doesn't involve medication is a good idea.

3. I don't think my machine is set at a reasonable pressure. It feels comfortable if I'm on my back, perhaps a bit light on pressure if anything, but nothing I'd ever complain about - I've grown quite accustomed to the pressure . If I lay on my side, I feel my breathing is more constricted, like I would require more pressure to sleep comfortably in that position. Is this normal? When I did my test, I took an auto adjust machine home for a week - the first 5 nights I wore it I slept like a log, flat on my back, never moved at all but by the end of the trial, I was beginning to have the same issues as above. I really don't know how I managed to lay like that for 5 days because I can't seem to do it for a whole night anymore! I can't change any of the settings on the machine I have to test this theory though but, from what I've read, I may need to consider buying an auto adjust machine. I sincerely hope not since they want $1400 here to buy the S8, and I just don't have that. Will this constant pressure machine meet my needs if I bring it back to the hospital and have them adjust it or should I start saving for an adjustable one?

There are only two ways to determine whether your therapy is going well: How you feel, and a review of the data. I'm not familiar with your machine, but it IS a data-capable cpap, so you should be able to access the AHI and Leak data on the LCD screen. (Eventually, you can purchase software and a card reader and get a lot more detail from the data.) And yes, you CAN change the settings on your machine. Someone here can guide you to those instructions for your machine, if that's what you want to do. But you should look at your data for awhile before determining what (if any) change should be made.

As to whether you'd be better off with an APAP over a CPAP, I can't say. Many people get very effective therapy with a fixed CPAP pressure, and others are advocates of APAPs. As with everything else with this therapy, it's an individual thing.

Thank you very much for the amazing amount of wisdom on this board, I was feeling a bit overwhelmed before I found you guys!

We remember how overwhelming it is in the beginning. But you're in the right place now.

[VYoung]

Thank you for your support and advice! Yes, I've looked high and low and can't find any reference to a nose bridge lump. It's tiny, you can barely see it, but it's new and I sure notice it if I touch it. It's most definitely internal somehow though it baffles me - the only thing I can think of is that perhaps when I turn around in bed at night, the end of my nose gets pushed over and it's just irritated the cartilage a bit because my mask is really quite comfortable when it isn't raining. (I think I've cured that problem now - we went from prairie to mountains to prairie again, all through a Canadian winter this last week so it's been... interesting.. happy to be home!). You're right, we absolutely need a new bed - we're sleeping 2-4 people deep in a double bed on a mattress that is well well past it's replacement date. <sigh> Another expense to add to the sleepless expenses. Tried replacing it once, it was a disaster but it's quickly moving it's way up the list again. Kids don't need college funds when they're little right?

I'm pleased to hear that I might be able to adjust my machine myself - I did go through the manual but my eyes started crossing and, as I'm sure you can all relate to, it started putting me to sleep! I'll pull it out tomorrow and see what I can figure out. Thank you so much!

[BleepingBeauty]

Thank you for your support and advice! Yes, I've looked high and low and can't find any reference to a nose bridge lump. It's tiny, you can barely see it, but it's new and I sure notice it if I touch it. It's most definitely internal somehow though it baffles me - the only thing I can think of is that perhaps when I turn around in bed at night, the end of my nose gets pushed over and it's just irritated the cartilage a bit because my mask is really quite comfortable when it isn't raining. (I think I've cured that problem now - we went from prairie to mountains to prairie again, all through a Canadian winter this last week so it's been... interesting.. happy to be home!). You're right, we absolutely need a new bed - we're sleeping 2-4 people deep in a double bed on a mattress that is well well past it's replacement date. <sigh> Another expense to add to the sleepless expenses. Tried replacing it once, it was a disaster but it's quickly moving it's way up the list again. Kids don't need college funds when they're little right?

I'm pleased to hear that I might be able to adjust my machine myself - I did go through the manual but my eyes started crossing and, as I'm sure you can all relate to, it started putting me to sleep! I'll pull it out tomorrow and see what I can figure out. Thank you so much!

Rainout can be solved in a bunch of different ways. At the high end of the rainout solution totem pole is the Aussie Heated Hose. (A fine product, from what people here have to say about it, but it's fairly expensive. There's a much cheaper "knock-off" heated hose solution posted here which involves using a reptile heater cable and a dimmer switch.) Most people find that a fleece hose cover does the trick. Check out Rested Gal's Lab Rat Trophy awards for all kinds of nifty solutions to various xPAP issues (hose management, mask fitting tips, etc.): viewtopic.php?t=15104

Re: adjusting your machine's settings... Chances are you only received the User Manual with your machine. To enter the setup menu, you'll need access to the Provider (or Clinician) Manual. I'm sure someone else here can point you to where you can find and download it.

There's a whole lot of help to be had here, and many of us wish we'd found the forum sooner than we did. You're at the beginning of your therapy journey and you're here already, so you're ahead of the game.

[warrain]

Did you get the ResScan software? Here in Oz it is available free with a doctor's letter of recommendation. I adjust my CPAP pressure via the ResScan program on the PC. Very easy to adjust all machine settings there. Let's know if you need any assist.

[VYoung]

I didn't realize there were two versions of the book - no wonder I couldn't figure out how to do anything! I'll look around online, see if I can find it.

I don't have the software either, any chance it's mac compatible? If it isn't, I'm not completely sol as hubby has a pc - for all the tech support I provide him for that cursed machine he should let me use it to run this software! I see it's on ebay for 21 bucks, sounds like it might be worth it.

Oh, and I used some cream on my nares as I saw mentioned elsewhere on here and readjusted the mask again last night by tightening the back strap and shortening the top one and tilting the mask until it felt right and my nose felt better this morning - lump wasn't as tender as previous mornings! I think I had the mask itself too low on my face, the pillows too high, and it was just putting pressure in the wrong spots on my nose. When I checked it this morning first thing, my nose is still more pinkish than normal from the little lump on down but right at the lump it turns back to normal flesh color. It all went back to normal fairly quickly, about the same time the mask press marks disappeared from the one side of my face. So it's definitely the mask making that lump. Had a nurse friend look at it today and she said it's cartilage and that once it stops being aggravated it will go away. So I'm going to continue messing with my mask until I get the right fit since that seems to be the issue.

Thanks everyone!