still sleepy

jomac30 · Post by **jomac30** » Fri Oct 12, 2007 7:58 pm

9 months on cpap-not really sleeping any better. Is this normal? I have a resmed m with a heated humidifier. My pressure is 13. I tried a couple of nasal masks. I don't like the straps across my cheeks especially in the hot weather. I tried nasal pillows but the air burns my nostrils. Last night I tried a comfortlite ll which seemed comfortable, but I'm wondering how to know if I'm using the right size seal. I get a little leaks at the bottom.
I was wondering if i'll ever get more than a couple of hours sleep.
I still get tired and fall asleep for about a half hour in the afternoon.
The only way I can sleep for about 6 hours would be if I don't sleep at all for one night and then the next night I'll be tired enough to sleep.

Any suggestions? When will this cpap start working for me? I NEED SLEEP!!!

Wulfman · Post by **Wulfman** » Fri Oct 12, 2007 8:26 pm

Sounds like all you've tried are nasal-type masks. I'd suspect that you're leaking therapy air out your mouth. Do you wake up with a dry mouth? That would be the biggest clue.
Leaking air = bad therapy = no recovery.

Choices:
Taping lips shut.
Polident adhesive denture strips to seal the lips.
A full face mask.

Den

Slinky · Post by **Slinky** » Sat Oct 13, 2007 5:18 am

Jomac, Wulfman pretty much hit the nail on the head.

I would also add the suggestion that you click on Profile at the top of this page and scroll down thru your information to near the bottom and enter which CPAP, mask and humidifier you are using. Then you don't have to remind us each time you post a question you'd like help with. If you look on the top of your machine you'll find the brand and model. For instance: you said you had a Resmed M - but Resmed doesn't make an M. So I'm assuming you mean the Respironics M Series brand. But there are several models w/in the Respironics RemStar M Series. Clarifying that will help us help you.

And a belated welcome to the forum from me! Its a great place to be to maximize your benefits from xPAP therapy.

jomac30 · Post by **jomac30** » Sat Oct 13, 2007 1:26 pm

Thanks everyone. I'm not sure if I'm using the right size simple cushion on my comfortlite 2. It came with 2 cushions and I'm using the smaller one. I don't feel air going into my eyes, but I wake up with my eyes feeling "heavy". It seems like the air from the exhale vent is blowing toward my eyes and I can't block that vent. I think this mask is the most comfortable I've tried so far with no straps across my cheeks.
How would I know if the larger simple cushion would be better for me?
I'm overweight and depressed and this cpap thing is making me more fed up because its one more thing I have to worry about doing correctly.
My insurance pays for new hose once a month so I've gotten lazy and just use it for a month without washing it and then throw it out.
I was told at an A.W.A.K.E. meeting that I could switch DME after 13 months because that's when the machine rental will be paid in full. So by the end of February I should have a new DME. Hopefully things will be easier with someone new.

Goofproof · Post by **Goofproof** » Sat Oct 13, 2007 2:21 pm

If you have the "M" Pro, I would get the software so you could see how you are doing and get some idea of what is wrong. As Wolfman says, I supect you are leaking your treatment out of you mouth. The pressure has to remain trapped in your airway to hold it open. Some use taping or a FF mask to seal the mouth. Jim

jomac30 · Post by **jomac30** » Sat Oct 13, 2007 3:13 pm

Where and how do I get the software? Is the smartcard considered the sofware?

Slinky · Post by **Slinky** » Sat Oct 13, 2007 3:28 pm

The software isn't going to tell you much until you gain some more experience and understand more about sleep apnea and CPAP treatment. And you haven't responded or shown any interest in the suggestions regarding mouth leakage of air. Something you could easily start with and the most likely cause of your poor response to CPAP therapy so far. Did you try taping your lips last night?

As far as the ComfortLite II and nasal pillow size. Try the two sizes you were given, if they don't seem to be doing the trick ask you DME for the next size. You are eligible for a new cushion every 30 days. That doesn't mean you need to get a new one every 30 days and its ridiculous to do so 'cause they last much longer than that - but - since you need to try a new size for the same mask, ask the DME for one. They come in S,M and L.

