Yet another newbie with questions

Hello! Total CPAP newbie here (last night was night 2) with some questions. I have a ResMed AirSense 10 and a Dreamwear mask.

1.
The exhale port on the nose piece is pointing straight out but somehow I still manage to have air blowing up into my eyes and making my nose feel cold. I haven’t seen anyone mention this yet - does this indicate a fit problem and is there a way to tweak it so this doesn't happen?

2.
I’m exclusively a side sleeper and that is causing some trouble with the mask. When I lay on my back, it is quiet and there is minimal air escaping (just the abovementioned exhale port). As soon as I roll to my side, the nose piece is shifted (or gaps, I’m not sure) just enough to cause leaking around the upper nostril, although not enough for the ResMed to detect it. I have seen many reports of this here, but no solutions thus far. My nose piece is already a small, so I can’t size down for a better seal. I have found that if I move the hose port closer to the back of my head I can make the frame pull the nose piece tighter against my nose, which solves the leak problem but causes pressure across my cheekbones and moves the frame up to right below my eyes. While this is not ideal, I could probably handle it if the frame would stay there, but in this position the cloth strap on the back cannot be tightened enough and so the hose port creeps forward on my head and the leaks return. BTW, this happens even at the starting pressure of 4, though of course it gets louder and more annoying as pressure ramps up.

I’m motivated to try to make this mask work; I have a nose piercing which i’m pretty sure precludes the use of nasal pillows and I really don’t fancy using a full face mask if I don’t have to (I don’t like breathing through my mouth anyway so there’s no upside to it for me). Any strategy suggestions would be most welcome. One thing I have noticed is that the machine is currently set to Pillows for mask type - should it be set to Nasal instead?

3.
The humidifier is using water, but as I mentioned above the air that escapes the mask feels quite cold. It doesn’t bother me to breathe it but it is making the leaks more uncomfortable. Is this normal? Climate Control and Tube Temp are both currently set to Auto.

4.
Once I get it all arranged and start to drift off to sleep, it feels like I immediately wake up with a need to take a deeper breath. Whether it’s really immediate or not I don’t know, but the machine recorded 16 events per hour during the 2:37 I wore the mask last night, so it’s clearly happening often. The machine is currently set to auto pressure and before I took the mask off It was up to 16.9, which sounds like it should have been a gale force wind but was actually only slightly more noticeable than the lower settings. The only reason I knew it was high was that I started having stray globs of air escaping into my mouth (at least that’s what it felt like). At that point I gave up and took it off, since I felt like I really hadn’t slept at all with it on. I know I’m still in the adjustment phase but I’m wondering if this is normal? So far I’m way more tired with the machine than without it.

My husband is about a month ahead of me in this adventure and has the same equipment, but he hasn’t had any of the same issues. Figures.

I plan to sign up for MyAir and will also install SleepyHead, but I’m not quite sure what to look for in the output of either that would help with any of the above. I will contact my DME if things aren’t better by Monday (today is Saturday) but since he gave me very little info to start with and they only have a few masks to choose from, I’m not super hopeful of getting a lot of help there. I have a manual for the machine but nothing came with the mask; I found and printed out the sizing guide to confirm that I am in fact a small, at least as far as the nose piece goes.

Thanks in advance for any suggestions!!!!

I am not having the mask problems you are having so I am not able to offer any specific suggestions but you can find the user guide online by googling "Respironics Dreamwear Brochure". You will find threads specific to this mask if you search "Dreamwear" on this forum. Also, there are many online videos including one on Cpap.com. It takes a while to get a mask adjusted just right. I love this mask, no more leak problems.

I have my machine set for "pillows".

I manually adjust my humidifier and temperature so I will let someone else advise you on the auto setting.

Your pressure likely needs some adjusting and the experts will come along and help you with this.

Do you and your husband have the same machine?
Do you have the clinical manual?

Here is a link to your Clinical manual. https://sleep.tnet.com/home/files/resme ... -guide.pdf This shows you how to change settings.
You can change your humidity settings to manual and have separate humidity levels and tube temperature. The tube temperature can actually be set down to 60 degrees. The manual setting may increase the possibility for rainout but if it happens have the hose above the machine level and the moisture will run back into the humidifier.

Are you and your husband monitoring your therapy with Sleepyhead? Here is a link to learn how to download it. https://sleep.tnet.com/resources/sleepyhead
Then if you want we can show you how to post your data to see if we can find settings that might help you.

Sonnyboy wrote:I am not having the mask problems you are having so I am not able to offer any specific suggestions but you can find the user guide online by googling "Respironics Dreamwear Brochure". You will find threads specific to this mask if you search "Dreamwear" on this forum. Also, there are many online videos including one on Cpap.com. It takes a while to get a mask adjusted just right. I love this mask, no more leak problems.

