Newbie here with how I am doing with this.

[BrianV]

Hi everyone! I am glad I found this site. It nice to find people who are going through the same thing. I have been on my machine for a little over a month now and I feel only a little better. Some days are better then others. So here are my issues so far:
1) I have tried a few different masks with the Mirage Liberty fullface hybrid being the best so far. However that being said I keep having acne problems from the head gear. I have been washing my face before putting the mask on as well. Any recommendations on what best to use that wont dry out my face? I have pretty sensitive skin.
2) The nasal pillows have been causing irritation just inside the nose. I have been using Ayer gel with aloe which feels ok when first putting the mask on but hurts a lot when taking it off. The sore will bleed as well some nights.
3) When I wake up and through out the day my teeth seem to be sore. Not sure if it has to do with the pressure from the mask or the air being pushed in. I am not aware of what my pressure is set at but understand its pretty high. During my sleep study I started off with just the nasal pillows which I liked but when they were dialing in the pressure it caused my mouth to open so I have to use a full face mask. I als used the Quatro mask but I got to many leaks at night. The other mask I also tried was the Fitlife total face mask but I couldn't get comfortable with it. Freaked me out.
4) I still feel a little droggy throughout the day even though I do get about 8 hours of sleep a night with the equipment on. I am trying to be totally compliant. The equipment provider scare the heck out me saying I could die if I don't wear it. She also told me some horror stories of those who did not. I have a huge fear of suffocation always have. It got a little worse last year after watching my mother pass away from ALS. We pretty much had to watch her suffocate at the end.

Sorry for the long post. Again I am really glad I found this site and look forward to hearing from everyone.

[Slartybartfast]

(2) The Ayr gel should work. I tried it early on, but switched to K-Y; it's heavier than the Ayr and it's lots cheaper.

(3) Pressure on teeth is the result of straps being (possibly) too tight. If there is any way for you to do so, make a concerted effort to make nasal pillows work. That will eliminate that problem. You might need to tape your mouth shut or use a chin strap.

(4) Some folks feel better immediately (me), while others report varying degrees of delay before they feel any difference. However, CPAP is not a magic bullet. Sleep apnea, may, in fact, be secondary to what is causing you to feel groggy. Only a good wide-awake sleep doctor can determine what other complications you might have that are interfering with your ability to get restful sleep.

Hang in there. Keep reading about what others have been going through, and be persistent with your doc, if you're not feeling better.

[Edit: I see you're using VPAP. Your pressure might make nasal pillows alone more difficult to keep from leaking, but give it a try. The high pressure you require might be what is requiring the straps on your full face mask to place so much pressure on your face, causing teeth pain.]

[Pugsy]

Sounds like the nasal pillow part of the Liberty is too tight. Nasal pillows shouldn't cause anything more than minor tenderness.
Most common mistake...too tight with the straps.
Get some Lansinoh lanolin ointment. I think it will provide a better barrier than the Ayr gel and less likely to cause the nasal pillows to stick to your skin. Nursing mom's use it for nipple soreness.
If your pressure are rather high then the nasal pillows do present a challenge to keep them to stay in place with the Liberty or Hybrid type of mask. Gotta be secure so the pressure doesn't blow them right out of the nose.
Check out this link for the pantyhose/tights trick for adding security to the nasal pillows without having to tighten the straps up so much.
wiki/index.php/Hybrid_Mask_Modifications

For the acne situation..try a mask liner. You can make your own or buy them ready made.
Scroll down to near the bottom of the page. You can make your own with an old T shirt. There are disposable liners you can buy but Padacheeks last for months and months. Fully washable.
http://www.padacheek.com/PAC_Maskliners.html

Sore teeth...mask is likely too tight.

I still feel a little droggy throughout the day even though I do get about 8 hours of sleep a night with the equipment on. I am trying to be totally compliant.

