Not adjusting to CPAP, TMJD and sinus problems, seeking advice

[Keeska]

Hi SDBud. You were dealt a tough hand to play. I'm sorry your teeth were too big for your mouth. My brother had the same problem (and the same solution). And I'm very sorry about your TMJD. I know how extremely painful that is. I hope you find a workable, tolerable solution for your CPAP therapy. Fingers crossed for you.

What was the solution for your brother?

He had 4 teeth removed so the others could come in.

[sleepy-programmer]

For the first time ever-- I'm on round 3 with this machine, have returned it 2 times before-- I slept an entire night with my mask on. 6 hours total. The night before I slept 7 hrs with a 1hr gap in-between where I remember taking the mask off. AHI .4 last night. I woke up feeling … kinda content? Peaceful? It was really freaking weird.

I think I found my comfort settings. Heat and humidity off.

[palerider]

For the first time ever-- I'm on round 3 with this machine, have returned it 2 times before-- I slept an entire night with my mask on. 6 hours total. The night before I slept 7 hrs with a 1hr gap in-between where I remember taking the mask off. AHI .4 last night. I woke up feeling … kinda content? Peaceful? It was really freaking weird.

I think I found my comfort settings. Heat and humidity off.

SEEEE? just by being part of this group, you're sleeping better

[zonker]

For the first time ever-- I'm on round 3 with this machine, have returned it 2 times before-- I slept an entire night with my mask on. 6 hours total. The night before I slept 7 hrs with a 1hr gap in-between where I remember taking the mask off. AHI .4 last night. I woke up feeling … kinda content? Peaceful? It was really freaking weird.

I think I found my comfort settings. Heat and humidity off.

MOST excellent! i think that this is an often overlooked part of cpap therapy; some of us have to find what works FOR US. not for the general population of cpap user, but US.

if i tried sleeping without heat or humidity, well, i just wouldn't sleep.

yet it works for you.

here's hoping you get continued good sleep and wake up refreshed!!

[sleepy-programmer]

Thanks all for the encouraging words.

Results are varied. I had two full nights of sleep with the mask on now, and those were good nights of sleep. They were a major relief on my jaw, evidence that I do hold my jaw forward during the night to help me breathe. My sinuses just rejected the mask two nights in a row. Congestion = pinhole breathing = mask off in the middle of the night. Trying a FFM is a last resort, I've never been a mouth breather and I don't fancy becoming one. I'm gonna try a night with humidity level 1. I did get 2.5hrs sleep at the end of last night with the mask, I woke up and put a little aquaphor in my sinuses. I'll try that one again too. Also going to order nasal pillows. If numerous testing with that doesn't work then I'll lean towards a FFM.

Once I've had a month or two of good sleep I'm hoping some of my pain symptoms abate. Sinus surgery is an option for me and I'm thinking will really help breathe with a nasal mask. I just can't survive a week of no sleep post-surgery right now.

I find myself almost anxious at night-- I can calm it down so it's no worry. It's excited anxiety! The thought of an actual good night of sleep makes me want to cry. But I got this. Wish me luck y'all.

[booksfan]

It's excited anxiety! The thought of an actual good night of sleep makes me want to cry. But I got this. Wish me luck y'all.

The thought of a good night's sleep is exciting! I wish you well, and many, MANY good nights of sleep to come!

[sleepy-programmer]

I was wrong, I slept 3.5 hours then ditched my mask last night. Noticed it two hours later and put it back on with some Aquaphor.

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[CreativeChris]

Hello guys!

I hope you are finding your sweet spot! The forum has helped me find what works. Unfortunately I need to switch to a BiPAP but hopefully the transition should be easy.

Here is what I have found during my journey:

-I use the device all night every night. I got used to it after time and look forward to it now. The results are too good to skip. You'd now have to pry my CPAP out of my cold dead hands.

-I have had sinus surgery as well as tonsils and adenoids removed. This did ZERO to help.

-I have taken every supplement and vitamin known to man to help sleep and the symptoms of OSA. They don't. I now take some regular vitamins to supplement my diet.

-While CPAP is not a cure I couldn't care less. Neither are the hard contacts I have been wearing for years but can't fight genetics. I prefer to use what works to aid my life.

-High humidity gives me a MAJOR sinus headache.

-The PAP helps drastically keeping swelling in my sinuses down. In fact it helps alleviate cold symptoms the one time I have had a cold since starting CPAP. Furthermore I was getting sick at least every 6-8 weeks prior to starting therapy. Getting better sleep helps heal your body.

