First, let me say I tried to search through the board and didn't quite find an answer to my problem, and second, thanks in advance for your advice.
About 5 years ago I was diagnosed with OSA and had surgery (UPP/tonsillectomy/septoplasty), which really didn't help my sleep apnea. I was then placed on CPAP (3 years ago now). I was able to adjust to the machine and could fall asleep easily enough, but I couldn't get through the night without ripping the mask off after about 2 hours. I gave up on CPAP after about 6 months. Earlier this year, I decided to try it again, because my blood pressure, weight, etc., were all getting worse. I went for another sleep study, got a new machine (Fisher Paykel), but I continue to have the same issues, and quite honestly I haven't used the machine in months. I would like to be able to solve my problems and be compliant in using the machine.
The problem I have is that after a couple of hours with the mask on, I wake up feeling like I can't get enough air. It will take me 10-15 minutes to catch my breath and for my breathing to return to normal. I don't have too many problems falling asleep, and can usually fall off in about 15-20 minutes, once I settle all of the leak issues and overcome the feeling of not being able to exhale all the way. I wonder if CO2 is accumulating in the the tubing, or if I am just claustrophobic. My doctor and the respiratory company (Apria) have tried a number of fixes with no success (follow up sleep studies, APAP machine, different masks, etc.) The only answer anyone can give me is "just keep trying, you'll get used to it".
I found with the APAP that I was able to fall asleep faster and stayed asleep longer, but I still ended up ripping the mask off. However I only had that machine for a week for diagnostic purposes only.
I have a couple of thoughts after searching through the net a bit:
1. I probably need a better CPAP machine than the one insurance will pay for, and I am thinking of buying one outright. Not sure if I need APAP (like the remstar auto) or just a CPAP with Cflex. But I really liked the APAP when I had it for a week (it was a remstar auto) and I liked how easy it was to exhale with that unit. almost felt like I wasn't wearing a mask at all.
2. I am definitely not happy with Apria. I need to find a company that is more service oriented I think, or at least willing to work harder to help me solve these issues.
3. I probably need to try some kind of nasal pillow type of mask rather than the more traditional nose cup type of device. I am thinking I may just be experiencing claustrophobia??
I don't require a very high pressure. The latest sleep study and the APAP both came back with a recommendation of 8 cm of water. I do have a lot of allergy issues that I try hard to control, but I still have difficulty breathing through my nose some nights. Right now I take claritin and flonase to try and keep my nasal passages clear.
Anyway, I am not sure what else to include here so let me just end this and say that if anyone has any ideas on how to solve my problem I would appreciate hearing back. Also, if you have any thoughts on what is a good CPAP to relace the fisher paykel or good mask recommendations I would appreciate it.
Thanks again
Need CPAP help
11 posts
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Colorado Jan
I am nowhere close to an expert and there are probably others who have had experiences closer to yours than I have...
But I just wanted to encourage you to get the Auto-pap machine, the Remstar with Cflex. A lot of people really like it, it's at the top of the list along with a couple of other good machines. And if that was one you liked, get it.
This is your HEALTH we are talking about. Seriously, if you can even keep the mask on for a couple of hours a night, that is better than nothing. Do you wake up then? Can you not put the mask back on for another couple of hours? You have to keep at it and you have to tell yourself there is no way out of this commitment to your health. That's really the only way to succeed, because really now...who the heck WANTS to sleep with a mask on their face? NONE of us do! It's just that some of us have refused to give up.
As far as nasal prong masks go...the Swift is liked by quite a few people and is really minimal as far as what goes on your face and what strap apparatus keeps the thing on. A few pretty simple tweaks here and there with the straps and you have a great fit and a great mask. The Aura (is it now called the Headrest??) is another one people like. Really almost nothing touches your face with that one, but the headgear is more noticeable in my opinion. Both good choices though.
If you were going to consider keeping the current machine you have, maybe a higher setting would be more beneficial. If you feel like you are gasping for air, maybe the CPAP setting isn't high enough?
Good luck and keep us informed as to your progress!
Jan in Colo.
