Star date 64827.9 - CPAP Night 1...Questions...

[causticcompliance]

Wow... got my S9 home last night...set it all up and off to nighty-night I went.
and oh how blissful it was...well kinda...
Got in bed at 8:00P, fell sleep around 8:30P woke up around 11:30P (not sure why really, just woke up)
Back to sleep around 12:30A woke up around 3:00A and that was that. Couple of strange minor interruptions during that time but I am fully charged and wide awake...I was whistling in the shower at 3:30 in the morning. It was great. I did run into some questions/issues/concerns and am really hoping for some feedback from all of you...pretty please?

1) INTRO - I got the Swift FX nasal pillow (Thanks Robysue, Pugsy and others - it is almost unnoticeable and so gentle on my little nose ) and some sort of generic chin strap thing that I am thinking doesn't work. Not sure but as I fall asleep, my mouth stays closed (teeth together) but I think my lips separate from the pressure through my teeth. I believe that may have been what caused the small interruptions I experienced. Sleep was far better than without the CPAP of course but still not the quality and duration of sleep as I am working towards.
QUESTION. - I read in a couple of posts how people are using some sort of tape or something over their mouths to keep their lips from allowing pressure to escape but I am uncertain of exactly what is safe to try etc. Could someone point me in the right direction on this? Methods used, tips, links etc?

2) INTRO - I finished a fairly decent sized dinner last night around 5:30P which was a good 2 1/2 hours before bed. It wasn't anything spicy or acidic. Basic chicken and veggies but I noticed at my 11:30P and 3:00A wake up times that...uh well... I was "eminating odorless fumes from the rear" <sigh> and my tummy felt a little distended and bloated. I have a feeling I may have swallowed some air and after some minor research here it sounds like it might be "Aerophagia".
QUESTION - Could this be caused by my first questions issue of pressure escaping through my lips? If not, are there any tips to try to prevent or reduce the aerophagia? Honestly it isn't terribly bad (little discomfort) and actually kinda funny when my "butt burps" but I am concerned about any secondary health issues that could come up because of it.

3) INTRO - As comfy as my FX Nasal Pillows are, and I do hardly notice them, I feel a very slight irritation, this morning, on the lower edge of my nostrils just at the top of my upper lip. I would like to believe that this is simply because the device is new and foreign to my skin and that will eventually just go away...but just in case...
QUESTION - Is there anything I might do if the irritation gets worse that can help ease that? I really like the simplicity and unobtrusive style of the FX and plan on sticking with it so I am hoping a recommended salve, gel or something can help ease the issue if it gets worse?

As sick as this may sound (I would certainly prefer not to have Apnea) this is really kind of interesting and fun to learn/experiment with. Especially with all of you out here having so much good info on the subject.

Thanks a bunch for reading and I look forward to any info you all may have to offer.

Regards,

Cc

[cflame1]

try this post for directions with taping:

viewtopic.php?t=7952

folks either use a medical tape or a blue painters tape.

[JointPain]

Wow... got my S9 home last night...set it all up and off to nighty-night I went.
and oh how blissful it was...well kinda...
Got in bed at 8:00P, fell sleep around 8:30P woke up around 11:30P (not sure why really, just woke up)
Back to sleep around 12:30A woke up around 3:00A and that was that. Couple of strange minor interruptions during that time but I am fully charged and wide awake...I was whistling in the shower at 3:30 in the morning. It was great. I did run into some questions/issues/concerns and am really hoping for some feedback from all of you...pretty please?

For a first night you did really well. Congratulations you lucky devil.

1) INTRO - I got the Swift FX nasal pillow (Thanks Robysue, Pugsy and others - it is almost unnoticeable and so gentle on my little nose ) and some sort of generic chin strap thing that I am thinking doesn't work. Not sure but as I fall asleep, my mouth stays closed (teeth together) but I think my lips separate from the pressure through my teeth. I believe that may have been what caused the small interruptions I experienced. Sleep was far better than without the CPAP of course but still not the quality and duration of sleep as I am working towards.
QUESTION. - I read in a couple of posts how people are using some sort of tape or something over their mouths to keep their lips from allowing pressure to escape but I am uncertain of exactly what is safe to try etc. Could someone point me in the right direction on this? Methods used, tips, links etc?

Try just keeping your mouth gently closed and resting your tongue on the roof of your mouth just behind the teeth. It will be the tongue that makes the seal. Of course, during the night your tongue might move and having the lips closed is a good back up plan. I just went to my local CVS pharmacy and they had a range of different sticky medical tapes. I chose 1" Nexcare Flexible Clear tape, which says on the back its hospital name is 3M Transpore Surgical Tape. I fold the end 1/4 inch over on itself so there's an easy to grab handle for taking it off in a hurry if I need to. Actually, I do that on the roll side of the tape so it's also a handle for getting the tape off the roll the next night. Roll the lips in before you tape so you're just taping skin.

