Newbie w/some advice needed and questions

[peachbrand]

Hi All
Been on cpap consistently for about a month now but having so many problems. This is my 2nd sincere try since October 31st. To summarize my history, I'm a light sleeper with severe insomnia all my life (problems falling asleep and staying asleep), began having more memory and concentration problems 3 years ago with chronic fatigue. Thought it was the Ambien I had been taking for years, so worked hard to come off it, started sleeping better but was even more exhausted and sleepy during the day. Finally got a sleep study after seeing 2 different docs in the last 2 years, dx this fall with "moderate" OSA, severe in REM. I am a thin female 36 years old.
First of all, I have been a stomach sleeper for years, and I desperately wanted to sleep during my sleep study so I trained myself to fall asleep on my back (with strict sleep hygiene and deprivation), but I prefer not to be there for long. So I've tried a multitude of masks in my 2+ months on cpap...ALL of them wake me up many times a night with leaks. I can imagine some obstructions wake me up as well still and then I start fiddling with the mask (I hate having things on my face). I've tried mostly nasal pillows (including Swift FX, Aloha, Opus), but have tried nasal masks (including Sleepweaver Advance) and a full mask. The Pilairo so far is the least leaky of them all but is so easy to pull off despite tying the strap in my hair (a tip from another post I saw). I know I wake up a lot when the mask hits the pillow as I roll on to my side (maybe because it startles me), and often that is when it begins to leak. I have never successfully been able to sleep on my stomach with my face turned to the side because the masks push up against my pillow (and I even push myself to the edge of the pillow) and I get a leak. So far the Sleepweaver Advance was the only mask I could actually get onto to my stomach in without the pillow pushing it into my face, but it leaked a lot...I truly think I will sleep better if I can get physically comfortable again, but am afraid as long as I'm on cpap I won't. I have been taking Ambien (sometime in excess) since i've been on Cpap and have tried other things with it as well (clonazepam, lorazepam, PS Calm, Nature Made Sleep). Any ideas?
Secondly, my DME person is at my doc's office 2 hours away. With my abnormal work schedule and her excuse of being very busy we can't hardly ever seem to connect by phone and when i can talk to her she never seems to understand this next issue. I'm wondering if it's a machine defect...
I have had issues of rainout in my masks and sometimes it will run down my face. I use heated tubing set at 5 (the warmest), turned the humidifier down to 1, and have a warm room temperature (68-70degrees). Often I use my mask for only 4 hours and use 3/4 of a tank of water (isn't that a lot?). My DME person wants the machine set at tube temp 5 and humidity 3 and gets mad when i change it but i'm tired of waking up at night in a swamp. I tried a hose cover but it didn't seem to do much...the water I find when I wake up is entirely in the nasal pillows and such...i don't see much in the tubing. The machine is on the floor. It is a Respironics REMstar system one a-flex with heated tubing and humidifier. Set on A-Flex 3, pressure 6-8. Purchased new on 10/31/3012.
Thank you for your time!

[Pugsy]

I tried a hose cover but it didn't seem to do much...the water I find when I wake up is entirely in the nasal pillows and such...i don't see much in the tubing.

This is actually fairly common when using a nasal pillow type of mask despite having a heated hose or hose cozy and/or even a not so cool bedroom. The moisture in our exhaled breath is condensing in the nasal pillow itself.
Routing the hose overhead (like some people do) actually will make it worse because any condensation that does occur in the nasal pillow can't run uphill so it goes back down into the nose or comes out the vent holes and you get a cold spray.
Machine placement won't help either because the main part of the problem is in the nasal pillow itself.
Neither will changing the humidifier settings all that much....people who don't even use a humidifier have reported this problem.

I know because I have experienced it myself.
Padacheek makes a barrel cozy that will help. I use the Swift FX nasal pillows myself and have been using this barrel cozy (will be 2 years next month) all year long because besides helping with the rain out, the material is just so comfy.
http://www.padacheek.com/PACSwiftII_Barrel_cozy.html

I don't think she has one for the Pilairo but you might call her and ask. Or if you are real handy you can maybe make something yourself. Just make sure to leave the vent holes uncovered.

Regarding amount of water used...that depends on humidifier setting, pressure used, leaks, temperature used along with ambient room humidity and it isn't unusual to use up most of the water during night. All depends on a combination of factors.
I use up almost a full tank every night if I sleep 8 hours..if I sleep 9 hours there is a good chance the tank will be dry.
Don't worry about amount of water used...use whatever feels best to your nose. Some people need more and some people need less and some people want more warmth and some people like cooler temps. There is no right or wrong...it strictly personal choice.

Have you investigated a different pillow for maybe allowing you to sleep more on your stomach? Some pillows have cut outs on the sides where the mask can sort of lay and not cause some more pressure on the mask and face. I use a buckwheat pillow and it lets me make a little "nest" for my mask (Swift FX) to lay sort of at the edge of the pillow and I can sleep on my stomach just fine that way. Many forum members here like the pillows with the cut outs on the sides. I use a buckwheat pillow also because of my arthritis in my spine...can't stand high profile pillows because of neck issues...but if I didn't I might try one of those with the cut outs. You can even make your own with a cheap memory foam pillow by cutting the foam away.

[chunkyfrog]

I've wondered why some of those masks don't come with a spit valve, like on a band instrument.
A little tube could terminate in a bottle below the bed; maybe even have a mild suction, like in the dentist's office.

[Julie]

Sent you a PM about stomach sleeping...

[jencat824]

I've wondered why some of those masks don't come with a spit valve, like on a band instrument.
A little tube could terminate in a bottle below the bed; maybe even have a mild suction, like in the dentist's office.

Great idea! Now go get the patent before someone beats you to it. When having this problem its frustrating.

I had a lot of this with my series M machine, but my new Icon (even though I hate its lack of data the Icon has some good features) does not have this problem. With my M series I put a thin layer of Tshirt material in the tube, just a very small piece, in the end closest to my mask. This absorbed some of the rainout before it hit my mask. Not perfect, just a homemade work around.
Jen

[2kittymom]

I tried several different sleep apnea pillows, and finally decided that a memory foam pillow worked best for me. I wouldn't give up on the Sleepweaver Advanced mask. Once you get it adjusted right, it's pretty good. You don't need to unstrap it - just stretch it over your head. If it springs any leaks, I just pull it off my nose and let it reseat itself. I also found that daily washing keeps a nice fit. It must stretch a bit during the night. Good luck.

[chunkyfrog]

Both SleepWeaver masks allow comfortable sleeping in any position.
With my élan, it took a couple weeks to learn how to wear it.
(It's a skill you are not born with)
I tried the Advance, but had to return it because it doesn't come in a small size.
They have free return insurance when bought from our hosts, cpap.com.

[zenman72]

Are most of you still having memory/concentration issues even after using a cpap?

I use a cpap (or apap) and still seem to have pretty severe memory/concentration issues and it really worries me. It's gotten to the point where I cannot seem to cover it up well anymore to others.