Rocky start with APAP - what next?

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
zleeby
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Re: Rocky start with APAP - what next?

Post by zleeby » Tue Nov 15, 2022 9:30 am

Hey all! After some fiddling over the past several days, I've managed to get the pillow mask more comfortable, and now I'm attempting to use mouth tape to finally put a stop to my leakage. 3 nights ago I tried a vertical strip over my lips, but that didn't stay secure for long. 2 nights ago I used a horizontal strip, but after waking up 3 hours into the night, my 3am self decided to immediately strip the tape off... Finally, last night I put a horizontal strip on and kept it on all night. Here's the data for that.

When I applied the tape (Nexcare Strong Hold Pain-Free Removal Tape), it felt like my mouth couldn't open at all without a strong effort. Still, when I woke up once in the night, the tape had come loose enough that my mouth was able to open just a little bit. I resealed it to be as tight as it was before, but by the time my alarm went off, it was loose again. According to the data, the leakage wasn't quite as bad as usual - still far from ideal though. And upon waking up in the morning, I found that a good deal of air had accumulated in my mouth and puffed up my cheeks a bit - that wasn't especially comfortable...

What should I do to get the tape fully secure? I saw a video from TheLankyLefty27 suggesting that high humidity might moisten your tape and loosen it that way, but my tape didn't feel especially wet even though my humidity was maxed... Is there a specific manner of applying the tape that'll ensure it's as tight as possible? Should I try a different tape brand? Or a different kind of appliance altogether? Any insight would be massively appreciated!

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ozij
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Re: Rocky start with APAP - what next?

Post by ozij » Tue Nov 15, 2022 9:54 am

zleeby wrote:
Tue Nov 15, 2022 9:30 am
When I applied the tape (Nexcare Strong Hold Pain-Free Removal Tape), it felt like my mouth couldn't open at all without a strong effort.
Do you fold your lips in (without stretching them)?
The other thing that works for me it to make sure the strip is long enough to really be stuck away from the corners of your mouth.
And upon waking up in the morning, I found that a good deal of air had accumulated in my mouth and puffed up my cheeks a bit - that wasn't especially comfortable...
Not fun. But that does mean the tape did its job at that point.
Maybe it will get better with that "tongue to the roof of your mouth" practice... What's your pressure?

I don't know the type of tape you're using, but I found out that sometimes (more so with the Bleep mask) it helps if I add a top layer of Micropore paper tape on top of what I use now. I still have Micropore left over when I used for mouth taping.... and had to remove it with baby oil in the morning. Will not apply it directly to my lips ever again.

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Mask: AirFit™ P10 Nasal Pillow CPAP Mask with Headgear
Additional Comments: Machine: Resmed AirSense10 for Her with Climateline heated hose ; alternating masks.
And now here is my secret, a very simple secret; it is only with the heart that one can see rightly, what is essential is invisible to the eye.
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Good advice is compromised by missing data
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zleeby
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Re: Rocky start with APAP - what next?

Post by zleeby » Tue Nov 15, 2022 6:03 pm

ozij wrote:
Tue Nov 15, 2022 9:54 am
Do you fold your lips in (without stretching them)?
The other thing that works for me it to make sure the strip is long enough to really be stuck away from the corners of your mouth.
I did fold my lips, but only a little bit. I can try folding them fully tonight.
The strip covered the corners of my mouth, but only barely. I can definitely try extending it farther.
Not fun. But that does mean the tape did its job at that point.
Maybe it will get better with that "tongue to the roof of your mouth" practice... What's your pressure?
I haven't been practicing that because, from what I can tell, my tongue rests at the roof of my mouth by default. Anytime I check to feel where my tongue is during the day, it's at the roof.
My current pressure is min 7.0, max 15.0, EPR 1.0. It seems to only ever rise after a leak has already started.
I don't know the type of tape you're using, but I found out that sometimes (more so with the Bleep mask) it helps if I add a top layer of Micropore paper tape on top of what I use now. I still have Micropore left over when I used for mouth taping.... and had to remove it with baby oil in the morning. Will not apply it directly to my lips ever again.
The tape I'm using is micropore, from what I can tell. You can read a description here.

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Additional Comments: Machine is Resvent iBreeze APAP.

lynninnj
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Re: Rocky start with APAP - what next?

Post by lynninnj » Tue Nov 15, 2022 8:42 pm

zleeby- I’ve been trying to look at the data and only see two lines and it’s hard to make them out. Admittedly I have harder time in my little mobile.

I am missing things like ahi and settings info.

_________________
Machine: AirSense 11 Autoset
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Beware the schoolyard bullies, mean girls, and fragile male egos. Move along if you can’t be kind.

zleeby
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Re: Rocky start with APAP - what next?

