The Daily Blowdown

[TalonNYC]

On Pugsy's suggestion (and can I just say thanks again for having someone like Pugsy to help out!) I'm going to update a single thread with the morning reports.

Touching base daily in forums like this has been a huge help for me in cementing new, positive habits. I'm also very much about social connection, so if anyone else wants to post here, they are more than welcome!

3/25/2011
Night 4 is over. Not bad overall, finding out new stuff every day. Woke up once during the night, fell back to sleep in about 5 min.
AHI 3.7
Leak 2.9
7 hours sleep

Observations: Thanks to the stress of going through the process of getting the machine and then beginning to use it, I had an acne breakout. Of course two of those zits were on the bridge of my nose and under my nose - talk about perfect placement. Flex-foam bandage worked great on the nose bridge, so I was able to tolerate the mask.
Woke up with the unit slightly skewed on the nightstand. Not sure how that happened, as I don't appear to have moved around more than usual last night. Go figure.
Still kind of groggy in the AM, though a bit less each day. I'm NOT a morning person, so I doubt I will ever wake up completely bouncy and refreshed.

What I learned last night:
Do NOT watch "Ghostwatch" on youtube within 10 hours of sleep
The chinstrap seems to have helped, as my AHI dropped nearly a full point from last night. Hybrid mask is nearly delivered, so the mouthbreathing will be irrelevant soon.

[JayC]

Love your style; like the "Observations" section!

What a great record to look back on to remember/notice many elements. When I have done this for things in the past, my records have been more vanilla/boring/a necessary chore if I wanted some history to look for trends of multiple variables.... this seems like fun!


Nice job....I'll tune in!

J

[PtownKev]

Hey Talon, I think keeping a record of your daily progress is a great idea. I've been keeping a daily "log" of my sleep since I started on CPAP about three weeks ago. I make a note of how long I slept, my AHI for the night, what mask I was wearing, the humidity setting and any issues/problems that I had during the night. It's helpful to track what works and doesn't work for you.

I also had the same problem with breaking out at the site of the nasal mask. I got big painful pimples on either side of my nose, right where the mask sits. I'm almost 50--what the h*ll am I doing getting acne at 50??? I got my second nasal pillow mask (Swift LT) yesterday and tried that last night. It's very comfortable and more stable than the Swift LX, but still have a lot of leaks reported on the graph this morning. Sigh. It's always something, right? Someday we'll find the perfect combination and will just be able to go to SLEEP without all the fiddling and adjusting and tweaking.

[Pugsy]

got my second nasal pillow mask (Swift LT) yesterday and tried that last night. It's very comfortable and more stable than the Swift LX, but still have a lot of leaks reported on the graph this morning. Sigh. It's always something, right? Someday we'll find the perfect combination and will just be able to go to SLEEP without all the fiddling and adjusting and tweaking.

pe


Lots of leaks (especially if substantial size) may point to mouth breathing. While the machine can compensate for some, the bigger the leak and longer in time some effectiveness may be lost. Watch carefully for signs of mouth breathing. Dry mouth, sore throat and maybe someone reporting snores. If there is more than tiny bit of mouth breathing must consider adding something to aid in keeping mouth shut like tape, chin strap, learn to keep tongue in roof of mouth or use a full face mask if mouth breathing cannot be managed. During the initial adjustment phase with new mask we can expect some leaks related to the mask but if it persists, consider the mouth as a potential leak source also.

[TalonNYC]

In my case, Pugsy, it DEFINITELY is. I found myself "motoboating" when I woke up during the night the first 2 days. The chinstrap seems to be helping quite a bit, and the hybrid should make it a moot point. I never realized just how much I was mouth-breathing before starting CPAP, as I tended not to wake up with a particularly dry mouth.

[PtownKev]

Pugsy always has good advice. It's something that I've thought of but I'm not sure that mouth breathing is the issue. For one thing, I never wake up with a dry mouth on CPAP, whereas I always used to without the machine (I know I was snoring with my mouth open all night pre-CPAP). Another thing is that I had virtually zero leaks with the nasal mask, but big leak fluctuations with both the Swift FX and now the LT. I'm not going to give up on the LT (yet!) but it was discouraging to see a very similar pattern to the nights with the FX. I might give the chin strap a try anyway--I'm always willing to find solutions that will make this work for me--but I'm guessing that mouth breathing is not the problem here (although I freely admit I could be dead wrong about that assumption!).

Talon, let me/us know what you think of the hybrid mask--I'll be interested to hear your impression.

[TalonNYC]

I've found that I don't wake up with a dry mouth on CPAP - mostly due to the humidifier. So even though I know I was mouth breathing the first 3 nights, my mouth was not dry in the AM.

