Newbie says Hello...

[kohrmy]

Hello,

I'm a Newbie to the forum and the high-pressure world of CPAP. I have suffered from sleep apnea for many years, but just recently jumped through all the hoops to get diagnosed and prescribed CPAP. The sleep study, while the most expensive overnight activity I've ever had, went smoother than I'd expected. I aced the first part of the night with disturbances in the mid-to-high-40's when only 15 was required to qualify for CPAP the second half of the night. I awoke that morning chuckling from the odd sensation of my cheeks puffing out like I was facing off against a tornado, but only the sensation of a light breeze on my face.

I've read through some of the New Users information, and searched for a few topics that were on my mind. So far, I have found the information on this forum quite helpful, part of me wishes I'd stumbled across it years ago. Anyhow, here I am now, signed up and speaking out.

Last night was my first night at home with my CPAP machine. I'd be lying if I said that I wasn't disappointed when I dragged myself out of bed this morning. I know it can take time to get used to CPAP, and that it can be challenging, but I kinda hoped my story would be one of those "My first night on CPAP was amazing! I awoke a new man!" But that's not how it was.

It started off fine, my pressure is 13, with an optional ramp up over 20 minutes from 6. Unpacking the machine and it's accouterments was almost fun, cracking open a jug of distilled water, modeling my full face mask for my daughter, though when her first response was "Are you my mummy?" I'll admit it took a second to realize she was referring to a monster from Dr. Who. I got everything hooked up, and laid down to try it out. The ramp up seemed almost silly low pressure, so I cut it off and went straight to the full 13. An initial surge, and the mask held, without the leaks I worried would be my bane. My Good Night's Sleep was finally arriving.

Cut past bedtime for kids and relaxing TV with my wife, and I went to bed around midnight, which was a bit later than I would have liked, but I was still looking forward to this new experience. I've been so exhausted, this great night of sleep was going to be a godsend. I started off on the full 13, settled in, my head on the edge of the pillow so that I wouldn't push the mask too much to the side. I adjusted the jaw strap a bit, fiddled with the nasal bridge adjustment, and then drifted off to sleep, the C-FLEX breath matching mine, the sound mingling with the white noise of my wife's humidifier.

I woke around 2 to go to the bathroom, I was a bit sore from lying in one position for a couple of hours, but it was an excellent opportunity to use the quick release on my mask. The mask didn't bother me a bit as I did my business, so I climbed back into bed and gladly hooked back into my new friend. The sleep study had specifically recommended avoiding the supine position, and to be honest, I've always snored the most on my back, so I don't include that position in my list of restful positions anyhow. I was concerned about putting too much pressure on the mask if I laid on my chest, and switching to the other side would point my mask's exhaust at my wife, so I returned to the same side I'd been on earlier. Going back to sleep didn't come easy this time. Starting off on 13, even though I'd just been on it, seemed like a gale and even with the C-FLEX, exhaling was kinda a chore. Leaks tickled my cheeks, and adjusting the mask didn't seem to seal them for long. I hit the ramp to drop the pressure, thinking I could get comfortable and have it rise slowly when I was back to sleep. I drifted off for a bit, but awoke again around 3 am, the leaks worse than before. I moved the mask around a bit, tightened a strap or two, and laid on my back to see if gravity would help with the leaks. Bad choice. I was tired enough that I fell asleep on my back, awaking with a supine snort around 4. I fought with the mask until about 5, giving up in frustration and doing what I'd told myself I wouldn't do, turning off the machine, putting the mask in a drawer. I was done. But sleep was no better without the mask, I awoke more exhausted than before. My wonderful night had turned into a nightmare, and I had to drag myself into work grumpily.

Still, it wasn't all bad, I swear once I got moving that I was a bit more alert than normal, and I breathed through my nose easier than normal too. Though there was a lingering sensation of the mask on the bridge of my nose and upper cheeks, I'm thinking I might have cranked that in too tight to fight the leaks. I'm a life-long mouth breather, though I consciously try to use my nose when I'm awake, which is why I ended up with a full mask, but my throat was less sore this morning than I'd expected, so the humidifier must have been doing it's job. Seeing that the DME included the humidifier standard, and that not only would I not have to fight for it, but my insurance would help pay for it, was a great thing to hear last Friday, even though I wasn't able to get the machine until this Wednesday.

I read the suggestion today about easing into the CPAP, wearing the mask while you're fully awake to get used to the breathing pattern, and the cycle of fighting the pressure sounded very likely what I was doing last night...bleargh...I'm starting to have difficulty stringing words together. Instead of sitting with the CPAP and winding down with a Nova, I'm out in the living room typing away this long-winded post. I've become an expert at avoiding sleep. That's part of the self-feeding cycle of my bad sleep as of late. I'm pretty sure it's a visceral remnant of the flight-or-fight experiences that have invaded my sleep, but subconsciously, maybe even consciously, I fear going to sleep...it's a bad thing to do, sleep...but I know it's necessary, and that it can be a good thing...I want it to be a good thing. So I'm stepping away from the keyboard, I'll bid you all Good Night, may you sleep well and wake refreshed. (and I'll dare to wish the same for myself.)

