HELP! New CPAP User - Possible Mouth Breather?

[Ashi]

Greetings Everyone!

I am a total newbie to all of this and I am soooo glad that I found this forum. This is going to be a long post, so please bear with me.

My wife has suspected that I have sleep apnea for about 15 years. She would always tell me that I stopped breathing in my sleep, but I never really knew that this was a problem............15 years and 100lbs of weight gain later I cannot stay awake during the day. So, I went to our local sleep center and had the test done. Surprise! Sleep apnea. The test showed that I had 509 apneas/hypopneas and a AHI of 80.5.

Two weeks later I went in for the second test using the CPAP. It was horrible. I tried on the Respironics ComfortGel and the Profile Lite Gel masks but after some problems with the Profile Lite I used the ComfortGel. I have no problem with the comfort of the mask but no one told me that I had to keep my mouth closed! I thought that the air coming out of my mouth was the way it was supposed to work. I fitfully "slept" throughout the night and I was miserable. In the morning I had a terrible headache and my sinuses were completely dry and swollen and clogged and I felt bad.

The results of the second test showed that the CPAP helped quite a bit (I can't imagine how considering how I felt the next day) so my doctor prescribed a CPAP machine for me. He also took x-rays and said that my sinuses were in bad shape so he prescribed Rhinocort Aqua and Astelin for use before bed (I take Allegra daily as well). I have had this thing now for 2 days.

I have a Respironics REMstar pro 2 with C-flex, a REMstar heated humidifier and Profile Lite Gel Mask. The setting on the CPAP machine is 14 due to the results of my second test.

I cannot fall asleep with this thing on! I am apparently a mouth breather because of all of my sinus problems and I cannot breathe through my nose at all with the CPCP or at any other time for that matter. I cannot believe this didn't come up until I read about it on this forum.

Both nights that I have tried to use the CPAP I could not fall asleep. I can't keep my mouth closed because I feel like I am suffocating. I tried a makeshift chinstrap on the second night after reading about it here and I cannot keep it on for more that a breath or two because I am not getting enough air through my nose and I cannot exhale through my nose against the pressure even using the ramp feature.

Apparently this thing worked a little bit during the 2nd study, even when I fell asleep with my mouth open (I must have closed it after falling asleep at some point). So I have tried to fall asleep with my mouth open but everytime I am about to fall asleep like this I wake up with a choking sensation.

I am miserable and I really need this thing to work. After reading all through this forum (which is AWESOME by the way) I have decided that I need to use a full face mask instead of the nasal only mask. I am going to call my DME first thing Monday and get one to try. Does anyone think that this will help?

Any help or insight into the use of a FF mask or any other suggestions on how I can use the CPAP properly and also go to sleep would be greatly appreciated!

-Ashi

[idahogal]

I do think a full face mask is the way to go for you. It sounds like this may just be the remedy you need. Is air escaping from your mouth when you have it open? I know there are a few people out there that can have their mouth totally open and block air with their tounge. I certainly think that a full face will help.

[roster]

I am a total newbie to all of this and I am soooo glad that I found this forum.

I am miserable and I really need this thing to work.

-Ashi

[/url]

Wow Ashi, those two sentences perfectly describe thousands of us when we first started out!

A couple of comments from my own experience - please weigh them against good posts from others that are sure to come:

1. I hope you have a sleep clinic and sleep doctor who are as willing to help as mine. In my case, I can and have taken problems like you describe to the clinic's "CPAP Director" who would advise me. As soon as it got beyond her ability to offer advice, she would have the doctor call me on Friday afternoons when he had 20 minutes to listen and advise and we got accomplished much including changing sleep medications over the phone.

2. I have never used an FF mask but I know the failure rate is high because the masks are so big and uncomfortable. However after discussing it with your clinic you may want to try one temporarily. This might be your best first course of correction.

3. Longer term, I believe you need a good remedy to what your doctor described as "sinuses in bad shape". There are good remedies for this problem and your sleep doctor might want to send you to an ENT or other specialist. This is a problem that you may be able to solve in a week or two with the right treatment.

4. If this can be solved you will want to go back to a nasal mask. You may need to tape your mouth with the nasal mask. I am a big advocate of trying this because it has been an easy and very effective part of my treatment. If you get to this point I can send you the detailed mouth taping procedure which works for me.

Congratulations, your diagnosis of osa is a big first step to improving your life. Keep pressing to move your therapy forward, but at the same time stay patient. Please let the forum members know how your progress goes and they will give you advice at each step.

rooster



_________________

CPAPopedia Keywords Contained In This Post (Click For Definition): newbie

[NightHawkeye]

Ashi, give a full face mask a try. The two good ones are the Ultra Mirage Full Face Mask by ResMed and the Fisher Paykel FF Mask which goes by a number I'm sure somebody will post. You need to be aware though that if you have TMJ problems the full face mask is likely to push your lower jaw back and you could end up with worse apnea than not being on CPAP. (I found this out the hard way!)

Be aware that if the full face mask doesn't get the job done for you, there are still quite a few options available. Here's a link to a recent thread covering several options for improving nose breathing:
viewtopic.php?t=8607&postdays=0&postorder=asc&start=0

Good luck with your treatment.

Regards,
Bill

[Gidgie]

I think the Fisher Paykel mask Nighthawkeye referred to is the 431.......a mask I just love.....The chin cup allows for some movement while still maintaining a reasonable seal.......I say 'reasonable' as an average, because people's faces are so different......And leaks can be fixed......most of the folks here know the saga of 'Gidgie and the Moleskin'.....
Most of all, don't give up. You have absolutely no idea how really GOOD this can get..........Stay with us Ashi......!

[Ashi]

Thanks for the replies! The advice was wonderful.

I called my DME and traded out my Profile Lite Gel for the FlexiFit HC431 Full Face Mask and it works allot better. I can actually breathe wearing this one!

For the past two nights I have been able to fall asleep while wearing the mask. The fit is good using the large sized insert but I have to tighten it down fairly tight to get a good seal.

The first night I made it for almost 2 hours but took the mask off in my sleep and last night I made it for almost 3 hours before I pulled the mask off in my sleep. I set the audible alarm on the second night in an attempt to wake myself up and put the mask back on, but apparently it didn't work.

I am looking for suggestions on how to keep from pulling the mask off during the night. Is it possible that I can put two hoses together and place the machine much farther out of reach? Any suggestions are greatly appreciated.


Thanks!
Ashi

[laurel]

I have tiny nasal passages (and issues with inflamation and allergies and all that) and I've had a lot of luck with Rhinocort Aqua. My doc prescribed two squirts per nostril per day and it really does help me. Stick with it, even if it seems like it's not making much of a difference.

Good luck with the full mask and keeping it on, sadly I don't have any advice on that score. I've been happy with just a nasal mask and haven't pulled it off during sleep yet. I'm sure others will have some good advice for you.