I fell off the wagon

[Guest]

I’m new here. I’ll try to make this a short story and not a book.

I’ve been aware of the sleep study business since about 1986. My wife just happened to work in the neurology department in a hospital that was pioneering a sleep lab and had a couple of doctors on staff, that were sleep study pioneers in our area. Boy, have things changed since then. Now, the hospital no longer has a sleep lab, I guess, because everyone saw what a cash cow this business was going to be and private sleep labs and doctors have come out of the woodwork.

While my wife worked at the hospital and it had a sleep lab, I had my first sleep study around 1991. I did it for two reasons. My wife twisted my arm and they needed suspects to train new techs on, things were slow at time. The study revealed I did indeed have sleep apnea, but for some reason I never followed up.

In 2007 my wife decided I needed to have a sleep study and get on a CPAP. She lined it up, I went the two times and got a prescription I guess you call it, never seeing a doctor. That was one difference. The first sleep study I saw a neurologist before the study and was to see one after and never followed up after the first night. Anyway, the sleep lab referred me to a medical equipment outfit. They didn’t get to sell me the machine, because we already had one from my wife’s adventure a few years before. She couldn’t tolerate it, so, I had a machine at my disposal. I got the machine adjusted to my setting and was to get fitted for a mask. Somebody at another company gave me their, what I thought was, exorbitant price for a mask and I dropped it again in the summer of 2007. All I needed was a mask.

Finally in 2009 my wife talked me into trying to find a mask online and order it. I was an accident waiting to happen when it came to driving. I’m lucky to be here. I could nod off at the wheel any time day or night. I found a mask, ordered it, and I got started on the CPAP.

It took me a while to get used to the pressure, but I finally did. Then like a lot of you I’ve seen, I couldn’t keep it on at night. I would just try it every now and then. Finally last year sometime, I kept on until I could keep it on most of or all night. I got to the point that I would be sleeping so good, I would wake up in the middle of the night on my bad shoulder with it hurting so bad I couldn’t move. I didn’t have to worry about driving anymore. I had solved that problem. I never really saw that burst of energy someone was looking for either.

Sometime around the end of November or beginning of December last year, for some reason I would lay down to go to sleep and not put on my mask. I think I decided to cut back on it some because, I had discovered that the mask was making depressions in my forehead. They showed up in a portrait we had taken in early November. I even had my wife ask the doctor she works for, a neurosurgeon, if it was going to eventually push into my brain. He told her it was caused from the constant pressure of the mask over a period of time and I needed some kind of padding and he also assured her it wouldn’t go into my brain. I still haven’t solved that one. Maybe someone can tell me what to do about that. Then I fell off the wagon for a short time.

I started trying to get started back on and it had turned cold weather. I would wake up during the night with my throat and mouth would be so dry I couldn’t swallow. I don’t have a humidifier or a warmer. I’m lucky to have the machine itself. I was blaming it on the cold air.

Our house gets cold at night during the winter. I was able to sleep with it last year, in colder weather than we had this year, so, I was baffled. I’ve been trying it every night for the past few weeks and even on the warm nights like last night I wake up with the dry mouth and throat. When I wake up my mouth is closed and no leaks. I don’t see how I could sleep with my mouth open with the CPAP pressure. To complicate it, now I wake up between 3 and 4 am and toss and turn until I get up.

Any ideas on how to pad my mask so I don’t leave a depression in my forehead and does anybody have any idea on the dry mouth and throat? I am about ready to give up again.

I just remembered something. I stopped smoking in December. Would that have anything to do with it?

Thanks

[LSAT]

You will probably get lots of help if you supply some information...like...WHAT MASK DO YOU HAVE?

[wolewyck]

The dry mouth/throat thing-- you really do need to get the humidifier. You may be able to find one used if you look around, but what many have found here is that if you're going to be consistent with CPAP, you have to find ways to make it comfortable for you. That includes a humidifier, and finding a mask that you like.

There are many, many kinds of masks out there. The standard style nasal mask has that forehead-piece that can leave visual marks although they usually go away during the course of the day. If that is bothersome, however, you can try other types-- something with nasal pillows, for instance. The Swift FX as a minimal "footprint" and seems to be very popular--I know it works for me. There are also a variety of full face mask options. See if your wife's connections can at least extend to getting you a mask fitting done, where you can try on a variety and see which seems most promising. You may need to try several before finding something that really works for you.

You gotta stick with it though-- persistence is the name of the game here in terms of getting both the health benefit and the "feel good" benefit.

[Goofproof]

Odd's are, you are using a Nasal mask and Mouthbreathing, making your treatment not ideal. Your mask is not adjusted right, too tight makes it worse.

