Need serious mask help.

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
violettt
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Need serious mask help.

Post by violettt » Sat Jan 28, 2023 7:21 am

Hello-

I have been struggling for 7 months to adjust to sleeping with a CPAP machine and it is still like fighting an uphill battle. I was told for a long time that it will take a while to get used to, but seriously, how long can I possibly keep going like this feeling worse than I did before?

I have tried nasal pillows, nasal that is not the pillow (just under the nose), the full nose, the full face, and the under the nose / over the mouth (DreamWare full face with the attachment at the top, Resmed same one, and Amara that attaches at the face) masks, with different sizes in all of them.

I cannot spend the whole night on my back or on my sides, I just can't, it is bad for my back. The best fit masks I have found so far are 1) the DreamWare full face mask for sleeping on my side, but it leaks/face farts if I am on my back to the point where I can't use it, 2) the DreamWare nasal mask for sleeping on my back but it leaks too much if I am on my side plus I get that sticky dry mouth even with a chin strap, or 3) the full nose mask but again I get the sticky dry mouth even with a chin strap. My doctor suggests switching masks when I want to change sleep positions but I do not find this practical for the way I sleep because it would not just be one and done in the middle of the night and it also involves changing the machine settings. I might as well just stop sleeping and get up at 3 am. Then of course there are the times that I just get fed up having an octopus attached to my face cuffing me to my bedside table.

Even nights when I feel like I got decent sleep I am still tired. I feel like this is a losing battle. The best sleep I get is when I take the masks off and sleep without at night or when I take a nap without it in the afternoon. Please help.

Thank you!
violet

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robysue1
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Re: Need serious mask help.

Post by robysue1 » Sat Jan 28, 2023 10:41 am

violettt wrote:
Sat Jan 28, 2023 7:21 am
Hello-

I have been struggling for 7 months to adjust to sleeping with a CPAP machine and it is still like fighting an uphill battle. I was told for a long time that it will take a while to get used to, but seriously, how long can I possibly keep going like this feeling worse than I did before?
I am sorry that you are having such a rough time. My own adjustment to sleeping with a CPAP was very long and it took about 9 months before I was starting to sleep well enough with the CPAP that there was anything positive to say about it.

Improvement in how you feel can be very gradual and when you're still fighting an uphill battle and feeling worse than before starting, minor improvements can be lost in the day to day battle.

I would suggest you consider keeping a sleep log: The first sign that CPAP was doing me some good was when I noticed the phrase "woke up without hand & foot pain" appearing several times a week in the sleep log I was keeping to rein in the insomnia monster that moved into my bedroom when I started CPAPing.
I have tried nasal pillows, nasal that is not the pillow (just under the nose), the full nose, the full face, and the under the nose / over the mouth (DreamWare full face with the attachment at the top, Resmed same one, and Amara that attaches at the face) masks, with different sizes in all of them.
Finding a mask that you can use needs to be your first goal.

No mask is perfect. And different individuals have different needs when it comes to finding a mask that is comfortable enough to sleep well with the mask on your face.

And it appears you've been swapping masks in and out with some real frequency. So it may be the case that you simply haven't given yourself enough time to figure out how to make a particular mask work for you.

So let's start with the basics: Can you answer these questions for me:

1) What is your favorite sleeping position? As in before you started on your CPAP adventure, what position or positions did you prefer to sleep in?

2) Have you tried to make any of the masks work in your favorite sleeping position? If so, what happened? If not, why not?

3) Do you breathe through your nose during the daytime?

4) Are you conscious of where your tongue is when you are awake and not talking, eating, or drinking something? If so, where does your tongue typically rest in your mouth?

5) Can you list the pros and cons of each mask type that you tried? In other words, can you fill in this kind of a chart:

Nasal Pillows masks: Things that I liked: LIST THEM. Things I didn't like: LIST THEM.
Nasal cradle (under the nose) masks: Things that I liked: LIST THEM. Things I didn't like: LIST THEM.
Nasal mask (cover the nose): Things that I liked: LIST THEM. Things I didn't like: LIST THEM.
Full face masks: Things that I liked: LIST THEM. Things I didn't like: LIST THEM.

Things you liked should include whether the mask was genuinely comfortable when you first put it on, regardless of what happens later in the night.

Once you identify the type of mask you seem to prefer in terms of comfort, then the task becomes making your chosen mask work for you. The first step in that is making sure you understand how to properly fit the mask at the beginning of the night.

I cannot spend the whole night on my back or on my sides, I just can't, it is bad for my back.
Once you have decided what kind of mask you want to use, with our help, you should be able to make that mask work in all of your sleep positions.