But I just wanted to encourage you to get the Auto-pap machine, the Remstar with Cflex. A lot of people really like it, it's at the top of the list along with a couple of other good machines. And if that was one you liked, get it.
This is your HEALTH we are talking about. Seriously, if you can even keep the mask on for a couple of hours a night, that is better than nothing. Do you wake up then? Can you not put the mask back on for another couple of hours? You have to keep at it and you have to tell yourself there is no way out of this commitment to your health. That's really the only way to succeed, because really now...who the heck WANTS to sleep with a mask on their face? NONE of us do! It's just that some of us have refused to give up.
As far as nasal prong masks go...the Swift is liked by quite a few people and is really minimal as far as what goes on your face and what strap apparatus keeps the thing on. A few pretty simple tweaks here and there with the straps and you have a great fit and a great mask. The Aura (is it now called the Headrest??) is another one people like. Really almost nothing touches your face with that one, but the headgear is more noticeable in my opinion. Both good choices though.
If you were going to consider keeping the current machine you have, maybe a higher setting would be more beneficial. If you feel like you are gasping for air, maybe the CPAP setting isn't high enough?
Good luck and keep us informed as to your progress!
Jan in Colo.
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wading thru the muck!
- Posts: 2799
- Joined: Tue Oct 19, 2004 11:42 am
louie1961,
During your sleep studies did the tech indicate any issues related to your allergies? Does it seem that your feelings of apparent suffocation might be related to your allergies closing your nasal passages? I do not have allergies, but I have found that when I have a plugged nose due to a cold I am able to open my nose up by increasing the humidity. To do this without experiencing significant rain-out, I bought the Aussie heated hose.
What was it about the APAP that you liked? Was it just the c-flex? I use the REMstar auto with c-flex and would recommend it, but with a titrated pressure of 8cm the auto may not really be doing much that a fixed pressure cpap would do. If money is not a concern, the auto would be a good choice though because it would be able to adjust your pressure should your needs change... and should you so choose it can be set to work as a fixed pressure machine.
I also use the aura nasal pillow interface; IMO it is the most comfortable, least restrictive interface available. I'll offer one caveat though, if you are not able to keep your nasal passages open, a nasal only interface will be difficult to tolerate.
Seems to me your first issue to resolve is the apparent suffocation...my suggestion is to increase the humidity and see if that can improve that situation. Once you have that solved you can work on improving your overall comfort.
During your sleep studies did the tech indicate any issues related to your allergies? Does it seem that your feelings of apparent suffocation might be related to your allergies closing your nasal passages? I do not have allergies, but I have found that when I have a plugged nose due to a cold I am able to open my nose up by increasing the humidity. To do this without experiencing significant rain-out, I bought the Aussie heated hose.
What was it about the APAP that you liked? Was it just the c-flex? I use the REMstar auto with c-flex and would recommend it, but with a titrated pressure of 8cm the auto may not really be doing much that a fixed pressure cpap would do. If money is not a concern, the auto would be a good choice though because it would be able to adjust your pressure should your needs change... and should you so choose it can be set to work as a fixed pressure machine.
I also use the aura nasal pillow interface; IMO it is the most comfortable, least restrictive interface available. I'll offer one caveat though, if you are not able to keep your nasal passages open, a nasal only interface will be difficult to tolerate.
Seems to me your first issue to resolve is the apparent suffocation...my suggestion is to increase the humidity and see if that can improve that situation. Once you have that solved you can work on improving your overall comfort.
Sincerely,
wading thru the muck of the sleep study/DME/Insurance money pit!
wading thru the muck of the sleep study/DME/Insurance money pit!
I'm going to chime in here on a coupe of points.
First, like you, I could not tolerate the mask the DME gave me. AND, like you, I finally decided that for a NUMBER of reasons I had to make this work.
I need a mask that doesn't involve so much coverage and headgear. I don't THINK I'm claustrophobic, but the mask they gave me actually hurt. So I quit.
