Heavy/irregular breathing, occasional snoring - Please help

Hi all,

I've been using a CPAP machine for 15 years, and found your forum last year. I started off with the RemStar Pro from Respironics in 2005, and have used the ResMed S9 machine since 2014. For years I used the full face mask, then shifted to nasal, and now my current setup is the DreamWear Nasal mask and headgear. I stopped using the humidifier years ago.

While I feel better using the machine, my wife still complains about heavy/irregular breathing and occasional snoring. For years, she has worn earplugs, but is over that and would like her life back, so to speak. It's bad enough that shes's had to put up with Darthvader for this long. I'm no fan of it either, but what can you do? Sometimes, while still awake, just as i start to fall asleep, I notice the nasal mask gets bursts of air through it, so I've gotten in the habit of cleaning this on a DAILY basis with dish soap and warm water.

Is the solution to get a chin strap to go along with my current gear, or is there something else in my numbers that could help explain things?

Hi, have you considered going to the newer model, Airsense 10 Autoset (which gives you the option of using plain cpap, but also auto)? Just wonder why you're only on the 'plain' version as it does look like your pressure might want to go higher - we change after all, whatever the machines do. Chinstraps don't always work well even if they're not uncomfortable as they don't seal your lips, but you don't appear to be 'leaking' in any case. Have you seen an ENT re the snoring - there might be a reason for it not directly related to OSA, but possible fixable (tho' it won't cure your OSA of course). I didn't see evidence of snoring on the post, but I'm not that familiar with your machine. I wouldn't use a humidifier in Seattle either.

Have you seen a GP recently looking for any new 'conditions', just doing lab work, etc.?

Any new meds? And do you sleep on your back - that'll provoke more apneas and snoring for sure.

The S9 AutoSet model does have the option for the auto adjusting pressure mode.

Though to be honest I don't think it would make a whole lot of difference but might be worth giving it a try and see what the machine wants to do when it can roam around a bit.

Might be interesting to see the Flow Limitation graph instead of the respiration rate graph or mask pressure graph.
The snore statistics don't point to very many snores.

The DreamWear Mask....notorious for the DarthVadar sounds for some people...myself included.
How do you route the hose? Lay on the bed or up overhead in some fashion?
Ever consider a different mask? There are masks out there that aren't so noisy.

My last visit to GP was in 2017, so it could be time for a visit. I do sleep on my back, as I’ve found this most comfortable with the mask. No meds at all.
Flow Limitation graph added below
The DreamWear Mask....notorious for the DarthVadar sounds for some people...oh great! I suppose I can look at a new mask. Any ideas about one that could be less noisy?
I route the hose overhead--sleeping on my back seems to work the best for this.

Your FL graph is a bit "active" compared to someone's graph who doesn't normally have much in terms of FLs but I have seen worse.
If in auto adjusting mode your machine would likely try to increase the pressure to reduce the FLs. Is it a factor in what your wife hears in terms of snoring or breathing....don't know but you might want to try auto mode with a small range and see what happens....something like 9 minimum and maybe 13 or so maximum just to see where it wants to go.

Flow limitations (assuming you aren't having nasal congestion) are early signs that the airway is trying to collapse. Now yours aren't growing up to be full grown OAs or hyponeas but the machine when in auto mode will try to reduce them with more pressure because it's an integral part of the auto algorithm.
Now if you have a lot of nasal congestion...just disregard what I said...we can't fix nasal congestion FLs with more pressure. You have to instead do the usual stuff for nasal congestion.

Check out the ResMed AirFit P10 nasal pillow mask...it's about as silent as any mask I have ever tried....both in vent noise and the lack of Darth Vadar sounds.
I am using the Bleep now with a diffuser which also gives me the quiet but it might not be so easy for you to try. The P10 is easily found just about anywhere. The reason I went to the Bleep was the no headgear thing...just a little preference of mine. I got tired of dents in my cheeks causing big bags under my eyes. The P10 is still my second choice mask to use.

