does your machine slap you in the face

[JohnBFisher]

... Forgive me if this is just a stupid reply but I just related to the slapping mask. ...

No need to apologize. It is NOT a stupid reply. Your experience is just as valid as mine ... and in this case more valid. I had not experienced something I would describe as slapping ... until I saw your post. DOH! Yeah, it does feel like that. See? A good reply because it shows someone else how you dealt with the situation and they are not alone. So, thanks for adding to the fray!

[jweeks]

my AHI is 2.0, average of 1.9 over the last 7 nights, if I remember correctly from this morning. I think I saw a leak rating of 68 or something like that, but I'm not sure what that means.

Hi,

An AHI of 2 is great, and the average shows that it wasn't a fluke. The leak rate sounds high. I am used to seeing numbers in the 25 to 35 range. Then again, each mask is different, and each mask has a different built-in leak rate. The issue is two fold. First, if you have a high leak rate, you are not likely getting effective treatment. The pressure that you need is leaking out. Second, the machine doesn't work right under high leak levels, so that 2 AHI might not be accurate.

At this point, I'd suggest reading the manual for your mask, and find out what its leak level is for your pressure level. If you are OK, then I think you are doing OK for now. If the leak level is high, then we need to figure out what is going wrong.

-john-

[akousw]

my mask didn't really come with a manual. It came with a trifold of bullets on how to clean it, and this illustrated thingy with pictures of a guy and some smiley faces that I think is supposed to deal with how to wear it. I don't really have any more information than that. Will surf for info, I guess.

[akousw]

look's like it's going to be between 29 and 30. The 7-day avg I have reported is 60.1L. I have twice the airflow out of that thing I need! so, I guess I was right, I have a pretty bad problem. Now, what to do about it...chunk the mask? Tape the exhaust holes? Tighten the straps until I whince and cry and all my bloodflow stops going to my head?
I already spend a considerable amount of time trying to fit and refit the mask in bed as part of going to sleep. (And my wife still has no idea what I'm talking about, however many times I repeat this.)

[Stormynights]

If I tighten my mask too much I get leaks. If it isn't tight enough I get leaks. There seems to me to be a sweet spot on the tightening to get it just right. Try fitting it before bedtime in front of a mirror then go lay down. This is what I did to get it right. Understand that this is advice from another noob. After I get my machine on I gently lift the mask off my face and that way the air flow seems to help it seal. In the middle of the night I need to tighten it just a tad. I don't know why mine seems to loosen during the night but It did more at first than it does now.

[BleepingBeauty]

look's like it's going to be between 29 and 30. The 7-day avg I have reported is 60.1L. I have twice the airflow out of that thing I need! so, I guess I was right, I have a pretty bad problem. Now, what to do about it...chunk the mask? Tape the exhaust holes? Tighten the straps until I whince and cry and all my bloodflow stops going to my head?
I already spend a considerable amount of time trying to fit and refit the mask in bed as part of going to sleep. (And my wife still has no idea what I'm talking about, however many times I repeat this.)

Obviously, your leaks are out of control, and your first mission is to solve that problem. The machine isn't able to compensate for such high leaks, so you're not getting anywhere near effective therapy yet.

Whatever you do, DO NOT TAPE THE EXHAUST HOLES on the mask! They're there to serve an important purpose (to vent the CO2 that you're exhaling). Every mask is designed to work this way. There's a Fitting Guide (among other things) for the Forma on F&P's website that you can download (see the links on the right side of this page): http://www.fphcare.com/osa/mask-solutio ... -mask.html

It takes time to properly adjust any mask, so give it your best effort. If you ultimately find that it's just not the right mask for you, try another.

Best of luck.

[jmelby]

look's like it's going to be between 29 and 30. The 7-day avg I have reported is 60.1L. I have twice the airflow out of that thing I need! so, I guess I was right, I have a pretty bad problem. Now, what to do about it...chunk the mask? Tape the exhaust holes? Tighten the straps until I whince and cry and all my bloodflow stops going to my head?
I already spend a considerable amount of time trying to fit and refit the mask in bed as part of going to sleep. (And my wife still has no idea what I'm talking about, however many times I repeat this.)

Do NOT tape the exhaust holes... those are there to vent CO2 and you would be putting yourself in real danger if you tape over them. My suggestion would be to try a different mask. I found the Forma to be very leaky as well and have had much better success with the Activa LT nasal mask. If you are in your first 30 days, your DME should exchange your mask for you... ask them to try several different ones to see what you think will work for you.

[akousw]

Well, here's a question: can anyone tell me of a full face mask (since I seem to be a partial mouth breather, confirmed by my lab tech) with instructions that are a little bit more understandable than the forma full face? These pictures don't seem to give me enough detail to tell me what to do (did I mention that I am minorly autistic?) Instructions that include WORDS might be a really helpful start.

[BleepingBeauty]

Well, here's a question: can anyone tell me of a full face mask (since I seem to be a partial mouth breather, confirmed by my lab tech) with instructions that are a little bit more understandable than the forma full face? These pictures don't seem to give me enough detail to tell me what to do (did I mention that I am minorly autistic?) Instructions that include WORDS might be a really helpful start.

Generally speaking, here's the advice found on CPAP.com about mask fitting:

"How do I best fit my full face mask?