I just recently bought the REMstar auto with cflex and heated humidifier. AND I bought the Swift nasal pillow interface (mask). No hose up between my eyes. Virtually nothing on my face, minimal headgear that's as easy as a baseball cap to put on and take off.
Now it MAY be that your machine isn't the problem. I don't think you'll see a lot of argument here if I tell you that the mask is the hardest part of getting all of this to work. I'd say make that a priority. Your observation that you may be able to use a nasal pillow type better is a valid observation. YOU are going to have a feel for what works for you. Now *I* may tell you to get a Swift. Someone else may tell you they like the Aura better. Someone else may have another suggestion. At your pressure (same as mine) the Swift is not noisy and may be a good thing to try. Most complaints about the Swift being noisy seem to be at pressures around 12 and higher. Anyways... it's still a pig in a poke because what works for me may not exactly be the answer for you. HOWEVER, it's probably the cheapest pig.
Cheaper to experiment with masks than machines.
Now... THAT being said... you seem to have observed that you got to sleep faster and stuff with the REMStar auto with cflex. Did you have a heated humidifier? I find that even if I'm a bit stuffy right before bed, getting on the machine actually seems to open me up and I'm very comfortable. I have to blow my nose a lot as soon as I get out of the shower though, but that's fine. The point is that for me the heated humidifier made a HUGE difference in the comfort aspect. But the MACHINE question...whether you really need an auto or not or whether you need cflex or not (I find the cflex amazing..can't imagine how I lived without it) is something I'd try chasing AFTER you get the mask thing a bit more under control.
You can get a mask for under $120 pretty easily. Many MUCH less than that. Easier to experiment in that price range in case your insurance is being a bunch of ****heads (like mine are).
THEN once you get the mask thing going...then decide if a different machine will help. The nice thing about the REMStar auto with cflex is it's versatility. It can do auto with cflex or without. It can also be set to straight cpap and still use the cflex.
That's kinda the direction I'd be going in.
First, like you, I could not tolerate the mask the DME gave me. AND, like you, I finally decided that for a NUMBER of reasons I had to make this work.
I need a mask that doesn't involve so much coverage and headgear. I don't THINK I'm claustrophobic, but the mask they gave me actually hurt. So I quit.
I just recently bought the REMstar auto with cflex and heated humidifier. AND I bought the Swift nasal pillow interface (mask). No hose up between my eyes. Virtually nothing on my face, minimal headgear that's as easy as a baseball cap to put on and take off.
Now it MAY be that your machine isn't the problem. I don't think you'll see a lot of argument here if I tell you that the mask is the hardest part of getting all of this to work. I'd say make that a priority. Your observation that you may be able to use a nasal pillow type better is a valid observation. YOU are going to have a feel for what works for you. Now *I* may tell you to get a Swift. Someone else may tell you they like the Aura better. Someone else may have another suggestion. At your pressure (same as mine) the Swift is not noisy and may be a good thing to try. Most complaints about the Swift being noisy seem to be at pressures around 12 and higher. Anyways... it's still a pig in a poke because what works for me may not exactly be the answer for you. HOWEVER, it's probably the cheapest pig.
Cheaper to experiment with masks than machines.
Now... THAT being said... you seem to have observed that you got to sleep faster and stuff with the REMStar auto with cflex. Did you have a heated humidifier? I find that even if I'm a bit stuffy right before bed, getting on the machine actually seems to open me up and I'm very comfortable. I have to blow my nose a lot as soon as I get out of the shower though, but that's fine. The point is that for me the heated humidifier made a HUGE difference in the comfort aspect. But the MACHINE question...whether you really need an auto or not or whether you need cflex or not (I find the cflex amazing..can't imagine how I lived without it) is something I'd try chasing AFTER you get the mask thing a bit more under control.
You can get a mask for under $120 pretty easily. Many MUCH less than that. Easier to experiment in that price range in case your insurance is being a bunch of ****heads (like mine are).
THEN once you get the mask thing going...then decide if a different machine will help. The nice thing about the REMStar auto with cflex is it's versatility. It can do auto with cflex or without. It can also be set to straight cpap and still use the cflex.
