Newbie and CL2 - observations & questions

[DJ]

Hi all,

I've been lurking in this forum since being diagnosed with severe OSA about a month ago and have greatly appreciated the wealth of information here and the friendly attitudes of you all. I've been on my CPAP for three nights now, two of those using the ComfortLite 2 interface. I thought I'd share a few observations, and I have a couple of questions for you experts.

Observations:

CPAP - Even though it's not an APAP, I'm liking the REMStar Pro2 w/ C-Flex. It's quiet and easy to operate, and the C-Flex provides a noticeable improvement over the machines I used during my sleep studies. However, the unit is on the big side, and I can see that I'll probably want to buy a smaller CPAP for travel. I think I want to buy the card reader and Encore Pro software.

Interface -
The CL2 fit is great. During my 2nd sleep study, I tried the F&P HC407, ComfortClassic (both leaky and hurt the bridge of my nose), and Swift (way too loud exhaust, couldn't comfortably sleep on my side). My first night with the CPAP at home, I had an Activa. Again, the bridge of my nose hurt and I didn't like the expansion/contraction movement of the seal on my face and how it touched my lips at times. I also thought the exhaust noise was on the loud side (unlike the general consensus on this forum). I went back to my DME and they suggested the CL2.

So, my 2nd night I tried the CL2 with the medium simple cushion (at first). After about 3 hours of fruitlessly trying to control leaks (plus still not liking the contact on the bridge of my nose), I switched to the medium pillow setup. The adjustability of the CL2 is remarkable and I quickly got a reasonably comfortable and leak-free fit. The pillows are great! Before trying them I thought they would have to be intrusive and uncomfortable, but I haven't found that to be the case. I can roll from side-to-side and be on my back and stay leak-free.

I'm using the Activa short hose with the CL2 (thanks to RG and others for that suggesion) -- my DME kindly allowed me to keep it when I mentioned I had read here about how that hose works well with the CL2. The Activa hose definitely helps. So far, the CL2 elbow that others have complained about hasn't been a problem for me, but the Activa hose definitely helps there. I have my hose hung from a sash on my headboard, so it stays out of the way pretty well.

I haven't had any problems with the CL2 fit and the material on the forehead piece. I don't have to make it very tight, and I'm not waking up with any significant marks on my forehead. I'm able to sleep on my side without really noticing the headgear. So far, no hair problems.

The exhaust is very quiet. I basically can't hear it unless my sheet flops over it.

Questions:

The inhalation noise (whooshing sound) of the CL2 is bothering me and keeping me awake. I hope I'll get used to it. Is this typical for the CL2? Are there any tricks to use to quiet it down any?

I've been getting some condensation in the CL2 headgear hose and down in the pillows attachment. My wife put some fleece over the delivery tube and Activa hose, so I haven't had condensation in those parts, but the moisture drops in the pillows have wakened me. I have my humidifier set at 2, I thought I'd save setting 1 for the summer... Again, is this typical for the CL2, and are there any ways to deal with that issue other than put the humidifier at its lowest setting?

My mouth is coming open and then the rush of air wakes me up. I have a moustache and beard, so I'd rather not tape, and I want to avoid a strap. I've seen some references to training yourself to keep your lips closed and tongue in place -- how do you do that training?

Thanks all for reading this and any help you can provide.

Dave

[rested gal]

Wow, DJ...you're off to a really great start. Nice description of what you're doing to make your treatment as comfortable as possible.

Here's something that you might be interested in, as an alternative to tape for controlling mouth air leaks:

mouth leak solution, cheap DIY oral appliance Topic started by frequenseeker

Condensation in the hose causing water to drip out on your face -- best way to stop that is by getting the Aussie heated hose from sleepzone.com.au ($89 U.S. dollars which includes shipping to the U.S.)

Hope things continue going well for you!

[DJ]

Thanks, RG. I was thinking that the Aussie hose wouldn't help me much since all of the moisture is showing up down in the mask (with my wife's fleece cover, I'm not getting any visible condensation in my current hose), but I should probably give the Aussie a try anyway.

