New TAP PAP mask review

[Pugsy]

Pugsy, after you post your review on cpap.com, please put a copy of that review here.

I could do that but it was essentially what I said just a bit ago. I didn't go into all the little bitty details.
I can sleep in any position...bed pillow never touches the mask...mouth guard a non issue for me...number one mask and I have tried just about every nasal pillow mask out there.
I went in to a whole lot more detail here than I did there...though afterwards I did go glance at a few and I see that some did go into a lot of detail. Maybe I should have gone into more detail there. I just draw a mental block when it comes to composition. It doesn't come easy for me at all despite what some people might think here. Ask me a question and I can write a novel as an answer...ask me to compose something from scratch and I can barely come up with my name.

I did use Pugsy over there though...so anyone familiar with the forum will know who it is.
More people gave it 4 or 5 stars though. There are always going to be people who don't like something. That comes with anything anyone ever buys or uses. Can't please all the people all the time.

I still can't imagine what in the world that person who said you had to stay on your back was thinking...Geez...there's a way to make any mask work in any position if we fiddle with things long enough.

[bryansong]

Pugsy,

Did see that written, sleeping on the back? I just had a couple of minutes to continue reading the reviews but I didn't come across that laying on the back. I am sure I read that.

Bryansong

[Pugsy]

Did see that written, sleeping on the back? I just had a couple of minutes to continue reading the reviews but I didn't come across that laying on the back. I am sure I read that.

I didn't read but a couple of reviews and didn't see that mentioned but that doesn't mean anything since I didn't read all of them. You may have seen it. What I wrote in my review wasn't challenging to any one person anyway...I just said I could sleep in any position easily.
Doesn't really matter much if you dreamed it or not. Don't worry about it. Someone somewhere would be wondering anyway.

[bryansong]

Thank you!

[grybeard77]

First night trial using the TP with head gear and no mouth piece. Every thing went well except for one minor thing which I will go into later.
All in all, the TP was very much like the Aloha, the straps on each side felt very light and met the pillow block at a good angle. It doesn't have the adjustability the Aloha has where the straps meet the pillow block, but it still fit my nares almost at the right angle, for me. I sleep on my side 95% of the time and had no problem sticking my head into the pillow, or turning over and for a short time on my back, still little or no leakage.

My minor problem was with the head gear which was to small for my head. It kept trying to slip up and off several times during the night. It lacks any adjustment ability with the straps for length, and I may try to use another makers head gear instead. I'm sure I have one or more head gear from other masks that will work with minor changes

Tonight tho, I am going to use both the head gear and the mouth piece and hope my saliva problem will go away a
enough to keep my pillow dry...

[bryansong]

grybeard77

Good luck with the saliva issue.

I too thought about using some of my old head gear to put something together for routing the hose over my head. I don't have the TP yet but I really like the headrest head gear and the way it isn't on my cheeks (at least not very much.) I am not familiar with the Aloha, I'll take a look at it.

Bryansong

[grybeard77]

Dam--, last night was a disaster. Got all set up to try the TP with the straps and the mouth piece and when I tried to put the mouth piece in, it wouldn't go in/on to my upper teeth. I had fitted it the day before and darned if when I went to use it, it had folded up in several places so it blocked me using it. Back to Aloha,

Tonight, I will refit the mouth piece just before going to bed and we'll see what happens. BTW, and most likely the cause, my upper teeth are far from straight and level so the mouth piece when fitted and first removed, it looks like some one stepped on it. So later, I can't get it back in place because some of the out of line teeth prevent it. Oh woe is me....LOL

[Pugsy]

Just a quick update.
Still doing well with the Tap Pap...each night it is becoming more and more part of my natural routine.

I don't know if it is my imagination or just wishing but I am starting to notice that my times with probably short lived mouth breathing leaks are reducing...both in how high the leak goes and duration.
I still seem to have them at the times during the night where I probably am in REM sleep...may or may not be on my back because I don't always wake up enough to note if I am on my back or not.
Though the time spent seems to be reduced and the leaks are more spikey and not not so much of a whole block of time.
Hard to describe. Instead of 15 minutes with a block of leak staying around 24 L/min...I am seeing brief spikes lasting maybe 5 minutes or less in short little bursts.

I will try to find a couple of examples to show you.

So is the presence of the mouth guard reminding my brain to tell the mouth to stay shut? I don't know at this point. It looks like it but of course it could just be a coincidence. For sure...whatever it is...it seems to be an improvement...not that the short blocks of large leak really ever mattered all that much to me but it is nice to see somewhat of an improvement.
For sure it hasn't made things any worse and I sleep well considering life in general.
Leaks don't wake me up at all. Wake ups are always related to life in general and not my mask or leaks or pressure.

So far no TMJ pain...no teeth pain. I sure like being able to scoot all over the pillow and not have the head gear straps slide up or whatever.

[Pugsy]

Here's the example I was mentioning in regards to the appearance of the leaks.

I am seeing this pattern more



than this pattern with the long plateau.

[bryansong]

Good to hear, read. Please keep the updates coming. I haven't ordered the Tap Pap yet but your results are very encouraging.

Bryansong

[jagzoo]

Well I now have 8 nights of using the TAP PAP mask. And I LOVE it. I don't even feel it on me, don't wake up and need to adjust it when I roll from position to position, in fact I never have to adjust it. It just fits!!