Post by zleeby » Tue Nov 15, 2022 9:34 pm

lynninnj wrote:
Tue Nov 15, 2022 8:42 pm
zleeby- I’ve been trying to look at the data and only see two lines and it’s hard to make them out. Admittedly I have harder time in my little mobile.

I am missing things like ahi and settings info.
Sorry, I'd only been posting the graphs for events and leakage. Here's everything else.
In terms of settings:
- current mask is P10 nasal pillows
- current pressure is min 7, max 15, EPR 1
- current humidity is 8 (8 is the max)

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ozij
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Re: Rocky start with APAP - what next?

Post by ozij » Tue Nov 15, 2022 10:08 pm

zleeby wrote:
Tue Nov 15, 2022 6:03 pm
I don't know the type of tape you're using, but I found out that sometimes (more so with the Bleep mask) it helps if I add a top layer of Micropore paper tape on top of what I use now. I still have Micropore left over when I used for mouth taping.... and had to remove it with baby oil in the morning. Will not apply it directly to my lips ever again.
The tape I'm using is micropore, from what I can tell. You can read a description here.
Thank you, zleeby, you're always very informative, what I meant to say is that I can't comment on your type of tape because I've never used it. From its name, it sounds like you chose well.

_________________
Mask: AirFit™ P10 Nasal Pillow CPAP Mask with Headgear
Additional Comments: Machine: Resmed AirSense10 for Her with Climateline heated hose ; alternating masks.
And now here is my secret, a very simple secret; it is only with the heart that one can see rightly, what is essential is invisible to the eye.
Antoine de Saint-Exupery

Good advice is compromised by missing data
Forum member Dog Slobber Nov. 2023

lynninnj
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Re: Rocky start with APAP - what next?

Post by lynninnj » Wed Nov 16, 2022 7:02 am

zleeby wrote:
Tue Nov 15, 2022 9:34 pm
lynninnj wrote:
Tue Nov 15, 2022 8:42 pm
zleeby- I’ve been trying to look at the data and only see two lines and it’s hard to make them out. Admittedly I have harder time in my little mobile.

I am missing things like ahi and settings info.
Sorry, I'd only been posting the graphs for events and leakage. Here's everything else.
In terms of settings:
- current mask is P10 nasal pillows
- current pressure is min 7, max 15, EPR 1
- current humidity is 8 (8 is the max)
Thanks!

On paper it looks pretty decent but how you feel maybe matters more.

_________________
Machine: AirSense 11 Autoset
Mask: ResMed AirFit N30 Nasal CPAP Mask with Headgear
Additional Comments: Newbie who loves her machine!
Beware the schoolyard bullies, mean girls, and fragile male egos. Move along if you can’t be kind.

zleeby
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Joined: Sat Sep 10, 2022 11:52 am

Re: Rocky start with APAP - what next?

Post by zleeby » Wed Nov 16, 2022 9:03 am

Hey everyone! Last night's data was about the same as the night before, aside from a higher AHI... What I noticed this time when waking up in the night and in the morning: My mouth was largely still sealed shut, except the very left corner had opened itself up, and I could definitely feel the air leaking through it.

I did fold my lips more tightly and extend the tape farther past the corners of my mouth. Not sure what else to try... I wonder if the corners of my mouth are able to dislodge from the tape by stretching outward, which could be prevented by stretching my lips outward as much as possible before applying the tape? And the humidity could also be loosening the tape, though again I really don't feel any moisture in the tape when I wake up. Any other thoughts?

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Additional Comments: Machine is Resvent iBreeze APAP.

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ozij
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Re: Rocky start with APAP - what next?

Post by ozij » Wed Nov 16, 2022 9:48 am

zleeby wrote:
Wed Nov 16, 2022 9:03 am
I wonder if the corners of my mouth are able to dislodge from the tape by stretching outward, which could be prevented by stretching my lips outward as much as possible before applying the tape?
No don't do that - they will "unstretch" naturally and create folds in the tape.

_________________
Mask: AirFit™ P10 Nasal Pillow CPAP Mask with Headgear
Additional Comments: Machine: Resmed AirSense10 for Her with Climateline heated hose ; alternating masks.
And now here is my secret, a very simple secret; it is only with the heart that one can see rightly, what is essential is invisible to the eye.
Antoine de Saint-Exupery

Good advice is compromised by missing data
Forum member Dog Slobber Nov. 2023

zleeby
Posts: 17
Joined: Sat Sep 10, 2022 11:52 am

Re: Rocky start with APAP - what next?

Post by zleeby » Wed Nov 16, 2022 10:25 am

ozij wrote:
Wed Nov 16, 2022 9:48 am
No don't do that - they will "unstretch" naturally and create folds in the tape.
I see, is there anything else you recommend?

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ozij
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Re: Rocky start with APAP - what next?