And you didn't mention stomach sleeping at all. Is sleeping on your stomach your favorite sleep position? Although many stomach sleepers take one look at a CPAP machine and conclude there is no way to use a CPAP while sleeping on their stomach, they're wrong. My husband sleeps with a CPAP and on his stomach most of the time---as in he spends maybe 80% of his sleep time on his stomach and he does it with a CPAP mask on his face.

So if you are a stomach sleeper, please let us know: It's much better to find a way to make CPAP work with your favorite sleeping position than try to change your sleep position in an effort to make CPAP work.

The best fit masks I have found so far are 1) the DreamWare full face mask for sleeping on my side, but it leaks/face farts if I am on my back to the point where I can't use it,
Sounds like you need some help learning how to fit the DreamWear full face mask so that it doesn't spring a leak when you move around in bed. And keep in mind, there's much more to fitting a mask than just tightening the hell out of the straps.

2) the DreamWare nasal mask for sleeping on my back but it leaks too much if I am on my side plus I get that sticky dry mouth even with a chin strap, or
How much is it actually leaking? Can you post some data? Are the leaks waking you up?

The sticky dry mouth with a chin strap does make it sound like you are doing some mouth breathing. But it would be nice to see some data to confirm that.

And again, how are you trying to address the leaks when they happen?

3) the full nose mask but again I get the sticky dry mouth even with a chin strap.
Again, that's evidence that you may be doing some mouth breathing at night.

My doctor suggests switching masks when I want to change sleep positions but I do not find this practical for the way I sleep because it would not just be one and done in the middle of the night and it also involves changing the machine settings.
Let's add that doc's suggestion to the long list of clueless things said to new CPAPers by sleep docs who have never tried to sleep with a CPAP machine.

You're right: It is ridiculous to be expected to switch your mask every time you want to change sleep positions: That will guarantee some severely fragmented sleep, and fragmented sleep leads to feeling really awful when you wake up and feeling really awful during the daytime.

What you need is to figure out a way of fitting your favorite mask and managing the hose so that you can change positions in your sleep without waking up to nasty leaks. So let's start with some basics:

We'll assume (for now) that you need a full face mask since there is a bit of evidence that you may be mouth breathing at night. You say the DreamWear full face mask works ok when you are on your back, but it springs leaks when you turn on your side.

There are several things that I would suggest as things to try:

1) Fit the mask when you are on your back. In other words, lie down on your back at the beginning of the night to fiddle with the mask. When you think you have the mask fitted, then turn to your side and see if it starts leaking. When you start adjusting the straps, you may find that you need to tighten one side more than the other to accommodate side sleeping. Once you are pretty sure the mask is sealed when you are on your side, turn back onto your back and see if the mask stays sealed. And be sure that you do not over tighten the straps. When the straps are too tight, the air cushion cannot fully inflate, and when the cushion is not fully inflated the probability of springing a leak is increased.

2) It could be that when you turn on your back, the machine is more likely to increase pressure due to more flow limitations and/or more events. And once the pressure increases, that could cause the mask to spring a leak. So make sure you fit the mask at your full therapeutic pressure, particularly if you use the ramp. Again, showing us data may help us figure out if you are using more pressure on your back and whether that additional pressure is what's leading to the face fart leaks.

3) Consider getting a CPAP pillow with cutouts for the mask to hang into when you are on your side. Alternatively, see if you can sleep with your head close enough to the edge of the pillow so the mask can hang down. Sometimes masks will spring leaks when the pillow pushes up against the edge of the mask when you are sleeping on your side.

4) When you have a leak---regardless of whether you are on your back or on your side---try pulling the mask cushion gently away from your face. (Be prepared for a gush of air to be blown at you.) Once the cushion is away from your face, it can fully inflate. Then gently let go of the mask and allow it to resettle onto your face by itself. This procedure will fix a lot of small leaks and once you master it, it can be done without fully waking up.

5) Consider hanging your hose or draping it over your headboard. This helps prevent the weight of the hose from yanking on the mask when you attempt to turn over while asleep. This trick works best if your head and face are outside of the covers.

Then of course there are the times that I just get fed up having an octopus attached to my face cuffing me to my bedside table.
It sounds like you have some experience feeling like you get tied up in the hose when you're trying to move around in bed. Hanging the hose may very well help with that feeling.

Even nights when I feel like I got decent sleep I am still tired. I feel like this is a losing battle. The best sleep I get is when I take the masks off and sleep without at night or when I take a nap without it in the afternoon.
Unfortunately every time you consciously take your mask off and go to sleep without it, you are teaching your brain that it does not need to accept the presence of the CPAP in your life. In other words, this habit allows your brain to continue thinking about the CPAP as the enemy instead of your friend.

