New to CPAP and looking for advice

[CapnCPAPn]

I've been on CPAP for about a week. I am still trying to get used to it. Most nights I wake up in the middle of the night and feel like I can't breathe through my nose anymore and have to take it off.
I have the Philips Wisp mask that just goes over the nose.
I find that it is hard to exhale just through my nose against the air coming in.
I had the humidity at 3 and sometimes that seemed too dry. Put it at 4 and it wasn't bad. Put it at 5 (max) and didn't get a good sleep. That was last night. I had to take the mask off and just sleep without it.
Considering switching it to a full mouth and nose mask since I have always been a mouth-breather when I sleep.
In your experience, how long before you really adjusted and stopped the mouth breathing?

[HerbM]

You will get more focused help if you post your machine model (put it in your profile) and machine settings.

Do you have EPR (exhalation pressure relief) enabled? What setting? (3 is common).

Many people report not getting enough air if the pressure isn't HIGH enough but you say this is only an issue on EXHALATION so that may not be an issue for you.

Is your nose stopping up? Is this more the mask, the pressure, or your nose? (If you can tell.)

Notice that a stuffie nose MIGHT actually be helped by more air as well.

Someone will give you more useful answers likely, but giving your settings and machine can speed that along.

[CapnCPAPn]

I put my mask and machine in my profile.
I was prescribed at an "8" for the pressure, not exactly sure what that means.
The pressure seems to be from the mask, maybe just takes some getting used to.
Before CPAP I would put a Breathe Rite strip on my nose to help open it up. Maybe I am missing that. I don't to wear one and mess with the seal of the mask.

[newpapper]

I am also an 8 (this means a pressure of 8 centimeters of water) and use a Wisp mask too. Yesterday I realized it is distorting my nose and I think causing resistance to breathing in and out. I took the hose and elbow off and reached in the hole and felt my nose pushed up. I also compared breathing like this with no elbow, to the effort with no mask. The mask is definitely giving me resistance to breathing. It is already the large size so it can't go any bigger. I guess my nose is too big for this mask. It was chosen because it sealed the best of all I tried. I am going to try a full face Quattro like in my titration, but would like to investigate nasal pillows also.

[Pugsy]

Please confirm your model of equipment chosen.
The image you chose is linked to model number 550 in the Respironics brand. The PR System One Auto CPAP with AFlex.
The model number is on the bottom of the blower unit..a 3 digit number with some letters in front of it (DS or REF) and maybe a letter or two after it.
Should be 550 or 560...might be 551 or 561....the 6 or 5 in the model number denotes series.
The 60 series machines are the newest models...odd that you would be given a 50 series machine but not impossible.
We ask because with the 60 series machines there are additional options for the humidity choices that might help.

Your pressure of 8....is that a constant pressure or does it vary later on during the night?
You probably should get the software and check your reports...and/or look in the clinical setup at the settings.
Links for software are in my signature line.

Your congestion issues with the Wisp. I found that the ever so little pressure from the mask on my nasal bridge area of my nose caused congestion.
I don't normally have congestion issues though.
I wasn't able to use the Wisp for this reason but I was able to use the similar mask in ResMed line...the Nano Cushion mask.
Don't know why except maybe the pressure (ever so little) simply wasn't in the area that causes me congestion.

If you have frequent nasal congestion issues and/or feel the Wisp's added pressure is making the issue worse, you may want to try a full face mask or a different over the nose mask.

If you put your fingers up on the sides of your nose...near the nasal bridge area...and apply a little pressure...does that cause congestion to worsen?
It does for me...and when I remove my fingers the nose opens up again.
This type of congestion is fairly common...it means that we need to avoid masks that put pressure on the nose if we can.
So if someone ONLY gets congested with the mask on....that is a possible factor.
The amount of humidity is also a possible factor. Some people do better with more and some people do better with less.
It's a person preference issue and each person has to figure out what they need. There is no right or wrong with humidity preference.

