Oracle Oral 452 - first time issues/difficulty

[zoltar_speaks]

I finally took the plunge and decided to try the Oracle 452 - Second Edition (?) on my own (my previous "sleep doctor" abandoned me and switching to a new organization/sleep doc takes 6-months before an appointment is available). The reasons for switching/trying an oral mask are thus:

1. Sensitive skin - can't tolerate anything over my nose - make me itch constantly - eventhough I wash/scrub before going to bed, it will become oily in <60-minutes. Even using Breathrights cause itching.
2. Nasal issues - have had nasal problems my whole life. Went through both turbinate reduction and deviated septum surgery. While it helped reduce the pressure from 15 to 12 (and cut the apnea incidents in half - DUH), I still have issues. Any air/wind in my nose causes it to shut down/close/congest. Even just laying down/horizontal causes closure. Thus forcing air in my nose is contradictory. I have had to live off nasal decongestant (yes, I know this is wrong on many levels, but nothing else works - only use in 1-sinus at <half dosage).
3. Sleeping results using current mask (5th one I have tried) are not very good.

The "mask" I have been using is the Respironics OptiLife and Cradle Cushions. The cushions (1-large hole for whole nose vs 2-pillows directly in each nostril) but it is problematic with the varying sinus openings (often causing headaches/ringing in ears when the sinuses are complete shut down.

Now to the issue(s). The first night I tried the Oracle, I slept through the whole night (surprisingly) and felt pretty good throughout the day. This was my only "successful" night with the Oracle, thus far. I continue to try it, every night, usually ending up switching back to the OptiLife.

I have tried both mouth-pieces, neck strap, nasal plugs, etc. I get in bed and usually fall asleep by 11pm but will then wake around 12:30-1am, for no reason, and can't get back to sleep until I switch (or go without). The second night I tried it, I kept trying to get back to sleep but after waking almost every hour, I gave up around 3am.

One thing I noticed the second night was I kept hearing my sinus open/close due to the forced air in my mouth trying to escape through the sinus. Eventhough I was wearing the nasal plugs (large), there were often events with air escaping through my nose (I am going to order the "Smiley's Nose Plugs" I saw mentioned in another similar discussion/post here.

I also noticed sometimes the saliva buildup in my mouth would cause bubbling sounds/sensations in my mouth (I wear ear-plugs to sleep since the machine sounds would keep me away - I am a very light sleeper - I can hear the phone ring through 32db ear plugs).

Since I bought the Oracle via CPAPxChange with the option to send it back within 30-days, I need to make some kind of decision about keeping it, pretty soon (getting ready to travel to New Zealand in December).

So, thoughts? Suggestions? Ideas? War-stories? Experiences?

[JDS74]

Take a look at my experience through the link down near the signature part of the message ( lower left corner).
That will take you through all the stuff I did to make it work.

If you think you can tolerate the mask, and it sounds like you can, you may need to use the nose clips I found to close off your nasal passages until you learn to sleep without them.

If you PM me with your snail mail address, I will send you a sample to try before the return date comes due.
I assume you are in the US so overseas delivery shouldn't be an issue.

It will also be helpful if you post your equipment list so we can see what you are using. There might be some equipment issues as well.

Do you use the humidifier at a high number? Humidifier use with this mask is required.
Do you have extra insulation around you hose to help with rainout? That often results in what is percieved as saliva in the mask but is just condensation.
Do you have a hose support system that keeps the hose vertical at night? With this mask and the clips I recommend, having the hose vertical is very helpful.
The strap with the mask is optional for use. With your pressures, it may be you don't need to use it at all. In any event, it should be quite loose.
Do not tighten it up like a chin strap - this will cause an increase in obstructive events

[zoltar_speaks]

Thank you for the response.

I just got around to updating my profile/equipment so it should show up, now. Currently listing my "Respironics OptiLife Mask, Headgear and Cradle Cushions" until I can fully commit (if possible) to the 452.

Yes, I have tried the humidity setting on everything from 3 (read somewhere to use that as a minimum) to 5 (maximum). I usually have post-nasal drip so extra drying is usually welcome for me. I keep a bottle of water handy, as well as some Biotene spray, if needed.
No, I do not have the tube insulation and yes I have experienced "rainout" with the 452. Usually keep humidity off/low with OptiLife mask.
Yes, I have the hose hanging from above, keeping it vertical. Of course, getting ready to travel for a month, that wont be an option.
I an keeping the neck strap a little loose. I am an active sleeper so don't know if I can do without - knowing me, I would probably spit or yank it out in my sleep. With my regular mask, I use a super-strong, wide chin-strap since regular, thin ones would always slip off.

EDIT: Not sure why my machine isn't appearing at the bottom. It is an Respironics M-Series BIPAPAuto

[Pugsy]

EDIT: Not sure why my machine isn't appearing at the bottom. It is an Respironics M-Series BIPAPAuto

That's because the M series machines were discontinued and links to discontinued equipment seem to be broken.
Just manually add it to your comments section like I have my spare Bipap shown. That way it's always there and we can see at a glance what you are using.

