Still struggling with CPAP after 3.5 months

[Franco]

I have OSA and at the sleep study they said my pressure needs to be set to 13. I have been using the ResMed AirSense 10 AutoSet CPAP with Heated Humidifier. It is set to ramp up automatically. I originally had a large Mirage Quattro Full Face Mask, but struggled for about 2 weeks with air leaks waking me up at night. No matter what adjustments I made whether I was sitting up or laying down to adjust, air leaks would happen. Also the mask was making me a bit claustrophobic as well. So I called the company and got them to exchange the mask for a Resmed Quattro FX Medium mask. (I printed the sizing chart from Resmed, and it said I was a medium). The new mask took care of the claustrophobic feeling, but I was still experiencing mask leaks. I tried a whole bunch of solutions including disposable soft cloth tshirt type mask liners (called cpap comfort pads) that went under the cpap mask and I also tried sticky liner pads that attached to the latex pillows of the full face mask (They didn't work at all. They would unstick and fall off. Then I tried Pad-A-Cheeck liners and those did not help either. I would wake up after about 2 - 3 hours sleeping and I would either have a severely dry mouth or an air leak or both. I was also messing around with the humidity level of the machine trying every possible setting each night to see if anything would get better. I also tried adjusting the temperature setting to see if that would help as well. Finally after about 2 months of playing with the settings, I changed everything back to the autoset setting and let the machine do the settings for me, and I set heater setting to as low as it would go, and set the humidity to a high setting (Since I live in So. CA, which tends to be pretty dry). Still had issues with those settings as well, and the dry mouth was driving me crazy (I sleep with a bottle of water by the bed since I am a mouth breather, I would always have a dry mouth and it woke me up sometimes so I could take a drink). Finally I ordered Sulivan Chinstrap and stopped using the mask liners and noticed that the leaks had stopped. Now the leaks has mostly stopped, and my dry mouth problem went down significantly. From a scale of 1 to 10, 10 being sahara desert dry mouth, now it's about a 4 or 5. The problem now is that I wake up still after about 2 to 3 hours of wearing the mask and take the mask off and the chin strap off for the rest of the night. The cause of me taking the mask off is mainly that I tend to be really hot at night and sleep with a fan on me, but the face mask makes my face feel really hot, and that's why I'm taking it off.

So if you're still with my after this long message, my question is: If I use the chinstrap that I currently have, has anyone been successful as a mouth breather in switching to a nasal pillow and had any better success with keeping the mask on and successfully treat the OSA? Any other ideas or suggestions you have? I have been using the ResMed MyAir website to check my treatment each day, and my worst score is usually the Usage hours since i'm always 2-3 hours, usually the mask seal is 17-20 out of a possible max of 20. The events per hour vary from 5 to 13 events per hour, mask on off is usually 1-3 per night. Total score is usually 45-52 on average with an occasional 75 or 80 when I can manage to keep the mask on for a few hours longer at night.

Thanks for any and all suggestions.

[Julie]

Hi - it sounds like you need to try a lot of other FF masks in diff. sizes, while lying down rather than sitting. The chances of your having the 'right' one for you first time out are slim and most of us have had to try others. Cpap.com will let you try others for 30 days for a small 'return insurance' fee, unless you're lucky enough to find other DME's in your area who'll let you try some at least in the office (while lying down). Chinstraps can't keep your lips closed... have you tried taping (do a forum search for it and see lots of ideas).

[andycole]

Hang in there - it is supposed to get better over time. I am a mouth breather due to sinus issues and use full-face mask (FFM). Almost 5 months on ASV and I just tried my 5th or maybe 6th mask and no luck. In this case I have a mark on the bridge of my nose where it apparently pinches while I sleep. I will use my ResMed F10 until I can talk to Sleep Medicine RT who gave me this Amara gel-cushion FFM. While I do get leaks with the F10, I am sleeping through them.

[chunkyfrog]

Over twenty masks under the little (but long) green belt before I found a mask that was better than just OK.
Patience, persistence, and faith that only a frog has such a weird face.
You will find your bliss.