-Some masks direct the air oddly for me creating irritation within my nasal cavities. Dreamwear works better for me than the p10.

-I have purchased out of pocket for several masks to find the right one for me. The price is nothing compared to choking every night and waking up beat up with a headache and generally feeling like shit.

-I look at maintenance of the machine and wearing the mask as a blessing. There are so few people that are treated and have what we now use to make our lives better. I am a developer and look at the technology as a modern marvel!

If you are vigilant in your treatment at the end of the day you are doing something that can improve your life drastically. The countless years of damage I did to my body by ignoring the issue because I didn't want to be tied to an ugly mask were nothing more than foolish and careless.

While I am no expert like Pugsy and Palerider we have our own journeys and any piece of advice I can give please do not hesitate to ask!

[sleepy-programmer]

-I have had sinus surgery as well as tonsils and adenoids removed. This did ZERO to help.

Hi Chris! Thanks for sharing. I will be buying up a few masks pretty soon myself. Just want my DME to send me a freebie first since I qualify-- I'll probably ask for the p10 or dreamwear. One question: did the sinus surgery help your sinuses tolerate CPAP better? I could have my turbinates reduced, deviated septum fixed, and something installed device whose name I forget that will open my sinuses up. I'm tempted because working with my sinuses has been very tricky.

[sleepy-programmer]

The past four nights I have ~1hr gap where it looks like I didn't wear my mask, then I put it back on. I'm very confused. I don't remember taking my mask off *or* putting it back on in my sleep. I just remember going to bed with the mask on, falling asleep, then waking up with it on.

Any ideas? Looks like I'm just doing this without any memory of it.

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[dogsarelife]

CPAP is uncomfortable. Wearing it forces my jaw forward a bit, I can notice this just wearing it while awake. This is a pain problem for me because of my TMJD. Sleeping on my side is also painful on my jaw. Sleeping on my back makes my apnea worse. I figure I should try either a FFM or nasal pillows. Insurance will only let me pick one, not sure which I'll do, probably FFM. I've worn a FFM before it's the most uncomfortable thing,

Hi - I'm quite new to cpaptalk but I just wanted to offer some empathy for your situation. I'm in a somewhat similar boat as you (had 4 wisdom teeth out, and also 4 molars out for braces, and oh how I wish I could go back in time). I started out with the same mask, the Resmed N20. At low pressures the N20 was fine, but as the pressure increased and my jaw got pushed forward, it became increasingly uncomfortable and I found myself ripping it off in my sleep a couple of times. Maybe that's why you keep ripping it off in your sleep - meaning, It's not your fault but that that there's something else going on that needs to be addressed, like your overall comfort level or some combo of teeth/jaw discomfort and the 'why' doesn't get registered because you are asleep in the middle of the night?

Our faces (long, narrow, small jaw) look/sound so similar I guess I just wanted to throw that out there. I hope the P10 works but if not there is probably a full face mask out there.

I wanted to share that I too hated the idea of full face masks at first, but have made my peace with it for now. The F20 bothers some people because it can push their jaw back, but this is actually more comfortable for me than the N20 and P10 forcing my jaw out or making me push my tongue against my front teeth. And at least with the F20, I haven't had any TMJ issues with it. I'm so sorry you have TMJ - it sucks so much and so do the awful headaches that accompany it.

So basically - offering encouragement to keep trying masks and I do believe there is relief out there for you. It is the act of peeling back an onion, very very slowly.

I don't have many friends who understand either, and I can understand how you want surgical relief NOW. it's very depressing when you're not sleeping well, and I considered surgical options. I really at one point was so fed up I dreamed of asking for a temporary tracheostomy so that I could experience at least one decent night of sleep at certain points.

So my final suggestion - I saw you used Afrin before - have you been able to try out some combination of nasal congestion meds like zyrtec, claritin, Flonase, allegra to see if those help you all while you are waiting for a surgery consult? Would you consider using Afrin selectively in one nostril on those really bad nights? It's a little bit of chicken and egg - congestion begets worse sleep which begets more congestion (and pain, as you have experienced, as well as irritability, anxiety, brain fog) in my experience, so I just try to address congestion every night.

Or maybe a nasal dilator?

I'm not sure if I helped but you have my empathy and I'll check back in your thread and hope you find some combination that works for you.

[sleepy-programmer]

Hi friend. Wondering if you’ll still see this. It’s funny I came back to this thread today because I just came to the conclusion you told me about. My nasal mask is holding my jaw in a bad place. The pressure of having to keep a tight mouth seal is giving me TMJ issues, can’t even slack the jaw a little because it’ll fill my cheeks with air. I think I need a FFM. I’m about to try the F20 and the P10. It’s too bad the nasal N20 is soooo comfortable now. I actually love it. Ah well.