In other words, you are making it harder for your body and brain to learn how to sleep well with a friendly octopus on your face whose only purpose in your life is to help keep your airway from collapsing at night.

My suggestion is that when you absolutely cannot stand the idea of keeping the mask on at night is to get out of bed. Yes, get out of bed, go to a different room, and sit quietly or read something boring for a while. When you start feeling sleepy instead of angry at the octopus, go back to the bedroom and mask up and go back to sleep.

Likewise: When you need to take a nap, go to the bedroom and mask up.

In other words, you have to teach your brain to accept that time for sleep = time to wear the mask.
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Miss Emerita
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Re: Need serious mask help.

Post by Miss Emerita » Sat Jan 28, 2023 12:20 pm

I'll add just one thing to robysue1's post: you might try supporting your lower jaw by wearing a soft cervical collar in place of a chin strap.

Well, actually two things! Other forum members have recommended the "falcon" position for stomach sleepers:

http://www.uarsrelief.com/sleepingposmaskleft1b.jpg
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violettt
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Re: Need serious mask help.

Post by violettt » Sat Jan 28, 2023 10:40 pm

Thank you so very much for your thorough and thoughtful response! I have done my best to try to respond to everything below but then on preview it dropped a lot from the bottom, I guess I ran out of room, so I will have to respond in multiple relies:
I am sorry that you are having such a rough time. My own adjustment to sleeping with a CPAP was very long and it took about 9 months before I was starting to sleep well enough with the CPAP that there was anything positive to say about it.
It's good to hear that it has taken this long for others, it felt like people I have spoken to either had it make a difference much sooner or, for the most part, they just gave up before keeping going for this long.
Improvement in how you feel can be very gradual and when you're still fighting an uphill battle and feeling worse than before starting, minor improvements can be lost in the day to day battle.

I would suggest you consider keeping a sleep log: The first sign that CPAP was doing me some good was when I noticed the phrase "woke up without hand & foot pain" appearing several times a week in the sleep log I was keeping to rein in the insomnia monster that moved into my bedroom when I started CPAPing.
Thank you for this. I was keeping a log for a while but got really busy having to do physical therapy for a different ailment day and not and eventually just stopped the log. I should start again. It's hard to notice slow, gradual improvements, but it could be happening....
And it appears you've been swapping masks in and out with some real frequency. So it may be the case that you simply haven't given yourself enough time to figure out how to make a particular mask work for you.
I've used each type of mask for several weeks, with different size masks at least a few days each. The two that have worked best of those I have used for at least two months.
So let's start with the basics: Can you answer these questions for me:

1) What is your favorite sleeping position? As in before you started on your CPAP adventure, what position or positions did you prefer to sleep in?
Favorite is on my side, but I have been having problems with my shoulder and hip so it is hard to stay on either side too long. I also love sleeping on my stomach but have found it difficult to do with a mask on. Plus at some point my back gets sore and I need to switch to my back.
2) Have you tried to make any of the masks work in your favorite sleeping position? If so, what happened? If not, why not?
Yes. The DreamWare full face works very well on my side for the most part, but when I have to switch to my back because of joint issues or my back getting sore is when I run into problems.

violettt
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Re: Need serious mask help.