The Darth Vadar noises are more of a conducted noise and with the P10 I just didn't have it. Now the ResMed P30i which uses a similar tubular air flow thing as the DreamWear...the Darth Vadar noise was so bad I couldn't even begin to sleep with it. It was that annoying to me.

Here's what a really boring FL graph looks like.

No nasal congestion, so I will try and adjust the range!

That Bleep mask looks intriguing. Do you find that adhesive tape to be bothersome at all for the nose?

No, I don't find the adhesive on the nostrils a bother at all. To be honest it sort of disappears on my nose and is much less annoying than messing with headgear is potentially annoying. I wake up often in the mornings with the Bleep on and have to sort of clear my head a bit and realize I have the mask on and the machine is on. I wake up and don't feel anything or hear anything and for a few seconds I don't even think about the cpap being on or the fact that I am wearing a mask.

Now if I try to cheat and not clean my nose/face ahead of time...the adhesive will fail. I had that happen over this past weekend.
I just didn't feel good and I didn't wash my face and within about 15 minutes or so the adhesive failed and I was in leak city. I knew better than to try a short cut but I did it anyway. So off the Bleep came and I quickly donned the P10 and went back to sleep.
As I looked back on the day...even though I didn't wear any make up that day I did give myself a sort of renewing face lift with a hydrating cream to help fight my wrinkles. Even though early in the day when I did that...still had some oils remaining on my skin. I needed plain old soap and water to get rid of the oils. When I do my proper skin prep...the adhesive simply doesn't fail me.

For the most part once I put the ports on and attach the mask to the long hose...the Bleep pretty much disappears on my face. I don't even feel it. For many, many years I used to tell my husband that "if only I could just tape the nasal pillows to my nose I would have the perfect mask"...because I always hated the headgear side of it. Then someone did what I was wanting to do...came up with a way of gluing the mask onto the nose and from then on I knew I had found mask nirvana.

BTW...I have used the DreamWear...in all versions...the under the hose cushion and the pillows as well as the full face mask.
I did learn how to tune out the DarthVader noise but I had to make a concerted effort to tune it out. It's our own breathing being conducted through the hose and the frame against our head. The P30i...that noise was so bad I couldn't even tune it out at all.
I have tried a lot of masks over the years mainly because I just like to learn about new stuff and try new stuff. I thought I wanted to try the P30i but I have decided I don't really want to. It's just too noisy for me.

Try raising the EPR to 3. That might help a little with the flow limitations.

Wasn’t sure if I should start a new thread, of post a reply here. I did a virtual chat with my GP in October 2020. I was issued a new SDcard for my ResMed S9 machine card and was fitted for a ResMed P30i shortly thereafter. Yes, I know it has similar design to the DreamWear mask I previously wore, but figured I needed to start somewhere! While I’ve gotten used to the nasal pillows of the P30i, there are still air leaks, and my wife complains about horrible noises coming from the mask. Sometimes she resorts to kicking me in hopes I’ll wake up and adjust my breathing at night. She’s still wearing the earplugs.

I’ve been cleaning the mask daily, washing the nasal pillows, and still can’t seem to achieve the ideal fit for myself. I guess I need to say for BOTH OF US…argh! In addition, the other thing that started after receiving the new headgear is a buildup of phlegm in the morning. I never experienced this before, and am unsure of the connection with my new equipment. In the past few weeks, I’ve experienced a nighttime cough before bed on a couple of occasions, resulting in my going mask free. While our current climate of COVID and masking up, this cough has me thinking all sorts of things.

I’m eligible for new equipment this week and will try out the ResMed AirFit P10 nasal pillow mask. In addition, I wonder if getting the ResMed S10 AirSense unit would make more sense. That way my GP has the remote monitoring option. Either that or I need to do a new sleep study, start from square one. Attached is one of my recent sleep readouts.