3) INTRO - As comfy as my FX Nasal Pillows are, and I do hardly notice them, I feel a very slight irritation, this morning, on the lower edge of my nostrils just at the top of my upper lip. I would like to believe that this is simply because the device is new and foreign to my skin and that will eventually just go away...but just in case...
QUESTION - Is there anything I might do if the irritation gets worse that can help ease that? I really like the simplicity and unobtrusive style of the FX and plan on sticking with it so I am hoping a recommended salve, gel or something can help ease the issue if it gets worse?

I use a drop or two of Astroglide on the nostrils (unscented KY jelly is also recommended here) just before putting on mask. It seems to reduce a slight irritation I feel wearing the mask and helps make a better seal. That might help. I had a slightly different issue (tenderness at the top of the nostril) that went away after a few days.

[Pugsy]

Another choice for moisture and protection for tender nostril area is Lansinoh. A thick ointment market for nursing mothers as protection for sore nipples. Usually found in the baby section of Walmart. Lasts forever in the tube because only small amount is used. It protects well and acts as a bit of a sealant also when used at night with the mask.
Barrel cozy from Padacheeks will help also. Very soft and limits the amount of friction against the silicone. With time minor tenderness from the nasal pillows will decrease to nothing. If it hurts too much, they are too tight.

The gas issue? You can try sleeping on your side or stomach. This acts like sort of a road block to prevent the air from entering stomach. Not foolproof but will help. Medically the gas or minor aerophagia is not harmful other than potential discomfort. Annoying yes, but not harmful in the sense of doing damage to the body.

Try practicing the tongue to roof of mouth trick. With time it becomes a habit and acts as a good barrier to prevent the lip flutters and chipmunk cheeks. Use tape in the meantime. I can actually do a wide open yawn while masked up and no air escapes from the mouth. It does work and some people can learn to keep mouth shut and not have to tape for the rest of their lives. I did.

Congratulations on clearing the first night hurdle. You did better than a lot of people do. It will get better and easier as time goes by.

[causticcompliance]

I really am "lucky" or as I like to say blessed in that my apnea is mostly mild (11 after falling asleep then 30 during any REM stage)
Really I do believe that may be the reason why it has been so easy the 2 times (the second was last night) I have been on a CPAP.

I will try the tape and tongue thing simultaneously, thats actually a good idea in the hope that I won't need the tape eventually and if the tongue thing doesn't work, I am at least that much closer to being comfy with tape already.

So could the Aerophagia be caused by the open lips issue or could there be something else happening while I am asleep?

[Pugsy]

So could the Aerophagia be caused by the open lips issue or could there be something else happening while I am asleep?

It could be open lips.
It could be the air going down the airway and making a slight detour into esophagus and a weak sphincter at the opening of esophagus to stomach lets the air in. Sometimes that area of the distal esophagus has some damage from prior GERD, sometimes it is just a bit weak, so lets only a little air in, sometimes a lot weak and a lot of air gets in causing more than minor discomfort....

The worst case of aerophagia I ever had was when I let myself use a Full face mask and breathe through my mouth, so I do think that mouth breathing (which is mouth you have with the lip flutters but not as huge as large mouth breathing issues) can be a contributing factor.

I do have a history of GERD so maybe I have a bit of damage to distal esophagus. I do on occasion even now have a tiny bit of aerophagia because some mornings I just have to expel more gas than other mornings and I can't blame it on tacos or beans. Other mornings, nothing at all. Other than the one time with the full face mask, it has never been painful. With the full face mask it was horrible, pain, basketball belly, nausea and farts that would make a truck driver blush.

If you only have minor discomfort, I would not worry about it. If you have history of GERD and it persists enough to be more than annoying you can try some of the usual GERD tricks to see if aerophagia symptoms lessen. I take Prilosec.
Raising the head of the bed didn't help me but others it does help. Remember air rises so if bed is elevate the air will rise and there is good chance it will stay in stomach to be relieved by large belch.

Finally even those people who have maybe more aerophagia than usual do report that with time it seems to lessen on its own as the body adjusts to the air pressure.
For those people with huge aerophagia problems sometimes other things need to be done like lowering the pressure a bit and slowly increasing pressure after body has become more adjusted. Severe, severe aerophagia can warrant a different type of machine.

Since you mention this in passing and it doesn't sound like you were in extreme distress (you would know) it sounds like you are like me, minor annoying gas and I bet with time, it lessens and only happens occasionally.