Thanks, I found the brochure but it doesn't say anything I hadn't already seen. All of the info about this mask seems to be very basic - they just assume no-one will have any problems, I guess.

Sonnyboy wrote:Do you and your husband have the same machine?

Yes, we have exactly the same setup except that his nose piece is a medium, which seems to be working fine for him.

Sonnyboy wrote:Do you have the clinical manual?

I do, I got lots of info on the machine, almost too much to wade through, but nothing on the mask.

OkyDoky wrote:Here is a link to your Clinical manual. https://sleep.tnet.com/home/files/resme ... -guide.pdf This shows you how to change settings.
You can change your humidity settings to manual and have separate humidity levels and tube temperature. The tube temperature can actually be set down to 60 degrees. The manual setting may increase the possibility for rainout but if it happens have the hose above the machine level and the moisture will run back into the humidifier.

I haven't heard of "rainout" before but I think I get the idea. I live in the Pacific North-wet, I can handle it.

OkyDoky wrote:Are you and your husband monitor your therapy with Sleepyhead? Here is a link to learn how to download it. https://sleep.tnet.com/resources/sleepyhead
Then if you want we can show you how to post your data to see if we can find settings that might help you.

I installed the software earlier today, but I need to get an SD Card reader before I can do anything with it. I'm thinking that if I get the mask issues taken care of the machine may be able to fix the rest, but that may be a tad too optimistic...

Dancers Need Sleep! wrote:I need to get an SD Card reader before I can do anything with it

Be sure and check out your laptop because many newer ones have a built in one. If not they are cheap.

Re:
"I’m exclusively a side sleeper and that is causing some trouble with the mask. When I lay on my back, it is quiet and there is minimal air escaping (just the abovementioned exhale port). As soon as I roll to my side, the nose piece is shifted (or gaps, I’m not sure) just enough to cause leaking around the upper nostril, although not enough for the ResMed to detect it. I have seen many reports of this here, but no solutions thus far. My nose piece is already a small, so I can’t size down for a better seal. I have found that if I move the hose port closer to the back of my head I can make the frame pull the nose piece tighter against my nose, which solves the leak problem but causes pressure across my cheekbones and moves the frame up to right below my eyes. While this is not ideal, I could probably handle it if the frame would stay there, but in this position the cloth strap on the back cannot be tightened enough and so the hose port creeps forward on my head and the leaks return. BTW, this happens even at the starting pressure of 4, though of course it gets louder and more annoying as pressure ramps up."


What size frame are you using? If you are using a small, you might want to try a medium.
When I tried a small frame I felt a lot of tightness across my cheekbone like you are describing.
The mask should feel comfortable, not tight.

The hose port should be at the top of your head, not the back. Also make sure the air is not flowing into the pillow or blanket and then coming back and blowing into your eyes.

Possibly a pillow that lets you mold it the way that works for you would keep the nose piece in place?
Check out the CPAPfit pillow on Amazon.
A lot of forum members, myself included, like this pillow.
Search CPAPfit pillow on this forum and you will see loads of positive feedback.

Hope you find the answer that works for you.

Dancers Need Sleep! wrote:

Sonnyboy wrote:I am not having the mask problems you are having so I am not able to offer any specific suggestions but you can find the user guide online by googling "Respironics Dreamwear Brochure". You will find threads specific to this mask if you search "Dreamwear" on this forum. Also, there are many online videos including one on Cpap.com. It takes a while to get a mask adjusted just right. I love this mask, no more leak problems.

Thanks, I found the brochure but it doesn't say anything I hadn't already seen. All of the info about this mask seems to be very basic - they just assume no-one will have any problems, I guess.

look on youtube, there's lots of videos, some might be helpful to you

Actually I had to look at the videos multiple times and the brochure multiple times too before I had everything right.
In the beginning I would have the strap upside down and many other crazy things and totally not have a clue until I compared all parts with the pictures.

I also experimented with my head pillows. I have two of Bret's pillows and one regular foam pillow. The foam pillow does not work for me at all. I have removed filling from Bret's pillows, the fullest/firmest of the two works the best.

I also shift the exhale port so the air blows away from me and not into me. I like to cover my head with the blanket but I make sure there is plenty of room for the air from the exhale port to blow away from me.

Took me a week or 2 before I got it right..

Sonnyboy wrote:What size frame are you using? If you are using a small, you might want to try a medium.

The frame is a medium. It's comfortable if I keep the hose port at the top of my head - it was only that tight when I moved the hose port back to try to increase the seal.

Sonnyboy wrote:Possibly a pillow that lets you mold it the way that works for you would keep the nose piece in place?

I had to give up my Hullo buckwheat pillow the first night - it was too firm and it felt like it was constantly pushing the mask out of position. I'm doing ok with my old foam pillow but I will check out the one you mentioned.

