A rough but encouraging first night

[NotLazyJustTired]

Firstly, I logged over 4 hours on the new machine for my first night. I am declaring that a victory.

I did have some challenges with the mask and maybe someone here can help me with that. As I stated in my other thread I took a nap when I got the machine home and had zero issues with mask fitment and slept for an hour very soundly. Felt like a million bucks when I woke up. Last night was not so smooth.

For starters, the DME did not give me the appropriate headgear for the Swift FX nasal pillows, it is on order though, expected in about a week. The headgear I am using are the ear straps, little elastic bands that go around the ears. I was a bit skeptical of this working since I do have a tendency to roll over a lot.

So last night I get the mask on and fire the machine up; it's the S9 AutoSet. I thought I was in the middle of a hurricane there was so much air coming through the mask. At first I thought the machine had a problem and then I realized the mask was not on quite as good as I thought. But even after I got it fitted properly the AutoSet was pumping so hard I just couldn't breath. I thought it would back the pressure down after a few normal breaths, but it got to a point I couldn't stand it and I just shut the machine down.

On my next attempt I used the mask fitment function which seems to jack the pressure up while you are adjusting, but when you dismiss the smiley face the pressure seems to go back down to the starting pressure. I suppose this is the proper way to get the mask on?

So I was good until about midnight when I woke up and rolled over. Same issue...hurricanes. I tried to futz with the mask to get it back where it needed to be without waking myself up too much, but it seems that is more art than science. Perhaps it is the ear straps that are making this so hard. When the pressure again became unbearable I shut the machine off. By now I am wide awake so I turned the light on to see if perhaps I had the mask on upside down. The Swift FX seems to be symmetrical, but I noticed the ResMed logo and decided to try that on top. This time again I used the mask fitment function and that seemed to get me back in business.

I slept very well, perhaps more soundly than I can remember, until.... At 4:10 am the garbage truck pulls up and that roused me. Again, rolling over started another leak. I futzed with the mask a bit, but by this time my ears are sore from the straps and my nares are feeling a bit tender too. I didn't think I was going to be able to go back to sleep so I shut her down and took the mask off

Sorry if it seems like I am whining. I am not. I fully expect to have a period of adjustment as so many people have told me so. I guess what I would like to know is:
1) Will the usual Swift FX headgear improve the leak situation?
2) I really believe if the garbage truck had not woken me I would have slept through to the alarm, but do most newbies have issues with tender nares and if so how long to adjust to this?
3) What is the normal procedure for fixing leaks in the middle of the night, especially with the AutoSet machine which seems to ramp the pressure up to compensate? Do I have to initiate the mask fitment function every time as this seems too intrusive to my sleep?

Thanks in advice for any help, advice, or encouraging words!

[DreamStalker]

I think your doing things right. Just keep futzing with it to figure out how the mask fits you. Once you get the proper headgear, things should get better. The mask is the hardest part of getting this therapy to work.

Keep in mind that waking up with a dry mouth generally means you are leaking air out of your mouth and that issue will need to be resolved.

Hang in there and keep coming back here to read and get ideas on how to resolve any issues that may come up.

[Pugsy]

The Bella Loops (those ear things) are a challenge even for a seasoned nasal pillow veteran like me. I have used them with success but it took me a week to get them "just right". I know some newbies have started out with them and got it perfect quickly and never looked back but I think for most newbies the Loops are not what I would suggest for the first time.
The other traditional headgear will be a lot more stable for you so when it arrives I think you will like it a lot better.

So for now couple of hints...about the raging pressures...sounds like you have APAP mode engaged...next time that happens just turn the machine off briefly and then right back on. That's the only way to get the pressure reduced quickly enough.
In APAP mode the machine doesn't make changes to pressure in the blink of an eye...going up or down. It takes a few minutes and that seems like an eternity with gale force winds blowing.

See if you can rig up some sort of hose management system to keep the hose away from your body. See this thread for ideas.
viewtopic.php?t=10640
When we turn over in bed the hose gets pulled and with the Loops it is real easy to have the weight of the hose movement pull the mask out of the nose...those loops can't hold it and if we have it tight enough to hold it...it pinches the ear off or feels like it anyway.

Do the final fitting while laying in bed...don't do it sitting up in bed. Make tiny adjustments...like one notch at a time on the strap. The weight of the hose affects fit if you are trying to adjust sitting up.
I had some massive leaks when I first started using the mask...the trick is to find enough tension to hold the pillows in place with tossing and turning and not so much tension it pinches the ears. There's a real fine line there and can take a lot of fiddling to find that line.

[Viperdave]

in terms of mask adjustments while you sleep, you will get to the point where you are doing it without even thinking about it.

Ive only been on my machine for a month, and i can do adjustments without really waking up. and as a stomach cpap sleeper, i make adjustments every night.

