Removing Mask at night

[jsc360@ymail.com]

I have been using cpap for about a month now. Still adjusting somewhat. Over the last two nights I have been removing the mask during the night and waking up in the morning having no recollection of removing it. I'm afraid this may keep happening. Has anyone else ever experienced this, and if so, how did you deal with this?
BTW, I have a pressure setting of 8.

[avi123]

Have you noticed that other posters have registered and showed their types of machines and masks and some of them, like me for example, even provided their addresses, genders, and ages. In the past, your question was asked and replied to, at least 50 times.

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[49er]

I have been using cpap for about a month now. Still adjusting somewhat. Over the last two nights I have been removing the mask during the night and waking up in the morning having no recollection of removing it. I'm afraid this may keep happening. Has anyone else ever experienced this, and if so, how did you deal with this?
BTW, I have a pressure setting of 8.

Hi there,

Welcome to the forum. If you could use the link in my signature to fill out your equipment profile, that would help members better tailor their advice to your situation.

Regarding taking the mask off, in my own situation, I would do it because I felt I wasn't getting enough air and that full face masks I was wearing were pressing on my nasal area causing more congestion. Haven't had any problems since I switched to the nasal elan mask.

So I guess the question I would ask is your mask comfortable? Do you have any nasal congestion problems? Also, do you feel you are at the right pressure?

49er

[library lady]

When I started this journey, I did the same thing. I'd always be so surprised and not know when I took it off. Eventually that didn't happen; it's part of the adjustment I think. It rarely happens now. So it's trial and error, could be that your mask is not the right mask for you, or if you are otherwise comfortable it could be part of adapting to this new way of sleeping. I think a lot of people do take their masks off in the beginning, and then wonder when they took it off. So it's probably up to you whether to try a different mask or stick with the one you have if it is comfortable.

[Day_Dreamer]

I have been using cpap for about a month now. Still adjusting somewhat. Over the last two nights I have been removing the mask during the night and waking up in the morning having no recollection of removing it. I'm afraid this may keep happening. Has anyone else ever experienced this, and if so, how did you deal with this?
BTW, I have a pressure setting of 8.

Disengage the auto on/off setting if your machine has this. When you take it off the noise of the air will remind you to put it back (some of the time)

[Todzo]

I have been using cpap for about a month now. Still adjusting somewhat. Over the last two nights I have been removing the mask during the night and waking up in the morning having no recollection of removing it. I'm afraid this may keep happening. Has anyone else ever experienced this, and if so, how did you deal with this?
BTW, I have a pressure setting of 8.

I see this mentioned quite often here.

Since you are still in the three month “getting used to CPAP” phase I would recommend that you spend some quality time with the machine during the daytime. Start out in bed without the machine and let your breathing quiet. Note that level of breathing. Put the mask on and return to that rate. Also check mask fit, and hose management as you move to all the usual positions.

Then during the daytime with mild distraction such as a book, light music, light TV. The hope is that with more of the brain awake the breathing reflexes will develop more quickly and respond to the changes that occur as CPAP works and allows your body to heal.

When you go to use CPAP at night use the same procedure of letting your breathing quiet in bed and then putting the mask on and returning to that state. It may also help to think of things beautiful or pleasant memories as you do this.

I believe it is likely that anything you can do to reduce stress in your life will help. I did find that as I was able to reduce stress in my life similar symptoms to yours ceased.

Most people think of sleep apnea only as obstructive sleep apnea. However there is a much broader spectrum of causes of apnea. As well the point at which arousal occurs with an event may well change. They are beginning to sort it out[2,3].

I and others[5] have found moving vitamin D3 into its active range helpful.

And during my journey away from sleep apnea I have found that I did not know how to eat well or move well. My three years with a dietitian helped start me on my continuing life long journey to eat well. I still strive toward the basic goal of 10,000 steps a day (running about 80% at this time) and do intend to use more personal trainer time as I pursue an active lifestyle. Lately I have been thinking that running, which is known to help with brain development, might well be worth the risks to my knees at my advanced age. By eating well and moving well I hope to promote whole body metabolic health and I can say it does appear to help with my tendency to have centrals emerge as I use CPAP.

hth


[1] Morgenthaler TI, Kuzniar TJ, Wolfe LF, Willes L, McLain WC, Goldberg R. The complex sleep apnea resolution study: a prospective randomized controlled trial of continuous positive airway pressure versus adaptive servoventilation therapy. SLEEP 2014;37(5):927-934 Related article (commentary):833

[2] Danny J. Eckert, David P. White, Amy S. Jordan, Atul Malhotra, and Andrew Wellman "Defining Phenotypic Causes of Obstructive Sleep Apnea. Identification of Novel Therapeutic Targets", American Journal of Respiratory and Critical Care Medicine, Vol. 188, No. 8 (2013), pp. 996-1004. doi: 10.1164/rccm.201303-0448OC

[3] Sairam Parthasarathy M.D., Emergence of Obstructive Sleep Apnea Phenotyping. From Weak to Strong! American Journal of Respitory and Critical Care Medicine VOL 188 2013
-- critical closing pressure [Pcrit] - Arousal Threshold - ventilatory control Loop gain - and genioglossal Muscle responsiveness. Pcrit, Loop, Arousal, Muscle (PALM)--

