Struggling adapting to APAP

Hello

I have been following this forum for a few weeks. There is a ton of great info on here and I really have enjoyed reading. I have been on the CPAP for 2 weeks now, and I am not sure I can say it has been successful at all (although my Sleepyhead numbers are pretty decent)... AHI has been between 1 and 4 every night. I am using a Remstar APAP w/ Humidifier set at 5 - 15 cmH20, and for the most part have not experienced any leaking issues (while on my back only).

Sadly, I have not made it for more than 4 hours of consecutive sleep. Typically, I wake up after 3-4 hours, and in a half asleep mode, rip off my mask and sleep on my side/stomach instead. I haver been one to sleep on their back and I think that is what I am struggling with most. And the general discomfort of the mask itself. I will say that before the CPAP I was waking up in the middle of the night as well, so this is not something new. I was hoping the CPAP would let me get a full 7 our 8 hours though at least once by now.

Any advice would be great!

Thank you

Andrew

Mask is ResMed Mirage FX Nasal Mask
CPAP is Remstar Auto A-Flex w/ Heated Humidifier

Are you not sleeping on your side because you're wearing a mask? You should be able to do that. I sure to, whether I'm wearing a nasal mask, FFM, or nasal pillows.

If you fill out your profile to include the model of your mask, I'm sure there are people on this forum who can offer comfort suggestions.

Oh oops I thought I had added it to my profile already! Yeah, when I roll over to my side it leaks. That is not what causes me to wake up though. I am just randomly waking up, enough to realize I'd prefer not having the mask on, but not really awake enough to stop myself from doing it.

Mask is ResMed Mirage FX Nasal Mask
CPAP is Remstar Auto A-Flex w/ Heated Humidifier

Google Pap Pillow - it might help with the mask leaking.

Andrewl3287 wrote:Hello

I have been following this forum for a few weeks. There is a ton of great info on here and I really have enjoyed reading. I have been on the CPAP for 2 weeks now, and I am not sure I can say it has been successful at all (although my Sleepyhead numbers are pretty decent)... AHI has been between 1 and 4 every night. I am using a Remstar APAP w/ Humidifier set at 5 - 15 cmH20, and for the most part have not experienced any leaking issues (while on my back only).

Sadly, I have not made it for more than 4 hours of consecutive sleep. Typically, I wake up after 3-4 hours, and in a half asleep mode, rip off my mask and sleep on my side/stomach instead. I haver been one to sleep on their back and I think that is what I am struggling with most. And the general discomfort of the mask itself. I will say that before the CPAP I was waking up in the middle of the night as well, so this is not something new. I was hoping the CPAP would let me get a full 7 our 8 hours though at least once by now.

Any advice would be great!

Thank you

Andrew

Mask is ResMed Mirage FX Nasal Mask
CPAP is Remstar Auto A-Flex w/ Heated Humidifier

I think there may be a combination of issues. The pressure changes (within the range) may be disturbing your sleep and if you're trying to sleep in a position you're not accustomed to, that would be problematic.

A narrower pressure range or single pressure........and a different bed pillow which would allow you to sleep in the position you're accustomed to may help.

I can't use a range of pressures because the pressure changes disrupt my sleep and I have a Chiroflow water-based pillow to allow me to sleep on my side.........because I've never been able to sleep on my back.


Den

.

thanks for the advice. i went and looked at my sleepy head logs the last 2 weeks and the trend is I wake up after the pressure increases rapidly after a few VS consecutive events. I'm not sure if this is a cause or an effect though. I tend to have an OS or CA around 3-4 minutes before waking up on about half the nights. Maybe I need a higher min pressure, but not necessarily a higher max pressure.

I will definitely look into getting the pillow. I just can't wait for the night I fall asleep and stay asleep till the AM....

Hi,

Your body is very good at adapting to all kinds of circumstances. In fact, you are probably pretty well adapted to getting pretty poor sleep. Now that you are breathing better with CPAP, your body doesn't quite know what to do. You essentially have to learn to sleep all over again, starting with unlearning how to sleep poorly. Some people get through this quickly, others take longer. I routinely woke up after 3 hours of sleep for months. It took me over 6 months to get to the point where I could sleep an entire night.

