New User struggling with air flow and mask

I am a brand new to CPAP user. Just two weeks in and have not slept a night with the machine yet. I have been struggling with the mask. Started with nasal pillows and could not get a good fit, now onto nasal mask. The size they started me with is too big so I need to switch it out now too. The bottom part of the mask sits on my lips. I think I need to go down a size.

But my biggest issue is how high and fast the air is blowing. I can't get used to that. It seems as if it is drowning me. I can't figure out how to exhale against all that blowing air. Also, I was told and watched some video that you should not be hearing any air blowing or aware of a loud noise from the air delivery. As in your bed partner is not supposed to know you are even using a machine. Did I get that part wrong? THe machine is set to ramp up and start at 4. I am told that is the lowest possible setting. But how do you get used to all that blowing air? And it really does make a racket.

I am trying not to be frustrated with this process - but the whole "call about mask questions." "Come switch masks" - which takes days to find a time in my schedule (and I know that is my problem - but why don't they check how these masks work while you are there?) And I have not received any type of answer on the noise and air blowing questions.

Does anyone just give up? I know I am going to have skin problems as the few times I was trying the nasal pillow mask I ended up with a bad breakout. I have highly sensitive skin. I am not convinced that the amount of effort I that I am putting into this and not getting any results is worth the continued hassle.

Any thoughts?

I am also new to CPAP therapy (6 days) and using the Autoset and the N20 mask. (My wife has been using a CPAP for 9 months with an F20 mask.)

If the cushion (the part that touches your face) is too large, there will be a lot of leaks. (I have M and L cushions, and the L cushion leaks a lot, so I am sticking with M.)

One thing to check: when you attach the hose to the mask, there are two clips, one on each side of the hose. If you get only one clip connected, the mask will make a terrible noise and have a huge leak at that connection point. The person who fitted the mask to me emphasized that when connecting the hose to the mask you should hear two clicks. I got that wrong once and it was really noisy.

The mask does have a normal vent near the top of the hose, but it is not particularly noisy.

The only reason I know my wife is using her machine is that I can feel the vented air. It's not a problem and I cannot otherwise hear it. Now, if she takes off her mask while the machine is running, the sound of the air is very loud. But that's because the air volume is very high when the mask is not on the face.

Another possible clue: put on the headgear and mask on your face, connect the hose, and then turn your machine on. If you are using SmartStart, that may be getting in your way. If you turn that setting off, you will need to tap the button on the top of the machine to get it started. Air pressure will start at 0 and then increase to the ramp speed (4) over a couple breaths. Many of us find that a 4 cm minimum is actually too low to be comfortable and start at a higher pressure.

I have heard a couple other mentions of the air flow is too low when starting - but I absolutely fail to see how that is the case. If feels like a jet engine blowing me out. I am told for my machine 4 is as low as it can go. If a smaller size nasal mask doesn't help I think I'm done. I really wanted to use the nasal pillows, but could not get them to fit. Was willing to try the nasal mask, but I can't resolve the extreme air pressure from both pillows and mask. I just don't understand how this is to work. That much air- heated or humidified is not going to be good for my sinuses. I have terrible allergies as it is. I would think there would be a way to try a half setting to get some type of assimilation to the machine.

Tikicatt wrote: ↑

Tue Jun 19, 2018 1:07 pm

I have heard a couple other mentions of the air flow is too low when starting - but I absolutely fail to see how that is the case. If feels like a jet engine blowing me out.

If you turn your machine on before you put your mask on, it will feel like a jet engine. If you don't start the machine until after you are masked up, it should be pretty mild. Or maybe you are far more sensitive to moving air than I am.

Tikicatt wrote: ↑

Tue Jun 19, 2018 9:37 am

But my biggest issue is how high and fast the air is blowing. I can't get used to that. It seems as if it is drowning me. I can't figure out how to exhale against all that blowing air. Also, I was told and watched some video that you should not be hearing any air blowing or aware of a loud noise from the air delivery. As in your bed partner is not supposed to know you are even using a machine. Did I get that part wrong? THe machine is set to ramp up and start at 4.

You've managed to psych yourself out. There's very little air blowing when the mask is on your face. Sure, when you take the mask off, the machine revs up to full speed trying to build pressure... but when you put the mask on, it slows WAY down, to a super gentle low pressure. 4cm is what you get by sticking a straw 4 centimeters (1.5 inches) into water. if you can do that, and blow bubbles, you can overcome 'all that blowing air'. Even at a pressure of 20, it's not enough to blow up a balloon.