Post by violettt » Sat Jan 28, 2023 10:59 pm

2) Have you tried to make any of the masks work in your favorite sleeping position? If so, what happened? If not, why not?
Yes, DreamWare full face mostly works well in my favorite position. Some nights it gives me a hard time, but not the majority.
3) Do you breathe through your nose during the daytime?
Sometimes if I am wearing a KN95 or N95 masks, other than that, no. And I don't know that I breath through my mouth at night, but I do know that when I was younger if I slept in a car/bus or plane my jaw would drop open, but I'd still be breathing through my nose.
4) Are you conscious of where your tongue is when you are awake and not talking, eating, or drinking something? If so, where does your tongue typically rest in your mouth?
Mostly rests on my top palette.
Nasal Pillows masks: Things that I liked: LIST THEM. Things I didn't like: LIST THEM.
Like the minimalist design, not as.... claustrophobic. Didn't like that it would shift as I moved around at night and cause air to start shooting out of my nose and wake me up. Tightening the straps to the point this stopped made it too uncomfortable to wear straps. Also ended up with very dry mouth.
Nasal cradle (under the nose) masks: Things that I liked: LIST THEM. Things I didn't like: LIST THEM.
Like the minimalist design, not as.... claustrophobic. Worked pretty good for sleeping on back. Didn't move around as much as the nasal pillows did for me but still shifted. Didn't like that it was hard to sleep on my side (preferred position for large portions of the night) and not have leaks. Also, sometimes the spot under my nose would get sore, and often I would get the sticky dry mouth (not the absolutely dry mouth as with the pillows).
Nasal mask (cover the nose): Things that I liked: LIST THEM. Things I didn't like: LIST THEM.
Like that it felt secure in place, doesn't move around so much, don't tend to get leads on my back or sides. Don't like the tube attaching at my nose, sticky dry mouth, and it has started to cause a lot of soreness on the bridge of my nose that became very sensitive so I could only wear it a few nights in a row.
Full face masks: Things that I liked: LIST THEM. Things I didn't like: LIST THEM.
For the full over the nose and mouth face mask there was nothing I liked about it. I did not like that it felt claustrophobic and I had a ton of leaks. It felt too small at the bridge of my nose and too big at my mouth.
For the Dreamware full face which is like a nasal cradle but also goes over your mouth, for the most part this is the most comfortable for me, though sometimes it feels like too much - like an octopus is on my face. I like that I can sleep on my sides with no or minimal leaks, and that the hose attaches at the top of my head which I find much less disturbing than attaching at my nose. I don't like that I can't see to sleep on my back with it without big leaks and face farts. Also, sometimes it leaves the area under my nose really sore and I have to stop using it for a few nights.
And you didn't mention stomach sleeping at all. Is sleeping on your stomach your favorite sleep position? Although many stomach sleepers take one look at a CPAP machine and conclude there is no way to use a CPAP while sleeping on their stomach, they're wrong. My husband sleeps with a CPAP and on his stomach most of the time---as in he spends maybe 80% of his sleep time on his stomach and he does it with a CPAP mask on his face.
I do like to sleep on my stomach! I just gave up on trying to make that work, but if there is a way to do it I am happy to listen to ideas for it!
The sticky dry mouth with a chin strap does make it sound like you are doing some mouth breathing. But it would be nice to see some data to confirm that.

See above on the mouth breathing, I think it just pops open. Also, sometimes the pressure causes my lips to part even with a chin strap and mouth closed. I have a ResMed AutoSet 10 but I live in Thailand (am American) and don't know how to get the data off the machine as I don't think it has wifi capability.
And again, how are you trying to address the leaks when they happen?
Adjusting the straps till it goes away or I give up and take the mask off and go without.

Thanks!
violet

violettt
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Re: Need serious mask help.

Post by violettt » Sat Jan 28, 2023 11:24 pm

My doctor suggests switching masks when I want to change sleep positions but I do not find this practical for the way I sleep because it would not just be one and done in the middle of the night and it also involves changing the machine settings.
Let's add that doc's suggestion to the long list of clueless things said to new CPAPers by sleep docs who have never tried to sleep with a CPAP machine. [/quote]
She says she uses CPAP to sleep. However, I get the sense that in Thailand the culture is that doctor is always right and people just do whatever the doctor says because they are the doctor. I could be wrong, but this has been my experience with other things she has told me a MUST do even when I say that isn't going to work for me, let's find another way.
What you need is to figure out a way of fitting your favorite mask and managing the hose so that you can change positions in your sleep without waking up to nasty leaks. So let's start with some basics:

There are several things that I would suggest as things to try:
I skimmed this before bed last night but was tired and didn't fully comprehend. Will try tonight. Great suggestion on adjusting the mask at full pressure and when on my back! And good to know about too tight straps - doc keeps telling me to make sure they are tight enough.
I usually just sleep with my head to the edge of the pillow, but I'll look into CPAP pillow. The ones I have seen in my limited search are memory foam, which I don't like as my neck ends up hurting when I sleep on it.
It sounds like you have some experience feeling like you get tied up in the hose when you're trying to move around in bed. Hanging the hose may very well help with that feeling.
My favorite mask has the hose attach at the top of my head and it doesn't yank the mask away from my face. My second favorite (over the nose) I don't have a problem with leaks. The octopus part is more about just having this big thing on my face with a strap at the top of my head and one or two going behind my head. It's a lot. Many nights I'm fine with it but some nights its just too much for me.
Unfortunately every time you consciously take your mask off and go to sleep without it, you are teaching your brain that it does not need to accept the presence of the CPAP in your life. In other words, this habit allows your brain to continue thinking about the CPAP as the enemy instead of your friend.
Likewise: When you need to take a nap, go to the bedroom and mask up.
Well noted, but I do need to be able to get sleep - for a while I was really starting to go crazy with a sleep deprived brain. And there are many times I can barely keep my eyes open when I am at work - I can't simply go into my bedroom to put on my mask because I am at my office, 35 minutes away and can't leave work for 90 minutes for a 20 minute nap. I suppose if I really think about it those days are less now than they used to be, but it still happens.

