Help for a newbie getting used to mask

[Rem949]

Hello! I'm a new CPAP user and could use some help. After suffering years of excessive daytime sleepiness, I was finally diagnosed with mild OSA (AHI of 13.5). It was a surprise because I don't snore, I've never woken up gasping, and I don't fit any of the other most common indicators. Still—happy to have a diagnosis that will hopefully help me stop being so sleepy and tired!

I have the Respironics Dreamstation with C-flex and a heated humidifier, and I've been using the Dreamwear nasal cushion. I used it for a about a week, then was on an 18-day trip in the African bush so I didn't bring it, and now I'm home trying to get used to it again.

At the beginning, the respiratory therapist let me try on some of the different styles (nasal cushion, nasal pillows, FFM), and I liked the Dreamwear nasal cushion best by far—the top-connecting hose was a huge plus, and the cushion and headwear felt so light and minimal. She sized me as a small. The first few nights I used it, as soon as I'd start to drift off, I'd wake up gasping—it felt like the mask was blocking my nostrils and I was suffocating. After a few days, I switched to the medium size cushion, which made less contact with my nostrils. I was at least able to fall asleep. I've been wearing while reading in the evenings to help get used to the feel. (The machine shows a mask fit of 100 percent in the mornings, so I think the size medium is fine in that respect.)

Several weeks later, however, it's still not feeling totally comfortable. Some nights I'm able to keep it on throughout the night, but I'm still sleeping really lightly, waking up many times, and it seems like it's mainly the feel of the silicone on my nose that's waking me up. I'm considering trying the Dreamwear full face mask, but I can't tell from photos online whether that also has a nasal cushion inside. Does anyone know?

...Maybe it's not even the mask that's the problem, but that's all I can think of at the moment. I'm going to keep trying to get used to wearing something on my face at night, because I really don't want to be so sleepy all the time anymore, but I'm getting to the point where I'm getting so frustrated I don't want to go to bed or that I wait until I'm realllly tired before I put on the mask, just so I can fall asleep as fast as possible. Any advice would be much appreciated. Thank you!

[Pugsy]

Welcome to the forum.

Yes, the DreamWear full face mask does use an under the nose cushion similar your current DreamWear except it also encompasses the mouth. All one big cushion.

Here's an image of the inside....the nasal opening is on the bottom of each cushion and the size and shape varies a little.

[Rem949]

Welcome to the forum.

Yes, the DreamWear full face mask does use an under the nose cushion similar your current DreamWear except it also encompasses the mouth. All one big cushion.

Here's an image of the inside....the nasal opening is on the bottom of each cushion and the size and shape varies a little.

That's so helpful, thank you! I wonder if the Dreamwisp would be better for me then. It looks like that one has less contact with the nose but still has the top-connecting hose.

[Janknitz]

There are two things that may be happening:

1) you are having some claustrophobia in the mask. Other masks may help, but it may just be that feeling. I had terrible claustrophobia at first. The way I handled it was that I would make myself count to 10 SLOWLY before ripping off the mask. And sometimes then make myself count to 10 again. If I ripped off the mask, I'd calm myself down and then put it back on. Eventually I got to the point where I was calm enough to continue after counting to 10, and then gradually this stopped happening.

2) You may not have optimal settings. A little more pressure might help, although it would be helpful to see your charts to see if apnea or too low pressure is the problem before making any adjustment. Are you able to use Oscar or Sleepyhead to access your data and post it?

I'm not sure if you are on a fixed pressure or using APAP. If you are on a fixed pressure your machine will NOT respond to apneas, so you may still be having them at the pressure you are on. Even on an APAP, the machine does not respond immediately to apneas, so you may do better with increased pressure to prevent them if that's what's causing you to wake up feeling like you cannot breathe.

Finally, APAP's are often set up to start at a very low pressure (4 cm) and go up (slowly as above) as needed. It may be that you are having apneas at that low pressure and never get into a deep sleep because when you remove the mask, turn off the machine, and turn it on again, you are starting all over again, back at the low pressure. Some thing if you are using a fixed CPAP pressure with ramp. When you turn it off and turn it back on, you're starting out at the low pressure if ramp is on.

Hope this is making sense!

[Nandos]

Hi Rem949 and welcome!!

I have had my CPAP now for about a year and a half and I half to say it's helped so much.

It did take me a bit to get used to the mask though. The first couple of nights I was so tired I just did not care, but as my body started to heal, I became more aware of the mask to the point that I would get anxiety when I would go to bed. Also like you I would wake up throughout the night normally the first one would be 2 hours it was odd to say the least.

What I found to help the most was to make the mask a bit tighter on my face as the slightest air leak across my face would just wake me up. (I use a F&P Eson 2) After that it was playing around with the settings on the CPAP machine itself, with the output and humidity settings offering the most beneficial changes.

Since my adjustments to the machine and mask my AHI average is around 1.0 which is great considering I was a clinical emergency to start out.



