Newly diagnosed - what am I doing wrong?

[scottjf8]

I just got diagnosed and got my machine Friday - the ResMed S9 Elite with the Nasal mask (not the nasal pillow). I have mild OSA.

Both mornings I've woke up with a really stuffy nose. This morning I woke up at 5am with such a stuffed nose, I was mouth breathing, and had a terrible sore throat and dry mouth (which I'd expect). I ended up taking the mask off and sleeping w/out it on the couch.

I've got my pressure at 7 per my doc, and I tried the humidifier at 3, and last night moved it down to 2. Should I crank it up?

I live in Texas where it's 100 degrees, but not terribly humid out.

Any suggestions welcome.

[Dojers]

Turn up your humidifier - especially if it's dry where you are. You may also need to look at a full face mask if your nose is getting stuffy. Your mouth is getting dry because you are opening your mouth to breathe when your nose stuffs up. Temporarily, try getting some of the paper tape in the bandaid section to help keep your mouth closed while sleeping with your nasal mask on with your humidity turned up. I, personally, would turn the humidifier all the way to 5 to start (it's where I keep mine all the time) and then drop to 4 if it turns out too much. If you're still finding your nose is plugging, get a full face mask because you're going to need a way to breathe through your mouth - oh, and btw, don't tape ALL of your mouth closed - leave the corners open so you can get some air in - just close the front of your lips if you feel like you need the ability to breathe through your mouth. I do that in my Liberty (a "hybrid" type mask that is full face but has nasal pillows instead of a nasal mask type over the nose) except I cover the corners and leave the center of my lips open for air. Check whichever one works best for you if you find you are still getting stuffy. You may prefer taping the corners and leaving the center of your lips open as well.

I close the corners because in my full face mask, I get chipmunk cheeks if air gets in that way which gets annoying when you're trying to sleep. In a nasal mask, you won't have that problem. Give it a shot and see how it works. If it works for you, I would recommend a chin strap. But only when you find out if your nose clogging goes again. No sense spending the $$ on a strap if your nose is going to continue clogging. Good luck and let us know how you make out. It helps others when they run into the same problem.

Edited to add: opening your mouth with a nasal mask on means all that air going into your nose is rushing through your mouth and drying it out really bad. That's why it's so dry.

[Pugsy]

Some people need more humidity. Some people need less.
If last night lowering to 2 made the nasal congestion worse then I would try higher
BUT
you say you have dry mouth and sore throat and you are mouth breathing then it is highly possible that your mouth is falling open during the night allowing exchange of air and especially leakage of the pressurized air. It goes up the nose and exits out the open mouth and doesn't really get to the part of the airway it needs to get to.

If you are mouth breathing no amount of added humidity will fix the dry mouth and sore throat. Plus you are losing therapy.
You will need to work on keeping mouth closed for sure. Chin strap, tape or full face mask.

The stuffy nose can be helped with humidity though. You may need more. This preference is highly individual and you will just need to try more vs less to see which works best for you.

[chunkyfrog]

If you got your mask from a local DME, please be aware that you should be able to try masks for up to 30 days with full return privileges.
They are reimbursed for the masks they take back--don't let them tell you otherwise.

[scottjf8]

If you got your mask from a local DME, please be aware that you should be able to try masks for up to 30 days with full return privileges.
They are reimbursed for the masks they take back--don't let them tell you otherwise.

The DME is great. I'm gonna call them in the morning

[scottjf8]

Evening crowd bump for other suggestions/ideas...

[Muse-Inc]

I used a pillow mask for almost 2 yrs and had to run at 75% of max humidity to keep my nasal airways from drying out. Lost about 45#s and starting losing therapy air via loose lips and hadda switch to a FFM. My choice was the RespCare Hybrid Universal...pillows and an oral cushion that allows mouth breathing but no loss of therapy air -- comfortable too. When I switched masks, I had to reduce humidity to the bottom third of the settings. Dry air running thru nasal tissues will likely dry 'em out. Dry mouth means you're losing therapy air meaning you need a FFM, chin strap, or try a soft-foam cervial collar -- these are in reverse order of expense. Good luck!