I can't offer any ideas on the Oracle use since I have never even seen one. My main mask has always been a nasal pillow mask so I am zero help with the others.

[zoltar_speaks]

Thanks for the heads-up on the machine type. I have added it as a comment.

[JDS74]

You can get a hose hanger that is portable, folds up, and fits in your CPAP travel bag.
They are available from Amazon and other sources.
You can't use this mask with little or no humidity so when you switch between masks, be sure to change the settings.
A hose insulation tube will help with the rainout.

[zoltar_speaks]

Still can't really use the 452. Waiting for my nose plug/clip, host liner - should arrive today.

FWIW, not sure if it makes a difference, both my dentist and ENT said my problems are caused by my tongue being too large. I went to my ENT asking about the "apnea surgery" and he said I wasn't eligible (I still have my tonsils).

Yes, I tried the AveoTSD via my dentist but even after trying all the fittings/adjustments, still couldn't get a good nights sleep so gave up on that.

[hueyville]

As I am a slow learner can you tell me how your able to tolerate nose clips but not a mask over nose? I had a lot of mask issues especially with regards to bridge of nose but once I found the correct mask for me that was over. BTW quattro air after five other masks. Seems to me the fight with nose clips, drool and air trying to come out your nose it is trading problems. I do understand the need for comfort though. Weird thing is the quattro mask even stopped my mouth breathing which in turn stopped the snoring. I did the switch mask and headgear once a month routine for almost a year before hit right combo. That cost some money but what good is xpap if the mask disrupts your sleep more than the apnea. Feeling your pain.

[zoltar_speaks]

You are right and I don't know if I will be able to tolerate it. All I know is right now, just trying the 452 as is, the air pressure forces airflow back through and out my nose. So, I am hoping the nose clip will work. Sometimes I am able to tolerate the Breathright strips throughout the night - other times I wake up itching and yank it off. My skin is so sensitive, any airflow over the nose surface from those kinds of masks causes itching (when they first tried this kind of mask during the sleep study, I kept waking up to scratch). The nasal plugs I ordered were from another discussion/thread about the 452, as one the F&P folks recommended.

Since I use ear-plugs to sleep, I can hear/feel the sinus passages being forced/pushed open when trying to use the 452. I tried simply holding my nose shut with my fingers and letting the air pressure flow freely into the sinus and throat (I don't care what the literature says about "getting used to the oral mask without having to use the nose plugs" - it takes mental effort to keep my sinus/nose closes) and it wasn't terrible. Obviously I could not fall asleep that way......

I will make a decision by the end of next week (or sooner) about returning the 452 and chalk it up to one more failure and return to my current mask and nasal sprays to be able to get some sleep, albeit poor.

[hueyville]

All I can say is keep trying. The pap therapy is a must for me but masks were killers. Have a huge box of self paid losers. Even Ieventually found the right combo but had to change DME's as my original was very limited on brand names. Had to work from a larger pool of contestents. When I found the right one I knew it the 1st night. Had that miraculous feeling of the perfect glove. Keep trying and you will eventually hit a winner.

[zoltar_speaks]

Well, got the nose clip yesterday and was eager to use it to see if it would make a difference with the 452.

Unfortunately, last night was a disaster. I have to pinch the nose clip (strong wireform) so tightly to stop any leaking, it was uncomfortable no matter where I positioned it.

Again, could not sleep more than 2-hours with the 452, before waking up for no apparent reason. Tried repositioning the nose clip but by that time, my nose surface had become oily enough (I always wash/scrub my nose before going to sleep - doesn't stay clean very long), that no matter where I positioned it, it kept sliding/moving and became even more uncomfortable. Fell back asleep for a while but again woke up about an hour later.

I gave up and went back to the nasal/regular mask. So today I am a zombie and can hardly think straight.

It is quickly looking like this is not a workable solution - don't know where to go/what to try at this point.

[JDS74]

I tried all sorts of commercially available nose clips.
I only found one that was workable.
See the post noted below on which one actually worked for me.

[zoltar_speaks]

I did read a lot of that post about the nose clip you got from your doctor, but don't know how to get one. I am willing to try anything, but my hopes for this mask are fading-fast.

[JDS74]

I did read a lot of that post about the nose clip you got from your doctor, but don't know how to get one. I am willing to try anything, but my hopes for this mask are fading-fast.

If you PM me your snail mail address, I'll send you one.

[zoltar_speaks]

All I can say is keep trying. The pap therapy is a must for me but masks were killers. Have a huge box of self paid losers. Even Ieventually found the right combo but had to change DME's as my original was very limited on brand names. Had to work from a larger pool of contestents. When I found the right one I knew it the 1st night. Had that miraculous feeling of the perfect glove. Keep trying and you will eventually hit a winner.

Looking for some tips on cleaning the Oracle / 452. It is a royal pain to disassemble it completely - concerned about breaking the plastic inlet tube that connects to the "teeth rest" piece.

Right now I have been simply cleaning in warm water / Ivory soap and letting it air-dry until evening and then reassembling. I seem to recall something about using mouth wash?

Suggestions/tips/ideas/neat tricks?