With your mask attached to the long hose and the CPAP / BiPAP machine, begin by putting your mask on with the straps as loose as possible. Lie down on the bed, on your back and turn on the airflow. Starting with one of the forehead support connections, tighten each strap a small amount, moving around your face from one attachment to the next. Tighten the straps only as much as needed to hold the mask securely in place.

This allows the cushion to maintain a seal during movement. There can be a tendency to over tighten a full face mask which causes one side or the other to lift off the face."

Masks are a very individual thing. What works for me might be a terrible choice for you, and vice versa. There's no easy way to know which one might work for you until you try it. That said, being that you need a full-face mask, I can highly recommend the one I use (the Hybrid, which consists of an oral cushion and nasal pillows). There's nothing going over the nose, so there's no irritation to the nose bridge, no air blowing into your eyes from leaks, etc. I do have to amend the headgear to enable the pillows to stay seated, but I get very good (and very comfortable) therapy with this mask.

There's a rival to the Hybrid called the Liberty (made by ResMed). Very similar masks, but the Hybrid offers far more sizing options and also sports a chinflap (which I find stabilizes the mask on my face and allows me to keep my mouth shut and breathe through my nose most of the time, which is purportedly better for us).

You can check out any mask you're interested in on cpap.com and read user reviews of each one at the foot of each page. Or check the Product Challenge link at the top of this page to read detailed user reviews on masks that were pitted against each other to see which was liked best.

Hope that helps.

[DreamDiver]

The M-Series Slap. Yeah. Now that I think about it, mine does that too. That was one of the first things I noticed about the S9 Autoset is that pressure rises very smoothly over a 30-second transition period to your preferred start pressure (ramp or otherwise). For someone just starting out and claustrophobic, this gradual pressure rise could ease the transition to full-face mask wearing. When I first started with the M-Series, it didn't even cross my mind because I didn't know any better, and I'm not claustrophobic about masks. I just figured that at least I know the pressure is on. But now that I look back - wow. It really does slap you in the face -- sometimes enough to knock your mask out of whack.

[akousw]

Well, I just got about four hours of sleep after looking at the thing. The good news is that the machine now shows my leak avg over 7 days at 58.1 L/m which I guess is a little bit lower. Then again, I also heard somewhere that CPAP therapy is supposed to help people in our condition sleep through the night, which might mean that I just didn't fix the problem. So, yeah.

[jweeks]

Well, I just got about four hours of sleep after looking at the thing. The good news is that the machine now shows my leak avg over 7 days at 58.1 L/m which I guess is a little bit lower. Then again, I also heard somewhere that CPAP therapy is supposed to help people in our condition sleep through the night, which might mean that I just didn't fix the problem. So, yeah.

Hi,

A few things to consider...

1) the leak rate is still about 60% more than what I would expect.

2) it might be that this simply isn't the right mask for you.

3) it is possible that you have more than one issue, and CPAP might only be getting to the first issue.

4) it might be that you have a more complex case, and this is the indicator that you might need a more complex treatment.

5) it might be that you have a high sleep debt, and it is going to take a while to get used to the machine and get caught up.

Sorry to offer more questions than answers. There is no cookie cutter solution for this yet.

-john-

[akousw]

Well,

1) This is a 7-day avg, not last night's value. I havn't seen any way of actually viewing last's night's values, unless there's something that I'm missing, so, I don't think that it's that far from what it should be. This morning, it was about 56.9. It's probably a little bit high, but a 7-day avg that gives me 6 days of 60.x and magically goes down to 30, then I probably ought to go to the Emergency room and see why I am inflating like a balloon! I expect that the daily leak value is a little bit higher than normal still, but I don't think that it is going to be a problem as long as it continues to drop until it reaches the mid-forties range over the next week.

2) I am still considering that possibility. I have discussed this with my wife. I have informed her that I intend to buy multiple masks, but I am not certain how open she is to that right now, so I may have to just make do with this one right now.

3) I am fairly sure that I DO have another issue, which I have not discussed, and have suffered for years, but have just tolerated for the most part because I enjoy having a nocturnal sleeping schedule chronic insomnia

4) My AHI 7-day avg is still consistently in the 1.x range, so I am assuming that my therapy has been pretty effective, even with the extremely high leak rate. CPAP therapy actually cut my belly protrusion (i.e. fatness) in half in about my second night of therapy. I also, yesterday, sort of surprised myself while I was driving because I was able to react pretty well. When I started college, I was one of those nuts who never drove slower than about 90 on the freeway. But I was good enough that I never even got close to a wreck. 3 years later, I got into my first accident, with a construction horse. On my way to Dad's for my sleep study, I made my wife panic by hopping the curb twice in the residential area before getting onto the freeway. Yesterday, I saw a car brake in front of me on the road and, almost without thinking, as if from a secret instinct that came from three or so years back, I just signaled, braked, and changed lanes within half a second. I almost surprised myself and thought I should earn a spot in the driving hall of fame, as what would normally happen is that either I would slam my brakes, or I would know that I need to stop because my wife screams at me. So, I think that this therapy's doing at least a couple little thingy's for me.

5) I am aware of this, and I am trying to give myself plenty of opportunity to sleep, but at the same time, I am probably going to need my school to be a little understanding if I am going through a slight technical adaptation phase.