[cosmo]

Taming the Mirage Quattro http://tinyurl.com/2ft3lh8

Read that if you already haven't.

The first nights are always the hardest, hang in there. You sound like you have a good attitude and plan going in this. You'll make it

[kteague]

Hello and welcome. As you are figuring out how to sleep with your mask, keep in mind even stomach sleepers seems to find a way. Some buy special pillows and others hack their own foam pillows up and make their own "custom" pillow that allows their mask to hang over the edge thus not get pushed loose. If you like stomach sleeping, you might search the forum for the term falcon position. It's a variation of stomach sleeping and others have shared how they made it work for them.

Hopefully you are sound asleep while this is being posted and tomorrow you'll report you made great progress last night.

[Kenwood]

If you like stomach sleeping, you might search the forum for the term falcon position. It's a variation of stomach sleeping and others have shared how they made it work for them.

Keep the faith....trust me it gets much easier with every passing night.

Here's is the thread on the Falcon sleep position:
viewtopic.php?f=1&t=36738&st=0&sk=t&sd= ... 15#p319598

[Sheriff Buford]

Welcome to the forum! Seems you are off to a good start and some of the complications you are experiencing are normal. Your body will get used to the mask and you will learn to really need (and want) the mask. I hope you'll start feeling better after the therapy gets a chance to kick in and do some repairs to the damage OSA caused to your body. Remember the mask search is a "journey" and most folks are not using the first mask they were issued. I went thru about 6 masks before I found "mine". Work all your issues here and search around and educate yourself.

Sheriff

[Pugsy]

Welcome to the forum.
Have you read about your software choices? If not, check out my signature line for PR S1 software options.
If you have the Pro with Auto IQ (that's model 450 which is shown on a sticker on the bottom of your machine) you can use SleepyHead without the Patch file.
If you have 460 you need the Patch file.

Mask fit, leaks and comfort are probably the hardest part of this therapy.

Your need for a bathroom break after 2 hours of sleep concerns me though..When you have time let's look at the software reports to see if something is screaming "fix me". Nocturia is a sign that the number of sleep apnea events might not be optimally reduced unless you have some other physical condition that causes nocturia.

[caffeinatedcfo]

I'm one week+ into CPAP and have similar experiences with my mirage quattro ffm. The first 3-4 hours usually goes great, but after that first awakening I can not seem to maintain a solid fit and end up with fragmented sleep the last 4 hrs. I have the medium mask and I'm wondering if dropping to a small will help.

[Kenwood]

I'm one week+ into CPAP and have similar experiences with my mirage quattro ffm. The first 3-4 hours usually goes great, but after that first awakening I can not seem to maintain a solid fit and end up with fragmented sleep the last 4 hrs. I have the medium mask and I'm wondering if dropping to a small will help.

Print this out and see...
http://www.resmed.com/ap/assets/documen ... ow_eng.pdf

[NotLazyJustTired]

Hello and welcome to the club. I've been three weeks on the mask and trust me, it does get better. Mask issues are, I think, the hardest part. 1) Getting the right mask, 2) Fitment and leakage issues, and 3) The dynamics of sleeping without creating "equipment related events" such as rolling over and knocking the mask causing a leak and such. Unfortunately, it all takes time and often causes more sleep disruption than the original OSA. That sucks, but it is a rite of passage we all have gone through. But these things can be fixed and adapted to. Then, if your therapy is effective, you will start to feel better. If not, don't be shy, some of the best help on the internet is right here. I see you've met Pugsy. If you are not too careful she will help you!

[Kenwood]

...but it is a rite of passage we all have gone through.

That made me laugh....CPAP hazing the newbies!

[cosmo]

...but it is a rite of passage we all have gone through.

That made me laugh....CPAP hazing the newbies!

Getting poked in the rear by DME is the first part of the hazing. Luckily I didn't have any DME problems. So I was unpoked.

[Sheriff Buford]

I'm one week+ into CPAP and have similar experiences with my mirage quattro ffm. The first 3-4 hours usually goes great, but after that first awakening I can not seem to maintain a solid fit and end up with fragmented sleep the last 4 hrs. I have the medium mask and I'm wondering if dropping to a small will help.

One reason you have get leaks late at night is that for some folks, their face will "relax" after several hours of sleep, and that's when the leaks will start, and adjustments will need to be made. If I have to make "late night adjustments" it ticks me off, because I should have had the right tension when I went to bed. I use the Respironics Fitlife Total mask and the old masks' harness used to stretch out when it was new, and I'd have to crank down on the mask for a few months until it got fully stretched out and it "settled in". They sent me a newer version of the harness and it seems they've finally listened to me and improved their product. I am 6 weeks into the new harness, so the jury is still out...

Sheriff

[kohrmy]

First off, thank you all for the warm welcome.

@cosmo: Thanks for the Taming the Mirage Quattro link, it was very helpful, as adjusting the mask to use its air cushion is kinda counter-intuitive. It was nice to see others' frustrations, and the solutions they found. And face farts...a totally apt description, how can a sound be so simultaneously funny and frustrating?

