one more newbie

[wearysoul]

Another newbie here—a 53-year-old male. I weigh about 152 lbs and am 5 ft 10 in tall. I have mild/moderate sleep apnea. The prescribed pressure is 6 cm.

I usually fall asleep quickly. But on my first night, I couldn’t sleep. I had trouble getting my headgear and mask adjusted properly. I don’t think I ever really got it right, for I kept hearing and feeling leaks. Seems I’ve read that some leakage is normal, though.

I also had trouble breathing. At times it felt as if the machine wanted me to breathe faster than I wanted to. We just weren’t in sync. I couldn’t seem to relax into a normal breathing pattern. I’m wondering if some of that may have been due to the 15-minute ramp that the DME set for me. Or maybe the leaks contributed to this issue.

In spite of being highly motivated, I was more anxious than I thought I’d be about connecting to “the hose.” So I wonder if my anxiety contributed to this experience. I stayed on the machine for a little over two hours and decided to quit. I wasn’t really sleeping—just dozing a bit—and I didn’t want to go on like that all night.

I felt worse than usual the next day. So I decided to take the second night off. I thought that maybe I would do better to just ease into this. I wondered if I was putting a lot of pressure on myself to perform, and if this was making it even harder for my mind/body to adjust to this new contraption.

Last night, I tried it again and I think I made a bit of progress. I took an Epsom salt bath before bed to help me relax. In spite of the bath, I had a headache when I went to bed so I took a Tylenol. I got the headgear and mask adjusted better and it felt like a better fit. No leaks, except at the joint where the hose connects (and maybe those are normal). And after my ramp ended, I slowly slid into a more normal breathing pattern. I’m now thinking I may not need the ramp. I even slept a little, but kept waking up. The headgear/mask felt a little too tight and the headache seemed to come and go. After about 2 ½ hours, I decided to quit for the night. But I feel more encouraged now. Maybe I’ll make it 3-4 hours tonight.

Maybe some of you can offer some practical advice or words of wisdom? I’ve already read a bunch of stuff on the forum, but feel I’m still at the bottom of a pretty steep learning curve. Thanks!

[ozij]

)Welcome, oh wearysoul!
First of all - remember you are not alone. Many of us - I'm one of them - went through similar experience in the beginning.

Second - masks don't have to be tight, certainly not to the point of hurting. They have to be snug - and gauging the difference is an art you acquire with time.

Third: The way you route your hose effects the masks stability. It boils down to what feels good for you - for me the hose has to dangle from above my head. A girl's hair elastic around the hose, a (clean, new ) shoelace tying that to a hook somewhere above my head made a big difference for me.

Fourth: The pillow you lay you head on also makes a difference.

Be patient - it takes time to learn this new way of sleeping --

Good luck!
O

[jdm2857]

Every mask is designed to lead a certain amount of air to allow exhaled CO2 to escape. Look at the mask where you felt the leak. You'll probably find small holes there.

I have not experience this, but many forum users complain that if a ramp is set to too low of a pressure they feel that they cannot get enough air. So if your ramp is set to start at 4, you may want to bump it up to 5 or even 6. Many users find that they can turn the ramp off altogether after a few days, but if it makes you more comfortable it really does no harm.

If you don't know how to adjust your machine, post back, and someone will give you the secret incantation.

[computerguy2202]

Hi and welcome;

It does take time to get use to the equipment...after all how many years have you been sleeping without anything on your face? Everyday gets better and you will get use to where the mask goes, the best place for the hose, ramping, etc.. I have my ramp starting at 7 and goes to 17 in 5 minutes. Within the 5 minutes I can adjust the mask, if needed, and get settled in before the machine blows my face off Don't give up, give it time, and use it every time you sleep.

[twokatmew]

I started at 7cm two weeks ago, and I tried the ramp at first. I ended up turning it off, as I felt like I wasn't getting enough air. I'm still waking with headaches and a sore right eye, but I manage to keep the mask on all night. (I do spend a bit of time lying there waiting for sleep to whisk me away.) I'm now at 9cm and still have the ramp off. I think it might be helpful with higher pressures, but I found at such a low pressure, the ramp is more hassle than help.

Welcome!

[LinkC]

Welcome, brother hosehead!

Know that mask leakage is rarely (if ever!) solved in one night. Some of us have been thru SEVERAL masks and almost infinite adjustments before conquering them. But it will come.

If the out of sync breathing issue remains, it's probably the result of a "breath relief" feature (called C-flex on Respironics machines) which lowers the pressure during exhale. The problem is, it senses the slowdown in your exhalation and starts restoring pressure before you finish exhaling. The idea is to provide full pressure for the entire inhalation. Some people have trouble finishing their exhale because the pressure is already being reapplied. If that sounds like your situation, you can turn the feature down...or off.

