My settings are as follows: Ramp Time: Auto, Humidity: 3, Start pressure 4.0 with auto ramp to 8.0 pressure. I've always used the AirFit P10 nasal pillows mask, with some changes in the pillows and strap over the time. I began with the XS pillows and have worked my way up to Mediums as they seem to be the most comfortable of all of them that I've tried. I do have a smaller sized nose, so they thought the smaller size would be good to begin with when I was fitted, but I found I was having a lot of leaks and adjustments with XS. I did switch to the For Her version over the last year to get a better fit because I was having a hard time with the strap stretching out a lot before it was time for insurance to pay for a replacement. I have experienced a large amount of weight loss, so it was suggested by my DME providor that I made need it to accommodate my smaller size. I do use the clips that are included to tighten the straps as they get looser. One at the top of my neck/base of my head and one on the top of my head.
I initially didn't have any problems adjusting to the machine or pillows and acclimated to it very quickly. I haven't ever been one to sleep with my mouth open or to rip my mask off in my sleep. So, I began using my cpap I believe in 2015. Although I can't say that I have ever felt any great benefits from being on it, I can definitely tell a difference in how my chest and breathing feels if I do not sleep with it for a nap. I have been 100% compliant at night with it though.
For the record, I mostly sleep on my back and occassionally will sleep on my right side. Before treatment I would alternate sides and back many times through the night, but this is the most notable thing I've noticed since beginning therapy. I now will usually fall asleep and wake in the same place. Definitely sleeping more soundly!
I'll try to outline my current problems:
I had bariatric surgery in late 2017 and have since lost 140lbs, stabalizing in late 2018. Something strange happened after that surgery and ever since then, I will wake up with super dry mouth, even though my mouth is closed. People feel adamant that I am now breathing through my mouth, but I am sure I am not because I will wake up with it closed and with my lips glued shut as well as my tongue plastered to the top of my mouth. Of course, this has been a concern for me because I don't want to have my dental health suffer because of a dry environment each night. I've tried playing with the humidity settings but nothing seems to change how dry my mouth gets each night. I've mentioned it to my doctors but I get met with a shrug but not much of a concern from them. My other issue with adjusting humidity is that I frequently wake up with a lot of moisture on my upper lip area, right under my pillows. Even if I have a great seal, according to my machine and by feel, I can have enough moisture to feel drips going down my face. Other nights though I'll have a dry lip. I can't seem to isolate where that issue is coming from. Perhaps my pillow size isn't right? I haven't noticed changing my humidity levels has really helped or hindered it, but logic tells me that raising them will cause it to get worse. So, this problem has been ongoing for a couple years now, but it was a very sudden change from what I experience prior to the surgery. I had never had dry mouth issues prior to that and I do not have dry mouth during my waking hours.
My next problem is that over the last couple months I am noticing more and more nights with a red face score upon waking. Some nights I'll be aware that I've had leaks and had to adjust it during the night and others I have no idea that anything was amiss and I'll be surprised to see that rating. I've tried switching out all of my parts to make sure everything was fresh and tight but I'm still not getting any better consistency. I have not changed any equipment, so I don't understand why I am suddenly having so many poor ratings when I have literally been sleeping the same for so long.
I've also noticed over the last couple months that I'm having a lot of excess gas. I'm waking a lot in the night or in the morning feeling very full of gas in my abdomen and having a lot of pressure and discomfort. Nothing feels different as far as my seal. I don't feel like I'm swallowing air or breathing irregularly when I'm awake, but of course, I am not present when I'm sleeping. Not sure how to address this. But, I know I have never had this issue before, and again nothing has been changed with equipment, pressure or sleeping positions. My weight loss has been stable for over a year now too, so I can't say that my pressure is suddenly much different for my needs...
Finally, I have recently been experiencing a sore inside of my nostril on occasion. I frequently use lanolin to help lubricate during the day and before sleep but I've found once one of these sores develops I can not get it to heal until I finally break down and use an antibiotic ointment my dr has prescribed I'll have to use it several times a day for many days to finally get it to heal. Again, can't really tell a cause other than irritation from either the pillow or the air pressure, but I haven't isolated any exact cause of when it might be causing an injury this time vs any other night.
I know a lot of these things are kind of a shot in the dark, but I know a lot of you are a lot more educated and have experience in these issues than I do. I feel like I'm not even sure who to ask as far as my medical providers any more because I don't have a provider that is directly watching this therapy any more. I'm sure I could reestablish with a pulmo or the like, but with a 15 min intake appt, I feel like I'll be left spending lots of money in trial and error and follow ups with a lot of shrugs first. So, that's basically why its been a few months of just limping by and living with it and not really knowing what else to try. I've thought about maybe needing to try a new mask, but it's the beginning of the year, which means my deductible isn't met and I don't know if it's worth the costs it would be to do all of that