I will also add this to the fun, as it definitely impacts my sleep and maybe impacts pressure settings? Not sure. I travel quite a bit, mostly for work. I live in Bangkok (1.5m elevation), but since I started on the machine I have spent two weeks in Bangladesh (~30m elevation, one hour time difference), then back to Bangkok for ~1.5 months, 6 weeks in Islamabad (~500-800m), 1.5 weeks in Karachi (~30m) in the middle of my time in Islamabad (both 2 hour time difference from Bangkok), back to Bangkok. Then 6 weeks in the US (120-160m, 12 hour time difference). Now I'm in Bangkok for 2.5 weeks and heading back to Islamabad in a week (another 2 hour time difference). I often take melatonin to help me get back on the right time zone.

Thanks so much again for your thorough reply and helping me!
Best-
violet

violettt
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Re: Need serious mask help.

Post by violettt » Sat Jan 28, 2023 11:26 pm

Miss Emerita wrote:
Sat Jan 28, 2023 12:20 pm
I'll add just one thing to robysue1's post: you might try supporting your lower jaw by wearing a soft cervical collar in place of a chin strap.

Well, actually two things! Other forum members have recommended the "falcon" position for stomach sleepers:

http://www.uarsrelief.com/sleepingposmaskleft1b.jpg
Thanks very much Miss Emerita! Interesting idea about the cervical collar. I'll look into it, though even with the chin strap sometimes the pressure would force my lips to open and air top come rushing out.... I will definitely try out the "falcon" position, that might be a winner for at least part of my night's sleep!

Best-
violet

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Re: Need serious mask help.

Post by Janknitz » Mon Jan 30, 2023 4:50 pm

If you had a choice, would you sleep on your back at all?

If the answer is "no", I suggest sleeping on your side or the falcon position, and staying off your back. Adjust the mask for your desired sleeping position at your highest pressure. There's no need to sleep on your back unless you are comfortable in that position.

I use the regular (not FF) Dreamwear and it's kind of loose. It will slip up the back of my head (yes, I have the "arms" but it still does)and when I roll side to side the nose cradle slightly dislodges. It only takes me one finger to reseat the mask, sometimes I just push right under my nose as I turn and then it will stay in place, although I usually have to pull it down in back. I am awake enough to do all that. I used to sleep in one position all night, but getting older I'm having more aches and pains so I need to change positions a few times a night--the pain wakes me, then I shift.

I bet the one finger technique would work on your FF Dreamwear too. Just gently reposition it when you turn, then go back to sleep. It becomes automatic over time, I don't even think about it too much and only remember some of the times I woke.

I wouldn't be comfortable in a cervical collar but I have one of those C-shaped neck pillows filled with buckwheat hulls. I took out most of the hulls, so it's very soft and floppy, and I can mold it under my chin or the side of my face to help support the mask. That helps, too.
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Re: Need serious mask help.

Post by zonker » Mon Jan 30, 2023 4:56 pm

violett? i hope you don't find the various and sundry methods suggested to be contradictory. they aren't because sleep and sleep apnea is a very personal and individual occurrence.

often, you'll have to try this thing or that thing in order to find what works best for you. it's a long journey and only you can determine what makes you the most comfortable.

good luck!
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Re: Need serious mask help.

Post by robysue1 » Tue Jan 31, 2023 8:37 am

violettt wrote:
Sat Jan 28, 2023 10:40 pm
So let's start with the basics: Can you answer these questions for me:

1) What is your favorite sleeping position? As in before you started on your CPAP adventure, what position or positions did you prefer to sleep in?
Favorite is on my side, but I have been having problems with my shoulder and hip so it is hard to stay on either side too long. I also love sleeping on my stomach but have found it difficult to do with a mask on. Plus at some point my back gets sore and I need to switch to my back.
So first you need to realize that it is possible to stomach sleep with a CPAP mask on your face. The usual suggestion is to try what's called the falcon position. Here's a picture of what it looks like:
Image
The wiki has more information at Sleep Positions. My husband uses this position with his full face mask for his predominant sleep position and his leaks are usually very well controlled. My husband's head, however, is usually closer to the edge of his pillow than is shown in this image.

