Cpap since 2016 but still tired; Plz help

[Miss Emerita]

Is it possible your hose is tugging on your mask and dislodging it? If so, you might try a hose stand to get your hose up and out of the way. Some people are able to use their headboards or bedside lamps to similar effect.

[cyberdreamer]

Yes, I have had some experience with the Resprionics Dreamwear masks...all the models...some more than others though.
Which model were you looking at?

I could make them all work and liked it well enough I suppose but I discovered that the smallest frame was still a bit too large for my head so there were some mask movement issues because of the overall frame size being a bit too large and allowing movement.
I could get it managed well enough with some wraps which were okay but added more "stuff" on my head which I really prefer as little "stuff" on my face and head as possible. So the DreamWear was never in the running for my primary mask....for that reason and the other reason is I prefer a diffused venting system that isn't noisy and doesn't bounce off anything to hit me in the face. While I like a fan blowing on me...I don't really like the vented air blowing in my face.

If you look at the mask I am now using (in my equipment profile which BTW maybe you could fill out yours) the Bleep mask has zero headgear so nothing on my head. All I have is a little nasal thing glued to my nose at night. About as nothing on my face and head as I could ever expect to get.

I experiment with masks just for the fun of experimenting with something new and different. That's how come I was trying the various DreamWear models. Just to learn what they were like and not so much because I was really in the market to change mask models at the time.

I was looking at the reviews for my Swift FX Nano mask I've always used and lots of people complains of terrible leaks!

I was thinking about purchasing the standard Dreamwear nasal mask that comes with medium frame and cushions of all size. However, some reviews complain of the mask easily moving and leaking and this is the problem I have with the Swift Fx nano. There's also complaints about excessive noise.

I could also buy just the Swift FX nasal pillow and reuse the mask frame I already have... That would be cheaper.

The new Resmed N20 looks interesting as well and it has high reviews.

Do nasal pillow masks tend to irritate the inside of the nose? I remember trying one at the first CPAP dealer I went to and it felt easier to breathe it, but I felt a little sting inside my nose where it touched. Don't remember the model.

[zonker]

Do nasal pillow masks tend to irritate the inside of the nose? I remember trying one at the first CPAP dealer I went to and it felt easier to breathe it, but I felt a little sting inside my nose where it touched. Don't remember the model.

may i recommend Lanisoh? it's lanolin cream marketed for nursing mothers to prevent sore nipples. it can be found in the infant section of your local grocery store.

i use it in conjunction with my p10 nasal pillow mask. keeps things nice and smooth.

[Pugsy]

With a nasal pillow mask there really shouldn't be anything touching anything on the inside of the nose.
Only the tiny tip of the inner cone actually goes just barely into the nostril but it shouldn't ever touch anything inside the nose.
If something is touching inside the nose...wrong size or too tight.
What they do is rest gently on the outside of the nostril...that's all that ever touches the nose.

Common mistake people make with nasal pillows is they either use a nasal pillow too small or they have the headgear too tight and the pillow tries to crawl up inside the nose.

Just order the nasal pillow that will fit your existing headgear and give it a try. Save some money.

[cyberdreamer]

Do nasal pillow masks tend to irritate the inside of the nose? I remember trying one at the first CPAP dealer I went to and it felt easier to breathe it, but I felt a little sting inside my nose where it touched. Don't remember the model.

may i recommend Lanisoh? it's lanolin cream marketed for nursing mothers to prevent sore nipples. it can be found in the infant section of your local grocery store.

i use it in conjunction with my p10 nasal pillow mask. keeps things nice and smooth.

Never heard of Lanolin before. Is it petroleum-based? Is there a risk of lipoid pneumonia or damage to the mask? If not, I'll definitely try it if I get a nasal pillow mask.

I use a lip balm from La Roche every night and it works perfectly to prevent lip dryness due to occasional mouth leaks.