Post by ozij » Wed Nov 16, 2022 10:57 am

zleeby wrote:
Wed Nov 16, 2022 10:25 am
I see, is there anything else you recommend?
Hmmmm...

Be sure to have a tab folded in on at least one side of the tape
Try a strip which is even longer - a finger's width away from the corners of your mouth (you can try with your pinkie's width first...)
After you've taped, try to blow out air through you taped lips - gently. It will give you a sense of where the "weak points" are.

I now use this tape: Medvance Soft Silicone Tape with Perforation for Easy Cut, and it started behaving well when I really extended it on both sides. I'm not saying it better because I really don't know - and it took me a while to "train it" - so if your tape is comfortable, suggest you try some more with what you have.

_________________
Mask: AirFit™ P10 Nasal Pillow CPAP Mask with Headgear
Additional Comments: Machine: Resmed AirSense10 for Her with Climateline heated hose ; alternating masks.
And now here is my secret, a very simple secret; it is only with the heart that one can see rightly, what is essential is invisible to the eye.
Antoine de Saint-Exupery

Good advice is compromised by missing data
Forum member Dog Slobber Nov. 2023

lynninnj
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Joined: Mon Jul 25, 2022 8:56 am

Re: Rocky start with APAP - what next?

Post by lynninnj » Wed Nov 16, 2022 1:42 pm

Treat the stuffy nose with saline perhaps?

_________________
Machine: AirSense 11 Autoset
Mask: ResMed AirFit N30 Nasal CPAP Mask with Headgear
Additional Comments: Newbie who loves her machine!
Beware the schoolyard bullies, mean girls, and fragile male egos. Move along if you can’t be kind.

zleeby
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Joined: Sat Sep 10, 2022 11:52 am

Re: Rocky start with APAP - what next?

Post by zleeby » Thu Nov 17, 2022 1:43 pm

Hey everyone! I'm happy to announce that I finally had a leakless night!! I followed ozij's advice of blowing gently with the tape on to identify weak points, and my mouth's left corner got loose, so I applied an extra, vertical strip of tape over the left corner to further secure it. And it seems to have worked perfectly!

I can't quite recall whether I woke up in the middle of the night or not. I did wake up several minutes before my alarm went off, and I heard some gargling noises in my tube. I've heard this can be a consequence of high humidity, so I suppose I'll turn the humidity level back down some. Strange that this problem didn't occur until now though...

There seem to have been far fewer obstructive events as well, which I'm quite excited about. Aside from turning down the humidity, I think I'll stick with my current setup, hope for repeat successes with the tape, and reassess how I'm feeling + what the data is showing in a couple days.

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Mask: AirFit™ P10 Nasal Pillow CPAP Mask with Headgear
Additional Comments: Machine is Resvent iBreeze APAP.

lynninnj
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Re: Rocky start with APAP - what next?

Post by lynninnj » Thu Nov 17, 2022 5:16 pm

Well done.

You might want to stick with what works for another night though.

Cover the hose a bit to prevent or minimize rainout.

If humidity was keeping you from mouth breathing it could become counterproductive.

imho don’t change the settings just yet

_________________
Machine: AirSense 11 Autoset
Mask: ResMed AirFit N30 Nasal CPAP Mask with Headgear
Additional Comments: Newbie who loves her machine!
Beware the schoolyard bullies, mean girls, and fragile male egos. Move along if you can’t be kind.

zleeby
Posts: 17
Joined: Sat Sep 10, 2022 11:52 am

Re: Rocky start with APAP - what next?

Post by zleeby » Sat Nov 26, 2022 2:55 pm

Hey everyone! Been a little while - shortly after my last update, I developed a cold, and I was hoping to fully recover before reevaluating my therapy, just in case the cold could be influencing the PAP's efficacy somehow. (For instance, perhaps the excess mucus could be obstructing my airway further, meaning a pressure level that is normally beneficial wouldn't be strong enough while I'm sick? Pure speculation though.) I'm feeling mostly better now, but unfortunately I still have a strong cough and some lingering mucus built up in my throat. I'm sure this will go away with time though. If anyone knows any way this might be affecting how effective my PAP is, feel free to share.

Here's my data from the past 3 nights. Now that the leaking is fully under control, my average AHI has gone down significantly. However, I still am seeing a lot of Flow Limitations. Should I be concerned about these? Data aside, I am certainly noticing a strong benefit in my sleep quality. I've gone from waking up feeling like a 2/10 to feeling like a 5/10. Of course, I want to raise that number as high as possible.

What should be my focus now? Do I need to try and reduce the Flow Limitations? If so, how ought I change the pressure to accomplish that?

Current settings: Min pressure 7.0, max pressure 15.0, EPR 1.0, humidity 5.

_________________
Mask: AirFit™ P10 Nasal Pillow CPAP Mask with Headgear
Additional Comments: Machine is Resvent iBreeze APAP.