Snoredog wrote:why do you think that is?
a) cannot turn off your thoughts from the day to fall asleep?
b) discomfort from the mask (straps too tight etc.)?
c) noise from the mask/machine or both?
d) cpap pressure itself preventing you from sleeping?
If you can isolate exactly what bothers you then address them one at a time, pretty soon you've eliminated everything that is preventing you from sleep.
Start with the noise aspect: If it is noise, the pillow style interfaces are the noisiest ones you can buy. The quietest most comfortable nasal interface I have ever used is the Somnotech Soyala. It is absolutely silent compared to any other mask out there. There is no exhaust hiss, no noise from the cpap air flowing through at all.
If the machine itself is keeping you from sleep, first understand the higher your pressure is the louder any machine or mask combination will be. This is a good reason to use any Ramp feature, you can start out with a much lower pressure making falling asleep much easier and hopefully by the time pressure does kick in you will be asleep. Nearly all machines have some sort of a ramp feature.
An autopap will be the quietest machine, there are many concepts behind the different machine therapies. I like the one that offers the quietest operation and delivers the least pressure. If it delivers the pressure I need when I am a sleep that is all I need. Bipap is the first thing offered by doctors (they don't have a clue), they are simply pulling the wool over your eyes when they do that, they are still giving you a basic straight cpap but only in a bipap machine, sure exhale pressure will be lower making it easier to breathe out but your IPAP or inhale pressure will still be high just like you were on straight cpap with a plain jane machine. That does nothing if cpap pressure is what is preventing you from falling asleep. If your IPAP pressure is 14cm, then an autopap set to 6cm to 14cm will do the same thing, the advantage is the autopap will start at 6cm and hopefully stay there until you are well into sleep. A machine running at 6cm pressure will be a lot quieter and more comfortable than a machine running at 14cm. Try it with your bipap, set both pressures to 6cm and give it a try, that is what you would have with an autopap. Try to fall asleep with your bipap at 6cm, the worst that could happen is you wake up gasping for air. With an autopap like the Remstars, you also have Cflex which adds in comfort on exhale.
Put the machine on the floor: If machine noise is the problem, put it on the floor or even under the bed. You will have to clean your filters more often but it will be quieter. You may also need a longer hose, they sell longer hoses at cpap.com for under $20 bucks.
Comfort: None of these interfaces are what I would call comfortable, even I at times become frustrated with the discomfort from them and sleep without, but the next day/night it changes my mind again on that concept. If a mask is not designed right it will be leaky and require more strap pressure to stop it from leaking. The FF masks are harder to seal because there is a larger footprint to seal with the cushion, it can have its good and bad, but if you are a mouth breather they can work well.
I have no connection with Somnotech whatsoever, I only know about them from my mask purchase after spending $100 for their Soyala from cpap.com. It was expensive compared to other nasal interfaces but well worth it. I have to say it is the best interface I've used in more than 5 years on cpap, that includes all the Respironics Comfortxxxx series, All the Ultra series from Resmad, the Hybrid, the breeze, nasalaire, the swift you name it I have pretty much purchased them all at one time. The Soyala is the best sealing requiring the least strap pressure (even over the Activa, got one of those in my dud drawer also).
So my suggestions:
1. Address the noise.
2. Address the discomfort (reduce/eliminate strap pressure).
3. Address the cpap pressure discomfort by using a lower machine Ramp pressure.
4. Consider a sleep aid like melatonin, been using it for more than 15yrs every night, has NO side effects compared to any other sleep aid on the market, prescription or non-prescription.
5. If you cannot find an acceptable quiet mask, consider the Soyala, it is comfortable and quiet.
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