Please help me adapt to this :(

[Mirrasi]

I just got my new machine (Resmed Auto set) APAP. It's set with a pressure range of 6 to 12. Using that new Amara full face mask on loan from the doc. I'm having some issues and want to find out if there is anything I can do to fix the problems or if I will just have to try and adapt.

I am a mouth breather in general. I don't feel like I breath well through my nose on any day. If I take Afrin, it makes a world of difference (though I rarely use it because I don't want to get addicted). My nose issues seem to vary throughout the day from really stopped up to hardly at all. But there is nothing in there, it's totally dry and feels as if something deep inside just doesn't let air through. As far as I can tell, there is nothing plugging me up. I'm wondering if it could be an issue inside (turbinates?) and if I should get this checked by an ENT.

So due to this issue I got a full face mask. But I don't like the feeling. I feel like a blow fish with the mask on. My cheeks poof out and it's wierd. I WANT to breath through my nose. (In fact, the nasal mask was much more comfortable and FAR less claustrophobic). But I feel like I am suffocating if I don't use my mouth.

1. Is it worth my seeing an ENT? Could there be something causing an issue?
2. If I bought my mask through a local DME, would they let me try it out? Or at least bring the machine down there and try it out? I was looking at mask prices with the return insurance on cpap.com and it was nuts. I can't afford to buy 4 or 5 different masks for testing. (I'm paying out of pocket)
3. Why are my ears popping when I swallow? Can I do anything about that? (I'm prone to ear infections when sick...never seen an ENT)
4. What if I want to yawn with the mask on? I have the sensation (likely mental) of not getting enough air and constantly wanting to yawn. So I take off the mask for a real breath.
5. What if I cough? I have a dry cough from some blood pressure meds that I started. I have stopped the meds and the cough is better but it's still there mildly.


I have not even attempted to sleep with the machine yet. Just trying to sit here with it on in the living room watching tv. Just trying to do whatever I can to give myself a chance to adjust. It's hard for me to differentiate when something is really wrong verses my mental state with it. (I freaked out in the titration and left after 30 minutes. These full face masks make me feel extremly claustrophobic but feel like I can't get enough air with the nasal ones).

[VVV]

Is it worth my seeing an ENT? Could there be something causing an issue?

Your body is screaming for attention from an ENT. Get yourself there right away for a full examination and discussion.

CPAP did not work too well for me until an ENT did some work and helped me with nasal breathing.

Good luck!

[Julie]

Hi - I guess I don't understand why you haven't seen an ENT and are asking strangers here about it... only you can say if it's worth it, but it sure sounds like it is. Ask local DME's about trying on masks... we have no say in that either... Please don't get me wrong, we would love to help with whatever we can, but those are things we can't do for you. I don't know why your ears are popping, but I bet others here can help there. You're unlikely to yawn with the mask because yawning is a symptom of low (relatively so) oxygen, and while Cpap doesn't deliver 02, it does direct more air at a better rate into your system than not using it. I can't remember an instance of it ever happening. You're also unlikely to cough much if you use the humidifier (though not too high because it can cause congestion in some people - play around with it and find what works for you... but if you do cough (and I have) you cough... nothing spectacular will happen, really.

Wear your mask (no machine) while watching TV til you get used to it... it does help.

If you tell us what pressure settings you were given, and whether or not you (plan to) use the ramp feature, we can help with those as well... Anticipating failure is kind of pointless, especially when you need to use cpap to have a decent life - you might even get to like it!

A little self discipline might be in order... it's 'just' a soft mask and room air - nothing dire or dangerous or evil.

[Mirrasi]

Thanks. I think I better. Also, I have been sitting here for 30 minutes with it on trying to watch tv and noticed 2 things...


1. My nose actually blocked up MORE.

2. The pressure has actually risen to 7.5 (auto pap 6-12 range). WHY would it do that while awake? I will say as well, I feel like the air is better right now. I still don't like this blow fish feeling when I breath in. And when I breath out, it's a very odd sensation. And my nose is still blocked. But now I don't feel like I am suffocating as much. I keep needing to take huge deep breaths every so often but it's much better than it was on the 6, and I don't need to yawn.

But why would that happen when I am wide awake sitting on a couch watching tv?