Your machine doesn't have EPR exhale relief..that's only on Resmed machines.
It will have some sort of Flex exhale relief...and you can adjust it.
Don't assume that a setting of 3 on the Respironics Flex relief offers the greatest reduction in pressure so it much be more relief. Flex doesn't work quite that way. The amount of relief is flow based so not nearly as dramatic as with ResMed's EPR.
Instead think of it more in terms of the timing of whatever reduction you are using (AFlex if in apap mode...CFlex in cpap mode). Yes a setting of 3 offers the potential for greater relief sometimes greater isn't as important as when the drop begins.
The timing thing...that's what makes Flex relief so nice...not so much the amount of the reduction as the timing rhythm.
So just play with the settings to see which one "feels" more natural like in terms of being in sync with your own breathing and go with that one no matter what the official number.
I found AFlex superior to CFlex in terms of feeling more natural. I also found that a setting of 3 sort of made me feel like I was breathing too fast but a setting of 2 was just perfect.
So play with it to see what feels best for you.
Read about it here.
http://aflex.respironics.com/

How long do people mouth breathe.....some never quit. Even when they can easily breathe through their nose.
Of course if your nose is so congested you have to breathe through your nose then you have to mouth breathe.
Sometimes the mouth breathing is just habit. Mine was.. I thought I was a "mouth breather" but it was mostly habit from gasping for air during the night due to the apnea events.
It took me about 2 months to learn to keep my mouth shut. Now I might do a little mouth breathing every now and then but nothing like I was doing the first month or so of therapy.
I had my reasons for not going the Full Face mask route to remedy the potential pressure loss from mouth breathing.
So I never used a full face mask.

I tell people...if you can normally breathe through your nose just fine during the day then a nasal mask (pillows or cushion) is a possible workable choice if that is what you prefer.
Not all mouth breathing means that the entire pressure goes out the mouth and it sure doesn't mean that the entire night of therapy is in the toilet because of 30 minutes of mouth breathing.

If you simply can't breathe well through your nose consistently and can't keep it open...then yes, a full face mask is going to be needed.

[newpapper]

I just found that my resistance happens when I push up lightly on the bottom of the tip of my nose. Your nose may vary.

[CapnCPAPn]

Wow, thanks Pugsy. I'm going to look into Flex exhale relief setting tonight.
And you saying it took you 2 months is encouraging to me to just hang in there.
I have a 30 day trial on the mask so I will see if I can get used to it for another week.

[Pugsy]

If you can change out the mask....do so now...don't spend any more time with it...just in case the pressure from the mask is making the congestion worse.
You can always go back to it if it ends up that isn't part of the problem.

Use whatever swapping out time you have available so mask costs don't come out of your pocket.
Some DMEs allow 30 days per mask...which is as it should be
but some DMEs only allow a 30 day period no matter how many masks...make sure that you understand what your DME does.
If you are 3 weeks into a 30 day only period..try a new mask now.

The 2 month thing...that was for keeping my mouth shut. I used a nasal pillow mask from the very beginning and never had mask issues.
So I didn't spend 2 months adjusting to the nasal pillow mask...I just spent 2 months taping my mouth closed.
Which if you have a lot of congestion in the nose...I don't recommend it. Remember I rarely have any nasal congestion at all...day or night.

[CapnCPAPn]

I normally blow my nose every morning due to colds or allergies, any time of the year.

Anyway, last night fell asleep watching TV. Woke up around 12:30 then went to bed and put the mask on.

I loosened the mask a little so that the nose piece wasn't pushing onto my nose so much but still made a seal. That made a huge difference. I didn't feel the pressure and slept all the way through until my alarm went at 5:00am. I didn't feel like I had the pressure or congestion.
So just a slight adjustment and I was good to go!

[CapnCPAPn]

GAH! After a good night, last night was horrible. I felt like I was suffocating the whole time. I ripped the mask off and slept without it and felt terrible.
Any recommendations? Stick with it? Switch to full face? Switch to pillows?
Anybody use a Breath Rite strip + the mask? Does it affect the seal?

