Not feeling rested in the morning...

[joeljjk11]

Hi everyone - so I have alternated between different masks over the past month and am trying to figure out why I don't feel rested or 'refreshed' in the morning.

I am currently using the Nuance Pro Nasal Pillows and before that was using the Airfit N10 nasal mask. The N10 worked better but it irritated my nose a real lot and actually was cutting the bridge of my nose. With the N10 I felt more refreshed in the morning. The nasal pillows are not leaking and my wife said I am not snoring with them but I still am really tired in the morning and feel that I just want to sleep much longer than I am.

Is my body still recovering from not sleeping normally for so long? The nasal pillows are definitely more comfortable and do not irritate my nose at all. I just wish I wasn't exhausted in the morning after wearing them. Any opinions or suggestions would be helpful. Thanks!

Joel

[joeljjk11]

The only thing I can think of is that the equipment supplier fitted me for a small size but I have been wearing the medium size pillows. Could this affect anything? I was told on this forum that the bigger size could help with exhaling and make it more comfortable.

[BlackSpinner]

Check your data with Sleepyhead to see if there are any big leaks.

[joeljjk11]

Wouldn't my machine detect this? It shows that there is no leakage at all.

[Pugsy]

The size difference in the nasal pillows shouldn't be an issue in terms of therapy effectiveness and if you are thinking that the size small would make you feel better...it's unlikely but there's nothing wrong with trying it to see.
The going up in size is mainly for those feeling like there simply isn't enough air movement in the smaller size which leads to a feeling of the breathing being a bit suffocating. In terms of therapy pressure itself there really isn't any difference.

Why the difference in how you feel? Don't know unless there is something with the nasal pillows that is less optimal than when using the nasal cushion mask....like hours of sleep or fragmented sleep for some reason.

How long did you use the nasal cushion mask? How long have you been using the nasal pillow mask?
Maybe if we compared SleepyHead results we might spot something.
And yes...SleepyHead will flag large leaks if you have them because the machine will flag large leaks and SH just reports what the machine is reporting.

[joeljjk11]

I will get set up with Sleepyhead soon as I currently don't have it on my computer. I will also try the smaller size pillows and see if it helps at all. I have noticed that when I sleep on my back the medium pillows are leaking quite a bit, but my machine is not detecting anything. Like I have done the mask fit on my machine and they leak alot on my back. Could the smaller pillows help this? I am not sure.

[Pugsy]

Is it possible that the nasal pillow and the minor leaks are causing you to wake more often during the night because of the leaks? They don't have to be big to disturb sleep.
Anything that disturbs our sleep or causes unwanted wake ups will affect how we feel during the day.

[astrodeb]

It is possible that when the OP says "the machine isn't reporting leaks", he means that there isn't a on the machine screen. That only happens with massive leaks (> 30% of the time, I think, as I learned from you folks). I can verify that there can be large leaks that disrupt sleep on this machine without the icon warning. Sleepyhead or other software using the SD card data will track them. Even medium leaks can disrupt sleep.

[Guest1]

investigate two things:
1) if you are on straight cpap (with or without exhale relief), your pressure need will typically go down on nasal pillows when compared to nasal mask OR FFM.
2) if you are on APAP, then pressure changes may be causing microarousals which knock you off from deeper to shallower sleep stage. In this case, a straight pressure may be the answer. This was the case with me. My AHI was lower with P10 than F10 on APAP. My 95% pressure was also lower. But I was feeling not fresh in mornings. So I went to straight pressure with exhale relief (a-flex at 3) on my prs1 60 series auto machine. And all is well since then.

YMMV.

[joeljjk11]

Thank you for the info. So you had to switch machines or did you keep the same one? I am honestly new to CPAP and am not sure how to adjust this on my machine.

According the My Air Resmed site I have had 0 Leakage (L/min) since using the nasal pillows again.

[joeljjk11]

I tested out my nasal pillows and realized they were WAY too loose and leaking all over the place. My machine did not detect leakage but they were definitely not right. I also switched to the small size pillow. We will see how I feel tomorrow.

[Pugsy]

It's very possible that the leaks were a disturbing factor to your sleep quality causing a lot of arousals that you may or may not realize they happened but it sure will trash how a person feels the next day.
The leaks don't have to be of the magnitude to hit large leak territory to disturb a person's sleep.
Let's hope that the tension adjustment and the change in size of the nasal pillow will let you feel more rested since you prefer the nasal pillows comfort wise.