That's kinda the direction I'd be going in.
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| Mask: Swift™ FX Nasal Pillow CPAP Mask with Headgear |
| Humidifier: S9™ Series H5i™ Heated Humidifier with Climate Control |
| Additional Comments: original pressure 8cm - auto 8-12 |
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Guest
Hi all, thanks for the responses.
Jan: Its a mix really. Sometimes I take the mask off and try to put it back on but find I can't fall back to sleep. Sometimes I am un aware that I have taken it off until the morning, and sometimes I am just so darned cranky with it that I don't even try to put it back on. I do notice that the nights I try to put it back on, I end up not getting much sleep and I feel more tired than if I didn't use the machine at all.
Wading: No, no mention of allergies during the sleep study. But then again, my dogs didn't go to the sleep center with me either. I don't know for sure but I don't think my issues relate the allergies. The allergies seem to be an all or nothing problem, in that when they are bothering me, I can't use the mask at all, unless I take some afrin or the like.
What I liked about the APAP was the ease of exhalation, whether that was due to the cflex or the low pressure it starts with, I am not sure. But I didn't have to fight to exhale.
Yardbird: I have never used a humidifier. I have read lots of positive reports on this board about the beneficial effects of one, but my DME and Doctor have never recommended one, so I never thought to ask.
I don't think my issues are so much a lack of physical airflow (e.g., no obstruction in nose, mask etc.) as far as I can tell. I can breath OK with the mask on, but when it wakes me up at night, I feel like I have been breathing into a paper bag all night. It could just be psychological or it may be physiological (maybe CO2 retention), but I can't quite figure it out for sure.
Thanks again all for your time
Jan: Its a mix really. Sometimes I take the mask off and try to put it back on but find I can't fall back to sleep. Sometimes I am un aware that I have taken it off until the morning, and sometimes I am just so darned cranky with it that I don't even try to put it back on. I do notice that the nights I try to put it back on, I end up not getting much sleep and I feel more tired than if I didn't use the machine at all.
Wading: No, no mention of allergies during the sleep study. But then again, my dogs didn't go to the sleep center with me either. I don't know for sure but I don't think my issues relate the allergies. The allergies seem to be an all or nothing problem, in that when they are bothering me, I can't use the mask at all, unless I take some afrin or the like.
What I liked about the APAP was the ease of exhalation, whether that was due to the cflex or the low pressure it starts with, I am not sure. But I didn't have to fight to exhale.
Yardbird: I have never used a humidifier. I have read lots of positive reports on this board about the beneficial effects of one, but my DME and Doctor have never recommended one, so I never thought to ask.
I don't think my issues are so much a lack of physical airflow (e.g., no obstruction in nose, mask etc.) as far as I can tell. I can breath OK with the mask on, but when it wakes me up at night, I feel like I have been breathing into a paper bag all night. It could just be psychological or it may be physiological (maybe CO2 retention), but I can't quite figure it out for sure.
Thanks again all for your time
I tried the swift and didn't like it, but if you would like to have it, I will send it to you - pm me.
I agree that your machine probably isn't the problem, if it is working properly. I understand that if your pressure should happen to fall off, CO2 will build up - maybe that is what is happening. The only other advantage of an APAP is that if you really need more pressure than what has been prescribed - the 8 cm, I think it will give it to you.
Get whatever is wrong fixed, you will be a happy camper, and camping season is awfully short.
I agree that your machine probably isn't the problem, if it is working properly. I understand that if your pressure should happen to fall off, CO2 will build up - maybe that is what is happening. The only other advantage of an APAP is that if you really need more pressure than what has been prescribed - the 8 cm, I think it will give it to you.
Get whatever is wrong fixed, you will be a happy camper, and camping season is awfully short.
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| Mask: Mirage Activa™ LT Nasal CPAP Mask with Headgear |
| Additional Comments: pressure 10-12 |
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Colorado Jan
Louie...
I just read over this thread again and I guess I initially missed the part where you say you don't have a heated humidifier. That really is a must. Your doctor and your DME probably didn't mention it because they don't use a CPAP machine and don't have a clue.
