New APAP user with questions

Hi,

I just recently purchased a Phillips Dreamstation APAP and a Dreanwear Nasal mask with gell cushions.

I tried and just could not get used to how difficult it was to exhale. It kept feeling like I could only exhale about 80% of what I wanted to.

I adjusted the Flex setting to 3 and it helped slightly but it just wasn't enough. Has anyone else experienced this?

So... I've now gone from that minimalist mask and ordered a Dreamwear Full Mask. My thinking is this:

1. the aforementioned exhale issue
2. I may be more of a mouth-breather than I originally thought
3. this mask has larger exhale ports than the nasal mask

Newbie question- with a full-mask I can exhale and inhale through my mouth if I want to, right?

Anyone here got experience with this mask and the Dreamstation and if so, what do you think?

I'm concerned about suffocating.

Now, I thought at first that would not be an issue because like I wrote, it has bigger exhalation ports than the nasal mask but then I read in the manual this:
"Use of this mask while the system is not on and operating may cause rebreathing of exhaled air. Rebreathing of exhaled air for longer than several minutes can in some circumstances lead to suffocation."

Yikes!

What do other folks do about this sort of situation?

Thank you!

Welcome to the forum.

Are you using the ramp option?

What are you pressure settings?

What size gel pillow are you using?

As for suffocating....that's a CYA warning that I think all masks will have in the fine print somewhere. Damn near impossible to do with the DreamWear due to the 2 vent hole system. Even if one hole gets totally blocked (which is actually very difficult to do) there is the other vent hole.

Answer the 3 questions I asked. I have a couple of ideas that might help you out with your discomfort exhaling and worries.

Thanks for the reply and the welcome to the forum!

I am using the ramp option but the nasal mask was so uncomfortable due to the exhale issue I was never able to really get to a therapeutic pressure.

The APAP I was told will adjust to the proper pressure setting for me so no titration study was done, only a sleep study which said I have severe OSA. It started at 4.0 cm, however, and only got to 5.0 or 5.5. Can't remember.

I tried the medium gel pillow.

So suffocation not likely. But will I get enough fresh air to wake up if the power goes off since rebreathing a lot of CO2 could prevent that, right? So I may not suffocate but may not wake up either.

Sorry for being paranoid...

Thank again!

If you are using gel pillows your mouth is available for breathing...you will not suffocate. If you are using a full face mask, there is a valve that will allow you to continue breathing. Turn off the ramp..you don't need it with low pressure settings.

Try an experiment for me while awake and under no pressure to go to sleep. Don't engage the ramp for this experiment because the ramp starts at 4 cm and we need to start with a little more.
Set the minimum pressure to 6 cm and the Flex exhale relief to AFlex at a setting of 3...try it and see how it feels...then try Aflex at 2 and see how it feels...and then 1 and see how it feels.
See if breathing is a little more natural feeling at those settings. Pick the one that matches your own breathing pattern and use it tonight.

You don't get the full benefit of the Flex exhale relief until the setting is at least 6 cm.
A lot of people experience problems exhale at the lower pressures like 4 or 5...they feel like they can't move enough air.
If you have the larger gel pillow...try it also. Sometimes the added volume in the next size large will also let more air move and make exhaling easier.

To answer your question: yes... you can open your mouth and breath thru it with a full face mask. I keep mine open all night. With pillow or nasal masks, you need to keep your mouth closed to receive proper therapy.

Sheriff

Thanks everyone for replying!

Great community!

So, last night I decided to wear the DW full mask. Contrary to what I thought, my wife says my mouth is open a lot when I sleep.

Strangely enough, it was not so bad once I got used to it.

I uploaded the data from the APAP to the Phillips app on my phone and here it is:

Usage: 5.40 hrs (not too bad for a first time I think?)
Min Pressure: 4.0
Max Pressure: 20.0
90% Pressure: 13.0
Mask Fit: 71%
Large Leak Time: 1.39 hours (my wife noticed that sometimes my lower lip was below the mask while I was sleeping, so probably because of that, right?)
% night in large leak: 29.1%
AHI: 0.5
Total Clear Airway Apneas: 0
Total Obstructive Apneas: 0
Total Hypopneas: 3

What do you all think?

Tonight I am going to try the medium frame and MW mask (tried M last night) and do a better job tightening the straps.

Does that sound reasonable?

I do seem more awake today. I woke up by myself around 6.30 AM and just could not go back to sleep really. Took the mask off as my mouth/lips were dry and tried to sleep some more but could not so went ahead and got up after 7.

Started feeling a little drowsy around 10.30 AM but pushed through it and now it is 6.15PM and I've not been drowsy at all today.

Suggestions/comments?

Thank you!

I also use the Dreamwear FFM. The only way I can keep my mouth closed is to use a firm, foam cervical collar. You can purchase hem at Walmart or Amazon. I used to purchase them at Walmart, but when I tried to order them last month, they would not let me use the site to store shipment, and wanted to charge me shipping on them. I ended up purchasing them from Amazon since I am a Prime member. This is the collar I use: https://www.amazon.com/Cervical-Collar- ... ollar&th=1

I use a 4 inch collar and my wife uses a 3 inch collar.

You are using a full face mask.... it's ok to have your mouth open! Instead of working to keep your mouth closed.... work at not having your lower lip slip outta the mask. Your numbers are good. Some people would kill for a .5 AHI. You have to give cpap therapy time. I wouldn't do anything.... you are in it for the long haul. Again, good work!

Sheriff

Thanks all!

Last night I used the M frame and the M mask and had much better results...

Usage: 5.28
Min Pressure: 4.0
Max Pressure: 20.0
90% Pressure: 14.5
Mask Fit: 99% (woot!)
Large Leak Time: 0.02 hrs
% night in large leak: 0.6%
AHI: 1.0
Total Clear Airway Apneas: 0
Total Obstructive Apneas: 3
Total Hypopneas: 3

My PCP said that my sleep study had had an AHI of "the 120s and 130s".

Is it really possible to go from that to an AHI of 1.0 or do you think I am doing something wrong?

Thank you!

pathogen wrote: ↑

Mon Nov 05, 2018 12:28 pm

Is it really possible to go from that for an AHI of 1.0

Absolutely.

What you had pre-treatment really doesn't mean anything at all to what you should expect with treatment.