New to CPAP and having trouble adjusting. Help!

Hi All:
I have just started on this cpap journey after many years of successfully wearing a dental repositioning device (SomnoMed). Dental device was getting old so my sleep dentist sent me for a home sleep study before ordering a new dental device (I am now medicare and previous sleep study was too long ago). Without my dental device my score was 47! - severe range. Requested home sleep study with device - score from this study 17 -better - but not good enough. So am now on apap - 4 nights in and feel like I have been run over by a truck. I had been sleeping well (I thought) - albeit with some significant snoring some nights prior to these recent sleep studies although I do have high blood pressure (regulated - but runs in my family) as well as restless leg issues (medicated with success - but again is a genetic component).
Issues since beginning treatment with Airsense 10 for Her with humidifier and ClimateLine hose, Swift fx nasal pillow mask for her and chin strap: Pressure set from 6 - 14.
1. difficulty fitting mask - wasn't well covered by my DME person - have been watching the videos and practicing - I have a very narrow face and can't seem to get the mask to fit without some whistling or having to reposition frequently during the night.
2. numbers each day look great - last night AHI 1.3, Central 1.0 Total 1.2, Leak 17 L/m and max pressure 12.1., but I feel awful and am not rested.
3. Have been waking up ~ 3 hours after falling asleep - and then having a fitful night thereafter - feeling like I have to reposition nasal pillows, moisture in nasal piece (humidifier set at 3) and last night noticed pressure then was 14 at this time -so think I woke up due to high pressure and leaks tho can't be sure.
4. wondering if I should go to a full face mask - some mouth breathing going on.
5. I was a stomach to side sleeper and am having difficulty adjusting to just side - never sleep on my back.
6. I think I tend to tuck my chin in my sleep - but am trying to prop my head with pillows to avoid this.
I am about to throw the machine out the door - but know I need to keep trying. Any suggestions? I am going to attempt to download the sleepyhead software to read my SD card so I can get more information. The Resmed "MyAir" tells me nothing useful.
My sleep PA says the OSA is primarily due to my oral structure. I have a narrow mouth and very long soft palate.
Suggestions?? Anyone out there have similar issues when starting?
Thanks,
xcountrygal

First off, don't throw your machine out - you'll need it.

1. Cant help with the mask other thsn saying keep trying
2. Those are good numbers (other than than the leak). It takes time for some to feel the results
3. It's possible the pressure is waking you up. To fix this, we need to know the settings for your machine (min/max pressure, using ramp, etc). It also takes time to adjust to this
4. If you are mouth breathing, you are not getting the full benefits of treatment (and mouth breathing may be causing some of your problems). You may want to consider a FFM
5. It's possible to do the stomach sleeping thing, but it's a learned behavoir. I use a FFM and spend quite a bit of tie on my stomach.
6. Not an issue I have, but some people here use a soft cervical collar to help with keeping the mouth closed, and it would havr to help with chin tucking.

Good luck and keep trying.

RiverDave

Actually your pressure settings may be too low - what are they pleaes?

Julie wrote:Actually your pressure settings may be too low - what are they pleaes?

xcountrygal wrote:Hi All:
I have just started on this cpap journey after many years of successfully wearing a dental repositioning device (SomnoMed). Dental device was getting old so my sleep dentist sent me for a home sleep study before ordering a new dental device (I am now medicare and previous sleep study was too long ago). Without my dental device my score was 47! - severe range. Requested home sleep study with device - score from this study 17 -better - but not good enough. So am now on apap - 4 nights in and feel like I have been run over by a truck. I had been sleeping well (I thought) - albeit with some significant snoring some nights prior to these recent sleep studies although I do have high blood pressure (regulated - but runs in my family) as well as restless leg issues (medicated with success - but again is a genetic component).
Issues since beginning treatment with Airsense 10 for Her with humidifier and ClimateLine hose, Swift fx nasal pillow mask for her and chin strap: Pressure set from 6 - 14.
1. difficulty fitting mask - wasn't well covered by my DME person - have been watching the videos and practicing - I have a very narrow face and can't seem to get the mask to fit without some whistling or having to reposition frequently during the night.
2. numbers each day look great - last night AHI 1.3, Central 1.0 Total 1.2, Leak 17 L/m and max pressure 12.1., but I feel awful and am not rested.
3. Have been waking up ~ 3 hours after falling asleep - and then having a fitful night thereafter - feeling like I have to reposition nasal pillows, moisture in nasal piece (humidifier set at 3) and last night noticed pressure then was 14 at this time -so think I woke up due to high pressure and leaks tho can't be sure.
4. wondering if I should go to a full face mask - some mouth breathing going on.
5. I was a stomach to side sleeper and am having difficulty adjusting to just side - never sleep on my back.
6. I think I tend to tuck my chin in my sleep - but am trying to prop my head with pillows to avoid this.
I am about to throw the machine out the door - but know I need to keep trying. Any suggestions? I am going to attempt to download the sleepyhead software to read my SD card so I can get more information. The Resmed "MyAir" tells me nothing useful.
My sleep PA says the OSA is primarily due to my oral structure. I have a narrow mouth and very long soft palate.
Suggestions?? Anyone out there have similar issues when starting?
Thanks,
xcountrygal