Another dynamic is that all people wake up a few times each night. Normal people don't notice it. However, folks on CPAP notice it because of their data, and also because of the machine itself. When you wake up to be partially conscious, the mask, air, and noise can bring you more fully awake. Some people are more sensitive to this than others. In most cases, you will get used to the equipment, and this kind of wake up event will quickly fade away. The big issue now is to avoid taking the mask off.

-john-

thanks john. i am still positive, and not overly frustrated yet. this forum is such a great source of information and inspiration. Every night i have gone to bed with the attitude that this will be the night that i leave the mask on the entire time, but haven't yet.. hopefully tonight is the night!

another thing to add. when i do sleep on my side, the type of leaking are almost like "puffs". like a small amt of air escapes every couple seconds in almost like a bubble, it is strange.

Last night went decently well, woke up at 1 am and managed to keep the mask on, then again at 4 am, when I took the mask off. Overall 6 hours w/ the mask on and AHI under 1 w/ 2 wake ups. I'll take it.

There are many masks to choose from. If one mask leaks and you can't fiddle with the head gear to stop the leak try another style. The TapPap is one that might allow easy leak free side sleeping, as well as the SleepWeaver Élan. Not everyone needs to use a hard plastic mask. Look at our sponsors web site for a great selection complete with reviews.

Andrewl3287 wrote:another thing to add. when i do sleep on my side, the type of leaking are almost like "puffs". like a small amt of air escapes every couple seconds in almost like a bubble, it is strange.

Where are those puffs of air escaping from? Knowing that may help us trouble shoot what's going on.

robysue wrote:

Andrewl3287 wrote:another thing to add. when i do sleep on my side, the type of leaking are almost like "puffs". like a small amt of air escapes every couple seconds in almost like a bubble, it is strange.

Where are those puffs of air escaping from? Knowing that may help us trouble shoot what's going on.

out of the side of the mask. feels like bubbles of air coming out.

Andrewl3287 wrote:

robysue wrote:

Andrewl3287 wrote:another thing to add. when i do sleep on my side, the type of leaking are almost like "puffs". like a small amt of air escapes every couple seconds in almost like a bubble, it is strange.

Where are those puffs of air escaping from? Knowing that may help us trouble shoot what's going on.

out of the side of the mask. feels like bubbles of air coming out.

First, make sure that you don't have the head gear too tight. Your mask uses an air cushion to form the seal, and if the air cushion cannot fully inflate, you'll get little leaks of the sort you describe. You might want to review the mask fitting guidelines that came with the mask carefully. You might also want to read through JanKnitz's Taming the Mirage Quattro essay. While the Mirage Quattro is not the mask you are using, many of the fitting principles are the same for the two masks.

A mask liner may also make a big difference with this kind of leak problem. You can order a real one from Padacheek. Or you can make a quicky mask liner by cutting an appropriate sized piece of fabric out of an old, soft t-shirt and then cutting a hole in the middle for your nose to poke through in the middle.

You don't need to sleep on your back -- in fact it may make it worse for you.

Four hours of full sleep on the machine is actually a good accomplishment. You will, eventually, with persistence, get better and better. It may be helpful, during this period, to actually ask for a tranquilizer from your doctor to help you sleep and get over this initial hurdle becoming acclimated to the machine. That alone may work wonders for you.

With careful pillow positioning, you should be able to sleep on your side without much problem. Stomach sleeping, with many mask models, is more difficult, because it can press on the mask and cause leaks, discomfort, etc., which can wake you up. Some fare better than others, like the nasal Activa mask. Also the better you fit the mask to your face, the better it will stay put, even with movement while sleeping. Using your machine's high pressure 'mask fit' setting is the best way to help set up your mask's strap settings. Watch the Resmed or Respironics mask fitting videos on Youtube for help with fitting.

Believe me, you will be able to get past this. Nothing is perfect -- but be persistent and you will get better at this.