Struggling with CPAP and Throat Issue

Hi All,

I am having a hard starting with therapy. I originally picked the P30i and found this was clogging my nose and feeling like I was suffocating even with the humidity set to auto. I called the provider of the machine and they were useless besides recommending a full mask. I changed the min pressure from 5 to 6 and disabling the ramp and that helped me at least try to fall asleep. When I about to fall asleep something in my throat popped/crackle and woke me up. I was up for about 30 minutes and slept without the device.

I decided to try the N30 mask as people who seemed to have issues with the P30 have had better luck with it. It does feel better to me but last night the same thing happened. I was up for over an hour and a half before being able to fall sleep without the mask again. I don't think this has to do with my mouth opening as that sound is different and I can tell (I also have mouth tape in case that happens). This morning I tried again with the mask but I held my mouth closed with my hand and the issue still happens.

Has anyone experienced this before? I can't really fall asleep on the side with this mask either. I could try something else that has the hose attach to the front but think with the weight I won't be able to fall asleep. Should I go with the full mask but then all of that air pressure will be all over my face.

Finally I have had 2 deviated septum surgeries. The first doctor was only qualified to clear the blockage, of course he never told me this upfront because he knew I would probably go elsewhere and the second ENT was qualified to shift the septum back in place. He also said tonsils looked fine to him. I also asked if everything is clear for CPAP and he ensured me it was. I'm just kind of lost as to what to do next so would appreciate any advice you could provide.

Thanks

I looked at your earlier posts. Could you tell us whether you've had a recent sleep study, and if yes, what it said?

It'd be very helpful if you could provide more information from your machine. Does it have an SD card in it? If not, do get one (32 GB or less). Then sign up for SleepHQ at https://home.sleephq.com/ and get a free account so you can share a link to data about your night-time CPAP use.

I don't know what's going on in your throat, but if we can take a look at your data during the time you experience the click/pop, maybe we can figure that out.

Thanks for the response. I had a two night home study done from a local medical group which has the chest, cancullia and oximeter and that test provided an AHI of 3 and 2.7. I had also a Lofta test which showed moderate sleep apnea.

Here is the first sleep study: https://imgur.com/a/7DkiniS
Here is the second from Lofta: https://imgur.com/a/fmBr8h5

Let me get the data off of the SD card. I didn't think it would be worthwhile as I never actually made it to sleep.

Also I have the machine information at the bottom of my posting but it is an Airsense 10 APAP with humidifier and heater. I have the heater off ATM.

Here is a share link for last night. I hope this is what you were looking for. If there is anything else that is needed please let me know.

https://sleephq.com/public/a84fd51c-ac3 ... 471c99b6b7

npolite wrote: ↑

Sat Jul 27, 2024 6:20 am

Has anyone experienced this before?

Yes, I experience something similar. No crackle, but the pop. And then air rushes into my mouth.
Here's a list of your reasons for not sleeping with the CPAP - it's a list of "yes, but".

• can't really fall asleep on the side with this mask either.
• I could try something else that has the hose attach to the front but think with the weight I won't be able to fall asleep.
• Should I go with the full mask but then all of that air pressure will be all over my face.

You are not used to sleeping with a mask and hose, nobody is when they start.
And that is the first hurdle - it's a meeting of your conscious brain ("I want to use CPAP") and the unconscious voice that says "Oh, I have so much trouble sleeping as it is, why are you adding all this extra stuff and making things so much more difficult? Go away!!!"

You have to face that unconscious voice and tell it, kindly but firmly: We need this paraphernalia on our face, and we need to learn to sleep with it.
Here's what you tell the rebelling, unhappy unconscious brain:

1. "From now on, there will be no attempting to sleep without the mask. When we're in bed, trying to sleep, we only do so with the mask on and the machine running. You (dear unhappy part of me) can yell and kick and scream as much as you want, and if we're not asleep within 20 minute I promise you I'll get up and we'll do something relaxing and pleasant, in another part of the home, without the mask. We'll go back to be when we feel ready to sleep with the mask. And get out again if we don't sleep. We'll do that as many times as necessary, but I, the conscious responsible part that understands the need for therapy will not let you, the unconscious, traumatized part, make me try to sleep without the mask".
   This is critical - because by taking the mask off and sleeping without it you're giving reinforcement to all those "I can't sleep like this" statements.
   This is really up to you - the part of you that came here to ask for help. If you care enough about getting that therapy, you shouldn't let the resisting part take over.
2. Accept that you're going to have to learn a whole new way of sleeping - and that the learning period is tough.
3. Help yourself get used to things when you're wide awake - i.e. set out "training time" which is not when you want to go to sleep. Use that time to learn how to handle your hose and how to sleep on your side

There are some technical things you could do:

• Try a different type of pillow that will make sleeping on your side with the mask easier. One type of different pillow has cutouts on the sides.
• Get a full face mask, the kind that feeds into your mouth from below. No, you won't have "pressure all over you face" and the pops will be less bothersome.
• Try a hose hanger

But the technical solutions will not help the unconscious refusal to sleep in this new way. And that refusal has to be heard by you, and taken care of. Kindly, and firmly.