[Mirrasi]

Hi - I guess I don't understand why you haven't seen an ENT and are asking strangers here about it... only you can say if it's worth it, but it sure sounds like it is. Ask local DME's about trying on masks... we have no say in that either... Please don't get me wrong, we would love to help with whatever we can, but those are things we can't do for you. I don't know why your ears are popping, but I bet others here can help there. You're unlikely to yawn with the mask because yawning is a symptom of low (relatively so) oxygen, and while Cpap doesn't deliver 02, it does direct more air at a better rate into your system than not using it. I can't remember an instance of it ever happening. You're also unlikely to cough much if you use the humidifier (though not too high because it can cause congestion in some people - play around with it and find what works for you... but if you do cough (and I have) you cough... nothing spectacular will happen, really.

Wear your mask (no machine) while watching TV til you get used to it... it does help.

If you tell us what pressure settings you were given, and whether or not you (plan to) use the ramp feature, we can help with those as well... Anticipating failure is kind of pointless, especially when you need to use cpap to have a decent life - you might even get to like it!

A little self discipline might be in order... it's 'just' a soft mask and room air - nothing dire or dangerous or evil.

I'm asking because I do feel claustrophobic with the mask so I don't know what could be a real issue verses just what's in my head. I did mention it to the sleep doc and he said he might prescribe a nasal spray but didn't say anything about seeing an ENT. I guess I figure if I needed to see one, he would have told me to go.

The APAP is set from 6-12 and it has a ramp from 4. I turned the ramp off. I felt like I couldn't breath at all. I haven't even tried sleeping with it yet, just sitting here trying to get used to it. I lasted 5 minutes yesterday. So far I've been sitting ehre 40 minutes and like I said earlier, it is auto giving me a pressure of 7.5 while sitting here. This is feeling much better! Still not perfect, still needing to take huge breaths at times. But I don't feel like I am suffocating or needing to yawn. Is that not odd to need pressure while awake? I should also mention I did the test to see if the mask is leaking and it isn't.

[Pugsy]

1. My nose actually blocked up MORE.

A couple of possibilities come to mind....humidity...some people need more added moisture and some people need less. So you might play around with the humidifier setting to see if that helps.

The other thought is something that I found happened to me when I tried a mask that put pressure on the bridge of my nose where the turbinates are...the least little pressure causes me to have immediate congestion.
Do this little test. Take your fingers and apply a little pressure to the bridge of your nose where the mask rests and give it about 5 minutes and see if you experience any congestion. Try to use about the same amount of pressure that the mask is applying in the same area.

[Mirrasi]

1. My nose actually blocked up MORE.

A couple of possibilities come to mind....humidity...some people need more added moisture and some people need less. So you might play around with the humidifier setting to see if that helps.

The other thought is something that I found happened to me when I tried a mask that put pressure on the bridge of my nose where the turbinates are...the least little pressure causes me to have immediate congestion.
Do this little test. Take your fingers and apply a little pressure to the bridge of your nose where the mask rests and give it about 5 minutes and see if you experience any congestion. Try to use about the same amount of pressure that the mask is applying in the same area.

Yes, and it's almost immediate if I am touching the side of the bridge up high. In fact, I had told my husband that with the mask on my nose breathing is immediately worse even though it's not smushing my nostrils in any way. Is there a full face mask that wouldn't do that?

I wonder if the local DME would have one of those hybrid masks I could try.

I think I will call an ENT tomorrow. If nothing else, it would give me piece of mind.

Any thoughts about why the pressure hovered between 7.5 and 8.5 while sitting up awake and I was breathing better (despite a good seal)? Shouldn't that only happen during an episode while sleeping?

[Pugsy]

The hybrid type of mask would be what I would have to use if I were going full face.
Either the Innomed/Respcare Hybrid or the Resmed Liberty so that nasal pillows are used and nothing on the nasal bridge.
Or don't freak out but this type of mask. There are several forum members here who love this mask.
https://www.cpap.com/productpage/respir ... dgear.html

Regarding the pressure increases while awake. The machine doesn't know if you are asleep or not and I suspect that the nasal congestion was reducing the air flow and the machine likely was responding to a perceived flow limitation or reduction in air flow.
It sensed limited air movement and tried to fix it. In your case it likely was just the reduction due to the nasal congestion.
The machine didn't know it was in your nose instead of your lower airway where the flow limitations and apneas usually occur.

[Mirrasi]

LOL, if I coulod get past the claustrophobia part, that mask you link would blow the contact lenses right out of my eyeballs! (I sleep in them)

You have definitely given me something to think about. I think I will call an ENT tomorrow to rule out any issues with my nose. Hopefully I will find the solution.

[Julie]

If you remember, I said 'no machine' when getting used to the mask... Pugsy's right, the machine will not report or chart things when you're awake as when you're asleep... you don't breathe the same way at all so it's not giving you authentic answers.