Second, you need to teach yourself how to turn over and move around in bed without getting caught in the hose and without triggering lots of leaks. It may be useful to practice this during the daytime when there is no pressing need for you to worry about getting to sleep or staying asleep. Figure out if you can "hug" the hose in order to move it with you when you turn over or if hanging the hose over the headboard seems to work better for you. (If hanging the hose seems to work better, consider getting a hose hanger system.) And when moving around in bed triggers a leak, see if you can learn how to fix the leak by gently pulling the mask away from your nose just a bit and then letting it go so it can resettle by itself. That simple procedure will fix a lot of small leaks caused by movement and once you know how to do it, it's possible to do without fully waking up in the middle of the night.

2) Have you tried to make any of the masks work in your favorite sleeping position? If so, what happened? If not, why not?
Yes. The DreamWare full face works very well on my side for the most part, but when I have to switch to my back because of joint issues or my back getting sore is when I run into problems.
Have you tried fitting the DreamWear full face mask when you are on your back at the beginning of the night and then turning to your side (or stomach) to go to sleep? If so, what happens?
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Re: Need serious mask help.

Post by robysue1 » Tue Jan 31, 2023 9:23 am

violettt wrote:
Sat Jan 28, 2023 10:59 pm
3) Do you breathe through your nose during the daytime?
Sometimes if I am wearing a KN95 or N95 masks, other than that, no. And I don't know that I breath through my mouth at night, but I do know that when I was younger if I slept in a car/bus or plane my jaw would drop open, but I'd still be breathing through my nose.
4) Are you conscious of where your tongue is when you are awake and not talking, eating, or drinking something? If so, where does your tongue typically rest in your mouth?
Mostly rests on my top palette.
If you usually breathe through your nose AND your tongue stays parked firmly on your top palette, then in theory it should be possible to make a nasal mask or a nasal pillows mask work. As long as your tongue is blocking the oral cavity off from the nasal cavity, it's even possible to open your mouth without it triggering a huge leak. But the extra pressure from the CPAP may encourage the tongue to move down off the upper palette and then air can go from the nasal cavity into the oral cavity and you do wind up with a rather largish leak.

Nasal Pillows masks: Things that I liked: LIST THEM. Things I didn't like: LIST THEM.
Like the minimalist design, not as.... claustrophobic. Didn't like that it would shift as I moved around at night and cause air to start shooting out of my nose and wake me up. Tightening the straps to the point this stopped made it too uncomfortable to wear straps. Also ended up with very dry mouth.
Sounds like you are way over tightening the straps for a nasal pillows mask. As counterintuitive as it sounds, the nasal pillows. masks become less stable when over tightened. The seal is established by the cones properly seating against the edges of the nostrils. When the straps are too tight, that can push the cones too far into the nostrils and that triggers the leaks and the discomfort. Some people also use too small of a nasal pillows cushion, and that too leads to too much of the cones being pushed into the nostrils.

Using Lansinoh nipple cream is often suggested as a way of making nasal pillows stay sealed. When I was starting out I did use Lansinoh and it did help, both in terms of helping me keep the mask sealed and in terms of easing some of the discomfort I was getting from the mask at the time. I haven't needed the Lansinoh for many years now.

The dry mouth, however, may indicate that you are doing some mouth breathing. Looking at the leak lines would be useful for determining whether it's worth trying to make nasal pillows your go-to mask.


Nasal cradle (under the nose) masks: Things that I liked: LIST THEM. Things I didn't like: LIST THEM.
Like the minimalist design, not as.... claustrophobic. Worked pretty good for sleeping on back. Didn't move around as much as the nasal pillows did for me but still shifted. Didn't like that it was hard to sleep on my side (preferred position for large portions of the night) and not have leaks. Also, sometimes the spot under my nose would get sore, and often I would get the sticky dry mouth (not the absolutely dry mouth as with the pillows).
Sounds like a nasal cradle mask has some promise for you.

If you want to revisit using a nasal cradle mask, I would suggest spending time while you are awake and not trying to get to sleep to learn how to adjust the mask so that its seal is more robust. Fit the mask when you are on your side and keep in mind that you may need to have the straps adjusted in a non-symmetric fashion. Once you think you've got a decent seal when you are lying down on your preferred side for sleeping, then start trying to move around in bed. See if you can figure out a way to guide the hose while moving so that it does not pull on the mask and break the seal. When you get small leaks see if you can fix them in the new position by pulling the mask away and allowing it to resettle against your face.

And again, remember that over tightening the straps can actually make the mask more prone to leaking.


Nasal mask (cover the nose): Things that I liked: LIST THEM. Things I didn't like: LIST THEM.
Like that it felt secure in place, doesn't move around so much, don't tend to get leads on my back or sides. Don't like the tube attaching at my nose, sticky dry mouth, and it has started to cause a lot of soreness on the bridge of my nose that became very sensitive so I could only wear it a few nights in a row.
Since the hose attaching at your nose is an issue, it's worth considering what you are doing in terms of hose management.

