Cpap beginner with many questions and no answers.

I was recently diagnosed with moderate to severe OSA. My pressure is set pretty low, 8cm. I have a few questions...one is are small leaks is problem. I am currently using a redmed ultra mirage FF mask with a remstar plus cpap. I have been on cpap for about one week and I do not feel much better and i was wondering if the small leaks (which seem impossible for me to get rid of completely) are taking away from my therapy. The leaks dont make any noise, but i can feel them on my face. How long does it take to start feeling better? I guess I am asking how long do you stick with it before trying to figure out if i am doing something wrong or need to try other masks? Also I am confused about central apneas....can these be caused by having a pressure that is set to high?

thanks

frustrated

Welcome,
Resmed makes good masks, However, we are all different. Have you tried a Resmed nasal mask ? Or perhaps the Swift by Resmed. Why the Full face ? Do yo have some other problem?

Give it a bit longer . You'll get the hang of it. Those FF masks seem to blow alot but the Resmed has a good track record. Look for a post earlier about some manufacturing problems with some Resmed masks.
http://cpaptalk.com/viewtopic.php?t=1662

Cheers,

Chris

Hi Shaefer1271,

Do the leaks wake you up? If they do that will make you feel as though you are not reated. Why are you using a full face mask? These are the hardest to make work and get used to. Take a look at the Swift that chrisp recommends. It's the one I use and makes the whole cpap thing esier to live with. If you are not locked into the REMstar plus you have, get a better machine. There are other machines, the REMstar Auto with C-flex for example, that will adjust the pressure for varying needs an tell you how you treatment is going. The machine you have set at 8cm may be missing too many of your obstructive events. It may not be, but unless you have a machine that will give you the data, you will never know.

Good Luck!

I have been using a ResMed ultra mirage FF mask for almost a year now. Because of the physical size of the mask itself it does get small leaks on certain nights (depending on how I turn during sleep, etc.) but it's the exception rather than the rule. I have been told by my RPT (respiratorty therapist) that small leaks do NOT reduce the efficacy of CPAP, so that's not to worry. There can be several possible reasons why it's taking a while to feel better. It could be your pressure setting is too low yet (remember the titration you go through during the polysomnogram is just a "snapshot" of a typical night's respiratory activity)- find out if you are still snoring at all with your mask on and that's usually an indicator of this. In my case I had the pressure problem taken care of but I was still falling asleep during the day so my physician perscribed meds to compliment the CPAP therapy- and now the problem has disappeared completely.

So it does take a little while and some trial and error getting the whole CPAP thing exactly where it needs to be so you feel better. Don't be afraid to ask questions on this board, with your RPT, your physician, etc. and eventually you'll get where you need to be.

Thanks for the feedback. I have a nasal resmed ultramirage mask but even with the chin strap on i was told i "puff out" air. I seem to breathe through my nose though. I thought this might mean I wasnt going to get the proper cpap therapy or is it ok to puff out air from your mouth? I have always been a mouth breather and last year I had my deviated septum fixed but I guess old habits (mouth breathing) die hard. I read that a FF mask will be good if you are a mouth breather so I decided to try it. I do not have a problem falling asleep with the FF mas at all. The thing that keeps me awake initially is worrying that I havent taken care of leaks thereby making it a waste of time. The small leaks do not wake me up at all because they do not make any noise and it is usually blowing on my cheek and not into my eyes.

WindFlyer wrote:I have been told by my RPT (respiratorty therapist) that small leaks do NOT reduce the efficacy of CPAP

That statement is not accurate. Small leaks will not affect the functionality of the cpap in clearing obstructions, but it will affect the efficacy if the leaks cause arrousals. In my case the small leaks around the Respironics comfort classic I used during my sleep study woke me up every time that sliver of cold air shot across my face.

I am new at this, so take this with a grain of salt. For various reasons I decided to try a cannula first. I used a mask at the lab for titration, but for home use I got over my initial negative reaction to putting something in my nostrils because of the convenience and because it doesn't scare my young kids. Anyway, I don't mouth breathe a lot, but do (did?) have a habit of occassionally taking a bigger breath that way. The CPAP basically does a pressure release through my mouth if I open it and it is a sensation that is undesirable - it doesn't hurt exactly, but I don't like it. In a matter of only a few days it pretty much cured me of that habit. Anyway, my point is that I would not go right to a full face because I sometimes open my mouth without trying to eliminate the behavior first. It might be simpler than you think.

BTW, I am very glad I tried the cannula. It takes me about 10 seconds to put it on, secured and leak free.

I am more than willing to forego the FF mas for something else. When I use a nasal mask, I seem to breathe through my nose and puff out air through my mostly closed lips (i wear a chinstrap). Is this puffing just me exhaling or is it a "leak" that is making the cpap ineffective?

Leaking thru the mouth. Try Rested Gals trick. Tape your mouth shut.

Carefully,, And leave a grab tab just in case.

Cheers,

Chris

What kind of tape should I try? It sounds more like I am trying to suffocate myself but ill try anything to feel better.

Dont remember the brand. Scar hiding tape I think its called. Something like that. Not Duct tape. LOL

The silicone scar patch was back when I was experimenting with making a mouth dam to be worn between teeth and lips, to block the air from gushing out. The most effective homemade mouth dam I ever made though, was with Nexcare Active bandaids, stuck against each other and cut to fit. Either of those "mouth dams" worn inside the lips with an Ace bandage around the outside, worked quite well.

Anyway....I went back to a simpler solution - taping the lips closed - which could be dangerous for some people. I do it, anyway. (Close your eyes, ICP )

The tape I use - Johnson & Johnson 2" wide, waterproof adhesive tape; two four inch long strips of it, placed over the lips, from mouth corner to corner, the two strips overlapping each other with folded-down grab tabs on every end. That's the only way I can stop lip puff leaks and be able to wear my favorite, most-comfortable-for-me interfaces - the Breeze/nasal pillows and the Activa nasal mask.

I don't recommend taping...could be dangerous. Better to try other things first - chin-up strips to keep the lower lip pulled up works for some people.

The key is not in keeping the jaw up, which is the only thing most "chin straps" address (and is why they often fail to get the job done.) The key is keeping the lips shut, if you are not one of the many lucky people whose tongue naturally maintains an airproof seal within the mouth while you are in the total relaxation of sleep. People whose tongue keeps a seal inside the mouth can actually sleep with mouth open and still not leak one bit of air out the mouth. We should all be so lucky!