New CPAP issues and rainout. HELP!

[DigDugSlug]

I was diagnosed with sleep apnea about 12 years ago. I used a CPAP religiously and had good sleep hygiene for 3 months but felt absolutely no benefit from using the machine. At the time, my sleep doctor said there was nothing else that could be done, so I frustratingly stopped using the machine.

So, I lived with it, but not well. Recently the frustration of never having a restful night's sleep in 12 years has really taken its toll. As you all know, it's difficult to concentrate, I want to nap all the time and just have a hard time functioning in general. It's ruined my life. So, I finally went to another sleep clinic recently and started using a new CPAP machine again. I still don't feel the benefit of the machine, but this doctor seems a lot better than the first and wants me to keep at it.

Admittedly, my sleep hygiene is not the best, but I'm trying. In the meantime, I've been having a number of issues with the machine and I'm wondering if anyone has suggestions.

I'm using a ResMed Elite II with a MIrage FX mask and non-heated tube. When I don't use the humidifier, I wake up with air pouring out of my mouth. So the doc gave me a chinstrap. The chinstrap is not very comfortable and it seems like I might not need it when I use the humidifier.

BUT when I use the humidifier, I keep having problems with rainout. I'm not sure if I totally understand how to use the humidifier properly. At my doctor's suggestion, I'm now keeping the unit on the floor. I never fill the reservoir above the fill line. I just started to use a fleece hose cover, but I'm still getting water splashing me and waking my up several times in the night. Not fun. I currently have the humidifier set at 3.5, but it seems that if I have it set much lower, then my mouth dries out.

I'm wondering If anyone has suggestions or ideas as to why I've never been able to wake up feeling even the slightest bit rested after using the CPAP? I've read that some people have had success with an APAP, do you think that is an option? My doctor seems to think that if my sleep hygiene is more consistent then that will fix the problem. But I'm skeptical because when I did use the CPAP the first time and had excellent sleep hygiene, I still felt the same waking up as when I didn't use the machine.

And if anyone has additional tips on how to decidedly prevent rainout. It's really frustrating and making me want to stop wearing the mask.

Also, what kind of card reader do i need to be able to read the ResMed memory card? I want to use the Sleepyhead software on my Mac but am unsure if standard card readers accept these cards.

Oh, apparently, the machine is doing something as the number of events has dropped from 12 to 8 I think, but I don't feel anything. I still wake up feeling as if I haven't slept at all.

Thanks for any help!

[kaiasgram]

Hi DDS, welcome! Can you use the ResMed Climateline heated hose with your Elite machine? If so, I'd recommend it. You may not need to lower your humidity if you use the heated hose. I get a bit of condensation in the a.m. inside my mask, but no problems with water waking me up ever. I think it's because of using the Climateline. I use a cotton Q-tip in the a.m. to dry up the moisture inside my nasal pillow mask.

Humidification won't take care of dry mouth if the problem is mouth-opening at night. Even with good humidification, if you have significant mouth leaks you'll get dry mouth. You mentioned using a chin strap but as you'll read here, many people still mouth-leak even with a chin strap, and as was the case for you chin straps can cause jaw soreness. A lot of people either go to a full face mask or find other ways to prevent mouth opening.

So in addition to seeing if you can use a Climateline hose I'd recommend getting that card reader (my Mac has a built-in card slot so I'm not sure which external reader you need) and looking at your leak data. The AHI value can get distorted if you have too much leaking, and of course you won't feel a whole lot better if your sleep is being disturbed by frequent leaks. When you can start seeing in more detail what's happening with your therapy you will be able to find more targeted solutions.

Also, I'm convinced that for the majority of people it takes a while -- sometimes a long while -- to recover from years of untreated sleep apnea. I'm willing to bet that the first time around you were not able to monitor your therapy and probably had no way to figure out why you were not feeling better. Stick around here and you'll find a wealth of information and ideas for making it work this time. Best wishes.

[Chikorita]

Hello and welcome. I've not got any advice for you except to say there are a lot of wise people here who will be along to encourage you. Hang in there.

[Pugsy]

The ResMed Elite II is very likely the S8 model machine...that would go along with the humidifier you have chosen.
It won't work with SleepyHead but you can use ResScan.
If your "numbers" that have gone from 12 to 8 are the AHI numbers...8 isn't low enough and likely would explain part of why you don't feel so great. We like to see less than 5 AHI.

I suspect your machine uses this smart card.
https://www.cpap.com/productpage/resmed ... -card.html
If so then you need this smart card reader
https://www.cpap.com/productpage/resmed ... -cpap.html
Only place I have see in for sale is on EBay from a guy in Israel.

The ClimateLine heated hose that has been mention will NOT work with the S8 models. You would need an upgrade to the S9 model. To make sure that you have a S8 model just click on my machine link in my profile and compare your machine to mine. If yours looks nothing like mine (which is a S9 model) then you have the older model.

If the addition of the fleece hose cozy doesn't help prevent the rain out then you may need to do something at the mask level. Our own exhaled breath contains moisture and when it gets out into the cooler aired mask it can condense in the mask despite having things well covered at the hose level. I use a barrel cozy from Padacheeks to help insulate my nasal pillows because I still get rain out from my own breath and I am using a heated hose. The air in the mask just cools down to quickly and the moisture gets released.

I'm wondering If anyone has suggestions or ideas as to why I've never been able to wake up feeling even the slightest bit rested after using the CPAP? I've read that some people have had success with an APAP, do you think that is an option? My doctor seems to think that if my sleep hygiene is more consistent then that will fix the problem. But I'm skeptical because when I did use the CPAP the first time and had excellent sleep hygiene, I still felt the same waking up as when I didn't use the machine.

No way to know but the mention of an 8 number if it is AHI points to less than optimal therapy for some reason. Might be leaks...might be suboptimal pressure. There's a huge list of things that can mess with how we feel the next day.
First thing to do though is make sure that the therapy part is at least optimal. If you wake up often for whatever reason you won't feel great even with good numbers. The cpap machine fixes sleep apnea stuff. If you have bad sleep hygiene issues it won't fix those.

First thing to do would be get a handle on whatever data you have available on the machine......
Consider investing in the smart card reader so you can have access to ResScan software for a more indepth evaluation.
Stat with the basics and the basic data..then start looking at other possible culprits. Most of us aren't so lucky that the only thing that messes with our sleep is OSA.....we normally have a bunch of other stuff messing around too.
Hours of sleep, fragmented sleep, short time on the machine, mask issues, leak issues and a bunch of other stuff not directly related to OSA.

[rjm]

I use the same machine S8, and all i did was change the humidifier setting(H4i) to "1", and the rainout is gone. When the weather warms up i set it to "3", and that works for me. I use the FX nasal pillow system. Try that. Good luck!