Do you prefer to hug the hose against your body? Or do you prefer to hang the hose over the head of your bed?

As for the soreness on the bridge of your nose: That sounds like you are over tightening the straps. You might also want to try a nose bridge protector from Padacheek.


Full face masks: Things that I liked: LIST THEM. Things I didn't like: LIST THEM.
For the full over the nose and mouth face mask there was nothing I liked about it. I did not like that it felt claustrophobic and I had a ton of leaks. It felt too small at the bridge of my nose and too big at my mouth.
For the Dreamware full face which is like a nasal cradle but also goes over your mouth, for the most part this is the most comfortable for me, though sometimes it feels like too much - like an octopus is on my face. I like that I can sleep on my sides with no or minimal leaks, and that the hose attaches at the top of my head which I find much less disturbing than attaching at my nose. I don't like that I can't see to sleep on my back with it without big leaks and face farts. Also, sometimes it leaves the area under my nose really sore and I have to stop using it for a few nights. [/quote]If I were you, I think I'd be working on figuring out a way to make the Dreamwear full face mask work better when back or stomach sleeping.

Again, start by playing around and practicing moving around with the mask on during the daytime when you're not actually trying to sleep with the mask. Start by fitting the mask when you are on your back to see if you can eliminate the leaks in that position. Since you say you're getting a lot of face farts, my guess is that you are over tightening the mask. Try loosening the straps and making sure the cushion has a chance to fully inflate. And pay attention to where the leaks are occurring. Are they at the top of the mask? Or are they around the area that covers your mouth?

And also try to determine this: If your mouth is shut is there more or less leaking than when your mouth is open? In other words, you need to try to tease out whether the issue is simply being on your back or whether the issue is that when you are on your back, you are more prone to opening your mouth wide open and the associated mouth movement is what's triggering the leaks.

Here's the thing about full face masks: The larger cushion means the mask has to seal well against a larger portion of your face. And that in turn means that facial movement (i.e. opening your mouth) may lead to more of a problem with the mask springing leaks than you have with a smaller mask.
And you didn't mention stomach sleeping at all. Is sleeping on your stomach your favorite sleep position? Although many stomach sleepers take one look at a CPAP machine and conclude there is no way to use a CPAP while sleeping on their stomach, they're wrong. My husband sleeps with a CPAP and on his stomach most of the time---as in he spends maybe 80% of his sleep time on his stomach and he does it with a CPAP mask on his face.
I do like to sleep on my stomach! I just gave up on trying to make that work, but if there is a way to do it I am happy to listen to ideas for it!
As I mentioned in the previous post: The falcon sleeping position is your friend. It works.
The sticky dry mouth with a chin strap does make it sound like you are doing some mouth breathing. But it would be nice to see some data to confirm that.

See above on the mouth breathing, I think it just pops open. Also, sometimes the pressure causes my lips to part even with a chin strap and mouth closed. I have a ResMed AutoSet 10 but I live in Thailand (am American) and don't know how to get the data off the machine as I don't think it has wifi capability.
There should be an SD card in the SD slot that is on the left side of the machine. All the data the machine gathers is written to that SD card. You can remove the SD card and insert it into an SD slot (or card reader) on your computer and then upload the contents into Oscar (a free program that you install on your computer) or SleepHQ (a web site that allows you to upload your data). Both Oscar and SleepHQ will show you the full efficacy data, including leak data for the whole night.
And again, how are you trying to address the leaks when they happen?
Adjusting the straps till it goes away or I give up and take the mask off and go without.
If by adjusting the straps, you mean tightening them, you may find that you need to loosen the straps instead of tightening them.

In the middle of the night when you wake up to leaks, first try this: Pull the mask cushion gently off your face (in whatever sleep position you are in) and let go. See if the mask will resettle with a better seal all by itself. You do need to be prepared to hear and feel a blast of air when the cushion is off your face; it will end once the mask has resettled. For many small and moderate size leaks, this is all that is needed to fix the problem.

If pulling the mask away from your face and letting it resettle doesn't work, then consider adjusting just the strap(s) that are closest to where the leak is occurring. Consider loosening the strap as well as tightening it. If that doesn't work, then consider loosening as well as tightening the straps that are farthest from the leak.

What I've found is that if a mask is leaking when I am side sleeping is this: If the mask is leaking on the side that is next to the bed, I need to loosen the strap nearest the leak and sometimes tighten the strap on the opposite side of the head. If the leak is on the side of the mask that is not next to the bed, I may need to slightly tighten that strap and often loosen the strap that is next to the bed.

