Newbie Needing Help w/ Sleepyhead ?

[FoggyBrain24]

Wow. Thank you. That was a master class. I am traveling today through Tuesday, but I will definitely see what I can find from the manuals.

As far the segment between 4-5 AM, I have a feeling I woke up and couldn't fall back asleep.

I will play around with the new mask tonight and see if I can cause some leaks..haha.

Fingers crossed, thanks for all of your help!

[FoggyBrain24]

Just tried my first night with the Dreamwear Under the Nose Mask.

I did not recall waking up at all, but similiar % of leaks reported. I've felt pretty good for the most part today, especially considering the lack of sleep (had an early flight).

I almost feel like I might be missing a piece, but all connects well beyond the hose leak.

Any thoughts?
https://imgur.com/uqJ85kO

[Pugsy]

Look closely where the leak at the hose connection is....there is a vent hole up there and that's normal venting.
Now the DreamWear little circle thingy on the clear plastic elbow...where it goes into the big hole in the silicone frame....that can sometimes be a bit finicky and if it doesn't fit quite right...it will leak.

So determine exactly where the air is coming from and if it is where the elbow thing attaches to the frame fiddle with it a bit and it will eventually seal and no air will escape that hole.

Now the vent...that's to be expected and it's so close to that elbow thingy you might be feeling the normal venting.

This is the under the nose cushion DreamWear and not the Gel pillows ...is that correct?

I see some large leak flags....can't see the leak graph real well but even if I could I don't know if it is mask movement or mouth breathing.
It's the first night so try just a teeny tiny bit of snugging it up with that back strap and see if it helps with the leaks or not.
While you did hit large leak territory, you didn't go deep into large leak territory. The data seen is probably fairly accurate. I doubt that any apnea events were missed during the period of time in large leak.

More importantly you slept rather soundly and feel fairly decently today...and that's real important. More important than the large leaks IMHO.
I wouldn't go to wild extra ordinary measures in an attempt to tame the leaks at this time. I would try just a little bit of more tension on that back strap.......not much though...just a little bit.
I think it took me 4 or 5 nights until I got the tension just right.

[FoggyBrain24]

Look closely where the leak at the hose connection is....there is a vent hole up there and that's normal venting.
Now the DreamWear little circle thingy on the clear plastic elbow...where it goes into the big hole in the silicone frame....that can sometimes be a bit finicky and if it doesn't fit quite right...it will leak.

So determine exactly where the air is coming from and if it is where the elbow thing attaches to the frame fiddle with it a bit and it will eventually seal and no air will escape that hole.

Now the vent...that's to be expected and it's so close to that elbow thingy you might be feeling the normal venting.

Just checked again, seems to be coming from the little vent holes in the elbow, so it sounds normal.

This is the under the nose cushion DreamWear and not the Gel pillows ...is that correct?

Yes, under the nose.

I see some large leak flags....can't see the leak graph real well but even if I could I don't know if it is mask movement or mouth breathing.
It's the first night so try just a teeny tiny bit of snugging it up with that back strap and see if it helps with the leaks or not.
While you did hit large leak territory, you didn't go deep into large leak territory. The data seen is probably fairly accurate. I doubt that any apnea events were missed during the period of time in large leak.

More importantly you slept rather soundly and feel fairly decently today...and that's real important. More important than the large leaks IMHO.
I wouldn't go to wild extra ordinary measures in an attempt to tame the leaks at this time. I would try just a little bit of more tension on that back strap.......not much though...just a little bit.
I think it took me 4 or 5 nights until I got the tension just right.
Thanks. Makes me feel better. It felt like it stayed in place nearly all night and seals pretty good. Hopefully I will get a solid 7-8 tonight.

Thanks again for everything.

[FoggyBrain24]

Just had my 3rd night with the Dreamwear under the nose mask.

I've been sleeping at a friend's place on an aerobed (never a great night sleep), but I think I am doing pretty well. I have not noticed any leaks at all, but I did wake up again around 4:45 AM (the chart is off by 1 hour as I am now in CST). I did notice that when I woke up, the water had run out of the chamber as well as my aero bed needed reinflating. After handling both tasks, when I laid back down, my mouth was extremely dry. I felt like I was breathing in through my nose, then into my mouth rather than into my lungs. I don't recall ever having this happen, almost like if I lose "rhythm" breathing, I was causing this on my own. I don't recall opening my mouth but it's possible. When I was given this headgear, they meant to give me a chin strap, but they didn't.

https://imgur.com/PSuzPkU

What do you think? I like this mask and think it's been a good adjustment and hopefully, I will be able to breath exclusively through my nose. I think the aerobed lacks the normal foundation of a bed, so wondering whether that is affecting the way I am breathing.