The post says 6 - 14, Julie.

That's OK. I miss lots of stuff, too. It's easy when you have to read so many posts.

Merry Christmas!


Den

.

To the OP, you might want to try a full face mask if you're having mouth-breathing issues.
They also come in handy in times of colds or congestion, etc.


Den

.

Hello and welcome. You mentioned RLS. What did your sleep report say about limb movements? RLS and PLMD (Periodic Limb Movement Disorder) sometimes go hand in hand. If one has PLMD, it's possible that resolving sleep apnea wakings, by virtue of sleeping better, can provide the environment for more sleep movements to manifest. This can result in more movement related broken sleep thus still not feeling rested even though CPAP treatment may be working fine. If this doesn't apply to you, please just disregard.

Your leak rate seems pretty good resmed allow a figure of up to 24 litres/min

Your difficulty fitting the mask is a common problem, so don't feel bad. I commend you for finding the videos. Even after watching the videos, I was so frustrated with the mask that I wanted to give up too. But don't, it gets easier with practice. And eventually you'll find one that isn't so frustrating. Notice I didn't say perfect because I'm convinced by what I've read in the forum, that a perfect fit doesn't exist.

I've tried nasal face masks and I actually prefer my full face mask. For me, the AirFit F20 is more comfortable and easier to position. Plus, once you get the straps just so, you can leave them for next time due to the magnetic closure.

I'm a mouth breather and I use a chin strap also, and that can get uncomfortable enough to interrupt my sleep, and it may be impacting yours also. In fact, the first thing I do when I wake is rip that puppy off. But there are multiple models out there to try also. A new year awaits.

I guess the common theme here is this is a marathon for most people not a sprint. It takes time and patience which is hard when you are sleep deprived. But it is your health and literally your life. Keep working on it.

Hello All:
Thanks for those offering support to a frustrated newbie.
I was experiencing significant middle ear and sinus congestion so did go back to DME provider and have switched out the nasal pillow mask for the Philips Amara View after trying a ffm that fit higher up on the bridge of my nose - (very painful with sensitive sinuses).
I have starting using Flonase to help with the nasal congestion and can feel the difference after just one day.
Went back to my mouthguard for last night to get some sleep and let the congestion resolve - much more rested today. I hadn't slept much at all since beginning APAP and was very sleep deprived.

As was suggested, I do believe my pressures may be too low - especially the bottom pressure of 6. I downloaded the sleepyhead software and can see that when pressures go up, they go up abruptly to 11-13 or 14 and then go back down to the 6 and then back up again abruptly over the course of the night. These abrupt rises in pressure match awakenings during the night - often 3 - 5x. Interestingly after going back to the mouthguard last night I only got up once during the night and had no issues with RLS. When on the APAP I was experiencing multiple times when my legs were restless or aching, but in a very different way than the usual.

I have both a call and emessage into my sleep Dr. office to ask about adjusting pressures, but so far (two days) haven't heard at all from them.
I was going to give myself one more night off the APAP to let my middle ears resolve further (my middle ears, particularly my R ear - which is also the side I tend to sleep on most of the night - have been a weak area for me for the past 10 years or so and I will have significant difficulty following long plane flights. My ears sometimes don't get back to normal for several weeks - wearing ear plugs made for plane travel have helped, but not done away with the problem. I also have a genetic low frequency hearing loss - so it is doubly difficult when my ears experience this congestion.
Again, thanks for all suggestions. Fingers crossed, this new facemask with be an improvement!
xcountrygal