But most of the time? Just pulling the cushion away from my face and letting it resettle fixes the leaks.
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violettt
Posts: 11
Joined: Sat Jan 28, 2023 6:50 am

Re: Need serious mask help.

Post by violettt » Fri Feb 03, 2023 8:52 am

Hahanghan wrote:
Mon Jan 30, 2023 2:21 pm
Have you considered other solutions for improving your sleep with a CPAP machine? I've come across the Dodow Sleep Device which some users have reported helps them fall asleep faster and get a more restful sleep. It's a small device that projects a calming light onto the ceiling, and the rhythm of the light slows down over time to signal to your body that it's time to sleep. It's also non-invasive, so it might be worth checking out if you're looking for a different option.
If you wonder whether does down work? You can read some reviews online and see for yourself.
Interesting, thanks Hahanghan! Will check it out

violettt
Posts: 11
Joined: Sat Jan 28, 2023 6:50 am

Re: Need serious mask help.

Post by violettt » Fri Feb 03, 2023 8:57 am

Janknitz wrote:
Mon Jan 30, 2023 4:50 pm
If you had a choice, would you sleep on your back at all?

If the answer is "no", I suggest sleeping on your side or the falcon position, and staying off your back. Adjust the mask for your desired sleeping position at your highest pressure. There's no need to sleep on your back unless you are comfortable in that position.
Thanks Jankitz! Every night I end up on my back at some point at least for a little bit or my back is unhappy. I don't have problems moving around, it just seems that when I am on my back my cheeks seem to sort of.... fall away from the mask and air leaks out the sides causing that face farting noise. I've seen a lot of reviewers say they can't even use this particular mask because they can never get a seal, one person even said they felt it was designed for people with a more flat face. I don't know, I can get a seal on my sides, just not my back.

violettt
Posts: 11
Joined: Sat Jan 28, 2023 6:50 am

Re: Need serious mask help.

Post by violettt » Fri Feb 03, 2023 8:58 am

zonker wrote:
Mon Jan 30, 2023 4:56 pm
violett? i hope you don't find the various and sundry methods suggested to be contradictory. they aren't because sleep and sleep apnea is a very personal and individual occurrence.

often, you'll have to try this thing or that thing in order to find what works best for you. it's a long journey and only you can determine what makes you the most comfortable.

good luck!
Thanks Zonker! It's really just exhausting and I'm so tired of fighting this seemingly endless battle....

violettt
Posts: 11
Joined: Sat Jan 28, 2023 6:50 am

Re: Need serious mask help.

Post by violettt » Fri Feb 03, 2023 9:05 am

So first you need to realize that it is possible to stomach sleep with a CPAP mask on your face. The usual suggestion is to try what's called the falcon position. Here's a picture of what it looks like:
Image
The wiki has more information at Sleep Positions. My husband uses this position with his full face mask for his predominant sleep position and his leaks are usually very well controlled. My husband's head, however, is usually closer to the edge of his pillow than is shown in this image.
Thanks! This is helpful.
Second, you need to teach yourself how to turn over and move around in bed without getting caught in the hose and without triggering lots of leaks. It may be useful to practice this during the daytime when there is no pressing need for you to worry about getting to sleep or staying asleep. Figure out if you can "hug" the hose in order to move it with you when you turn over or if hanging the hose over the headboard seems to work better for you. (If hanging the hose seems to work better, consider getting a hose hanger system.) And when moving around in bed triggers a leak, see if you can learn how to fix the leak by gently pulling the mask away from your nose just a bit and then letting it go so it can resettle by itself. That simple procedure will fix a lot of small leaks caused by movement and once you know how to do it, it's possible to do without fully waking up in the middle of the night.
I'm not having any problems getting caught up in my hose.

Have you tried fitting the DreamWear full face mask when you are on your back at the beginning of the night and then turning to your side (or stomach) to go to sleep? If so, what happens?
I have now done this and I thought I got the mask to a good place then a little while in all of a sudden it was leaking and I couldn't get it to stop no matter what I did with the straps or what position I was in. I ended up taking it off. The next night I still couldn't get a seal no matter what I did so I slept without a mask. The following night I used my over the nose mask, then the next night I went back to my old fitting of the straps on the DreamWear full face where it only leaks if I am on my back. There's something about this mask... I've seen a lot of reviews of this mask saying they can't get it to not leak and one person even said they think it is for people with a more flat face. I don't know. It works fine for me on my sides but when I'm on my back my cheeks just seem to fall away from the mask causing the dreaded face fart.