Regarding your CL2, do you also notice the whooshing inhalation noise? I just want to make sure my unit isn't defective...

Thanks again.

Dave

[ozij]

Dave,

Condesation, for me, also starts in the mask and the heated hose helped a lot.

I believe a whooshing nose on ispiration it typical of nasal pillows interfaces. I know it's typical of the Breeze and Aura (Headrest).

Sleep well.

O.

[sleepyred]

I agree - get the Aussie heated hose - I used my comfort lite II (with the simple cushion) and only had a little bit if water in it in the a.m. and I have my humidity set on 3. Mine seems to be the quietest of my 3 masks - activa, and breeze and this one). It only "hisses" at me when I leak air.

Out of anything I've bought, the Aussie heated hose has been the best investment!

[rested gal]

Regarding your CL2, do you also notice the whooshing inhalation noise? I just want to make sure my unit isn't defective...

Yes, that's a normal sound with the CL2, the whoosh when you inhale. Mine does that, too. As ozij said, a whoosh during inhalation is typical of nasal pillows interfaces. I run a fan in the bedroom which kinda' covers mask whoosh sounds.

[rested gal]

all of the moisture is showing up down in the mask (with my wife's fleece cover, I'm not getting any visible condensation in my current hose)

The fact that no condensation is showing up in your main air hose might be because even though the air is cooling off during the long trip, it hasn't cooled off enough to start forming condensation until the last leg of the trip. The last leg being when it finally hits the cold plastic of the connector hose or the elbow, or the cold silicone of the nasal assembly itself.

Using the Aussie heated hose which will keep the air warmer during the first and longest part of the trip (through the main air hose) could let the air hang onto its moisture a little while longer, after it leaves the heated hose. If the air is warmer when it begins that last foot or so journey to your nostrils, it has a better chance of making it all the way into you without losing some of the moisture at the last leg along the way...inside the mask itself.

With or without the heated hose, you might want to ask your wife to make a separate cover for the connector hose too. Good time to take her out to dinner, isn't it?

[DJ]

Yes, my wife is wonderful and she already went ahead and made a cover for the connector hose. I think I'll still get the Aussie hose once I make sure I can tolerate all of this.

Last night and during a nap today I had numerous episodes of air leaking out between my lips and waking me. I've been very sleepy all day. I also apparently swallowed a lot of air and the bloating feels pretty bad. I'm pretty discouraged at this point and am thinking this therapy is just too much effort. I can't see how I'm going to get my tongue to behave properly, and I know a FF mask won't work given how sensitive the bridge of my nose apparently is. I even tried taping during my nap and then had the blowfish thing going (which is when I probably swallowed the air). Geesh...

Dave

[Guest]

I'm pretty discouraged at this point and am thinking this therapy is just too much effort.

DJ, it is a very discouraging in the beginning and it is a HUGE effort. We've all been there and know what you're going through. But hang in there, because it's worth it. It's important to keep in mind that sleep apnea is a serious, potentially life-threatening condition and is linked to many health risks including (but not limited to) irregular heartbeat, high blood pressure, heart attack, diabetes and stroke. Living with the consequences of those possibilities would require a lot more effort than CPAP does; except for dying in a car accident or in your sleep, I suppose. That wouldn't require any effort at all.

Don't give up! It's worth the initial exasperation and sleep-deprivation to treat OSA. It gets better. Honest. You're doing all the right things and are well-informed. This forum is a fantastic source of help for just about any problem you might encounter as you adjust to this therapy. It can take several weeks. Hang in there!

[Moogy]

I also apparently swallowed a lot of air and the bloating feels pretty bad.

Dave,

When I first started BiPAP therapy, I had problems with the blowfish cheeks also. Here are some things that helped me.

First, if your cheeks get full of air, try coughing the air out (instead of just opening your mouth, which will cause a hurricane!).

Second, to minimize the cheeks filling with air, close your cheeks off a bit with a gentle sucking motion. Meanwhile, plant your tongue behind your front top teeth, against the roof of your mouth.

It DOES get better. In a short time, your mouth and tongue will learn to behave themselves, even when you are asleep. If not, you can resort to taping.

Moogy