Wakeup with a headache after 4 hours on CPAP

[jamesj]

I wakeup with a headache and dry mouth after about 4 hours on CPAP. The headache dissipates after a drink of water & about 10 minutes awake. When I don't use the CPAP machine I wake up without the headache and dry mouth from apneas 6 to 8 times during the night.

I have approximately 1,000 hours experience with CPAP usage. The major struggle at the moment is mask fit and leakage. I am currently trying a UMFF mask (standard medium), it seems a better fit than the other three I have tried, I.e. less leakage. The other three are UMFF (standard large), and two nasal masks, a Mirage Activa Nasal mask (with both a large & standard cushion), & a ComfortGel Nasal. I have issues with nasal masks because of intermittent mouth breathing when my nose stops up.

The CPAP machine was set at 9 and the doctor had it changed to 11 after a sleep study. The headache and dry mouth have continued unchanged from when the unit was set at 9.

The machine is a Resmed S7 lightweight with a heated humidifier. I live in a very dry climate (Arizona) and setting the humidifier to maximum relieves the dry mouth a little.

I am also wondering if the use of an APAP machine such as an S8 Autoset II with software would help me to improve this situation, after I manage to find a mask that fits well with minimum leakage.

[GumbyCT]

Any data capable machine with software will help to figure out what is going on. As would getting & reading a copy of your sleep study (PSG) to determine if you were having ANY centrals at all during your PSG.
Do you feel as tho you are having any trouble at all exhaling?
You never mentioned your sleep doc - is s/he aware of any of this?
Good Luck,
GumbyCT

[jamesj]

I don't know if I have centrals, I will have to get the report and read it / ask the doctor next visit. No issues with exhaling at 11, I experienced that at 9 occasionally. Will the the software for an APAP show centrals?

[DreamDiver]

I agree with GumbyCT. You need a data-capable machine to check what's really going on.

There are lots of reasons why you can be having headaches. That said, without knowing much more about your setup, I'm guessing you still have major large-leak issues. That's the most common reason why we still get headaches as newbies. If there is any hiss coming from the mask other than through the leak ports, it can affect the efficacy of therapy. Moving around while unconscious can leave you in a position where the mask torques slightly, allowing air to escape and therapy to become useless. When you wake up and straighten out your position, the extraneous hissing might stop, causing you to be entirely unaware that you weren't getting therapy. A papcap from SleepGuy (pursleep.com) would help stabilize your mask so it isn't as likely to torque and leak. Buy one.

You can't really know how well your mask is containing pressure without a leak profile from a fully-data-capable machine. If you're renting your current machine from a DME, order a fully-data-capable machine and exchange your S7 for the new one. Get your sleep doc to rewrite the prescription so that you get exactly the machine you want. Then you'll have to buy the software out of your own pocket.

[GumbyCT]

As would getting & reading a copy of your sleep study (PSG) to determine if you were having ANY centrals at all during your PSG.
You never mentioned your sleep doc - is s/he aware of any of this?

You never mentioned your sleep doc - is s/he aware of any of this? ? ? Your doc IS vital in getting you a data capable machine.
Your PSG will show if you had any centrals during your PSG.

Leaks will reduce your therapy pressure to allow OA's & Hi's to continue tho you think "I'm using the machine". The dry mouth is a clue to look for leaks. Leaks are hard to determine w/o a data capable machine. It's like walking in the dark.

Sleep position can also play a role, esp. if you are stressing your neck during sleep.

[jamesj]

Thanks, I will find a mask that fits with minimal leakage 1st. Then buy an APAP machine. I found a supplier for the Resmed 3.5 software & I am considering an S8 AutoSet II w/H4i Humidifier & ResScan Data Card Reader.

[ractar28]

Tell us about the headaches. Are they "sinus headaches" or even possibly "pressure" headaches from the mask being too tight?

[Wulfman]

Using a full face mask is no guarantee that you won't get "dry mouth". If your mouth is open, it's gonna get dry.
Too much humidity can have the effect of closing up your nasal passages and you're going to be mouth-breathing.
Are you doing a nasal rinse/cleansing before bed? Clear nasal passages and COLD water in your humidifier.....and not using it heated may help keep them open.

Do you have diabetes? That can also contribute to dry mouth.


Den

[jamesj]

Diabetes = no. I think my question was answered. My conclusion from this post and others is to get a mask that fits without major leaks. Thanks.

[nate fry]

Well One thing I used to do is go to the bathroom mirror and make the mask adjustment as even as possible. On the other hand you may have a really bad diviated septum. A humidifier might help and you probably need a chin stap to keep your mouth closed so it doesn't dry out. That is the beauty of apnea. There are so many varibles thay it is hit and miss. After 6 years and 1300 hr I decided to get the surgery. I think my problems may be over. good luck.