[robysue]

1) Sleep was far better than without the CPAP of course but still not the quality and duration of sleep as I am working towards.

CPAP is a process, not an instant fix after all. It sounds as though you are off to a good start!

2) INTRO - I finished a fairly decent sized dinner last nigh at around 5:30P which was a good 2 1/2 hours before bed. It wasn't anything spicy or acidic. Basic chicken and veggies but I noticed at my 11:30P and 3:00A wake up times that...uh well... I was "eminating odorless fumes from the rear" <sigh> and my tummy felt a little distended and bloated. I have a feeling I may have swallowed some air and after some minor research here it sounds like it might be "Aerophagia".
QUESTION - Could this be caused by my first questions issue of pressure escaping through my lips? If not, are there any tips to try to prevent or reduce the aerophagia? Honestly it isn't terribly bad (little discomfort) and actually kinda funny when my "butt burps" but I am concerned about any secondary health issues that could come up because of it.

Sure sounds like aerophagia to me. Yes, the air escaping through the lips might be a problem---particularly if the lip leak is "minor" one in that you also are experiencing chipmunk cheeks---i.e. the machine is pumping MORE air into the system (to compensate for the air leaking out of the lips) than is actually leaking out of the lips. And to relieve the pressure in the mouth you may be unconsciously swallowing that air in your sleep.

For some folks, the aerophagia naturally starts to relieve itself as the body acclimates to the air being blown up your nose all night. For others, aerophagia is an on-going battle. For me, it now comes and goes---seems to be tied to the pressure increases that my BiPAP Auto goes through when the allergies are acting up.

You might find trying to increase that time between supper and bedtime up to 3 hours (or more) if possible. When my aerophagia was at its worst, I needed a full 4 or 5 hours between "last food" and bedtime. Not easy or possible for most folks, but that and a pressure reduction were all that I found helpful.

3) INTRO - As comfy as my FX Nasal Pillows are, and I do hardly notice them, I feel a very slight irritation, this morning, on the lower edge of my nostrils just at the top of my upper lip. I would like to believe that this is simply because the device is new and foreign to my skin and that will eventually just go away...but just in case...
QUESTION - Is there anything I might do if the irritation gets worse that can help ease that? I really like the simplicity and unobtrusive style of the FX and plan on sticking with it so I am hoping a recommended salve, gel or something can help ease the issue if it gets worse?

I'll second Pugsy's suggestion of lanisoh. In addition to protecting your nostrils, it may help you get a better seal on the pillows since it's just a bit tacky in feel. Also getting a barrel cozy from Padacheek may help if some of the problem is being caused by the silicone in the pillow barrel hitting your cheek.

In addition to the pillow itself causing irritation to this spot, it can also be caused or aggravated by the exhaust flow bouncing off the covers and back at your mouth OR if you get condensation in the pillows that starts to leak out around the seal OR if you start drooling. So you'll want to protect the lips as well as something for that area between the nose and the lips themselves. Lanisoh will work. As for chapsticks/lip balms: During the day it doesn't much matter, but at night you will want to try to find something that is petroleum free OR at leas has petroleum way down on the list of ingredients.

[causticcompliance]

<waving> Hi everyone, missed talking out here... I am back from vacation. Great time just relaxing at the beach and enjoying the warm Myrtle Beach sun and breeze.

I am on night 8 of 14 with my CPAP (doc won't let me do APAP but it seems fine so I am not pushing it, yet).
Yes I know <sigh> night 8 of 14 you say? That's because I am a knucklehead and didn't use the thing on my vacation, and let me tell you, that will never happen again. Whew, it took me two days to get back to just feeling mildly miserable. Still had a great vacation till the last day though. I just didn't want everyone we were staying with seeing me get up to pee in the middle of the night looking like Hannibal Lecter from Silence of the Lambs...but the heck with that, they will just have to deal with it next time

So now in my 6th night and I can finally recall lots of dreams I had, and good dreams with a pretty decent straight 7 hours of sleep.
Which brings me to my first question...

I am watching my AHI's etc on just the S9 display (software is not all setup yet) and they have been staying fairly low (1.x) each night until last night. I had an AHI of 4 in 6.9 hours of sleep. I am wondering, does anyone else see a higher AHI and remember lots of dreams that night they got the higher AHI? It was the first night that I have had a complete 7 hours of pure sleep (that I don't remember waking up during anyway) with lots of good dreams and this has occurred.

Oh and the tips on aerophagia, taping and seal with my tongue are helping a lot. Only 2 mornings of bloat and "rear howitzer fire" since you all made the suggestions. I think I still need more practice of course, and maybe a better chin strap, but definitely helping. Thanks a bunch to all.

Hope someone can answer the AHI question. Thanks again.

Regards,

Cc