New to CPAP - Need advice...

[cb28210]

I've only been using a CPAP for almost a month. I really can't tell much difference other than not falling asleep anymore about 2PM if I stop and sit down for some reason. Should I expect a greater impact? My AHI was around 84, and with CPAP in the sleep study it went down to something like 0.4.

I am using a ResMed Tango with humidifier (because I don't have insurance) with a ResMed Mirage Quattro. I seem to fight leaks after the first 3-4 hours of sleep each night. I also like to sleep on my side or stomach and this mask makes that hard to do. An APAP seems to be the machine of choice on the forum, but my Sleep Center said they don't recommend them because they do not respond quickly enough to an event (apnea).

Any suggestions? I'm looking into trying a Mirage Liberty mask because the full face thing makes it hard for me to roll at night (which I like to do periodically). Should I 'invest' in a fancier machine? Should I look at some other mask?

Thanks

[DreamStalker]

The reason your sleep center thinks APAPs do not respond quickly enough to an event ... is because they don't know how to use or set them them up properly. If the min pressure is set to lowest setting of 4 cm (as they often set them to) ... they are generally correct. However if they set the min pressure to about 3 or 4 cm below the max pressure (which should be set at or just above your titrated pressure), then APAP machines work very well and respond to events just fine.

Re: mask ... it is the most difficult part of the treatment. You just have to try until you find the right mask for your unique facial size and shape. Specifically, you want to find a mask that does not let the air pressure leak out and that is comfortable enough for you to wear all night.

Forgot to add: You really need to have a machine that provides efficacy data (ie. AHI, and leaks) ... without it you are treating yourself in the dark. Think of OSA treatment in a similar way that diabetic and hypertension patients treat themselves ... with a glucose and blood pressure monitor respectively.

[LoQ]

I seem to fight leaks after the first 3-4 hours of sleep each night.

Every time someone mentions having trouble with mask leaks I want to suggest the Mack's silicone earplugs (or generic equivalent). I fear people would get tired of me saying this over and over, so I never bring it up. Also, I guess it must not work well for the majority, as it is so rarely mentioned by anyone else, either. Solutions to other problems, like heated hoses and such for rainout, taping for mouth-breathing, etc., get mentioned all the time, by contrast.

All I can say about the earplug silicone is that is it works great for me. It seems like a cheap thing to try, so why not?

[cb28210]

Forgive me - but I don't see the connection between leaks and earplugs... How will something in my ears help keep leaks from escaping from around my full face mask? Particularly when the leaks are most frequent around the bridge of my nose?

Thanks (though)...

[alnhwrd]

I agree and I agree. DS is 100% correct about needing a machine that will provide at a minimum nightly average pressure, leak rate, AI, HI and AHI. This is really the only way to monitor your therapy. And I love Mack's, have used it for months with great results. To make this work, Take a lump of the putty, break it in half and roll it between your hands into a rope about 1/8" wide. You will need to use one or two lumps to get enough to go all around the mask. Now place the rope all around the cushion until you have a gasket of silicone that will be between your face and the mask cushion. Put on the mask and kind of smoosh it down on your face. It should prevent or at least reduce the leaks greatly. If you are still having persisent leaks (biggest trouble spots for me are around the corners of the mouth) add a bit more, again rolled out into a tiny rope. Hope this helps!