But the heated humidifier really helps increase the comfort level of PAP usage and even helps keep your sinuses clear regardless of your allergies.
I've found that I don't like the HEATED part of the heated humidifier...so you just turn the heat off and use it like a passover humidifier...in other words, the air just passes over the water and picks up humidity that way. So get your Cflex, get a humidifier, try a Swift mask....and get back to us!
But KEEP USING YOUR CPAP!!!!!!!
Jan in Colo.
I just read over this thread again and I guess I initially missed the part where you say you don't have a heated humidifier. That really is a must. Your doctor and your DME probably didn't mention it because they don't use a CPAP machine and don't have a clue.
But the heated humidifier really helps increase the comfort level of PAP usage and even helps keep your sinuses clear regardless of your allergies.
I've found that I don't like the HEATED part of the heated humidifier...so you just turn the heat off and use it like a passover humidifier...in other words, the air just passes over the water and picks up humidity that way. So get your Cflex, get a humidifier, try a Swift mask....and get back to us!
But KEEP USING YOUR CPAP!!!!!!!
Jan in Colo.
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Snoredog
based upon your pressure requirement, I would suggest the Remstar Auto w/Cflex w/Heated Humidifier and since you already had a UPPP, I suggest a Resmed UltraMirage Full Face mask. You can easily get by with the Pro2 w/cflex but if you haven't had a PSG in some time it would be wise to spend the extra $75 bucks or so for the autopap.
But keep in mind an autopap is really not going to help you therapy wise (over the Pro w/Cflex for example). People go with a autopap mainly for lower overall pressures, obtaining downloaded sleep detail data, and/or to find new pressure if your condition has been changing due to weight/age etc. Your best sleep will probably come from using it in autopap mode for a while finding your ideal pressure then switching it to cpap mode w/cflex.
You need to take control over your sleep situation and not rely on someone unknown to your condition like Apria or insurance policies dictating your therapy needs. You also need to learn to program the machine yourself so you can confirm things are set correctly, no one uses a higher pressure than they actually need. I didn't like dealing with Apria either, so I bailed on thier bad ideas and bought on-line.
All you need to do is go back to your regular GP that knows your medical history and obtain a new script for the autocpap, humidifier & mask. Order it on-line here and fax over your script. It will come with the manual and you can set it up yourself. Order from cpap.com, they have the best price and make sure it has the humidifier.
But keep in mind an autopap is really not going to help you therapy wise (over the Pro w/Cflex for example). People go with a autopap mainly for lower overall pressures, obtaining downloaded sleep detail data, and/or to find new pressure if your condition has been changing due to weight/age etc. Your best sleep will probably come from using it in autopap mode for a while finding your ideal pressure then switching it to cpap mode w/cflex.
You need to take control over your sleep situation and not rely on someone unknown to your condition like Apria or insurance policies dictating your therapy needs. You also need to learn to program the machine yourself so you can confirm things are set correctly, no one uses a higher pressure than they actually need. I didn't like dealing with Apria either, so I bailed on thier bad ideas and bought on-line.
All you need to do is go back to your regular GP that knows your medical history and obtain a new script for the autocpap, humidifier & mask. Order it on-line here and fax over your script. It will come with the manual and you can set it up yourself. Order from cpap.com, they have the best price and make sure it has the humidifier.
I think I have taken a huge step in the right direction. I contacted my DME and asked them to bring me a nasal pillow type of mask. The gentleman showed up with a swift, and said try this for a few nights. Long stroy short, I think I have been getting claustrophobic and just didn't know it. I decided to put the swift on and watch some TV yesterday afternoon to see if I could get used to it. Lo and behold, I fell asleep on the couch for 4 hours, until my wife woke me for dinner. Last night I slept with the new mask pretty well until it became too uncomfortable on my upper lip/nose. The device was too cold. I think with a heated humidifier my problems may be solved. I will probably still look into buying a remstar with cflex. But the new mask was a very dramatic improvement. Thanks for your help!
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| Humidifier | |
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