Grrr...no sleep :(

[pandatx]

Fourth night was a living hell. I was up most of the night. My mouth kept opening. Or I woke myself up gasping for air. Clearly something needs to change with my mask. I have a couple of questions though...

1.if the pillows aren't working for me does this mean the nasal mask won't work as well? I'm trying to avoid the full face mask b/c of claustrophobia issues.

2. Also, regarding the chin strap...if you have your chin strap on but cover the exhaust with your covers or you get buried in your pillow, what happens then? If you can't open your mouth to breath when you need to?

3. What leak rate am I shooting for? I mean, I know optimal would be zero, but what is high?

Of course I will be calling my sleep doctor's office (who are also my DME) as soon as they open today.

[herefishy]

Big plug for the Activa LT if you go nasal.

[pandatx]

herefishy....do you get any soreness/irritation at the bridge of your nose with that mask? At my titration study the mask was so tight, I had soreness/bruise at the bridge of my nose for 2 days after.

[SleepWellCPAP]

Hello Pandatx,

You are a real trooper for sure! You don't have good results yet, but you are still hanging in there. Good for you!

You were up most of the night. I usually recommend if the equipment is keeping you awake, put it down and try again the next night. Your enthusiasm though is quite commendable.
1. Just because the pillows aren't working doesn't mean the nasal cushion won't. Pillows are prone to small leaks which lead to dryness. As far as the full face mask, most find it easier to get used to than they initially thought. I wouldn't discount it off hand.
2. Chinstraps are really nothing more than a brace to prevent your jaw from falling open. If you need to breath, you will overcome the tension of the chinstrap. I've worked with over 3000 people and none have succumbed due to the chinstrap.
3. Leak rate at 5 liters per minute or less is what I shoot for when evaluating downloads. Funny thing about pillow masks is that most have an unintentional leak of around 10. It's not enough to make a lot of noise, but enough to dry you out.

Thanks for posting! To improve air flow, have you tried any nasal products. Ponaris is usually what I recommend, but there are a lot of them out there.

[Pugsy]

Your S9 machine reports excess leaks...so your leak number to avoid is 24 L/min and it is best if you look at the leak graph itself to evaluate how much time you are above (and how far) that 24 L/min line.

[carbonman]

I'm trying to avoid the full face mask b/c of claustrophobia issues.

...gosh, it's so painful to watch this.
Everyone has to find their own way.

viewtopic.php?f=1&t=34880

sleep doctor's office (who are also my DME).

Best of luck w/that setup.

The cpap experience.....
it's much more than the mechanics of blowing air up your nose.
It's about you.
It is a journey into yourself.

[pandatx]

I honestly don't know what I would have done without this forum right now. Thank you so much to everyone who has taken the time (and patience) to reply to my posts. Carbonman, dude...it is painful to live it, lol. SleepWellCpap, thanks for all the info and encouragement! I'm really determined but with each night getting less enthusiastic. I'm tired.

Maybe my pressure is so low that I won't be able to use CPAP? The full face thing really freaks me out. I mean, I might not have a choice and will have to just grow a pair about it, but that will be a lot harder to get used to than this stuff I'm dealing with now. I have serious claustrophobia. I can't snorkel. I can't be in a crowded place. If I feel like I can't breathe I start to panic even though its not realistic to feel that I'm suffocating.

[carbonman]

Carbonman, dude...it is painful to live it, lol.

Been there, done that, have the T-shirt......burned the T-shirt.

The full face thing really freaks me out. I mean, I might not have a choice and will have to just grow a pair about it, but that will be a lot harder to get used to than this stuff I'm dealing with now. I have serious claustrophobia. I can't snorkel. I can't be in a crowded place. If I feel like I can't breathe I start to panic even though its not realistic to feel that I'm suffocating.

The cpap experience.....
it's much more than the mechanics of blowing air up your nose.
It's about you.
It is a journey into yourself.

You're in a fight for your new life.
I can't....I can't.....I can't.......aahhhh, yes you can.

[Pugsy]

Can you refresh my memory???? Pressure and EPR setting please?

Everyone...I have seen a screen shot of her leak graph....if she is mouth breathing it sure isn't very much. Her leak line looks better than mine does.
There's not nearly enough leak to compromise therapy and not nearly enough to require a full face mask.

[pandatx]

I'm at baby settings all the way. I think the low pressure might be the issue, but not sure what the solution is if its just bad enough to be apnea but only need very low pressure to stop it. If I could stop waking up feeling that sucking/choking feeling things would be great I'm adjusting as well as can be expected to breathing with this thing on me, but then I wake up gasping. It feels like so much more than what the machine data shows. Last night I pulled the mask off at 3:30-ish. I just couldn't take it anymore.

[Pugsy]

Increase the pressure to 6 cm and don't use the ramp. See what that feels like.
Ramp starts at 4 cm and EPR can't even work at 4 cm and for most people it simply is too stifling.
Heck, my own sister had to have 6 cm when I did an in home screening on her.
When I tried 4 and 5 cm..she yanked that mask off real quick telling me I was trying to suffocate her.

[Madalot]

Everybody is different (and I'm VERY different) so don't take this as anything other than an example.....

I feel suffocated at any pressure below 12. I need at least that much to feel enough air to feel okay. Currently, I'm at 15, but about ready to increase it to 16.

I am always amazed at people who are set at 6 or 7, marveling at how they can breathe with it that low!

[pandatx]

I love this forum

I wish I could personally give everyone a (((hug))))

Thanks so much, everyone, for the help/info/support xoxoxo

[Pugsy]

Okay...here's the plan.
Get a Small size in the nasal pillow and see if that helps with the air movement and stifling/suffocation/can't breath sensation.
Discontinue ramp because at 4 cm that's probably not enough air movement for comfort and EPR offers zero help.
Increase pressure to 6 cm...leave EPR alone for now. It's set at 3 but will only give 2 cm reduction at the pressure of 6 cm.

I am wondering if the gasping and mouth breathing and suffocation feeling is simple from not enough air movement and panic sets in and it snow balls.

If there is any mouth breathing going on it is such a tiny amount it is NOT showing up on the leak graph. It's pretty much flat except for occasional spikes. Nothing that looks anywhere near like prolonged mouth breathing.
Right now.. I see no need to do anything with the mouth. Let's not add stuff to complicate things when a person is already a bit sensitive to the least little change (this was mentioned in her sleep study report) unless there is a real need for some reason on other. Remember the K.I.S.S. principle...keep it simple if we can.

The Small nasal pillow might allow enough air movement at 5 cm but I think that 6 cm will simply be more comfortable all around because it allows for EPR to kick in and help smooth things out.

My thought was try to reduce or eliminate the discomfort from feeling like not enough air and hope that restful sleep occurs and mask issues get slept through...like the tiny leaks that are shown...they aren't enough to hurt therapy but if they hurt sleep well we want to do something but for now let's try to fix a known problem and hope any secondary issues are just byproducts of the known problem.

[cosmo]

Try EPR turned off. I found it annoying.