@kteague & @Kenwood: Thanks for suggesting the falcon position, I've actually used a similar position before, but seeing that it was possible with the mask was encouraging, and helped me shake up my thought that I'd either be on one shoulder or the other every night, effectively doubling my options.

@Pugsy: I haven't fully waded into the softwares yet, but I am definitely interested in downloading my data and tracking it in the long-term. Looking at the bottom of my machine, it's a 460P, so I guess I'll have some patching to play with. On the nocturia, I don't know that I'd be too concerned. Historically I tended to get up 3-4 times a night, sometimes more. I'm pretty sure I was initially waking up from my apnea, and then since I was conscious, I'd go to the bathroom. I try to hydrate pretty well throughout the day, because I have woken up many times with calf cramps and want to avoid that if at all possible. I've kept it in mind the last few nights, however, and asked myself if I really needed to go to the bathroom when I awake in the middle of the night. The answer has been no, so it's probably more a learned behavior than a biological imperative, and I can work with that.

@Sheriff Buford: Facial relaxation in the middle of the night makes sense, and helps explain my 2am wake-ups. Of course, the straps stretching could be an issue too, and makes the "fit it and forget it" a dubious feature, but fortunately one I hadn't counted on.

Update on nights 2-4:
Thursday night started out ok, I backed off the nasal bridge a bit, which I think inadvertently allowed the cushion to fill more, and didn't leave the same lingering sensation on my face. I fell asleep on my right shoulder, however, when I woke up to make adjustments around 3am, my shoulder was sore, so I decided to try the other side, and managed to get back to sleep until I got more cheek leaks around 6am and gave up. I read some of your replies, including the "Taming..." article, so I decided to give the mask a little less tension.

Friday night I went to bed a little earlier, around 11pm, and adjusted around 2:30 or so, I switched sides a few more times, figuring out that having the hose over my head was less disturbing to my sleep, and worked on both sides. I woke up around 5 am with a dry mouth, took the mask off, drank a bit of water and went back to sleep. After I got up, I realized that the humidifier reservoir was down to the heating plate. Turns out being lazy and not topping off the humidifier the night before was a bad idea...who knew?

Saturday I complained a bit about how the process was going, it seemed like I was actually getting better quality sleep for the first part of the night, but then I had the adjusting sessions in the dark and the morning capitulation, so I woke up more tired and frustrated in the morning than I used to. My wife said she thought I was breathing better after taking off the mask in the morning, but that it was disturbing how little I was tossing and turning with the mask on, she was waking up occasionally worried I was dead because I wasn't moving all night. I think she'll get used to it. Once I got going throughout the day, I was a bit better off, but dragging myself out of bed was still a chore. I did some more research, re-reading the "Taming..." post and watching some videos at ResMed's site, which suggested I was putting on the mask wrong, focusing on the straps more than the mask itself. So, that night I was careful to refill the humidifier, and took extra care adjusting the mask 3-4 times, sitting, on my back, and then on my side. I made it to 3am or so, and when I awoke to make adjustments, I figured I'd try washing my face and refitting it without making any adjustments. Unfortunately, I rolled over, smiled at my wife and passed out until 5 am. At 5 I got up, washed my face, and came back to bed. I'd been using a wedge to elevate my head, but wanted to give the falcon position a try, so I ditched the wedge and laid down carefully, surprised that the seal held with my head flat on the bed. I slept until 9:45, and probably would have slept a bit longer but for the desert in my mouth. The reservoir was empty again, what the what? It was a lot easier to get up, and for once I wasn't tired, so I just got up, earlier than usual on a Sunday morning, but meh.

I've taken a look at the reservoir, trying to figure out if I could fill it past the max line, but that's the level that the intake pipe comes in, so I don't see overfilling as an option. I'm thinking I'll dial down the humidifier from 3 to 2, in the hopes that a lower setting will last longer. The only other option that comes to mind is topping it off in the middle of the night, and to be honest, I really don't want to plan on that because I'd like to sleep through the night eventually.

Last night was the first time I got close to 8 hours of therapeutic sleep, and I'm cautiously optimistic that I'm starting to figure out this CPAP mask fitting thing. I am curious about other masks, as the dual-wall cushion seems a bit flimsy, but at this point, it's looking like I can make this Mirage Quattro work. *knock on wood*

[Pugsy]

What setting are you using on the humidifier?
Where you live is it a relatively low humidity locality?

Water usage depends on a number of factors..relative room humidity...pressure needs...humidifier selection and leaks.
I have always had to refill the tank daily with where I live and my own personal humidity preference and yes if I happen to get 8 hours or so it will be pretty much completely dry.
It has been that way no matter which machine I have ever used and remains true even with the S9 Climateline heated hose.
If I forget to top off the tank...I run it dry and my nasal mucosa let me know that they don't like it.

When you get your software up and running let's look at leaks to see if maybe there is room for improvement there to help minimize water consumption.

[cosmo]

Maybe look into getting a room humidifier?