New to APAP, struggling to adjust

Hello,

I only recently got prescibed an APAP machine. Based on what the Apria lady told me, it's set to start at pressure of 4cms and go up to 13 cms. I do tend to breathe through mouth so I have a full mask.

Being new to this, of course I was expecting that it would take me time to adjust and I was ready for it. However, the problem is I don't seem to find the right "fit". Every night when I go to sleep, I end up fidgeting with the mask straps because I can feel a leak, sometimes near my eyes (top of the mask) or chin (bottom of the mask). After all that when I actually do go to sleep, I invariably wake up after couple of hours and feel the air leaking, since the pressure has increased. Again, I tighten the straps but then it becomes so tight that it is very uncomfortable. I also get a huge red bruise on the bridge of my nose.

Another thing, which is really curious, is that three times it has happened that I wake up in the middle of the night and see that my mask is off. I have no recollection of me removing the mask!!! One time, even the clip was not undone. I don't know what to attribute this to.

Here's the details of the equipment -

REMStart Auto M series with A-Flex
Humidifier - I fill it up but the temperature setting is on '0'
FlexiFit431 Full Face Mask

Any advice? Please help.

First of all welcome and you have found the right place to get help!

Secondly, is there a reason your start pressure is so low? 4cm can be hard to deal with because it is really not enough air, I heard somewhere that somewhere around 6-7 is needed to be sure CO2 exits the mask properly... but I could be wrong on that... I will say for me that 4 is way too low. I start at 7 on my APAP and it's comfortable for me. I will probably bump it to 8 though.

Regarding your mask fit issues, 4 is a big jump from 13 and I can see how you would have mask fit problems when the pressure ramps up if you fit your mask only at 4cm. Is there a way to fit the mask at the maximum pressure so you know ahead of time the seal is good at the max pressure? My AutoSet has a mask fit feature. Also, you may just need to try a different mask, some work better than others. I did not do well with the Ultra Mirage but the Mirage Quattro works well for me.

Some use bandaids or medical tape to protect the bridge of the nose and find it helps.

About removing the mask, a little over a year ago when I got my first CPAP I would wake up to find the mask on my chest, I guess I wasn't used to it and would just remove it. That has gotten better with time. Are you new to therapy compeltely or just new to apap? Keep posting here, there are folks way smarter than me that will help you.

Thanks very much for the suggestions. I will search on the forum and figure out how to adjust the settings. I really like your idea of the "mask fit feature" and will check if my machine has that.

I am brand new to this therapy so I guess it's a matter of time, judging by overwhelmingly positive experiences posted here.

Thanks again.

Hello & Welcome, snoredevil! Glad you found this forum--SO much useful info and SO many helpful people here!

Yep, it just takes time. I agree, too, that the starting pressure of 4 is very low; typically, the low number is set close to your sleep study titrated pressure. Good luck, and hang in there!

"You are getting sleepy . . ."

The answer: Keep trying.
One say soon you will say to yourself, "This is easy!" It becomes like second nature. It's like one day it's a burden... then the next day it's a friend that you can't live without. It's hard to say when this happens... it could take a week.. a month... then all of a sudden it becomes a welcome part of your life.

As they say... perception equals reality. If we see something as a burden... we don't like it. If we see something as a benefit... we embrace it.

Welcome aboard and be sure you will get lots of good feedback here.

My 1st thought is, that mask may not fit (which is what you are indicating).

They are a good brand but I was never able to get the F/F version to fit around my mouth. I went to an Ultra Mirage F/F but while that was ok for a couple of years, my latest machine didn't like it so I switched to a quattro f/f and now very satisfied.

It does take trial & error - hopefully some of our members who have used that mask may have some help to get it fitting better.

Stick with it - it will work out eventually

Cheers

DSM