Newbie on CPAP for 2 Weeks and Confused...

[#1 Jets Fan]

I was diagnosed with very severe sleep apnea (apnea about once per minute).

I have a machine an a nasal pillow, which does not appear to leak, but my husband tells me I sometimes breathe OUT through my mouth. Is this practice interfering with the treatment?

I was told to mail the card to the RT this Thursday...will the card indicate whether or not I'm deriving the maximum benefit?

I love my nasal pillow and don't want full mask, as I had a panic attack with it on in my first sleep study in the hospital.

Thanks for any help or advice.

[nanwilson]

If you breath out through your mouth when using a nasal device you are loosing therapy. You may need a full face mask or try taping. I use a Respcare Hybrid, it has nasal pillows and a mouth piece, take a look at all the mask alternatives on cpap.com. If you have had your mask & machine for less that 30 days your supplier should swap you out for a better mask. If you want to stick with the pillow mask you need to read all the suggestions people have tried. Go to the search button, above left, and type in tape fix, you will get a ton of hints.

[Pugsy]

Please go to your Profile in the User Control Panel and then the equipment tab and choose your equipment in TEXT please (images hard to see, all look alike and require us to use link to see what you use)

Yes, there are ways to limiting the possible mouth breathing which will impact therapy. Depends on how much you do.
Chin straps, purchased and home made or use of tape to keep mouth closed. You can use the forum search feature to see lots of discussion in their use. There are ways to make the nasal pillow mask work since you like it and may not want to try Full face mask for whatever reason you may have.

The card from the machine may or may not show if you are receiving maximum benefit. Usually the RT for the DME only wants to check how many hours you have used the machine to satisfy insurance usage requirements.
Tell us which machine you use and we can then let you know if the SD card has more than compliance hours of use on it.

Depending on machine there can be on screen data and even software to see in depth reports. Not all machines offer this.
So need to know what you are using. With software we can see for sure if the mouth breathing is enough to lessen the effectiveness of the therapy.

[pap4life]

The nasal pillows is usually the "go to" mask for leak free. Stay with it if you can as it is usually leak free, more comfortable, lighter and more stable with movement during the night.

Yes..the card will tell the DME or RT how your therapy is progressing. Sounds pretty good to me, if you are leak free. Pressure may have to be tweaked a bit by the RT.

Nearly 50% of CPAP users use a chin strap or some other device for keeping their mouth closed.

[Slartybartfast]

I've often wondered whether someone could make a low-tack form of crazy glue (cyanoacrylate) that could be applied to help keep the lips closed. The stuff is used in surgery to close up wounds (Dermabond). It's been used for years in small animal surgery, too.

I know, simply Crazyglue two strips of Velcro to your lips!

(sorry, too much coffee this morning!)

Seriously, a chin-strap is in order, I think. Maybe one of these: https://www.cpap.com/cpap-mask-parts/cp ... straps.php

[W_HAMILTON]

Have you tried the mask where it has nasal pillows + a mask over the mouth? I went with the full face mask because this alternative felt like it was pushing too much air into my nose, but aside from that, it seemed much more comfortable. If a full face mask makes you feel claustrophobic, you might give that one a try.

[Slartybartfast]

If claustrophobia is a problem then it's probably best to really try to stay with the nasal pillows. What you're describing is called "expiratory puffing." It's most common for those who sleep on their back. I tend to do that, too, and try to sleep on my side as much as possible. The RT may or may not look any further into the data on your card than to simply determine how long you used your machine. Depending on which machine you have, he/she may not be able to even see your puffing.

Expiratory puffing, by itself, isn't really a problem. However it's thought to be a forefunner of open mouth breathing, which most certainly IS a problem. That's why you need to pay attention to any sign that you're doing it and take measures, like using a chin strap, to avoid it.

[#1 Jets Fan]

You are all amazingly helpful!

I will post my equipment descriptions when I get home from the office tonight.

Many, many thanks!

[#1 Jets Fan]

I've posted my equipment...can anyone give me advice about a chin strap I can order?

Thanks again!

[Pugsy]

Please check your equipment choice. What you have chosen was discontinued several years ago. Look at my machine via the link in my profile at the bottom of this post. It probably will look like mine and you need to look for machine choices starting with PR System One in the drop down menu. That Remstar model is confusing since they have used it on all their machines.
If indeed PR System One machine that is not the PR System One Remstar Plus (not fully datacapable), you should have a SD card in the back that will allow access to your reports either through software or the Onkor analyzer.
Here is link for the Onkor analyzer..
http://www.onkor.net/

Chin straps are as varied as there are people. What works for one person might not work for the next person.
Anywhere from a home made ace bandage chin strap to the papcap with lots of choices in between.

[#1 Jets Fan]

Pugsy, I have viewed your equipment and that is not what I have. I have a small card at the back of my machine (similar to one in my husband's old digital camera!). Perhaps they gave me an outdated machine??

[Pugsy]

Pugsy, I have viewed your equipment and that is not what I have. I have a small card at the back of my machine (similar to one in my husband's old digital camera!). Perhaps they gave me an outdated machine??

http://shop.talkaboutsleep.com/discount ... humidifier

I see you have changed your machine now to the PR System One Remstar Pro Cpap with CFlex. It is the straight CPAP version of the new model line where mine is APAP. That SD card holds your data and you can use either Onkor online analyzer or the software to see what has been happening in more detail than the onscreen LED data.
Using the reports you can see in detail if the leaks are significant enough to mess with therapy.
If you need software information send me a private message and I will elaborate on your choices.
You will need either EncoreViewer 2.0 or Encore Pro 2.4. Both are Windows based software so if you use a Mac or other OS, it will need a Windows environment. Onkor online analyzer will work with any OS. Instructions are available at the link on how to obtain the report. Some people have problems using Onkor and if you do then software is next option.

[#1 Jets Fan]

I used the instructions to find some "INFO" on my CPAP use so far.

No Leaks
No Periodic Breathing(?)
AHI 7-day average=4.4 30-Day average=5.7 (only used for 19 nights to date)
Average 7 hours/night on machine

Is is OK to expect the AHI will get better with CPAP usage? I'm reading that you should ideally be at "0" but not sure how to get there. I have about 80 lbs to lose, so hoping that any loss with also help?

This afternoon I have followups with pulmonologist and cardiologist.

[Pugsy]

AHI of 0.0 is unrealistic expectation to try to attain. Many never get it. A few do. Don't try to compare your progress with that elusive goal. I have seen it only once in 2 years and then it was for only 4 hours of sleep.

You can use software to see nightly what is going on in more detail than the information given off the LED Screen.
Otherwise the most informative on the LED screen is 7 day AHI average.
Your 4.4 is pretty good and is certainly within the less than 5AHI that is generally considered as acceptable treatment. Some people to seem to notice that they feel better with AHI of 2 or so. There is no one magic number because we can all vary from night to night.

The large Leak percentile showing on screen is pretty useless because it is on for time in Large Leak and a leak has to be monumental to rate Large Leak classification. A person can still have leaks significant enough to impair therapy and not trigger the Large Leak at all.

Here is an example of what you can see using software. See if this is more informative than the averages on screen.

[#1 Jets Fan]

I feel confident that I'm moving in the right direction!


Thank you again!