So, update from last night.

I had less trouble with the mask leaking - i'm not sure why. Maybe because I was slightly twisting the nose piece to make sure the exhaust port was pointing down as much as possible, and maybe that also made it fit better.

I set my tube temperature to 75 and noticed no difference. Think I'm going to try 85 tonight and if it's still not any warmer I'm going to say there's something defective there.

I managed 3:14 with the mask last night, and it didn't feel like that much time had gone by so presumably I was actually sleeping for some of it. But I still experienced many repetitions of being startled awake just as I was falling asleep, and feeling the need to take a deep breath. I've read in this forum that this is not too uncommon and may go away as I get used to the mask. It never happens without the mask so there is some hope that that will be the case.

My events were 13.2 per hour, which is half of what it was in my home sleep test but still obviously too high.

The machine is set to auto-ramp from 4.0, with a max set of 20.0. I'm finding as I get used to it that 4 is a bit too low; i feel like I have to take extra deep breaths to get enough air, which in itself is enough to keep me awake. And, due to the high number of events the machine eventually ramped its way up to 16.something, at which point the mask started to be forced away from my face ever so slightly from the pressure, and that made for a lot more noise and cold air blowing around. That was what forced me to take the mask off.

Thanks to this forum I've learned how to get in and change all the settings, not just the ones they intend for us to change, and i think I'm going to set it to start at 6.0 and have a max of 14.0, and see how I do with that. I don't think we can draw any conclusions about how well it's curing my sleep apnea until I get to a point where I can both fall asleep and stay asleep without the mask interfering, so that is my primary focus right now.

Any other suggestions are definitely welcome! Or even just confirmation that I"m on the right track, since I'm so new to all of this.

BTW, i should mention, since I know someone will ask, that I have not yet had the full sleep test, only the take-home overnight one. It was not a very good test because it wasn't a representative night; for some reason I spent the entire night feeling like I was over-caffeinated, even though I was not, and I didn't fall fully to sleep until about 5:00 am. They recorded an average of 25 events per hour and a few incidences of central apnea, but the doctor said to not worry about those for now because my having been awake so much messes with the test results. My personal opinion is that I didn't have the strap on tight enough, so when I was laying down and somewhat curled up, the strap was not detecting my breathing. But, that remains to be seen and unless things improve I'm sure a full sleep test is in my future. I'm really not sure how they could use that data at all, and why they didn't send me home to try again, but that's ok. I'm pretty sure the main conclusion, that I have sleep apnea, would have been the same.

Sleeping better is always a good sign.

Checkout Sleepyhead.
The software is free. OkyDoky provided you with a link a few posts up.
Then post some charts and let the experts here guide you with the pressure settings.

I still need to get an SD card reader - hope to do that today. (my laptop does have a slot but I do most of my work at home on a desktop system which doesn't)

Dancers Need Sleep! wrote:I set my tube temperature to 75 and noticed no difference. Think I'm going to try 85 tonight and if it's still not any warmer I'm going to say there's something defective there.

With the tube temperature not feeling warm you have to remember that the normal body temperature is 98.6 so it may feel a little cool especially initially before the humidifier is heated up. You might also try a hose cover to see if that increases warmth.

Dancers Need Sleep! wrote:The machine is set to auto-ramp from 4.0, with a max set of 20.0. I'm finding as I get used to it that 4 is a bit too low; i feel like I have to take extra deep breaths to get enough air, which in itself is enough to keep me awake. And, due to the high number of events the machine eventually ramped its way up to 16.something, at which point the mask started to be forced away from my face ever so slightly from the pressure, and that made for a lot more noise and cold air blowing around. That was what forced me to take the mask off.

Thanks to this forum I've learned how to get in and change all the settings, not just the ones they intend for us to change, and i think I'm going to set it to start at 6.0 and have a max of 14.0, and see how I do with that. I don't think we can draw any conclusions about how well it's curing my sleep apnea until I get to a point where I can both fall asleep and stay asleep without the mask interfering, so that is my primary focus right now.

I think it is probably good to increase your minimum pressure to 6 but you know you needed 16 last night and the machine will not go higher than what you need, I wouldn't limit the maximum to less than 16 until we can see what is happening with Sleepyhead. I know that pressure seems like a lot now but we do get use to it with time. Sometimes I have to pull on my mask to see if it is on.

Dancers Need Sleep! wrote:I still need to get an SD card reader - hope to do that today. (my laptop does have a slot but I do most of my work at home on a desktop system which doesn't)

Something like below is relatively inexpensive works with all sizes of SD Cards and will work on just about any system that has a USB slot.

http://www.amazon.com/Cable-Matters-Sup ... B00GFY2QXY