[cyberdreamer]

With a nasal pillow mask there really shouldn't be anything touching anything on the inside of the nose.
Only the tiny tip of the inner cone actually goes just barely into the nostril but it shouldn't ever touch anything inside the nose.
If something is touching inside the nose...wrong size or too tight.
What they do is rest gently on the outside of the nostril...that's all that ever touches the nose.

Common mistake people make with nasal pillows is they either use a nasal pillow too small or they have the headgear too tight and the pillow tries to crawl up inside the nose.

Just order the nasal pillow that will fit your existing headgear and give it a try. Save some money.

Oh I see! Maybe the awful physiotherapist at this first store there gave me the wrong size to try then. She was so bad that I almost gave up CPAP treatment! Tried to push me a dumb CPAP without humidifier for a lot of money, so I felt miserable for 2 days and couldn't understand how people tolerated CPAP.

I'll the Swift FX nasal pillow then and the Dreamwear mask later on if it doesn't work for me.

[Pugsy]

What you need to look at for any nostril tenderness is Lansinoh lanolin ointment/cream.
It's totally safe. Nursing mom's use it on their nipples to help with what babies mouths do to nipples.
If it's safe enough for babies....won't hurt us or the masks.
No petroleum in it at all.
Found in the baby aisle at places like WalMart....where bottles, nipples, pacifiers, etc are found.

[ChicagoGranny]

Never heard of Lanolin before. Is it petroleum-based?

It's sheep based!

[zonker]

Never heard of Lanolin before. Is it petroleum-based?

It's sheep based!

and that's not baaaad.

[PatOnCPAP]

Hi Cyberdreamer. Reading your post and looking at your graphs is almost a replica of what I've dealt with. All those Central flags looks to me like you are a very restless sleeper, as am I. I'd guess if we look closer at those CA's we'd see they are micro arousals (as Pugsy mentioned), not true Centrals. Trust me when I say that those micro arousals can leave you feeling ghastly in the day, even tho the CPAP is doing its job to stop any obstructions.

In my case, and I suspect yours, those arousals are from having to fiddle constantly with a mask that leaks when you move each time. Reason I found the mask leaks is the head strap is tugging on the pillow when moving in bed,and that causes the mask to slide on the face causing leaks. It only takes a small amount of head movement I found to do this. That and, as a previous post mentioned, the hose is also tugging when you move causing a possible shift in the mask.

I've manged to bring down my Centrals (arousals) a lot and start to get more restful sleep by doing the following:
Using either a chin strap over the headgear, or one of those cotton buffs that fisherman use to keep the sun off their faces. Also pulled over the headgear once the mask is on your face. I found it reduces the friction between the headgear and the pillow causing less mask movement which equals less arousals.
To keep the tube in place, I use a piece of stretch fabric around my chest and I feed the tube under there before clipping into the mask. I know I look a right old site with all this extra paraphernalia on me , but it really does make a difference leak wise if you are a restless sleeper. The more I research sleeping disorders the more I'm inclined to believe that us thin folk tend to be more wired naturally and so can be a bit more active in our sleep, or should I say more alert to subtle or light disturbances.

You mentioned insomnia and you also mentioned you are taking supplements. There are a few that can cause that, even though they may seem harmless, so I'd be interested to know.
I suffered with crippling insomnia for a very long time which was driven by the anxiety around my then undiagnosed sleep apnea. I'll spare you all the details, but should you wish you can PM me for more insight into what might be going on in your case.
I've also just had my second surgery for a deviated septum. There is a Dr here in South Africa that does a special kind of operation to open up the nasal airways. He makes use of a donor cartilage in the nose to create a splint. I had this op done 2 months ago after the first op 3 years ago didnt help much, and it has improved by nasal breathing a lot. The swelling takes around 4 months to subside so its yet to improve some more.
But before you consider septum surgery you might want to look at an orthodontic retainer to widen your upper palette. Its a rather long story as to how the 2 are sometimes connected so i wont post here, but you can PM me if you want to discuss that further.

