New guy saying hello

Hello everyone,

As I sit here and type I am wearing my full face Hans Rudolph 7600 Series V2 mask, and wondering how the HELL will I ever sleep with this thing on. I was diagnosed with OSA, with moderately severe sleep fragmentation but minimal O2 desaturations. My Respirator Disturbance Index is 17.1 / hour and 25.1 sleep arousals per hour. No PLMS

The study was done through a sleep clinic in San Antonio, but the machine and prescription are through the VA.

Ok so my settings on my machine are 6-12 ramp with exhalation at 3. (I think). The technician went through it pretty quick.

Today I am trying to wear the mask as much as I can to get used to it. I have a deviated septum that has been surgically repaired to the best it can be, but I still have some deviations which causes me to be a mouth breather. I also suffer from year long allergies so that worsens the mouth breathing. With all that being said, a nose mask was out of the question.

So lucky for me I found your site when I googled "what is the best full face mask for OSA" and a like to a forum conversation came up. I have been reading a ton of information but still trying to get used to it.

Like right now, my humidifier is set to 3, and I can feel the water condensation on my nose, which is causing me to itch and that is bad when one is trying to sleep. So do I turn down the humidifier? Is it the mask? So many questions.

I also suffer from Asthma so this exhaling against a pressure is very unusual and almost claustrophobic to me. I don't feel like I am getting all the breath out. In is ok, out is a strain. I asked the technician and she said 3 is as low as it goes. Is that true?

Well anyway it is nice to have a site to come to with this depth of information and support. I will keep reading and looking at other complaints and resolution and maybe try to sleep with this on. I am going to have to be good and really tired.

Also, anyone else have a wife or husband complain about the noise of the machine and the mask? I live out in the country and it is QUITE out here. The machine and mask sound like a hurricane is going on compared to the background noise of the house. Any suggestions on that?

Thanks and I look forward to talking with you all.

Richard H.

Welcome to the forum.
Do plenty of reading, searching (in the Search line above) and asking questions.

You need to get Sleepyhead software to monitor your therapy. It will tell you how things are working.
Typically, pressure and humidifier settings are the most-tweaked parts of the therapy. Finding the right mask is also crucial.


Den

.

Moisture in your mask could be from the humidity settings or even from the moisture in your own exhaled breath. Read posts number 2 and 3 in this thread as it talks about your various options to reduced or eliminate unwanted condensation in the mask or hose.
viewtopic/t94035/Pugsys-Pointers-3Deali ... -road.html

Flex at 3 that is the exhale relief and at the most if will give a 2 cm reduction during exhale but it might not be giving that if your own breathing is real forceful. How much actually reduces is based on your own breathing but the most it can do is 2 cm at the setting of 3.
I found that it wasn't so much the amount of reduction available as it was the breathing rhythm that was more important for my exhale relief. A setting of 3 made it seem like the machine was wanting me to breathe a little too fast and I couldn't get all the air out quickly enough. A setting of 2 worked better for me so you might play around with the different Flex settings (there's a demo available if your DME didn't lock you out) so you can practice with each Flex setting easily. If you can't see a demo available in the Flex menu you will need to go into the clinical setup menu and set the Flex option so you have access to it.
This explains how to get into the clinical setup menu.
http://www.apneaboard.com/pr-system-one ... structions

Look on the bottom of your blower unit for a 3 digit model number...should be 560...if the second 2 digits are 60 then you have a 60 series machine and there's an optional heated hose that would let you better deal with the condensation in the mask if you don't already have the heated hose.
To check for heated hose....look on the power brick...does it say 60 watt or 80 watt? Need 80 watt for heated hose. The hose itself...look where it attaches to the humidifier...is it black or gray/white on the end where the coupling is.
If you don't have a heated hose it can be changed with a little upgrade kit.

Machine noise....stick your fingers in your ears with the mask and machine on...does the noise level change or not? If it doesn't change then most of what you are hearing is what we call conductive noise and insulating the hose or using some sort of hose management system to get the hose up off the bed might help.

Make sure that your ramp (if using it) doesn't start at 4 cm because the Flex exhale relief won't/can't even kick in if the machine is not at least at the 6 cm starting point. Flex cannot work at the normal 4 cm ramp starting point.