If anything, this mask is not waking me up due to leaks, but I still seem to be waking up at least 1-2 times per night where I am aware that I am up, which wasn't the case a few weeks ago (when I was less focusing on my therapy).

[Pugsy]

Wait until you get back to your own bed before you start worrying about wake ups.

Besides...it is normal to wake up after REM sleep cycle...so remembering 1 or 2 wake ups is normal.

[FoggyBrain24]

Thanks. I just had my 3rd night on the aerobed, with 1 more to go.

Every night, I've be able to fall asleep pretty easily, only to wake up at 4:45 AM. At 4:45 AM, the water chamber is empty and my mouth is incredibly dry. I have not noticed any leaks, but I have not been able to fall back asleep at all, I've just been laying there for 3-5 hours. My energy levels have fluctuated a great deal each day as I would estimate I am only getting about 5-6 hours of sleep. My fitbit has not been able to track detailed sleep stages either, so I don't have much else to go out.

Appears that AHI remains low, but I'm getting troubled by my lack of sleeping through the night. Wondering whether the variance in pressure has something to do with it, or whether I should adjust the higher end down a bit. I could also try the chin strap when I return home on Wednesday, but I need to get more quality sleep.

I've noticed that I appear to be swallowing a lot of air and then my stomach feels bloated, but only with this under the nose mask. I see people describing aerophagia. Are their recommendations for helping to eliminate this?

https://imgur.com/xvdzugO

[Pugsy]

When you see the low AHI and you are also seeing a lot of time in large leak shown on the leak and the events graph...don't get too excited about that low AHI. We don't know if it is low because nothing happened or the machine was clueless.

It wouldn't be impossible for the wake ups to be related to the variable pressures....or the leaks....or just a normal post REM wake up because in those wee hours of the morning we tend to have more REM.

Water chamber being empty...what would happen if you reduce the humidity setting a little bit????

All the stuff that gets flagged while you are awake laying there for hours and hours....doesn't count at all.

[FoggyBrain24]

When you see the low AHI and you are also seeing a lot of time in large leak shown on the leak and the events graph...don't get too excited about that low AHI. We don't know if it is low because nothing happened or the machine was clueless.
OK, understood.

It wouldn't be impossible for the wake ups to be related to the variable pressures....or the leaks....or just a normal post REM wake up because in those wee hours of the morning we tend to have more REM.
With the under the nose mask, I feel like I would notice if it leaked at all. Do you think worth adjusting the pressure? Prior to CPAP treatment, I don't remember waking up often. Even a few weeks ago, prior to my posting on here, I don't recall too many instances of actually waking up. Now it seems to happen at the same time each morning. Not being able to fall back asleep is troubling, it's as if I know when I wake up, I am going to have some issues the next day.

Water chamber being empty...what would happen if you reduce the humidity setting a little bit????
I can reduce that for tonight. I am in Austin this week, where the air is much drier.

All the stuff that gets flagged while you are awake laying there for hours and hours....doesn't count at all.
I understand. What do you think about the aerophagia? I've only experienced this with the current mask. I do have my normal wisp mask with me, I could try to switch back tonight and see what happens. I just need to get a full nights sleep.

[Pugsy]

The aerophagia is something you have to figure out what gives you the best therapy without making the aerophagia worse and you are caught between a rock and a hard place for sure.

I would like to see you get a chance to try a real bilevel machine...because you need higher pressures but higher pressures make aerophagia worse...
plus I still don't like those VS2 snores. Those aren't normal.

When you have time...set yourself up and use the machine for 1 hours while awake with no desire or chance to go to sleep.
Make sure you are quiet and still and nothing going on that the machine might misinterpret as something to get a VS2 flag.
Use this for 1 hour so you have a nice long time frame to look at. Awake with no movement...there shouldn't be any flags of any kind except maybe an occasion SWJ event flag.
If there are tons of VS2 stuff...something is wrong with the machine sensors which makes me suspect everything.
I want you to be able to try a different machine....but they probably don't care what I want.
If you do the one hour test and there's a bunch of crap on it...you have ammunition for requesting a different machine and with your aerophagia issues....and your pressure needs....I think you need bilevel.

[FoggyBrain24]

Since I only seem to be experiencing aerophagia with the under the nose mask, would you think trying to go back to the Wisp? My DME also offered a FFM to try, I could possibly swing by and pick that up on Wednesday. I never had any symptoms like this prior to the last 4 nights.

What about reducing the high end pressure of the APAP?

Do you think waking up at the same time nearly every day indicates anything? The pressure chart shows some pretty big drops @ 5:45 AM (which mirrors 4:45 CST).This mask seems to handle the pressure range (9-19) better than the Wisp as far as leaks. I wish I could figure out what leaks are being flagged now as I don't notice anything.