Thank you, should I go with the F40i or the F30?

Ozij, can you correlate the "pop" with anything on the OP's SleepHQ chart? The "pop" phenomenon is new to me, and I'd like to learn more about it.

npolite wrote: ↑

Sat Jul 27, 2024 6:20 am

When I about to fall asleep something in my throat popped/crackle and woke me up. I was up for about 30 minutes and slept without the device.

Sorry to hear! I had a similar issue with EPR turned on... turning it off helped. My airway would 'slap' closed for a moment during the pressure transition. Turning this down helped, turning it off stopped it. Your EPR is set to max, 3. It will never go to below your min, so at most you saw EPR of 2.8 at your pressure peak.

This was/is a positional thing for me... only on my back and on my right side... on my left side it doesn't happen. I can still feel it sometimes on bi-level in these positions... but it's much gentler since my Aircurve has a gentler support waveform and I'm on higher pressures now.

I was never able to catch these 'slaps' on either Oscar or SleepHQ. Try turning EPR OFF or to a setting of 1 is my suggestion. Anyway, worth a try... good luck, let us know how it goes.

vandownbytheriver wrote: ↑

Sun Jul 28, 2024 11:47 am

Try turning EPR OFF or to a setting of 1 is my suggestion. Anyway, worth a try... good luck, let us know how it goes.

Thanks. I will give it a try and see. I really want to feel better and fingers crossed.

Sadly even with EPR off my throat is still doing it.

npolite wrote: ↑

Sun Jul 28, 2024 3:20 pm

Sadly even with EPR off my throat is still doing it.

A simple thing to try... sorry it didn't work. You can try advancing your jaw using a cheap MAD... I bought the SnoreMD for 40$ at Walmart, it did the job, not very comfortable though.

I'd say see an ENT, they might be able to just look, or they might want to do a DISE endoscopy. Raising your EPR effectively raised your pressure, so evidently that was not enough to stop it... not saying that more pressure won't help... I had to go from 13cm CPAP to 21/17 bi-level to open my airway fully. See if this throat pop thing is positional, that's another thing to try... is it in any position?

npolite wrote: ↑

Sun Jul 28, 2024 5:41 am

Thank you, should I go with the F40i or the F30?

I suggest you try both of them. Think of fitting a mask to your face and sleep as you would think of fitting shoes to your feet and walking....

Personally: I have never tried an F40 of any kind, I use an F30, and can sleep on my side with it.
I have read / seen videos that the F40 is easier for side sleeping.

The ResMed "i" masks have the hosק coming from above, and tube touching your face. Some peםple say the air flow noise is conducted through the tubes and their cheekbones. Others are super happy with these types of masks.

It's a hassle, it's not cheap, but there's no other option but trying a mask in person. You're going to sleep with the mask the whole night - if has to be the most comfortable one for you.

Miss Emerita wrote: ↑

Sun Jul 28, 2024 11:01 am

Ozij, can you correlate the "pop" with anything on the OP's SleepHQ chart? The "pop" phenomenon is new to me, and I'd like to learn more about it.

I'm sorry, Miss E, I can't do that. The way I experience it, that "pop phenomenon" is what gives me chipmunk cheeks or causes mouth leak. I've never attempted to see mine on the charts. It's' too transient, happens when I'm drifting off, and I do my best to tighten my tongue to the roof of my mouth and to continue drifting till I fall asleep.

Just and update here to the community, I was able to finally fall asleep on my side. I am also using a chin strap to keep my mouth closed. I am getting some leakage withe the N30i on my side but it isn't much. Do you suppose having the hose in front would work better for side sleepers?

I still have the pop issue when I am on my back even awake. Maybe I need another ENT's opinion on what might be causing this. And I still haven't found a soft enough bed to keep me from turning at night. I have a 3" Talalay 19lb soft latex topper, a 3" Dunlop 19lb topper and my mattress and it is still not soft enough. Do you think a Sleep number equivariant bed would be worth trying?

Here is last night
https://sleephq.com/public/296d8101-32b ... 9d18a4b03c

Here is another report: https://sleephq.com/public/52b6bed3-bdd ... a67a605842