[air_force]

Stick with it. It can take a lot of trial and error before things settle down. I'm in year 3 and have had issues all along. I finally followed up with my doc and found I was only using my mask 30% of the time. Had this crazy habit of taking it off in the middle of the night. Took sleeping pills for a month every night and broke the habit. Been on my own for a full month and now getting 80% compliance. Have tried various masks, but go between the Swift FX and the Swift LT.

[chunkyfrog]

Somebody said that all untreated apneacs are mouth breathers, and it's a habit we develop to get air when we are asleep.
Some believe they have "trained" their mouth to stay shut, but I wonder if the old habit just dies --if you are lucky.
My habit is still hanging on by a thread, but it is lots better than it was.

[Stevoreno_55]

Somebody said that all untreated apneacs are mouth breathers, and it's a habit we develop to get air when we are asleep.
Some believe they have "trained" their mouth to stay shut, but I wonder if the old habit just dies --if you are lucky.
My habit is still hanging on by a thread, but it is lots better than it was.

I have mouth breathing issues and I'm still looking for a good chin strap. I tried a ResMed FF mask a few years ago but with my current CPAP pressure of 18cm my mouth would still open up at times during the night while wearing a FF mask and come morning the inside of my mouth felt like it had been scrubbed with a steel wool pad so I switched back to a nasal mask and I'm still using a chin strap but I'm also still looking for a better chin strap because I'm still having mouth breathing issues. How can anyone train their mouth to stay closed while they sleep? I read on this board a few years ago where some people training to keep their tongues out of the way; again I don't know how they would do that either and others use to post they placed medical tape over their mouths at night; something I would never do. I've been using a PR Profile Lite nasal mask for years but might make a change soon; I might start a new thread to ask for nasal mask recommendations.

[CapnCPAPn]

I switched to a full face mask (Quattro). Actually the only one they had in the store was "Quattro for her" but it just seems like the only difference is some pink in the straps.
Whatever. I'll sleep in a dress if I have to.
1st night was last night and it made a huge difference. I probably only went to sleep for 4-5 hours but I wore it the whole time. From what I can tell I breathed through my nose most of the time. Woke up and felt like I couldn't breathe through my nose but then was able to open my mouth with the full face mask and went back to sleep.

[DEXSUZ]

Try not to get too confused by all the statistics that abound. Folks are very helpful on here but the whole endeavor comes down to the answer to one simple question: "Do I feel rested (more than I used to be) after I awaken from a CPAP night?"

I began CPAP one year ago and had many of the problems you've mentioned but have found nocturnal bliss as I adapted to the gear and the way it works.I've got a simple program that did wonders for my adaptation to assisted sleep. Here it is:

This is the four-step program I devised. I had a tremendous sleep study at the local krankenhaus but ran into a granite roadblock as I attempted to get accustomed to masks on my own. You might want to give this a try:

My main advice is to back away from immediately trying to do all-nighters with your full-face equipment. Use my four-step weekly plan WHICH WORKED WONDERFULLY for me:

1) During the first week sit, watch TV, or read with your equipment whirring away next to you. Get accustomed to the sounds, feelings of the moving air, and all the external trappings of the great chance at quality sleep you are nearing. Do NOT go to bed with the equipment.

2) Take the phone off the hook, draw the shades, evict everyone from the house, don't think about any nearby clock, and loosen your clothing as you lie on your bed in mid-afternoon. Turn on the CPAP gizmo, put the mask on your face, and close your eyes. Think peaceful thoughts, whatever they are to you. At some point in the week you WILL fall asleep. After you have this nap, you'll be amazed at what a refreshing experience it was.

3) During the third week have all your CPAP gear ready for action as you go to bed for the night. As you've done so many times throughout the years, you'll awaken far before morning. When you do, slap the mask on your face and turn on the CPAP gear before your groggy brain has any idea what's going on.

4) After successfully completing the first three steps at your pace, decide on a night (mine was March 3rd) when you have full confidence and will retire for the night WITH your mask on. You'll succeed!

My biggest mistake was expecting everything to go perfectly from the first night. One must be patient and keep anxiety as far away as possible. Come March 3rd, I plan on some sort of goofy celebration to mark one year of refreshing sleep I never had - over four decades - before last year.

Best of luck and God bless.