I know the BiPap may be a harder sell. If I can do the 1 hour test, do you think I would then provide that data to the sleep doctor specifically or to the DME to begin an argument for a different machine?

[Pugsy]

I don't know why the aerophagia is worse with the under the nose vs the over the nose cushion of the Wisp.
I am scratching my head over night one.

You could try limiting the max and see if it helps with the wake ups but bear in mind that if it is the events that are causing the wake ups....limiting the max will likely allow more events to happen...so a double edged sword there.
Try it and see what happens is about all I know to say.
Since there are any number of possible reasons for the 4 to 5 AM wake up...you keep trying different things to see if something works or not.

As to which mask to use.

Use the one that you sleep the best with and feel the best.
The best numbers in the world don't mean squat if you sleep like crap and feel like crap.
Don't use numbers alone to make a mask decision....use the how you sleep and feel as primary factor.
Pick the mask that lets you sleep the best...then worry about tweaking the settings.

I have no idea what will happen with a full face mask in terms of aerophagia alone. Again you just have to try stuff to see what happens.

[FoggyBrain24]

I don't know why the aerophagia is worse with the under the nose vs the over the nose cushion of the Wisp.
I am scratching my head over night one.
With the Wisp, I did not experience this at all. Only with this under the nose mask.

You could try limiting the max and see if it helps with the wake ups but bear in mind that if it is the events that are causing the wake ups....limiting the max will likely allow more events to happen...so a double edged sword there.
Try it and see what happens is about all I know to say.
Since there are any number of possible reasons for the 4 to 5 AM wake up...you keep trying different things to see if something works or not.
OK. It doesn't seem like I have much to go on here. Since I am getting up to 18-19 most nights, it's not like I could lower it by much.

As to which mask to use.

Use the one that you sleep the best with and feel the best.
The best numbers in the world don't mean squat if you sleep like crap and feel like crap.
Don't use numbers alone to make a mask decision....use the how you sleep and feel as primary factor.
Pick the mask that lets you sleep the best...then worry about tweaking the settings.
The Wisp has been fine for the most part, but I seem to be experiencing a lot of leaks when the range is 9-20. This mask doesn't leave, but the aerophagia is a new problem. I did sleep through the night a fair amount with the Wisp, but the leaks became almost constant.

I have no idea what will happen with a full face mask in terms of aerophagia alone. Again you just have to try stuff to see what happens.
Will have to see what happens over the next day or 2. I will be back in my bed tomorrow night. I will probably try to set up an appointment with the DME so I can potentially try another mask out. Sleeping through the night is the priority right now, if I can do that, I should feel good enough, I am just getting frustrated.

[Cpapian]

Just had my 3rd night with the Dreamwear under the nose mask.

I've been sleeping at a friend's place on an aerobed (never a great night sleep), but I think I am doing pretty well. I have not noticed any leaks at all, but I did wake up again around 4:45 AM (the chart is off by 1 hour as I am now in CST). I did notice that when I woke up, the water had run out of the chamber as well as my aero bed needed reinflating. After handling both tasks, when I laid back down, my mouth was extremely dry. I felt like I was breathing in through my nose, then into my mouth rather than into my lungs. I don't recall ever having this happen, almost like if I lose "rhythm" breathing,

Hi FoggyBrain 24 ...I am just replying to your last comment about air going through your nose and into your mouth. I have this problem also even when I am falling asleep.

One member helped me by telling me to put my tongue behind my top teeth and up against the roof of my mouth. He might come back and describe it better.

I also find using my cheek muscles to compress against my teeth, helps. It seems to close the mouth off as a place to go. Path of least resistance is closed off.

I suspect the muscles in this area need to build up strength to handle the higher pressures and a need to reinforce the breathing process, i.e. in through the nose and down the throat. I try to practice this while falling asleep.

Last night was a bad night for arophagia for me, so I will probably lower the minimum pressure by .5 for a night or two to give my body a chance to catch up.

[FoggyBrain24]

Hi FoggyBrain 24 ...I am just replying to your last comment about air going through your nose and into your mouth. I have this problem also even when I am falling asleep.

One member helped me by telling me to put my tongue behind my top teeth and up against the roof of my mouth. He might come back and describe it better.

I also find using my cheek muscles to compress against my teeth, helps. It seems to close the mouth off as a place to go. Path of least resistance is closed off.

I suspect the muscles in this area need to build up strength to handle the higher pressures and a need to reinforce the breathing process, i.e. in through the nose and down the throat. I try to practice this while falling asleep.

Last night was a bad night for arophagia for me, so I will probably lower the minimum pressure by .5 for a night or two to give my body a chance to catch up.

Interesting. Happy to try this. I am hoping this mask works. If not, I can try the Wisp again. Would like to avoid full face if I can.