How long have you been on it? You're doing the right thing wearing it during the day to adjust. It helps tremendously I think. For breathing with it, if you're just starting give it time. I had a lot of difficulty the first several days. I dont have asthma, but I felt similar breathing discomfort to what you're feeling. You get used to it. I struggled at first, even threw the thing off many times. Now, I dont even feel the pressure. I'm at a 6-18 and spend most of the night at 6 with a few bumps to usually 7 or 8 with an occasional 10. Those dont wake me up. Also, try to just relax and breathe normal. I kept trying to breathe with it and ended up fighting against it, making things worse.

I'm also in SA and I get hit with the allergy thing quite often so I went straight to the full face. It felt awful and claustrophobic at first, but I hardly notice it now.

Just to clarify - the humidifier is there to facilitate Cpap, not as therapy in itself, and depending on the season, your local climate, etc. etc. you may want to use it at the highest setting, or not at all - entirely up to you, so experiment. Make sure it's situated at a lower level than your head... you're less likely to get condensation that way.

The pressure settings (air blown from machine into you to keep your airway open and prevent apneas) are different from the humidifier and exhale relief feature settings, so don't confuse them, and set each feature according to what works for you, though air pressure settings prescribed by your doctor should be tried first vs winging those, at least until you find (or discover through SleepyHead software) that they might need tweaking. The EPR (exhale relief) and humidity settings are up to you.

Welcome to the forum, Richard! Glad you joined us.

As someone with asthma, it is difficult at first to get used to exhaling against pressure. BUT, you must persevere. Because once you do, you will be glad. Sleeping all night with a steady supply of filtered and humidified air is the best thing ever for your asthma. Especially during flare ups, nothing feels better than to rest with CPAP on.

So hang in there. Nearly everyone here had difficulty adjusting. But hard work and good advice pay off. You will be glad you did.

thanks for all the words of encouragement. Especially the one about keeping with it and getting used to it. I need this, I know, so I will keep with it. The tweaking of the settings I will do, and I did bump the humidity setting down to 2. I will try that tonight. I had about 3 hours with the mask on while I worked today and really no facial discomfort other than the moisture on the nose issue.

I will keep reading.

Thanks you all.

R

Hi Richard,

Are you feeling clastrophobic because of the mask in your face or because you think you are not getting enough air at a pressure of 6. Not sure which one since you mentioned the asthma at the same time.

I do not know what the minimum pressure needed for your mask. I know someone who turned off the ramp because they felt they could not breath/get enough air and did better without the ramp.

I do remember talking to one wife who could not stand looking at her husband's full face mask, it was the type that covered the whole face. It she actually shivered when she got the image of her husband is his mask. I remember feeling glad my husband did not react the same way.

Is it much louder then snoring that others complain about? Your heath is important. Try to reduce unneeded noise but some noise will stay. Does it make a difference if the machine is on a carpet or some cork, to muffle noise that may bounce off a hard surface?

I did not think the REMStar Auto makes that much noise. I have the M series. Leaks make noise and so do older tubing.

I know I often mentioned in the past and now the Hybrid, for me it was a life saver once I discovered it. I cut the little thing holding the two little pillow together so I was able to position them to fit my nose properly. They do not look symmetrical on the mouth piece but they fit my nostril openings properly now.

KeepSmiling wrote:Hi Richard,

I do remember talking to one wife who could not stand looking at her husband's full face mask, it was the type that covered the whole face. It she actually shivered when she got the image of her husband is his mask. I remember feeling glad my husband did not react the same way.

That gal would have left me a long time ago!

Sheriff

Are you sure it's moisture you're feeling on your nose and not just cool air making it feel like moisture? You said you took humidity down to 2, which is where I keep mine usually. It's humid here in SA so I figure I don't need as much. I'm guessing it will need to go up in the winter. Anyway, at a 2, the air is a little cool, especially if you keep your room temp low. It's possible it's just making your nose a little cold which you'll adjust to as well. I found if I bump the humidity up the air gets too warm for me. Sounds like a lot of "you'll adjust to" but it's true. I'm almost 2 months in now and it took awhile to get used to all the nuances. Some I'm still working on.