Good luck.

[Sir NoddinOff]

There are a lot of reports on this site of the feeling of claustrophobia while first using a mask. These feelings usually go away in the first week or two, so I suggest you relax and let the machine work it's magic. Also talk to your doc and see if you can get some different masks to try. I had a feeling of 'not getting enough air' initially, but now I have to check to make sure the machine is turned on! The human brain and body have an amazing ability to adapt to change so them a chance to adjust.

[Pugsy]

LOL, if I coulod get past the claustrophobia part, that mask you link would blow the contact lenses right out of my eyeballs! (I sleep in them)

I told you not to freak out. It does look pretty drastic and funny thing is that most of the people who use this mask successfully say the the air doesn't seem nearly as forceful with in the mask. I think it is due to the volume within the mask.
I have never had a chance to try one...never had the need and no one was giving one away just to satisfy my curiosity.
I know that I can't wear anything that puts pressure on the nasal turbinate area so that really limits my mask choices.
I do well with the nasal pillow mask and have used nothing else in well over 3 years. But then I don't have any extreme issues with nasal congestion generally. If you told me you could breathe just fine through your nose during the day and only get stopped up at night I might suggest a nasal pillow mask for you. They really are the least intrusive..easiest to seal and less overall general issues to deal with. I have even used my nasal pillows when I had a cold. Snotty nose and all. I just treated the cold symptoms like I normally would and cranked up the humidifier because more moisture actually unstops my nose. I don't do well with less moisture. Slept about as well as anyone sleeps with a crappy old cold. Didn't miss a minute on the machine.
I don't own any other type of mask other than the nasal pillows. I found the extra moisture really helped open up the nasal congestion. Sort of like a hot steamy shower does without the hot steamy part.

If you have severe congestion in the daytime though unless you want to work on that side of things and if you are like me and the slightest pressure on the nose causes congestion or makes the congestion worse then you are going to have some limitations.
I read somewhere what that pressure on the turbinates causing congestion was called something medical but I don't remember what it was. I can't even wear heavy sunglasses without getting a stopped up nose.

Hey forum friends. If you have one of those fitlife masks that you are read to throw in the trash...how about letting me experiment with it so I can speak on how it feels. Maybe we can get the "mask of last drastic chance" a better reputation and not scare the pants off of people when we suggest it. I am game to try one in the name of science but I don't think I want to buy a new one just to experiment with... I would be happy to test one that was one step away from the trash can. Doesn't need to be pretty. I just want to try one so I can explain to people how it feels.

Now Marrasi....I can get you a used Swift FX nasal pillow mask should you ever get your nose reasonably clear. So put that idea on the back burner. I can give you a used mask but the nasal pillow will be brand new. It will look new and not nasty cruddy looking.

[Suddenly Worn Out]

Afrin is an awful nasal medication that should be taken off the OTC market, IMO. You should be on a prescription nasal steroid spray. Like Nasacort AQ nasal spray, rhinocort or other. I use Nasacort AQ spray and it helps a lot.

Another thing that helps a lot is heated humidification. Hopefully you were issued a heated humidifier with your PAP device. If not, get one immediately. They are not too awfully expensive btw and if you have to you could probably buy one from the outfit that sponsors this forum. And crank that humidifier up in the late fall and winter, when the humidity drops. I max mine out from about October thru around the end of March. In the spring, summer and early Fall, I drop the humidifier setting or tend to get too much humidity.

The heated humidifier helps with the nasal stuffiness like prescription nasal steroid sprays help.

Honestly, I dont believe I could use CPAP without both of the above items. Compliance with CPAP is low and while I am compliant, most are not. There is a reason Im compliant, one reason is that I actually want to use this equipment and believe it genuinely helps me. The other is I believe it is postponing worsening of my health. And the third is I do EVERYTHING to make CPAP as comfortable as possible and to ameliorate side effects. That means gadgets, the prescription nasal steroid sprays, I work it hard.

Eric

[archangle]

If you remember, I said 'no machine' when getting used to the mask... Pugsy's right, the machine will not report or chart things when you're awake as when you're asleep... you don't breathe the same way at all so it's not giving you authentic answers.

That's worded confusingly. The machine WILL record data while you're awake but using the machine, but you need to ignore it.

Unfortunately, normal breathing while awake may show up as apneas. You need to mostly ignore any apnea data recorded while you're awake.

[archangle]

Be very careful about the ENT. Some of them are chop happy and will want to do surgery. Surgery for apnea has a very low true success rate, and a lot of side effects.