I found rhinocort is the only thing that helps my sinuses. I use that, a nasal dilator, humidifier in my room, and NO humidity from my machine. Seems to be the only combo that keeps my sinuses happy.

I’m also ordering a specialized TENS unit for the jaw. Hate dropping money on this but it’s the *only* thing that’s been easily effective for my TMJ pain. Current plan is to get out of this pain cycle I’m in, *then* hope good sleep starts to heal me. Wish me luck!

[sleepy-programmer]

Also I tried two nasal pillows masks, even just an 8.0 pressure forced through my sinuses is giving me pressure pain in the ears. I can probably thank TMJD for that too.

[dogsarelife]

My nasal mask is holding my jaw in a bad place. The pressure of having to keep a tight mouth seal is giving me TMJ issues, can’t even slack the jaw a little because it’ll fill my cheeks with air. I think I need a FFM. I’m about to try the F20 and the P10. It’s too bad the nasal N20 is soooo comfortable now. I actually love it. Ah well.

I found rhinocort is the only thing that helps my sinuses. I use that, a nasal dilator, humidifier in my room, and NO humidity from my machine. Seems to be the only combo that keeps my sinuses happy.

I’m also ordering a specialized TENS unit for the jaw. Hate dropping money on this but it’s the *only* thing that’s been easily effective for my TMJ pain. Current plan is to get out of this pain cycle I’m in, *then* hope good sleep starts to heal me. Wish me luck!

Hey SP, I'm sorry it turned out to be the case for you too that the N20 was holding your jaw in a bad place. I agree, the N20 is a great mask! I wish I could use it successfully too!

I hope you find some success with the Resmed P10 or the F20. Unfortunately with the P10, I had the same issue as the N20 - great mask, liked the minimalistic aspect, but the stenting of the airway positioned my jaw, bite, and tongue in a way that felt very unnatural to me. I hope that isn't the case for you, so I guess a heads up to watch out for that? I'm thinking about maybe trying the Bleep Dreamport next, but I wonder if nasal pillows aren't out for me :/

The F20 has been good for me - especially when I've been completely stopped up in my nose from a cold or flu. If you end up using the F20, my one tip is to make sure the top portion is between your eyebrows. Otherwise the air leaks into your eyes and that can wake you up. or, you know, watch the mask fitting video on youtube or on resmed, I'm sure they have decent instructions as well!

Do you know if you were a mouth breather as a kid or young adult? Some people seem to be able to make the transition to nasal breathing once they start xpap but I feel like it's harder for me with all the teeth that got pulled, because there's not enough room in my mouth for my tongue and my jaw to be positioned correctly. so I've quite often found myself mouth breathing with the F20 in the latter part of the night, I guess for REM sleep when the tongue and upper airway and jaw relax quite a bit.

So I guess I'm just sort of curious if that's the case with you too, or I'm imagining things?

Anyway, I hope the TENS unit gives you some pain relief for the TMJ issues - fingers, toes, legs, eyes crossed for good luck, because I know how much TMJ pain affected my ability to function. Best wishes for your sleep!

[zoocrewphoto]

When there literally isn't enough room for the teeth because of a small mouth, what do you propose as a healthy solution? It is rarely a matter of mere cosmetics in those circumstances, right? Teeth need to align to function optimally, as I understand it from the MMA people's point of view. Surgically enlarging the mouth with MMA is much more drastic than simply pulling teeth. Jaw health and bite health are real considerations beyond "nice smiles." And using MMA for every kid with a small mouth, for OSA prevention, doesn't sound like a workable solution to me.

My understanding is that pulling the teeth during the process of braces doesn't *cause* sleep apnea, but doesn't help prevent it either. In other words, people (like me) who have a small mouth, not enough room for the full set of teeth, tend to have the physical anatomy that leads to sleep apnea. If considered early, there are options now that will help to improve the amount of room and possibly prevent sleep apnea if done while the person is still growing. They didn't know that back when it was considered normal to remove 4 teeth and them move the rest to align them nicely.

I had the 4 teeth removed and braces. I also have a small chin, scalloped tongue, small mouth (dentists have to use the child size xray things), and I have narrow airways too. My mom never had braces, and at age 79, she still has teeth that don't fit properly in her mouth. Some of them are actually so badly aligned that they are more like a second row. She has sleep apnea too.