[Twentysix]

My nose blocks up often around 4 or 5 pm, BUT it does that too when not sleeping with the machine. Also depends on what side I am sleeping on, so maybe try your other side and see if that makes any difference? Good luck!

[scottjf8]

Cranked up the humidifier last night and it was better, but I was still up at 5:30am.

I talked to the DME today, she thinks I'm still trying to mouth breathe, so she's loaning me a full face mask for a week to try. See if that works better.

[archangle]

Cranked up the humidifier last night and it was better, but I was still up at 5:30am.

I talked to the DME today, she thinks I'm still trying to mouth breathe, so she's loaning me a full face mask for a week to try. See if that works better.

Have you tried a chin strap? If you can avoid mouth breathing, a nasal mask is MUCH better than a full face mask in several ways. If necessary, just try a 3 inch non-adhesive Ace bandage wrapped under your chin up over the top of your head to keep your mouth closed while asleep.

By the way, please go into your profile under control panel and fill in your equipment so we can help you better.

[scottjf8]

Sorry for the newbie question, but why is a nasal so much better?

[Bright Choice]

Keeping your nasal passages open is critical to achieving effective xpap therapy. In addition to determining the right humidity, the right mask, whether or not a chin strap is necessary etc, work on keeping your nasal passages open.

Take a look these two informational pieces. Both are really great.

http://sleeptreatment.com/allergy-video-series - Dr. Barry Krakow's videos on nasal breathing

http://doctorstevenpark.com/unstuff-your-stuffy-nose - Dr. Steven Park's free pdf on "Unstuff Your Stuffy Nose"

I use a neti pot to keep my nose clear. It is not as difficult as it might seem. There are threads here about nasal congestion - research them. Recently I have found that using sesame oil to keep my nostrils and sinuses clear has been as effective as any of the RX's recommended or any of the over the counter solutions. Just research solutions on this site and do some experimenting.

Good luck! Your are in the right place. There are wonderful people here who will help.

[BlackSpinner]

Sorry for the newbie question, but why is a nasal so much better?

It takes less room on the face (less places to leak or irritate) and it is better for the nasal passages according to my ENT. Since there is no way to keep my mouth closed i use the Hybrid mask.

[kongjie]

Like some other poster suggested, could it be that your nose always ends up being somewhat stuffed early in the morning, and that you're noticing it now because you have to breath through it? The neti pot has worked for me but in a situation where I needed to have my sinuses clear at night, before I put on the mask.

Could you have some hay fever issues that is causing this? Is the pollen filter intact on your machine?

I have pretty bad allergies so have to take a pill through the summer and also do Flonase in the a.m. Otherwise my sinuses would be too full to breath with the mask on. Under this regimen, I don't have a problem, with one exception.

On occasion I have dreams where I end up crying. So maybe 3 times over the last year I've had to rip off the mask in the early morning because I've been crying in my sleep and my sinuses are completely clogged. This sounds quite sad, but things aren't that bad LOL.

[archangle]

Sorry for the newbie question, but why is a nasal so much better?

There's a smaller contact area, so it's easier to get a seal. (Maybe.)

You can open your mouth to talk. Or even eat, take a pill, or drink water if your mouth is dry. You can cough more easily, etc.

It's less "invasive" and claustrophobic to some people. Perhaps more comfortable as well.

A full face mask presses back on your jaw. This can make apnea worse. You may need more pressure. Maybe. And maybe for some people and not for others.

Some people think you need more pressure with a FFM because you have more dead air space in the mask to flush out.

It's supposed to be better to breathe through your nose than through your mouth.

The larger surface area means more force from the pressure. You need more pressure on the straps.

However, if you have mouth leaks you can't fix otherwise, a full face mask may be your best answer. If your nose gets clogged, its FFM or nothing. I use a nasal mask, but I also have a FFM for just this reason. I've never had to use it in 7 years of CPAPing.

I think a full face mask should always be a last resort, however some people may like them better. I think lazy DMEs give them out so they don't have to deal with mouth leaks, chin straps, mask swaps, etc.