[NotLazyJustTired]

Thanks all for those kindly responses! I am committed to making this work and I am so glad I have a place I can come and get validations for the things I think I know and get informed of the things I do not yet know. I will slug it out until the new headgear comes in. I have a pretty bad headache today, but not that unusual from the pre-CPAP days. That stretch from about 1am to 4am was awesome as I woke up in the same position I fell asleep. That alone is a major accomplishment for me! I will take it!

[jweeks]

That alone is a major accomplishment for me! I will take it!

Hi,

That is so true that it is almost an understatement. Just getting the courage to use the machine in the first place is a major accomplishment. Falling asleep the first time using the machine is also a major hurdle for some people. The next goal is to sleep the entire night using the machine. I am sure that you will nail this one pretty quickly. After that, then I suggest doing whatever you can to sleep as much as you possibly can for a week to 10 days. Do that even if you have to re-arrange your schedule or take time off from work.

What do you do to adjust your FX when it starts leaking? When I tried the FX, the issue was that it would pivot down, and leak at the top. I never did solve that issue. The Swift LT, however, has an angle adjustment. That makes all the difference for me.

-john-

[NotLazyJustTired]

Thanks for that encouraging reply.

I usually can get the leak stopped by fidgeting with the hose; so I agree it may be an angle thing. If this doesn't work out I may try the Swift LT; it seems it may be a good solution.

[Catalytic]

Hey NLJT! Last night was my first night, as well. I'm using a full face mask, but I had to make adjustments multiple times due to knocking it loose on the pillow. One time I did have to turn it off, but the rest of the time I was just able to pull it away from my face and quickly reseat it without too much problem. I ordered a Swift FX for Her from CPAP.com last night, so I'll be watching your thread for hints on how to deal with it

[Pugsy]

I ordered a Swift FX for Her from CPAP.com last night, so I'll be watching your thread for hints on how to deal with it

If you haven't read this yet...give it a read. It's about the traditional headgear.
http://maskarrayed.wordpress.com/swift- ... ing-guide/

and this video
http://www.resmed.com/us/products/swift ... s&sec=true

there are some on you tube also.

[jweeks]

Hey NLJT! Last night was my first night, as well.

Catalytic,

That is good to hear. How do you feel this morning? How did the titration study go, and what did they come up with for pressure levels?

-john-

[NotLazyJustTired]

I ordered a Swift FX for Her from CPAP.com last night, so I'll be watching your thread for hints on how to deal with it

If you haven't read this yet...give it a read. It's about the traditional headgear.
http://maskarrayed.wordpress.com/swift- ... ing-guide/

and this video
http://www.resmed.com/us/products/swift ... s&sec=true

there are some on you tube also.

Thanks for that link; it is really quite helpful. It may help with the confusion and frustration I was experiencing when it took me some time to figure out how to get the leak stopped. I will watch the video when I get home tonight for sure! I cannot believe how much I am learning in such a short time!

[Drowsy Dancer]

For hose management: I love my Hose Boss, official name Cosy Hose BOSS: http://www.cpapsupplyusa.com/Boss-Cozy-Hose-Boss.aspx

I originally got it just for travel, because I used to just hang my hose over the bedpost, but now I use it all the time.

[steeve]

This sounds all too familiar to me, a newbie also; I've used my s9 autoset 3 Nights now.The difference being I have the quattro FX full face, I wanted the nose mask or possibly pillows but with my sinus problems was afraid there would be times I couldn't use them.

Like you, I know this will take time to adjust to. Am for now committed to making it work.

I understand fully why so many give up on this, It should be required of the sleep Dr. to give patients addresses of sleep forums such as this.

[NotLazyJustTired]

I understand fully why so many give up on this, It should be required of the sleep Dr. to give patients addresses of sleep forums such as this.

With everything I am learning on here over the past couple days, that EXACT THOUGHT occurred to me. I am going to mention it to my sleep Dr. on my follow up. I would encourage all to do the same. I realize some Dr's might discourage this as looking for non-medical advice, but since the forums are available 24/7 and it is near impossible to even speak to a Dr. without an appointment, well, you can do the math.

[StuUnderPressure]

Do the AWAKE chapters no longer exist throughout the USA?

Although the one in my area is sponsored by the DMEs & Sleep Doctors & do try to get the patients to follow the beat of "their" drums, they are a good source of general information (i.e. cleaning equipment & supplies, mask fitting, etc.)

Back when I went to them (14 years ago), I went primarily because:
1.) They fed you.
2.) The machines then had to have a manometer to check / set the pressure &
the AWAKE meeting was a fast way to have your pressure checked by the
DME without having to make an appointment to go to them.
3.) Did I mention they fed you? Pretty decent food by the way.