Tikicatt, I have the same machine you do and it's pretty silent. So where is the noise coming from? Do you hear the machine itself, or the air flow? If the airflow, from where? Is it in the hose, in the mask, or is the airflow from the CO2 vent hitting bedclothing? Is it leaking somewhere? There should be little or no noise coming from the machine. Sometimes the noise comes from conducted sound if your hose is on the pillow or mattress, so you might try lifting the hose up off those surfaces (hang it from the headboard or look at a hose management device). Make sure the vent isn't hitting the bedding and making noise, and look for leaks in the mask seal. Make sure all the fittings are tight.

You mentioned getting nasal pillows to "fit". Let's talk about that. Were you trying to fit the nasal pillows IN to your nose? They do not go IN the nose, they go against the outside of the nose. The little tip at the end barely passes the outside of your nostrils and does not touch the inside of your nostrils at all.

As for allergies, everyone has a "sweet spot" where the humidity of the CPAP air is just right. Some people need more humidity, some people need less. And generally, it HELPS your allergies, because you are breathing clean, filtered air with just the right amount of humidity. I do recommend that you do what you need to before masking up so that your nose is clear--whether that's prescribed allergy meds, saline spray, or a nasal rinse. But once you are masked up the CPAP should be helpful for your sinuses, though it may take some experimenting over several days to find that sweet spot with the humidifier.

See if you can identify what may be causing the problems you complain of. Then we can help.

Thanks for the advice, and yes, I have psyched myself out about this. I have yet to find a mask that fits so I can even really try out how this is all supposed to work. The noise is coming from all the blowing that is the air in the mask. The pressure is too high to exhale against all that blowing. So when I try to breathe out, it makes a bunch of Darth Vader noise. Or with all the leaking around the mask it is making a bunch of hissing noise. Or if I have pressed the mask as tight against my nose as possible to not have any leaks - it is popping my ears something fierce.

I did not understand about the pillows being at the end of the nose - how does it form a seal to keep all the air blowing past your nose?

At this point the tech at the office I am going to is saying full mask and there is no way I will ever be able to handle that. I don't understand why they don't have different sizes of masks that cover extra small. And getting a little ticked at the back and forth to try and switch it out. Or is that something everyone else goes through and that is just the bonus of having to deal with all this mess?

The mask does not deliver any type of super low gentle pressure. My definition of super low gentle pressure is not even being aware of any air movement. Instead it is blowing like compressed air out of a can. I am very sorry, but I do not understand the straw in water analogy. Am I supposed to be able to tolerate sucking water out of a straw with my nose to be able to tolerate air blowing up my nose?

I seriously experience a heavy amount of air blowing up my nose. I just can't figure out what to do with that sensation.

Talk to your doctor about your anxiety. Babies use more pressure than the 4 cm you are starting with...and yes, babies get put on this equipment for various problems.

Take one of the nasal pillows alone (no hose attached) and place it up so it gently touches your nostrils. Breathe in and out.
That's the level of pressure that needed to keep the pillows sealed. The pressure will hold the pillows against your nostrils. They do NOT have to crawl up inside your nostrils to seal and stay in place.
There are videos available for how to place and fit nasal pillow masks...watch them. Here's some of them. There are others online at various websites.
http://freecpapadvice.com/nasal-pillow- ... sk-reviews

Tikicatt wrote: ↑

Wed Jun 20, 2018 3:00 pm

I am very sorry, but I do not understand the straw in water analogy. Am I supposed to be able to tolerate sucking water out of a straw with my nose to be able to tolerate air blowing up my nose?

palerider wrote: ↑

Tue Jun 19, 2018 4:11 pm

4cm is what you get by sticking a straw 4 centimeters (1.5 inches) into water. if you can do that, and blow bubbles, you can overcome 'all that blowing air'.

Get a glass of water. Get a straw. stick the straw into the glass of water, so the end is one and a half inches below the surface.

Put your lips on the straw... blow air through the straw. Were you able to make bubbles come out of the end of the straw? If so, you've just exhaled against 4cm/h2o pressure. stick the straw 4 inches into the glass... can you still blow bubbles? that's *10cm/h2o* pressure!

No matter what your definition of 'low pressure' is, cpaps do operate at LOW pressure. Your problem is *leaks* not pressure.

The airflow is less than a dog experiences, hanging its head out the car window.
Pure bliss.
Channel your inner canine and enjoy the "ride".