However, I'm not sure about the actual results. My AHIs are up (OAs, HYs and CAs), my leaks are up and I don't understand why. Because I can't completely close my lips (lip to lip) because a piece of the mask is in between them, when I am sound asleep part of my lips slip open enough to let air escape. I have even tried taping my lips around the mouth piece but it doesn't seem to help. I guess the question is, do I keep using TAP PAP because it is so comfortable and I sleep better, or am I interfering with my therapy?

Here are my past 2 nights:

Last night is the worse but I felt I had a good night!! I don't understand all the events.




Here is the 15th :



I used the Oximeter on 3/11/13 and things don't seem to line up but I did have some short desats.



I don't know what to do. I am to to see my DME Wednesday, my 3 month anniversary, and he is planning on ordering me a new FX for Her. Then if I keep TAP PAP I would have to pay out of pocket for it and all supplies. What I would like to do, if TAP PAP is the mask I choose, is to go to a DME that has/will order the mask for me.

Any help/ advice would be very welcome.

[Pugsy]

Last night is the worse but I felt I had a good night!! I don't understand all the events.

It was still an acceptable night last night...not as pretty on paper but still a good night.
When I was first starting therapy about 3 months into things I was still waiting for the "miracle". Oh, I knew it was helping but the "miracle" that so many people talked about wasn't happening.
One morning I woke up and felt amazing...thought, Oh Boy, the miracle and it really was. I felt awesome all day.
I had made it a habit of reviewing my data in the evening back then because I didn't want to cloud my perceptions of my day by looking at the reports first. You know what I mean....see a bad report and automatically create a self fulfilling prophecy.
So I looked at the reports that evening after the most awesome day where I was bouncing around on cloud nine and I nearly fell out of my seat when I saw the AHI. It was 10.6 ...yep, double digit. No explanation and I never had that sort of "miracle" with that sort of AHI again. It was a fluke..a coincidence.

Even now I have nights like you did last night and I have nights like you did the night before. It just happens.
In my case when I have some little clusters like you had last night it almost always corresponds with probable REM stage sleep time periods. I am documented much worse in regards to my OSA in REM sleep...not position but REM sleep.
So I blame those clusters on REM stage sleep gremlins. Sometimes they just work overtime.

Base your mask choice on how well you sleep and how comfortable you are in general. Not on a few nights that vary from what you normally see or what you want to see because we simply will vary from night to night.

Your last night....I would suspect that my REM gremlins paid you a visit last night....maybe in cahoots with sleep position gremlins. You are using a fixed pressure...it's very possible that those gremlins needed just wee bit more pressure during those times to keep them away. We don't have any way to know when those gremlins are going to come visiting.
Look at the hypnogram here at this link under Physiology section. See where REM normally starts and see how it increases in frequency during the night and lasts longer with each time REM stage sleep is reached.
http://en.wikipedia.org/wiki/Sleep

I have had great nights, good nights and some horrible nights on every mask I have ever used.
I still will use the mask that I like the best and not make my choice on the AHI. Never have because it simply will vary from night to night for a lot of people.
I base mask choice on how well I sleep...how comfortable it is. Does it meet the bulk of my needs?

Sometimes I just have crappy nights...not the fault of the mask or my therapy in general...just the way it works out.
It's been that way with every mask I have ever used for any length of time.

BTW...those leak spikes...if they were mine and they didn't wake me up...I wouldn't give them more than a brief nod.

[jagzoo]

Thanks Pugsy. Your comments help me feel better. I am just learning how to interpret the graphs and find out what I should pay attention to and what I should just shrug at.
I'm getting so much information from this forum. I read it every morning and then again at night.

I was interested in your comments about pressure. I was wondering about changing my settings - going to APAP with a range of 9-12 maybe? Or just raising the pressure a little to 10? Do you have any thoughts?

Thanks

[Pugsy]

I was interested in your comments about pressure. I was wondering about changing my settings - going to APAP with a range of 9-12 maybe? Or just raising the pressure a little to 10? Do you have any thoughts?

Either one or both would be a good experiment to try.
You may be like me and those REM or supine sleeping gremlins may need a little more pressure at times and at other times not.
I saw 20 the other night which is a rarity to me.
Sometimes now matter how good I have tweaked things I still get a few of those little buggers...

Right now my current experiment is to see just how low I can use EPAP on my bilevel and still get decent reports the majority of the time. I accept an occasional "off" night and don't worry about reports that might not be so pretty. Most of them are and that's good enough.

Some nights you might need a little more than that 9 and some nights you don't.
You could sure try cpap at 10 or maybe even 9.5 and see what happens.
Same thing with apap mode...that 9 minimum will probably be enough for the bulk of the time but if you let it range upwards just a little it will likely reduce the chances of those OAs developing.
So if it was me..since I like to experiment (and you are comfortable doing it) I would probably try both for a week or so to see how it goes. You might not like APAP mode...or you may love it. I think using 9 to 12 would be a very good choice to try.

Also...in APAP mode your machine will flag Flow Limitations...it won't do it in cpap mode.
Just another data point to look at. If you wanted to try APAP mode with minimum of 9 and maximum of 9...that would equal what you are now doing in cpap mode but have FL data turned on.
You could also try apap mode with minimum 9 and max of 10...
Lots of minor little changes you can make.
If for some reason you find the pressure variations in APAP mode are disturbing to your sleep you can use a tight range.

Also remember

[jagzoo]

Thanks for the knowledgable feedback Pugsy; I think I'll start with APAP of 9 & 10.5. That will give me a chance to see what it feels like and turn on the flag. I'll see how that goes for a week, and report back (because I am certainly not doing anything all on my own), and then decide where to go next. Good night.