questions from a CPAP noob

[wandererrob]

Hi all,

I've been using my CPAP for about 2 weeks now and have a couple of questions since I have no idea what's normal and what's not.

My first night was awful and I ended up taking the mask off after about 3 hours. The next 2 nights I toughed it out and felt GREAT the next morning. Ever since then I've felt only marginally better than without the CPAP. I know my body is still getting used tot his thing and all, but is this normal?

Next question... I'm using a Fisher & Paykel Flexifit 431 mask. I can't seem to keep the thing sealed. Even freshly shaven, with my face and mask freshly cleaned the slightest movement makes it leak at the bridge of my nose. I've adjusted it several ways with no luck and am now sleeping with it pretty tight against my face. The sleep guy is supposed to be sending a new mask, but I have no idea when. In the meantime, is there anything else that can be done? And is this leakage during the night enough to make me feel like I am in the morning after those first 2 good days?

And if you have any other words of wisdom, I'm glad to hear them.

Thanks,

Rob

[hazwaster]

If you're using a full-face mask, and it sounds like you are, it's important the mask is the right size. I use a ResMed Mirage and love it. I have a wide face, and use a size large. If the mask is too small, or too large, all the tightening in the world won't help. When I first started CPAP, I used a nose mask only, but chronic sinus problems moved me to try a full-face mask. I wouldn't go back.

[Goofproof]

For me that mask worked fair, it did tend to leak more the last half of the night. Unless your DME ripped you off that mask should come with 3 sizes of seals, you might try the different sizes. If you weren't given them, you might have to buy them back from him on E-Bay. I ended up having better luck with the ComfortFull "M", now I'd want the ComfortFull Gel "M". a lot of it is how the straps fit, you want even pressure with the mask setting level on your face. After I get it set up, I gently pull it away from me face and let some air escape, that lets the seal sit better on your face. In the end everyones answer is different, our faces are all different. jim

[BeanMeScot]

You have gone without quality sleep for many years. Don't be surprised that it takes a while to feel better. Usually on the order of months. The first week for me was the worst and it has only gotten better from there.

[wandererrob]

After figuring out how to get into the clinical menu on my machine I got the following data. Could somebody give me an idea of where this stands on the scale of good-bad?

AHI - 1.1

AI - 0.0

HI - 1.1

Leak - 1.34L/s

I'm guessing the HI/AI thus the AHI is quite good considering that during my first sleep study they told me I stopped breathing 400 times in 4 hours of data. But I have no numbers to actually compare too. But the leak concerns me a little. Is that a lot?

[elader]

AHI of like 1 or 2 is excellent. You were at 100? Wow. Masks are supposed to leak. Average leak is what flushes your CO2 out of the mask. Every mask is different and the rate is proportional tot he pressure. But you really need to see downloaded data on a graph to see large leaks and whatnot.

The single most important thing you can do to make your therapy a success is to get a mask that fits. I was handed a mask to start that used to wake me up at night in agony. I spent two hours at my DME trying on 30 masks and picked my favorite. Make sure to try them when they are attached to a machine and in a sleeping position.

[RiverDave]

Your leak rate is way, way, way too high. Anything over about 0.2 is too high. Make sure the mask setting on the machine is correct. The machine is not helping you with lead rates that large.

[Hawthorne]

That mask comes with 3 seals. There should be a small, medium and a large seal. They all fit the same frame. Your leak rate is way too high.

Did you get the mask from your DME? You should have received all 3 seal sizes or did he/she sort of fit you and just give you one seal.

The other thing you need to watch, with that mask, is that the seal is firmly in the slot where it is supposed to go all the way around. It can pop out sometimes and then you have a really large leak. If you had that happen you would probably notice unless you are a very sound sleeper but I just thought I would mention it.

With that machine you do need to make sure you tell the machine what mask you are using.

[elader]

Your leak rate is way, way, way too high. Anything over about 0.2 is too high. Make sure the mask setting on the machine is correct. The machine is not helping you with lead rates that large.

see, I retain only Respironics specific minutia. Good to know.

[GuyK]

Mr. Noob -- I used that same mask to start with, and I learned a couple of things by trial and error.

First of all, as Hawthorne says, there were 3 seals that came with that mask (if the DME didn't give you all three, then please call them -- don't listen to them if they say they need to bill separately for them, they don't, the original package had all three).

I started with the M. When I thought that leak rate was too high, I tried both the S and the L. Both of those leaked worse than the M.

Then I discovered the mask straps need to be fairly loose. This mask, like other full-face masks, depend upon the "seal" inflating in order to make a good fit. Another thing my DME told me: "what most people don't realize is that almost all adjustments should be done with the lower straps". Whether that is true or not, I don't know, but I did find out that tightening the upper straps would sort of "lever" the bottom of the mask away from my face. I had more success when I loosened the straps.

Eventually, after talking at length with my DME, I moved to a different full-face mask. I've been very happy with it ever since. It is only slightly less comfortable (to me) than the F&P mask, and I get a lower leak rate, especially after doing the "teflon tape fix" to the mask.

[wandererrob]

First of all, as Hawthorne says, there were 3 seals that came with that mask (if the DME didn't give you all three, then please call them -- don't listen to them if they say they need to bill separately for them, they don't, the original package had all three).

Then I discovered the mask straps need to be fairly loose.

I only have the large seal and it will actually vibrate as it leaks if I don't have the mask cranked down hard against my face. The respiratory equipment guiy tried me in the various seals to see which fit best, but apparently that hasn't worked out so well in practice.

I do have a new mask on the way after sitting in the sleep guy's office trying other masks on. He's moving me from a full face to a nasal mask with a chin strap, so we'll see how that goes. I have no idea when it will arrive though.

[GuyK]

The DME guy should have left you with all three seals. You paid for them! (actually, they billed the insurance company for them)

Dry fit with you sitting up (and not laying down) is no way to really check out a mask. If there's anything I've learned in the last several months, it depends on everything, including sleep position, phase of the moon, facial cleanliness, state of facial hair, and anything else you can think of.

Seriously, these FFM's depend upon a certain amount of looseness in order to seal well. Cranking them down tightly is only encouraging more leaking. If your L is leaking (and those numbers should be below 0.5L/sec), then the fit is absolutely wrong.

I was very happy with the F&P comfort-wise, and if I didn't ultimately decide it just didn't fit my face all that well (so the leak rate didn't consistently come down), I'd still be using it. But I'm perfectly happy, comfort-wise, with the other FFM I have now.

[wandererrob]

Cranking them down tightly is only encouraging more leaking. If your L is leaking (and those numbers should be below 0.5L/sec), then the fit is absolutely wrong.

I did find the other seals. He stuck them in the bag, I didn't realize it. I'll try the medium out tonight as last night was miserable. Gave up and ditched the mask after fighting with it for 3 hours. I just could not keep it sealed at all last night.

As for the straps, if they aren't absolutely cinched down on my head the air just blows by the seal and for added fun will even make a rather flatulant sounding vibration on my cheeks. I'm calling the DME today to find out where the hell my new mask is. This needs to stop.

[wandererrob]

Your leak rate is way, way, way too high. Anything over about 0.2 is too high. Make sure the mask setting on the machine is correct. The machine is not helping you with lead rates that large.

I'm not sure what the setting options are, but it says "mask: standard" in the menu. Does a FF mask = standard?

[OutaSync]

Bumping...so someone with a Resmed can answer your question about mask settings.......