'Tis a puzzlement

Suetois · Post by **Suetois** » Sat Sep 17, 2011 1:04 pm

I'm still having a tough time keeping my mask on--I've been at this since November and, while my compliance is excellent, I keep removing my mask during the night. I wake up after a short time and put it back on, but to do that, I have to wake up pretty thoroughly. I do go back to sleep easily, but then the same thing happens. Repeat repeatedly. The hours look good and my AHI is <4, but I'm tired, and I'm snoring while the mask is off, so I wake up with a headache and a sore throat.

The quandary is that I do have a FF mask that I keep on and sleep very well with--but my AHI is much worse when I use it (in the 6-8.5 range) instead of the nasal mask that results in good therapy numbers, but lower quality sleep. My sleep doctor didn't like the numbers I was getting with the FF mask, which is why I switched a couple of times to the nasal mask I'm currently using. I've even switched from APAP to AutoBiPAP on the theory that I wasn't tolerating the exhale pressure. I like BiPAP a lot because it feels as comfortable as breathing room air. And yet, I'm pulling the mask off. It seems that I'm facing a choice between good numbers (that don't reflect "feel good" therapy) and bad numbers (but peaceful sleep). What would you do?

BTW, I've tried a total of five masks--two FF, two nasal, and a nasal pillow style. The nasal mask I'm using and disliking stays sealed well. The FF mask that gives me the best sleep leaks quite a lot. (I bought a PadaCheek liner for it, but didn't like the feel and didn't get much better results AFA the leaking problem.)

The frustrating thing is that every couple of weeks I get so exhausted that I do sleep through the night with the mask on--and I wake up feeling awesomely fantastic. I want that every night, but I'm having a really tough time getting there.

Goofproof · Post by **Goofproof** » Sat Sep 17, 2011 1:28 pm

The FF mask you can keep on and sleep with is the best answer. You also need to get the software and whatever reader you need so you can see really how you are doing, and which mask really works best.
Jim

gasp · Post by **gasp** » Sat Sep 17, 2011 1:32 pm

How about trying wearing boxing gloves on your hands so you can't take the mask off : ) OK, that's a bit extreme, but maybe mittens? Something to make it hard until your mind gets the hang of leaving it on. Your large leak numbers must be off the charts since the mask just sits there with air going into the bedroom . Or do you also turn the machine off in your sleep?

jamiswolf · Post by **jamiswolf** » Sat Sep 17, 2011 1:33 pm

Hi Sue,
I've had a lot of problems but not that one...well with the exception of one bad night.

I wear a nasal mask and use a wide chin strap on top of the mask halter. It would be almost impossible to remove the mask without removing the chin strap first.

Might that work for you?
Jamis

robysue · Post by **robysue** » Sat Sep 17, 2011 2:52 pm

Suetois,

In my humble opinion the reason you're still not feeling well when using the nasal mask is that your sleep is being too much disturbed by all the mask yanking off and waking completely up to put it back on. But there's hope that you'll eventually be able to sleep with that mask on all night since you say

every couple of weeks I get so exhausted that I do sleep through the night with the mask on--and I wake up feeling awesomely fantastic. I want that every night, but I'm having a really tough time getting there.

Like others have mentioned, I think you need to look at some of the detailed daily data. Have you downloaded SleepyHead or gotten your hands on a copy of Encore Viewer?

I'd start with looking at the leak lines for both masks. Perhaps there's some excessive leaking going on with one or both masks. And for whatever reason, when it happens with the FFM, it doesn't bother you enough to wake you up, but does manage to affect your therapy (and hence the higher AHI). On the other hand, maybe the way the nasal mask starts to leak bugs you enough subconsciously that you take the mask off in your sleep, only to have your conscious mind notice the mask is not there and wake you all the way up to put the mask back on.

Or, if there's no leaking showing up in the leak graphs, maybe there is something else that your unconscious finds deeply uncomfortable about the current mask and that's what's waking you up when you're not completely exhausted.

Emilia · Post by **Emilia** » Sat Sep 17, 2011 6:10 pm

If you strategically place tape over the headgear where you can tape to skin, it would alert you to the removal because of the skin pulling. It would awaken you enough to stop you, I would think.....

kteague · Post by **kteague** » Sun Sep 18, 2011 1:53 am

Just thinking back to the days when I took my mask off a lot and wondering how many whys were at play.... Did I just get used to it? Was my therapy more effective? Were my limb movements quieter so I wasn't so restless? Maybe a bit of each?

My mask removal stopped abruptly a few months into treatment. I tend to think that while my brain was still on high alert with the new sensations, the residual apneas resulted in the instinctual removal of anything covering the airway. I think if the action continues it might be worthwhile to try to lessen the AHI even more. Is using the full face mask that you tolerate and sleep well with, along with a change in settings to address the increased AHI, worth considering?

Suetois · Post by **Suetois** » Mon Sep 19, 2011 2:45 pm

Thanks for the great ideas! I'm going to try taping the mask down. If that doesn't work, I'll add mittens. If that doesn't work, I'll get a chin strap. And if that doesn't work, I'll get a used PC so I can download the necessary software. (I have a Mac, which is great--except that it's incompatible with so many things.) But all of that is going to have to wait until I'm not hacking up a lung. I caught something yesterday and coughed so hard that my eyes watered--which worked its way under the mask, disrupting the seal and causing enough leaks that I finally had to get up and let the mask dry off (and I took some cough medicine).

Sue

Suetois · Post by **Suetois** » Tue Sep 20, 2011 6:14 am

I taped my mask to my face last night (using surgical tape), and I think it worked. Thanks Emilia! I woke up to find myself pulling at the tape (which had a bit of hair stuck to it), decided not to do that, and went back to sleep for the rest of the night. I can't say I feel great, because I'm still sick, but I think this might work.

Sue

TalonNYC · Post by **TalonNYC** » Tue Sep 20, 2011 6:55 am

You may have already done this, but I find I need about 1cm/H2O extra pressure with the FFM than I do with the nasal. Once I bumped the pressure, my numbers returned to what they were on the nasal.

gasp · Post by **gasp** » Sat Sep 24, 2011 12:02 am

Suetois wrote:I taped my mask to my face last night (using surgical tape), and I think it worked. Thanks Emilia! I woke up to find myself pulling at the tape (which had a bit of hair stuck to it), decided not to do that, and went back to sleep for the rest of the night. I can't say I feel great, because I'm still sick, but I think this might work.

Sue

So worked better than boxing gloves huh? LOL Glad the tape worked. I can certainly see why having a bit of hair in the tape would be no fun to consider pulling it off especially when sleepy. Hope you feel better soon.

'Tis a puzzlement

'Tis a puzzlement

Re: 'Tis a puzzlement

Re: 'Tis a puzzlement

Re: 'Tis a puzzlement

Re: 'Tis a puzzlement

Re: 'Tis a puzzlement

Re: 'Tis a puzzlement

Re: 'Tis a puzzlement

Re: 'Tis a puzzlement

Re: 'Tis a puzzlement

Re: 'Tis a puzzlement

Mask	Humidifier

Additional Comments: Pursleep, Padacheek, Regenesis™ Pillow, Neti Pot, Travel Buddy hose hanger