Newbie with frequent dificulties staying asleep

[joetro]

Hi, all.

I've had my CPAP (new ResMed S9) and mask (full face Quattro FX) for a little over a week. I was diagnosed with severe sleep apnea and told to use 10 as my pressure reading. My prescription also noted I should use a small mask (I'm a guy, BTW). A full face mask was used at the sleep study because I told the nurse that I occasionally have nasal nighttime congestion.

So ... nearly one week in and I've been waking up multiple times nearly every night due to sensations of air around my eyes or cheeks. I use the Ramp to get up to the 10 pressure gauge and find it tolerable at lower levels. It seems, however, that on full blast for me, it's just not very workable. I run the fit test and do not find any leaks on the S9. Furthermore, the DME lady who came over did not have a small mask and fit me with a medium. I'm finding that I cannot wait until my 4 hours are up to turn the device off. I skipped a night to test it out and found that I woke up with substantially much more energy when I did not use the CPAP. I'm starting to get pretty frustrated and I'm wondering what I can do. I feel so much more tired with CPAP than without.

I don't want to quit or give up, and I want to keep using it for the long-haul. I know that it is often hard for newbies to get used to the device. However, I'm starting to think that something has to change. I'm wondering about trying to somehow figure out a way to set my S9 machine to maximum of, say, 8 rather than 10 on pressure. And slowly trying to ratchet up each night. I'm also wondering about the possibility of demanding that my DME company either provide me with a small mask as prescribed or see if I can't also get a nasal pillow. Something about the combination of mask and intensity of pressure just isn't working for me.

Thanks for your thoughts and support.

[Pugsy]

I occasionally have nasal nighttime congestion.

Try a nasal pillow mask.
You might be surprised to find that nighttime congestion is minimal to none and much less of a problem than dealing with a full face mask that is improperly sized. Heck, they are hard enough to manage when properly sized.

Please add your equipment to your profile as it makes it easier for us to offer ideas more specific to your needs.

Otherwise until you can get a different mask...
http://maskarrayed.wordpress.com/taming ... e-quattro/
and watch the video if you haven't seen it
http://www.cpaplibrary.com/masks.html

[Wulfman...]

Please add your equipment and pressure settings to your profile.

Maybe part of the problem is the Ramp. Try turning off the Ramp and going right to your therapy pressure. If your mask isn't adjusted to the full pressure, that could be one source of the leaks.

Another could be the type of bed pillow you use. "Standard" fiberfill pillows allow the head to sink into the pillow and can push the mask out of alignment.......hence, more leaks.

Never give up! Take each night at a time. It's "Baby Steps".


Den

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[joetro]

I'm using a nasal spray and de-congestant at night, especially during this cold and flu season. Is it worth calling my DME company back to make them give me the small? (She was surprised and sure it was just a typo, but maybe that was just to cover-up that she didn't have it).

[Wulfman...]

I'm using a nasal spray and de-congestant at night, especially during this cold and flu season. Is it worth calling my DME company back to make them give me the small? (She was surprised and sure it was just a typo, but maybe that was just to cover-up that she didn't have it).

Which one? If you're not aware, the nasal spray "Afrin" is DANGEROUS if used more than three times. So, hopefully, it's not that one.

Yes, the wrong sized mask can be problematic, so, I would recommend investigating that you have the "correct" size.


Den

.

[joetro]

I do use Afrin, two pumps a night, as needed. The videos were helpful for fitting, thank you.

[HerbM]

Don't know where you are or your insurance deal but many DME's actual have a deal where you are allowed to trade the mask for 30 days to find one that works.

Also, it would think you were ALWAYS be allowed to demand the one (or size) that was actually prescribed if you think that would be better.

CPAP.com (this forum's sponsor/host) also has a deal on some masks where you get free return insurance if you are willing to try buying your own mask.

I am going to try an AirFit P10 nasal pillow that way. $99 with free shipping too.

[Pugsy]

You might find that the humidified air using the nasal pillows actually helps with any nasal congestion and lessens the need for sprays.
How long have you been on the Afrin? Ever heard of Afrin rebound? If not, look it up....it's ugly...been down that road myself.

Can you normally breathe through your nose okay most of the time? If so, give the nasal pillows a try....nothing to lose and everything to gain including sleep.
Now if you simply can't breathe through your nose well...then stick with a FFM but get the right size

There's a sizing template here
http://www.resmed.com/us/assets/html/ma ... lates.html

The hardest part to this therapy is finding the right mask...don't be afraid to try several models as well as brands.
There should be a 30 day free trial mask swap with your DME...ask to make sure but don't spend all your swap time trying to make something work that doesn't want to....you can always go back to it later if you end up liking something.

[joetro]

Thanks; I've put a message into my respiratory therapist to troubleshoot and maybe to see about getting a small sized mask. I will stop using the nasal spray.

[Julie]

Some people find that too much humidity can cause congestion and need to turn down the level, plus the Quattro's known for needing very careful fitting instruction to work on given patients and if you didn't have that it may be the reason you're having trouble... presuming you have the right size for you. I wouldn't just switch to a nasal mask without giving it a decent trial (or giving other FF masks a try) because you apparently need one.

[joetro]

Any thoughts on my manually trying to decrease the maximum therapy pressure, at least initially, until I get more used to it? I seem to be okay at like 6 or maybe even 8, but I notice the problems when I wake up and it's at full blast (10). I know this wouldn't be perfect to reduce all events, but it would be better than where I'm at now?

[Bill44133]

Make sure that you are washing your face really good before you go to bed. You need clean face to perfect the seal.

[sleeplessinaz]

Hi there,
If your CPAP machine is an auto set, you can set it for a range of pressure. Like 7 to 12 so the machine can adjust to whatever pressure you need at that time.
Hope this helps,

[Pugsy]

Any thoughts on my manually trying to decrease the maximum therapy pressure, at least initially, until I get more used to it? I seem to be okay at like 6 or maybe even 8, but I notice the problems when I wake up and it's at full blast (10). I know this wouldn't be perfect to reduce all events, but it would be better than where I'm at now?

Yes, it would be better than where you are at now.
Your profile shows the S9 Elite...so fixed pressure. Are you using the ramp?
When you fit your mask for leaks you need to fit it at whatever full pressure you are going to use. If you are fitting it when using the ramp and when you first turn it on then you are fitting it to 4 cm..

Here's the provider/clinical manual for the S9
http://www.apneuvereniging.nl/forum/pdf ... manual.pdf

[Sir NoddinOff]

I'm using a nasal spray and de-congestant at night, especially during this cold and flu season.

Jumping back to the nasal congestion problem: As others have suggested, I’ll bet that’s your sleep maintenance problem right there. You’re using BOTH?

In my personal experience, either one of those OTC drugs keeps me wired all night long; I’d hate to think what would happen if I took both. I may as well just shoot up some meth! (They do shoot meth, right?) Please try all the above humidifier variations, homeopathic methods etc. As a side note: You may find you’ll have to taper off the decongestants if you’re a nightly user. I’m serious about that.