"People don't fall off the Wagon", they jump! Jim

[Big B]

Thanks guys,

Here is what I have: Mask-Aclaim 2 Nasal Mask
Machine-REMstar/Plus

Jim I guess I did jump of the wagon. My adjusment may be out of whack. I'll try readjusting it per the mfg.'s instructions. I probably do have it too tight.

Those marks I mentioned are actual indentions in my skull from the pressure of the mask. That's why I said I asked my wife to ask her neurosurgeon boss about them. If I do get some kind of padding I don't know if they will go away he didn't say. However, I did run across someone who's husband also uses a CPAP different set up and he has places in the back of his head from his particular mask. Does anyone else have these or do I and this other guy just have ours too tight.

Maybe I just need a new mask, but for now I'll have to see if I can get along with this one a while longer.

[Pugsy]

Not sure if this padding will work with your mask but I think you can see the idea behind it. Take a peek.

http://www.padacheek.com/PACActiva_UM.html

The indentation is in the soft tissue on the forehead. There is no "dent" in the bone but it sure looks that way for quite a while.

I wear the Swift FX. It is a nasal pillow type of mask. It has very soft silicone side straps. Even with the little felt pads that come with the mask, I still got "lines" on my cheeks and they would last half a day or so. Fleece pads do help. I could have made my own but Karen at Padacheek makes such nice ones I didn't want to go through the hassle so I ordered the fleece covers for my side pieces and no more side marks on my cheeks. Very comfy.

You may benefit from a mask change. It sure would be worth a try but in the meantime some sort of padding will help now.
There are many, many different types of masks out there to choose from.
Nasal mask, covers the nose like you have now
Nasal pillow masks, which use only little pillows pressed up against the nostrils. This is the type I use. Check out my profile below this post to take a peek at it.
Full Face masks that cover the mouth and nose at one time. Especially useful if a person breathes through there mouth a lot due to nasal congestion.
Do your homework and see what might appeal to you.

The Remstar Plus machine you have won't ever be able to give you any useful data as to leaks or even effective therapy. If at all possible an upgrade in machine to fully data capable is much better and at that time also get one with a humidifier. Most people do need the extra moisture that a humidifier offers. More comfort, more better to use all this stuff on our face. Every little bit of extra comfort will make this process more bearable.

It is critical to know if the leaks are significant enough to affect treatment. Otherwise a person doesn't know if they are getting effective therapy or not. So start thinking about a data capable machine down the road.

[Goofproof]

Be concerned that your machine doesn't collect useful data, so you will not know if your nasal mask is leaking out your mouth so bad that you are not getting the treatment you are needing. A FF mask would allow you to get treatment. A machine that collect full data and the software would allow you to see if your treatment is really working. The mask being too tight pushed the structure under the skin out of the way, wearing the mask looser will lessen that. Any mask tends to adapt the face to fit the mask over time, that may be seen as a good thing or not. We end up being XPAP Mask faced. Which beats Dead! Jim

[Big B]

Thanks folks.

I’m learning a lot. Mostly how ignorant and outdated I am.

I read where a lot of you know the results of you study. About all I got was hustled out the door after they woke me up, a bill, and a call in prescription to the place to adjust my machine. This place was the one my wife selected. If I recall, it was owned and run by some of the former coworkers and doctors my wife worked with way back when.

Correct me if I’m wrong, but I still think this has turned into a mega money maker for many. As I recall, in those early years this was all done by neurologist and they were specially trained and were the ones that read the sleep studies. I don’t know how it works around here today. My wife and I were talking last night and she said a doctor read my study even if I didn’t see one. I guess I should try and start attempting to get a copy of the study and prescription. I’ve read where some people have trouble getting masks and things without the prescription. I don’t know how I got my mask, but I did. I’m sure I’ll get some of the resistance, I have read about, trying to get the prescription. If it’s like everything else around here in the medical field, the lab owns the supply business or are part owner and they try to funnel everything through it so they can milk as much out of the “cash cow” as possible. It’s all about a dollar. My wife has been in the field around here all these years and currently works with individuals that have this type setup. Several businesses all tied to the main one.

Unfortunately, I’m like another guy I read about, no insurance, self and underemployed. Updating to a machine that gives all that data is probably out of the question. Maybe, about all I can do is try and get another mask and keep trying to get what I can out of what I have.

Thanks for the help.

[SUEBRIT]

I am new to CPAP and at the moment can only use it for 3 or 4 hours a night as I get used to it. At first I used the Nose Pillows, but they hurt one nostril so I changed to a mask, which is very light and does not leave marks on my face. In fact the instructions say not to tighten the straps. I use an EASY LIFE PHILIPS RESPIRONICS MASK. It is a half mask with a nose piece inside.

[ladyhen]

I actually saw a neurologist and he scheduled my study with the sleep center right down the hall. (Did I mention it was like a stay at a luxury hotel? I'd love to go back! LOL)