Also, the rules have changed: its now a new hose every 3 months so you might want to start washing and hanging one to dry whilst using the new or the older one in its place every other day.

jomac30 · Post by **jomac30** » Sat Oct 13, 2007 3:52 pm

I'm not using nasal pillows. The cushion I use is just like a triangular cap on the tip of my nose. The hose goes over my head.
Wouldn't taping my mouth shut be just as uncomfortable as wearing a nasal mask?
When did the change in replacement time for tubing start? Does this apply if Medicare is the insurance?

Slinky · Post by **Slinky** » Sat Oct 13, 2007 4:02 pm

Medicare is the one who changed the every 30 days to every 90 days for the hose replacement. The change was recent. Do you ever visit the mymedicare website?

Ah, you are using the CL2 simple nasal cushion. I started w/the CL2 nasal pillows and switched to the simple nasal cushion too. In fact, the CL2 w/simple nasal cushion was my favorite until I tried the Simplicity simple nasal cushion.

If you have mouth leaking, even "just" lip flutters, you just aren't going to get as effective therapy from your xPAP. Not when the therapy is blowing past your lips instead of opening up your throat passages so you can breathe. Your choice is to "tape" your mouth shut or use a full face mask IF you can find one that will work for you w/o excessive leaks. Now, we say "tape" your lips but you may well find that PoliGrip strips or a thin layer of PoliGrip gel will do the trick more comfortably. There are lots of tips here on taping, what kind of tape, how to use the PoliGrip strips or gel.

Also, if you go to the top of the page, click on the Red Ball w/the Question Mark, scroll down to Mask Fitting and click on that, you will find some tips for adjusting your mask cushion to reduce or eliminate leaks.

jomac30 · Post by **jomac30** » Sat Oct 13, 2007 4:16 pm

'my medicare"?? don't know how to access. What's the full site address?
I think I might have some mouth leak. I woke up a few times last night with it. I'm going to search for the Simplicity you mentioned.

Slinky · Post by **Slinky** » Sat Oct 13, 2007 5:37 pm

It will be cheaper for you to try the Mask Fitting tips and the other size of the CL2 simple nasal cushions than to switch masks for the moment.

The Simplicity is one of the oldest Respironics masks. There is very little to it. It needs some "fixes", simple "fixes" but "fixes" nonetheless. For most of us the center strap of the headgear is too long. The velcro is not tapered and can really rub your neck raw unless you are extremely careful when adjusting the straps or better yet take a pair of scissors and taper the velcro yourself. Its great that you can position the hose above your head w/a provided clip, towards your chest or wherever, as the swivel swings very free and easy. Just because it works great for me doesn't mean it will work great for you. You will have to try the various Mask Fitting tips w/the Simplicity just as you will ANY nasal or full face mask.

http://www.mymedicare.com

jomac30 · Post by **jomac30** » Sat Oct 13, 2007 6:28 pm

I like the idea of no straps on my cheeks so I will stay with the comfortlite 2.
I will try the mouth taping. Thanks a lot

Goofproof · Post by **Goofproof** » Sat Oct 13, 2007 7:24 pm

As far as the data system It's three parts, Your "M" Pro's smartcard, the software, and the card reader (DT-3500) and your computer of course.

mollym · Post by **mollym** » Sat Oct 13, 2007 8:27 pm

jomac30 wrote:I like the idea of no straps on my cheeks so I will stay with the comfortlite 2.
I will try the mouth taping. Thanks a lot

I really like the CL2 because of no straps on the cheeks also.
Once I started seeing statistics with the APAP recently I discovered
that I had way more leakage using the simple cushion than the
mask documentation said to expect. It doesn't leak when I am
awake and holding still. I tied a strap around my head about
eye level to keep it from moving out of place when I moved
from side to side. I also added a chin strap. With those two
changes the leakage statistics are back down much closer to
where they belong. The chin strap isn't as "sturdy" as taping,
but my pressure is low enough it seems to work OK.

Slinky · Post by **Slinky** » Sun Oct 14, 2007 9:22 am

A chin strap is where you learn whether your high leaks are caused by actually mouth breathing or if they are caused by the "lip flutters". I had no problem w/mouth breathing but I did have problems w/those doggone "lip flutters". A chin strap is absolutely no help w/the "lip flutters" whatsoever. Mouth taping can "cure" both mouth breathing and the "lip flutters". But if it is "just" the "lip flutters" the less drastic method of using a thin layer of PoliGrip gel works well.