Sent from my SM-G975W using Tapatalk

[Rem949]

There are two things that may be happening:

1) you are having some claustrophobia in the mask. Other masks may help, but it may just be that feeling. I had terrible claustrophobia at first. The way I handled it was that I would make myself count to 10 SLOWLY before ripping off the mask. And sometimes then make myself count to 10 again. If I ripped off the mask, I'd calm myself down and then put it back on. Eventually I got to the point where I was calm enough to continue after counting to 10, and then gradually this stopped happening.

2) You may not have optimal settings. A little more pressure might help, although it would be helpful to see your charts to see if apnea or too low pressure is the problem before making any adjustment. Are you able to use Oscar or Sleepyhead to access your data and post it?

I'm not sure if you are on a fixed pressure or using APAP. If you are on a fixed pressure your machine will NOT respond to apneas, so you may still be having them at the pressure you are on. Even on an APAP, the machine does not respond immediately to apneas, so you may do better with increased pressure to prevent them if that's what's causing you to wake up feeling like you cannot breathe.

Finally, APAP's are often set up to start at a very low pressure (4 cm) and go up (slowly as above) as needed. It may be that you are having apneas at that low pressure and never get into a deep sleep because when you remove the mask, turn off the machine, and turn it on again, you are starting all over again, back at the low pressure. Some thing if you are using a fixed CPAP pressure with ramp. When you turn it off and turn it back on, you're starting out at the low pressure if ramp is on.

Hope this is making sense!

Thanks for the response Janknitz! I've never experienced claustrophobia in other parts of my life, but now that I think about it, having something pressed up against my face altering my breathing does seem like something that could cause it! The counting is a good idea - I'll try it. I need to order an SD card reader so I can access my data. I'm going to do that right now! This week, I have my first follow-up with my sleep doctor. I think it's very possible the settings aren't right. With the CPAP, my AHI is a little lower than what my sleep study showed, but not my much. I don't think I'm getting the full therapeutic value.

[Rem949]

Hi Rem949 and welcome!!

I have had my CPAP now for about a year and a half and I half to say it's helped so much.

It did take me a bit to get used to the mask though. The first couple of nights I was so tired I just did not care, but as my body started to heal, I became more aware of the mask to the point that I would get anxiety when I would go to bed. Also like you I would wake up throughout the night normally the first one would be 2 hours it was odd to say the least.

What I found to help the most was to make the mask a bit tighter on my face as the slightest air leak across my face would just wake me up. (I use a F&P Eson 2) After that it was playing around with the settings on the CPAP machine itself, with the output and humidity settings offering the most beneficial changes.

Since my adjustments to the machine and mask my AHI average is around 1.0 which is great considering I was a clinical emergency to start out.



Sent from my SM-G975W using Tapatalk

Thanks Nandos! It's so good to hear success stories (the topic pinned at the top from 2006 is my favorite post!) because right now it feels like using the machine is making me more tired, not less, because I'm waking up so much. I've started playing with the humidity settings, and that has helped a little. My AHI with CPAP is still around 9, so I think there's room for improvement.

[Janknitz]

I'll try it. I need to order an SD card reader so I can access my data. I'm going to do that right now!

How will your doctor know if the settings aren't correct if your doctor can't see your data?

[Rem949]

I'll try it. I need to order an SD card reader so I can access my data. I'm going to do that right now!

How will your doctor know if the settings aren't correct if your doctor can't see your data?

It uses wifi to automatically upload to a cloud that he has access to. I did see him this morning, and he’s recommended increasing the pressure. My initial settings started at a 6, but I spent 90 percent of the time at a 9. Hopefully a higher pressure will make a difference!

[Pugsy]

It uses wifi to automatically upload to a cloud that he has access to.

It's not WiFi....it's cellular service just like phones use.
Now some Respironics machines will use BlueTooth for connecting to YOUR phone so you can use the app on your phone but the doctor gets his data from the internet cloud which the machine uses cellular data to transmit to the cloud that the doctor accesses.

[Rem949]

It uses wifi to automatically upload to a cloud that he has access to.

It's not WiFi....it's cellular service just like phones use.
Now some Respironics machines will use BlueTooth for connecting to YOUR phone so you can use the app on your phone but the doctor gets his data from the internet cloud which the machine uses cellular data to transmit to the cloud that the doctor accesses.

Ah cool, didn't realize that!

[Janknitz]

I'll try it. I need to order an SD card reader so I can access my data. I'm going to do that right now!

How will your doctor know if the settings aren't correct if your doctor can't see your data?

It uses wifi to automatically upload to a cloud that he has access to. I did see him this morning, and he’s recommended increasing the pressure. My initial settings started at a 6, but I spent 90 percent of the time at a 9. Hopefully a higher pressure will make a difference!

That's good. Not all doctors have that access, so it sounds like you have a good doctor there.