[ChicagoGranny]

I don't like hang-in-there advice. Instead, let's do something!

The cause of me taking the mask off is mainly that I tend to be really hot at night and sleep with a fan on me, but the face mask makes my face feel really hot, and that's why I'm taking it off.

Obvious question, can you set the A/C to a lower temp and see it that helps?

From a scale of 1 to 10, 10 being sahara desert dry mouth, now it's about a 4 or 5.

I have used this product every night for years and find it to be a big help - http://www.drugstore.com/orajel-dry-mou ... /qxp153412 . If you decide to try it, I can give you tips on application.

has anyone been successful as a mouth breather in switching to a nasal pillow

I would imagine someone has, but I don't think there are many. That's why so many FFMs are sold and used.

the face mask makes my face feel really hot

I understand that. Do you think a FFM with a small footprint would help? I have used this FFM for years with great success - https://www.cpap.com/productpage/RespCa ... -Mask.html .

As far as I know, it has the smallest footprint of any FFM. If you try one, I can give you fitting, adjusting and tweaking tips.

[Wulfman...]

I have OSA and at the sleep study they said my pressure needs to be set to 13. I have been using the ResMed AirSense 10 AutoSet CPAP with Heated Humidifier. It is set to ramp up automatically. I originally had a large Mirage Quattro Full Face Mask, but struggled for about 2 weeks with air leaks waking me up at night. No matter what adjustments I made whether I was sitting up or laying down to adjust, air leaks would happen. Also the mask was making me a bit claustrophobic as well. So I called the company and got them to exchange the mask for a Resmed Quattro FX Medium mask. (I printed the sizing chart from Resmed, and it said I was a medium). The new mask took care of the claustrophobic feeling, but I was still experiencing mask leaks. I tried a whole bunch of solutions including disposable soft cloth tshirt type mask liners (called cpap comfort pads) that went under the cpap mask and I also tried sticky liner pads that attached to the latex pillows of the full face mask (They didn't work at all. They would unstick and fall off. Then I tried Pad-A-Cheeck liners and those did not help either. I would wake up after about 2 - 3 hours sleeping and I would either have a severely dry mouth or an air leak or both. I was also messing around with the humidity level of the machine trying every possible setting each night to see if anything would get better. I also tried adjusting the temperature setting to see if that would help as well. Finally after about 2 months of playing with the settings, I changed everything back to the autoset setting and let the machine do the settings for me, and I set heater setting to as low as it would go, and set the humidity to a high setting (Since I live in So. CA, which tends to be pretty dry). Still had issues with those settings as well, and the dry mouth was driving me crazy (I sleep with a bottle of water by the bed since I am a mouth breather, I would always have a dry mouth and it woke me up sometimes so I could take a drink). Finally I ordered Sulivan Chinstrap and stopped using the mask liners and noticed that the leaks had stopped. Now the leaks has mostly stopped, and my dry mouth problem went down significantly. From a scale of 1 to 10, 10 being sahara desert dry mouth, now it's about a 4 or 5. The problem now is that I wake up still after about 2 to 3 hours of wearing the mask and take the mask off and the chin strap off for the rest of the night. The cause of me taking the mask off is mainly that I tend to be really hot at night and sleep with a fan on me, but the face mask makes my face feel really hot, and that's why I'm taking it off.

So if you're still with my after this long message, my question is: If I use the chinstrap that I currently have, has anyone been successful as a mouth breather in switching to a nasal pillow and had any better success with keeping the mask on and successfully treat the OSA? Any other ideas or suggestions you have? I have been using the ResMed MyAir website to check my treatment each day, and my worst score is usually the Usage hours since i'm always 2-3 hours, usually the mask seal is 17-20 out of a possible max of 20. The events per hour vary from 5 to 13 events per hour, mask on off is usually 1-3 per night. Total score is usually 45-52 on average with an occasional 75 or 80 when I can manage to keep the mask on for a few hours longer at night.

Thanks for any and all suggestions.

Is 13 cm. the setting you're using?
Are you doing nasal cleansing before bedtime? You need to be able to breathe through your nose, otherwise you're going to have to breathe through your mouth........which will cause "dry mouth".......even with a full face mask.
Too much warm humid air can make nasal congestion worse for some people.