Do you know about the software available so you can see for sure what is going on during the night?
ResScan or SleepyHead (links for SleepyHead in my signature line). ResScan doesn't have a Mac version but SleepyHead does if you are Mac user.
Link for ResScan in UncleBob's signature line here....memberlist.php?mode=viewprofile&u=38643
Tutorial on how to use ResScan here http://montfordhouse.com/cpap/resscan_tutorial/

So let's make sure that the therapy part of things is optimal before we start telling you "give it time"
If leaks are really bad...not only does it impact your therapy but it impacts your overall quality of sleep.
Are you waking often during those 8 hours of sleep? If so...any reason why that you can think of?

So the 2 most obvious things...let's make sure that the therapy looks good on paper before we start talking about other reasons why you don't feel so good (or as good as you hoped for)...so use the software. We will help you with understanding what you see.
If you are waking often...need to try to reduce the awakenings which means reducing whatever might be causing them.
Finally for some people it does take some time to really notice much of an improvement...those people have great reports...get good sleep but still don't feel so great...not everyone gets the quick fix unfortunately even with zero leaks and AHI 0.0.
So let's evaluate your data as the first order of business...make sure it is optimal before going into further detective work.

If you don't know how to post your reports so we can see what you are seeing...This thread talks about it from screen shots to posting.
viewtopic.php?f=1&t=81072&p=737779#p737779

The ResMed S9 comes from the factory with the default setting only to write summary usage data to the SD card (and for viewing on the LCD screen). You need to make sure Sleep Quality (available in the clinical setup menu) is changed from "usage" to just plain "On" for you to be able to see all the data available.
That is discussed in the ResScan video if you don't know what I am talking about or how to check the setting.

[khauser]

[Edit: I see you're using VPAP. Your pressure might make nasal pillows alone more difficult to keep from leaking, but give it a try. The high pressure you require might be what is requiring the straps on your full face mask to place so much pressure on your face, causing teeth pain.]

Nah. I use nasal pillows with pressures up to 17cm. Yes, there can be some leakage, but its minor and relatively easily dealt with (it's getting better as I try new ideas, despite the fact that I am not so new to xPAP).

Brian, I believe that if you are getting irritation inside the nose AND tooth pain from the mask you MUST have it too tight. That is SO common, we all tend to over-tighten the mask at first.

Most masks actually work better (ie, leak LESS) when they are NOT over-tightened. Doesn't seem like common sense, does it? But that's the case. So, tonight (or earlier if you want to avoid this while wishing to be asleep):

• Loosen the straps on your mask
• (I'm not sure how to make this part happen) cause your machine to go towards the higher pressure. If it were an apap, I'd say turn it to CPAP mode at the top end of your pressure. I don't know if you can do that.
• Lay down in your bed in your normal sleep position.
• Slowly tighten each strap until it JUST fits your face without leaks. You should still be able to easily stick a finger between each strap and your head, without causing the strap to stretch more.

It's also possibly you have the wrong mask. If you aren't a mouth breather you could indeed try nasal pillows, or a nasal interface. Mask choice is VERY individual and sometimes (often) takes us a bit to figure out which is best.

Keep plugging at it! The DME that scared you was only slightly overstating the issue. Breathing disorders cause our bodies to undergo incredible stress, so along with not getting restful sleep you're basically challenging your body to fight a life or death battle, so all the stress hormones are flowing and *if* you are already close to having a heart attack this can easily push you there. Even if you're otherwise in great shape, some people's oxygen levels drop so much that it can turn fatal.

That said, I know the DME has to push the compliancy issue for insurance reasons. You should not care about insurance issues ... you should care about your health.

[BrianV]

Thanks everyone for the responses. I will try loosing the straps a bit to see if that helps. I prefer using the Mirage Liberty because it's not as bulky as the other full face masks and I don't get that claustrophobic feeling like I did with the other masks. I will try the lanolin ointment on my nose. After looking at other posting on nose soreness it looks like that should help.

I will work on getting a report as well. After talking to the supplier the latest download she said looked really good. They didn't see any concerns at this time. However I would like to get a better idea what is going on.

As for waking up at night. I do get a few solid hours at a time, but I do occasional get up to use the bathroom and we also have a 17 month old daughter who still has trouble sleeping through the night so that also gets me up. However she is worth losing sleep over.

Thanks everyone