[PtownKev]

Good to know, Talon! So maybe I'll give the strap a try.

[nanwilson]

Mike
You say your machine got moved on the nightstand, to keep that from happening either use an old mouse pad to put it on or get some of that rubbermaid shelving stuff. The shelving stuff (can't remember the name) keeps your dishes from moving on the shelf....I use it in my motorhome, since my motorhome moves, my dishes don't slide around on the shelf. A second tip to use either a mouse pad or this stuff is, it also muffles the sound of your machine on the table. Actually I bought a gardening kneeling pad and cut it in half....half for my nightstand and half in the motorhome..its just over an inch thick so does a great job of keeping my cpap from sliding and muffles any sound coming from it.
Hope you understood what I was trying to say........haven't had my coffee yet so my brain is still not up and ready
Nan

[TalonNYC]

Thanks Nan, yup it makes sense. I'll try the mousepad idea, as I use a Magic Mouse (which doesn't use them) but I still seem to have collected about 40 of the things over the years...

[Pugsy]

In my case, Pugsy, it DEFINITELY is. I found myself "motoboating" when I woke up during the night the first 2 days. The chinstrap seems to be helping quite a bit, and the hybrid should make it a moot point. I never realized just how much I was mouth-breathing before starting CPAP, as I tended not to wake up with a particularly dry mouth.

I think that there are some people who just are mouth breathers for whatever reason. Maybe long term habit, maybe because of frequent nasal congestion or just whatever. I also think that some people become mouth breathers because they are trying to get more air into lungs because of the apnea events. Sort of a habit developed because of OSA not from a physical need to get air via the mouth. I can pretty much pinpoint when my OSA symptoms started as I would often wake with sore throat and my own snores would wake me up. When I first started therapy I was still in that habit of mouth breathing to try to get more air into lungs. I made a personal decision to tape because I didn't want to or couldn't use a full face mask. After a couple of months I started getting lazy and didn't tape. I discovered that I no longer seemed to have mouth breathing issues. So in my case I think it was just a habit I had gotten into trying to move more air. Once I was getting effective therapy I no longer needed that habit.

Will everyone be able to ditch that habit? Of course not but some can. I never was a mouth breather during the day and I rarely have nasal congestion issues so prime candidate to be mainly nose breather at night once I no longer needed the extra air due to events.

Some people adjust very well to full face masks as a solution to pressure loss due to mouth breathing. I couldn't because of other physical issues so I just decided early on that I had to make the nasal pillow mask system work for me. It is up to the individual to decide which mask system works the best for them. This is why I don't often suggest that a person go immediately to full face mask as a solution. I respect the desire to use nasal mask since there are ways to minimize the mouth opening issue so will usually just give the standard options. Now if someone reports they often have nasal congestion and even during the day have to mouth breathe, it would be silly to try to tape and use a nasal interface mask. Common sense dictates that person needs a full face mask. Other side of the coin is some people just don't want to mess with tape, chin straps or whatever so they opt for full face and that is fine too.

[TalonNYC]

Other side of the coin is some people just don't want to mess with tape, chin straps or whatever so they opt for full face and that is fine too.

For me, this is why I want the hybrid. I'm finding having this much stuff on my face at night is enough of an adjustment, so I want to avoid the tape - for now.

[Pugsy]

so I want to avoid the tape - for now.

Understood and I fully encourage you to do what you feel you should do just as I would offer ideas to someone that wanted to use something else. Anything to aid in comfort, peace of mind and effectiveness is okay by me.

I don't want to jinx you so I won't offer my experience with the hybrid. Many people do extremely well with it and I know my own experience isn't the norm. This fact can be attributed to every mask out there. What works for one might not work for another for any number of reasons and this is why we have lots of opinions and lots of different masks.

[TalonNYC]

Well, as I said, I just prefer to pretend to be a scuba diver at night, instead of the usual jet fighter =)

[TalonNYC]

Night 5 report time!

AHI 3.3
Leak 14.2

Notes: Woke up pretty good this AM, a bit fuzzy but not bad. I don't remember waking up during the night either, which is very odd for me. This was the first night with the hybrid mask. The Leak Rate is dramatically higher than with the nasal mask, but my AHI is down and the little happy face was in the report this AM (the S9 uses a green happy face or red sad face to report on overal mask fit for the whole night).

Things I learned tonight:
Ayr gel does indeed help with nasal pillows (see previous threads on this board)
The Hybrid takes quite a while to fit when you first get it. I spent about 1 hour fiddling with it while my ResMed S9 "Mask Fit" mode calmly told me that I was doing it wrong over and over.
The "mask fit" mode hurls a HUGE amount of air at you. I have no clue with the titration is, but it's extremely high compared to my normal 12 cm/H2O.

Edited for typ0s