Get Sleepyhead software so you can better see what's happening during the night.


Den

.

[kteague]

I was a mouth breather who was able to become a nose breather. Took a long time training with aids - everything from a neck brace to chin straps, tape, dental adhesive and wraps. I was lucky that there is nothing structurally wrong with my nose. My mouth breathing was tied to the OSA. I did learn that warm air makes me too congested to breathe freely, and mask pressure against the sides of my nose blocked my sinuses and caused congestion. For years now I have used pillow style masks with no need for aids. I learned to use a flat firm bed pillow to assure my head lays flat to prevent gravity from causing a slack jaw to fall open. I habitually keep my tongue suctioned to the roof of my mouth behind my teeth.

Do you know if your mouth breathing is due to obstruction or congestion, from the force of air blowing out, or just due to a slack jaw? Makes a difference. All that said, I have a family member who started on a full face mask and says she'd rather just use it than go through a big hassle trying to do otherwise. Often I've thought she might have made the wiser decision. I invested at least a year nearly obsessed with making the nasal pillows work, as I had other sensory issues going on that made a minimalist mask more acceptable for me. Best wishes figuring out what is best for you.

[snuginarug]

You've gotten a lot of good, sound advice about mask fit and selection. As for taking the mask off for the rest of the night... That's an annoying, pernicious problem. I understand it feeling hot and uncomfortable, I really get that. But sleeping without a mask is worse than no sleep at all. It's important to train yourself to put it right back on when you take it off in the middle of the night. Training yourself now, before it becomes an intractable habit, will save you a lot of grief. There are a lot of tips and tricks, and I will share the one that helped me the most. I impressed upon myself exactly how bad suffocating all night long is, and made it a rule that I cannot lie down without a mask on. If I take the mask off, I sit up, try to figure out what is going on and then put it back on before lying down again. I had a devil of a time adjusting to having a mask on my face while asleep and lots of broken sleep, but I now keep it on all night.

Eventually you will figure out what you need to make cpap work for you. This is a life-saving device and once you get yourself adjusted and situated, your body will thank you.

Hang in there.

[PEF]

I am a mouth breather who successfully switched to nasal pillows. I really don't know what I would do if I had to actually WEAR a FFM. The ones I have tried so far all leak massively because they seem too tight in the sinus area and too large under the lips. I tried 2 Hybrids, but they were both too large for my face. I cannot afford to keep buying FFM and having them useless. I have a Resmed F10 that fits when I am standing up, although not well, but leaks massively when I lie down and turn on the air. So far, the mask liners have not stopped the leaks. Additionally, the pressure over my sinuses stuffs up my nose almost immediately and then I breathe through my mouth which gives me a terrible sore throat that lasts all day.

On the other hand, the pillow masks all worked fine - all 5 of them that I have, but I like some better than others. I hardly knew I had them on. Except that I could not make it through a night with the APAP because of air getting into my mouth and rushing around and out my mouth. Right around the same time, I read a lot about how bad it is for your health to breathe through your mouth. So I set out to stop the mouth breathing. One thing I did was to tape my mouth at night. I had good instructions on how to do it. Use paper tape and tape vertically, not horizontally. Also, don't tape too aggressively because this is really about getting your brain used to keeping the mouth closed and more importantly, keeping the tongue forward and up against the roof of the mouth. When you do that, you create a seal that stops you from taking air in through your mouth. So I did this for about 2 weeks without using the machine and then tried it with the machine. I also lowered the pressure on my machine temporarily. This worked and I was able to actually sleep with the pillow masks. I am still taping after 2 months on CPAP, but hope to be able to eliminate the tape eventually. But I am happy. About 3/4 of my nasal congestion is gone and even if I get congested, I can still breathe well enough to use the pillows. Several of my bad symptoms, like morning headaches, nighttime acid reflux, sore throats and ticking ears, severe morning fatigue, have improved dramatically. I still have the same old insomnia. But I feel I am making forward progress. So I hope this helps. Just some suggestions.