[4]: Gilmartin G, McGeehan B, Vigneault K, Daly RW, Manento M, Weiss JW, Thomas RJ.
Treatment of positive airway pressure treatment-associated respiratory instability with enhanced expiratory rebreathing space (EERS).
Source: J Clin Sleep Med. 2010 Dec 15;6(6):529-38. Division of Pulmonary, Critical Care and Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.
Link: http://www.ncbi.nlm.nih.gov/pubmed/21206741

[5]: Those who are working with the D3 hormone (A.K.A. Vitamin D3) (e.g. Dr. Stasha Gominak, Michael F. Holick, Ph.D., M.D., Vitamin D Council) seem to be finding that the very low side of the “normal” range of 30-100 ng/L produces a range of symptoms including OSA, pain, and infection. All believe that a level lower than 50 ng/mL is not good and Dr. Stasha Gominak recommends 60-80 ng/mL for good health. It would probably be wise to check your vitamin D3 levels. See “The Vitamin D Council” for assay details.

[Day_Dreamer]

When I started this journey, I did the same thing. I'd always be so surprised and not know when I took it off. Eventually that didn't happen; it's part of the adjustment I think. It rarely happens now. .

X2

[Nick Danger]

x3. I think this is a pretty normal part of getting used to CPAP.

[kteague]

I did this for a while too. Until the brain adjusts to the new sensations, since while asleep we can't consciously reassure ourselves, it seems a natural response to a foreign object covering the face. In time the behavior should resolve. At one point I would put a bandaid across the strap over the side of my face so the pain of removing it would alert me to my behavior. A piece of medical tape would serve the same purpose. The thing you do want to be sure of is that the removal is not because of inadequate pressure or painful or misfitting gear.

[KylaManhattan]

I'm a couple of years in, and it still happens occasionally. I'll wake up, and the mask will be lying neatly on top of the machine, and on top of it, the wrist splint that I wear at night for carpal tunnel syndrome.

Note that this is how I would typically place the mask and the splint when I get up each day.

This leads me to believe that something occurs during the night which makes me think it is time to get up, but I fall back into sleep without actually getting up or remembering the trigger.

(It has occurred to me that it might be Lucy hoping to prompt an earlier-than-usual breakfast service. You know cats: they've got things to do, places to go, people to see, and little sympathy for the pathetic human's wish for just a few more minutes, please. )

[Fizzy42]

Im fairly new to CPAP as well, Oct 13. I still occasionally rip it off in my sleep it has become less
now, so hopefully as you get more use to it your'll stop doing it

[ems]

Check the pressure! I changed the pressure from 9/6 to 9.4/6 and I no longer take the mask off during the nite. I simply wasn't getting enough air... and that little bit helped greatly.

[55Kevy]

Hi All - new to CPAPTalk, haven't completed my profile yet.

I've been using a nasal CPAP since 1995, having gone thru 4 different CPAP machines and 5 or 6 different masks. From the beginning I had no trouble adjusting to the mask: the quality of sleep I got, compared to before, was so great I actually got to the point that I couldn't sleep without it. However, in the last 6 months or so I've started to not put my mask back on after going to the bathroom in the middle of the night. My subsequent snoring wakes my wife who tells me to put on my mask. I can't really say why I do this, or why I'm so resistant to comply when she nudges me. I've lost a lot of weight over the last 2 years (100+ lb) and had 3 joint replacement surgeries, and maybe subconsciously feel that I don't need the therapy anymore?

Anyway, just wanted to share this in the spirit that mask removal can happen at any point in the CPAP experience.

Kevin

[kteague]

...in the last 6 months or so I've started to not put my mask back on after going to the bathroom in the middle of the night. My subsequent snoring wakes my wife who tells me to put on my mask. I can't really say why I do this, or why I'm so resistant to comply when she nudges me. I've lost a lot of weight over the last 2 years (100+ lb) and had 3 joint replacement surgeries, and maybe subconsciously feel that I don't need the therapy anymore? Anyway, just wanted to share this in the spirit that mask removal can happen at any point in the CPAP experience.Kevin

Interesting. Do you have access to machine data to see if maybe your therapy needs tweaking with all the changes you've been through? Are you aware you are going back to sleep without the mask when it's happening? When I used to fall asleep before my head hit the pillow, I had to mask up while standing by the bed. If I so much as sat down, it was over. Congrats on your weight loss! How long has it been since you've had a sleep study? Sounds like from what your wife hears when you fall asleep without it that she hears a need for some treatment. Good luck getting past this bump in the road - a very long road, so congratulations on your track record.

[Todzo]

Hi All - new to CPAPTalk, haven't completed my profile yet.

I've been using a nasal CPAP since 1995, having gone thru 4 different CPAP machines and 5 or 6 different masks. From the beginning I had no trouble adjusting to the mask: the quality of sleep I got, compared to before, was so great I actually got to the point that I couldn't sleep without it. However, in the last 6 months or so I've started to not put my mask back on after going to the bathroom in the middle of the night. My subsequent snoring wakes my wife who tells me to put on my mask. I can't really say why I do this, or why I'm so resistant to comply when she nudges me. I've lost a lot of weight over the last 2 years (100+ lb) and had 3 joint replacement surgeries, and maybe subconsciously feel that I don't need the therapy anymore?

Anyway, just wanted to share this in the spirit that mask removal can happen at any point in the CPAP experience.

Kevin

Hi Kevin,

Very possibly time for a new sleep study and titration.

You have made a lot of changes. Congratulations on the weight loss!!!

Regret hearing about the joint replacements.

Take care,

Todzo