First Night done. Couple issues:

1. Had to set humidity at 0. Woke up with face full of moisture. Hose and equipment was set below my bed level. Then woke up with dry mouth. Sigh....
2. Woke up when pressure ramped up pretty high (didn't check to see what it was) with the mask leaking like crazy. It was blowing out everywhere. So I tightened the mask on the face and....
3. Woke up about 2 am with a killer pain in my nose from the mask (deviated septum, broken nose issue) so I will have to get some type of nose pillow

But I did fall asleep, which I would have bet money that was impossible. So knowing that, it is just time to keep adjusting things until I get it right.

I am really mostly concerned with getting the humidity level right. Anyone use the SYSTEM ONE humidification settings instead of the 1,2,3 manual setting?

There was a comment above about cold air versus moisture. To me when I pulled the mask off, there was condensation in the nose cup and in the cheek area of the mask to the point that I used a tissue to wipe it out. So I THINK it is condensation / humidity.

I have used the PR System one humidification with both the default non heated hose and the heated hose settings.
Do you have the heated hose or not? Makes a big difference in what the humidifier cranks out if the hose is heated or not.

I do not have the heated hose or the ability to put one on the system as it currently is configured. The humidifier does not have the connection.

Okay...without the heated hose you have 2 options for humidification...both have settings 1 through 5 with 5 being the highest.
The default humidification system is what is called the "new system one humidification"....don't know why they called it that.
The other option is called Classic mode...which is what we used to have before the new fancy system was offered.

These new machines have humidity sensors in the machines and they sense the ambient humidity and make adjustments (heat to the water chamber) in an effort to deliver a set amount of humidity. We are never told what that set amount is. Typically this "new fancy" mode uses that humidity sensor and adds sporadic heat to the water chamber in an effort to maintain whatever that predetermined humidity need is.
I don't like this mode. I found that even when set to the highest number that the air was uncomfortably cold in the winter and my nose still wasn't getting the humidity it needs.

Classic mode doesn't use that sensor and just keeps adding heat to increase the humidity because warmer water/air in the chamber equals more moisture in the air. The down side to Classic mode is condensation in the mask or hose. While condensation in the hose or mask won't hurt you...it is highly annoying and will disturb sleep and anything that disturbs sleep is unwanted.

Moisture in the mask...can happen even if no humidifier is used at all. Our own exhaled breath contains moisture and can condense in the mask if the room is cool enough.

You can switch from the new fancy mode to Classic mode by turning off the "system one humidification" in the clinical setup menu area.

If you are experiencing moisture at the mask level even at a low setting of 1 or 2 in the new fancy mode then it is because the ambient room temp is cooling the air down in the mask to the point the moisture gets released. This normally is not something that happens when you first turn on the machine and take your first breaths of the night. So I am not sure what you are experiencing when you first mask up is actual moisture on your nose or simply the cooler air feels like it is wet. The lower settings of 1 or 2....they don't crank out much moisture at all and I would think that no way could the moisture be felt pretty much immediately.

The heated hose can be added to your machine for $75 upgrade kit. It's just a matter of changing the lid on the humidifier and adding a different power brick along with the heated hose. It's easy to do...I did it myself without any problems.
https://www.cpap.com/productpage/pr-hea ... e-kit.html
and it will transform your humidifier to this one...be sure to read what it does to allow for hose air temp and humidity to be set independently
https://www.cpap.com/productpage/pr-sys ... ifier.html

If it is the cooler air that is feeling weird to you then the heated hose can be used to warm the air up and not have to automatically give you more humidity if you don't happen to want it.
Right now your air temp is going to be tied to the humidity setting and if you set it at 1 or 2 and your ambient humidity is high enough there may not be any warming of the water chamber and thus no warming of the air to your nose.
If it is moisture that you are feeling on your nose...warmer air should help prevent that moisture but right now you can't really control the hose air temp.

I have used nasal pillow mask for years and when I tried a nasal cushion mask the air just felt "weird" on my nose. If the air was too cool on my nose it would have caused a problem and the weird feeling would have prevented sleep.