Your leak "at the joint" may actually be that...OR it may be the normal operation of the mask exhaust port, which is often in that area. (Dunno what mask you have...) It allows the incoming air to flush out the CO2 so you don't breathe it right back in. But there ARE certain masks that are prone to leaks at the swivel fitting. (The fix is fairly easy, involving teflon plumbing tape, but we won't get into that unless it's an actual leak there.)

As ozij suggested, it's common for "rookies" to adjust their masks too tight at first. Most masks are designed so that the "skirt" inflates and internal air pressure makes the seal. If you can't feel that happening when you turn the air on, then you may be too tight. Many times, LOOSENING the straps will stop a leak (I know that's counter-intuitive, but it happens.) Experiment...

Good luck with your new "adventure"!

[twasbrillig]

Weary soul, good luck! I just wanted to put in a word for good sleep hygiene as you are getting mask and other issues adjusted. Even though you may not have needed to do this before, the extra stress of sleeping with a mask on might require this approach:

1) cut back on or eliminate caffeine
2) exercise briskly for a little while almost every day
3) avoid a nap unless you are so tired you can't work, drive, function, etc
4) do something relaxing before bedtime (I recommend some do-it-yourself yoga - you can learn some basic stuff from a book)
5) a warm bath is a good idea (Your body temperature has to drop for you to sleep. If you raise your temperature with a hot bath or shower, it makes it easier for your temperature to drop as you fall asleep...)

Hope this helps. You are right about the learning curve, and I think you have come to the right place to learn. CPAPtalk is a place where people are focused on educating and helping each other. I have been to other forums, and this one is THE BEST!

[timbalionguy]

IMHO, your pressure might be too low to be comfortable long-term. Many people here have had problems with pressures below about 7. A little extra pressure won't hurt most people, so ask your doctor about that.

My doctor recommended that the machine should come on at full minimum pressure, even though an autoadjust range was specified. This was good wisdom. My lower pressure was 10, and it did not take me long at all to get used to 10. It also helped me diagnose leak problems early on before moving on to higher pressures.

[RipVW]

Hello & Welcome, wearysoul! Glad you found this forum—SO much useful info and everyone here is so willing to help!

You're lucky to have found this forum as you begin CPAP--took me almost year before I found this place and, with the help of folks here, got my CPAP therapy working as it should. It does take time to get everything tweaked and working at its best, so patience is key as one begins CPAP.


"You are getting sleepy . . ."

[wearysoul]

)Welcome, oh wearysoul!
First of all - remember you are not alone. Many of us - I'm one of them - went through similar experience in the beginning.

Second - masks don't have to be tight, certainly not to the point of hurting. They have to be snug - and gauging the difference is an art you acquire with time.

Third: The way you route your hose effects the masks stability. It boils down to what feels good for you - for me the hose has to dangle from above my head. A girl's hair elastic around the hose, a (clean, new ) shoelace tying that to a hook somewhere above my head made a big difference for me.

Fourth: The pillow you lay you head on also makes a difference.

Be patient - it takes time to learn this new way of sleeping --

Good luck!
O

Thanks for the tips, O. I fiddled around with the hose last night, and I can see how it would work better dangling from above my head. That's definitely on my "to do" list.

[wearysoul]

Thank you for your reply. I turned the ramp off last night and it didn't seem to have hurt anything. It may have even helped. I'll continue without it and see how it goes. wearysoul

[wearysoul]

Thanks, computerguy, for your reply. And thank you to all the others who also replied. I'm blown away by the warm welcome I've received. And the comments have been very useful. I'll keep you posted on how it goes. wearysoul

[rested gal]

Thanks for the tips, O. I fiddled around with the hose last night, and I can see how it would work better dangling from above my head. That's definitely on my "to do" list.

Welcome to the message board, wearysoul. Cool nickname, btw.

Here's a link where you can get lots of ideas from simple to elaborate, for hanging the air hose out of the way:

LINKS to Hose hangers and methods of managing the air hose
viewtopic.php?t=10640

[DoriC]

Welcome. Glad you found your way here. As the spouse and "in-house cpap specialist" , I was able to observe that my hubby's breathing pattern did not match the Cflex mode(your machine has EPR). and the pressure was increasing before he had completed his exhale. At first we lowered it to the minimum (1) because it did help a bit adjusting to the mask, pressure,etc, but we very soon turned it completely off and he and his machine are now in sync. Pressure=12cms. Good luck.