[cyberdreamer]

Hi Cyberdreamer. Reading your post and looking at your graphs is almost a replica of what I've dealt with. All those Central flags looks to me like you are a very restless sleeper, as am I. I'd guess if we look closer at those CA's we'd see they are micro arousals (as Pugsy mentioned), not true Centrals. Trust me when I say that those micro arousals can leave you feeling ghastly in the day, even tho the CPAP is doing its job to stop any obstructions.

In my case, and I suspect yours, those arousals are from having to fiddle constantly with a mask that leaks when you move each time. Reason I found the mask leaks is the head strap is tugging on the pillow when moving in bed,and that causes the mask to slide on the face causing leaks. It only takes a small amount of head movement I found to do this. That and, as a previous post mentioned, the hose is also tugging when you move causing a possible shift in the mask.

I've manged to bring down my Centrals (arousals) a lot and start to get more restful sleep by doing the following:
Using either a chin strap over the headgear, or one of those cotton buffs that fisherman use to keep the sun off their faces. Also pulled over the headgear once the mask is on your face. I found it reduces the friction between the headgear and the pillow causing less mask movement which equals less arousals.
To keep the tube in place, I use a piece of stretch fabric around my chest and I feed the tube under there before clipping into the mask. I know I look a right old site with all this extra paraphernalia on me , but it really does make a difference leak wise if you are a restless sleeper. The more I research sleeping disorders the more I'm inclined to believe that us thin folk tend to be more wired naturally and so can be a bit more active in our sleep, or should I say more alert to subtle or light disturbances.

You mentioned insomnia and you also mentioned you are taking supplements. There are a few that can cause that, even though they may seem harmless, so I'd be interested to know.
I suffered with crippling insomnia for a very long time which was driven by the anxiety around my then undiagnosed sleep apnea. I'll spare you all the details, but should you wish you can PM me for more insight into what might be going on in your case.
I've also just had my second surgery for a deviated septum. There is a Dr here in South Africa that does a special kind of operation to open up the nasal airways. He makes use of a donor cartilage in the nose to create a splint. I had this op done 2 months ago after the first op 3 years ago didnt help much, and it has improved by nasal breathing a lot. The swelling takes around 4 months to subside so its yet to improve some more.
But before you consider septum surgery you might want to look at an orthodontic retainer to widen your upper palette. Its a rather long story as to how the 2 are sometimes connected so i wont post here, but you can PM me if you want to discuss that further.

PatOnCPAP, Sorry for the late reply, I hadn't seen your answer before. They probably are arousals as there were no CAs in my sleep study.

Those are interesting tips for reducing hose and mask movement during the night. I'll try other masks and some of your tips to reduce the leaks and consequently the arousals. I did found early in my therapy that putting the hose under my covers did lead to a lot of leaks, probably from the hose pulling the mask.

I do toss and turn a lot during the night. Once I recorded myself sleeping a few years ago and I saw that I unconsciously did sleep in lots of different positions throughout the night!

I haven't been having insomnia lately. Maybe b/c I haven't been using the nasal spray for a week.

Very interesting to know! I'm glad it helped you! For now, I've decided not to have the surgery due to all the risks and the very low chance of it actually curing my apnea. Also, my septum deviation has been classified as minimal in my last face CT scan.

Thanks for all the advice!

[cyberdreamer]

Is it possible your hose is tugging on your mask and dislodging it? If so, you might try a hose stand to get your hose up and out of the way. Some people are able to use their headboards or bedside lamps to similar effect.

I am trying to improve my hose positioning at night, since you and others have mentioned it can definitely cause mask leaks.

[cyberdreamer]

Just an update on my progress so far with stats. Tested mouth taping again last night and leaks don't seem to improve. (Feb 01 and 02 were regular nights and Feb 03 used 3m micropore tape)

I guess I have to try a full face mask now and perhaps other nasal ones later.

Will try to record myself sleeping to determine if hose is getting tangled somewhere too.

[cyberdreamer]

Thanks again for everyone's invaluable help throughout this journey not only in this thread but in all the others from other users!