CPAPtalk.com

Hi-

I recently discovered these forums, so thought I'd post here...

I've been using my CPAP for several years (5-10 or so) and it seems like I haven't been getting the miraculous, totally out of the fog experience that I've heard others talk about...and it's certainly been worse the past couple years, so I'm finally trying to do some things about it. I've changed groups at work this year (stress level reduced) and started biking the past few weeks (I'm about 60 pounds overweight). Now I'm trying to figure out if I can get a better CPAP experience. I tend to be a toss & turn sleeper...start off on one side, then maybe flip over to other side or my back, but usually end up sleeping on my stomach with head to one side or the other.

I'm still using the same machine I got initially (P-B Goodknight 418) - it's a straight CPAP (no APAP or humidifier or software). I've used several masks that have been a pain for one reason or another...

* P-B Breeze (both nasal pillows & mask) - always had little problems with fit and leaking, but the plastic coming over the forehead had a tendency to break.

* Respironics Contour Deluxe mask - trouble with fit/leaking. Makes septum feel like it's burning...I think this might be an allergic reaction.

* Respironics ComfortGel - same as above.

* ResMed Mirage Activa mask - has a ridge in the bottom that sometimes seems to irritage the bottom of my nose as the mask moves around during the night. I get a good fit with this and would be happy with it if I could get it to stop irritating the bottom of my nose.

* Res Mirage Swift nasal pillows - the straps have a tendency to ride up towards the top of my head overnight and make the whole thing insecure (i.e. it falls off occasionally). I occasionally have the same sort of "burning" sensation with this one (esp. if I really tighten up the straps, I think). Also, with the hose coming off to the side, I have trouble sleeping on one side (where the hose gets under the side of my face).

I'm currently trading off between the last two of those, but it seems like I'm frequently in the mode of getting irritated by the one I'm wearing a couple hours before wake up time. So I swap over to the other mask for the rest of my time in bed, but I don't think I really sleep well that last couple hours.

I did a sleep study near the end of last year and ended up settling on pressure around 12-13...I had been (self-adjusted) as high as 16-17, but we brought it back down because I was doing good around 12. I've never figured out how they can tell much from the sleep studies since it's not a "real" situation and I never seem to sleep well at them (apparently well enough for the instruments to record something meaningful, but I'm usually a wreck the next day...and playing a racquetball match the next evening is definetely not a good way to win ).

Anyways...I've also been wanting to occasionally go camping, but my current machine takes 24VDC input, so I've been thinking of getting something new that takes 12VDC that I can travel with. The P-B Goodknight 420 series seems like a good fit for that (combined with something like a 25-35 AH deep cycle battery ought to get me through a few nights...I've been scanning the other various topics for info on that).

What I'm also wondering is...

1) Do you think it's worth trying out a AutoPAP instead of CPAP?

2) How easy is it to get the software to check what's going on with the CPAP? Some of the machines I've read about say that it's compatible with software, but I haven't found (or really looked yet) the actual software for sale or comments on ease of use.

3) Anyone have any recommendations of masks to try out? I've been thinking of the ComfortCurve or ComfortLite 2 or the Aura/Twilight NP/whatever it's called...but don't really have a good feel for whether they'd be much different from what I've already tried.

Thanx!

Scott

what the hell is your question? I'm not reading all that

I'd think an Auto would be worthwhile, even if you ended up at one set pressure, in that you could check pressures over multiple nights, and perhaps arrive at a better pressure than can be obtained through a one-night titration.

If you're looking at the 420 series, you'll find the software for these machines to be the most readily available, currently. Puritan Bennett, unlike ResMed and Respironics, has not yet attempted to stop internet vendors from selling software to end-users. From those who have used software from more than one company, the SilverLining software seems to rate well, too.

As to masks, I have also had the Activa take a bite out of the base of my nose, and I suspect that others have shared this delightful experience. I've been thinking about filling in that portion of the rigid silicone with some food-safe silicone caulk so that there's no longer an edge to catch, but haven't yet tried it.

You mention a burning sensation. My guess is that a heated humidifier may well improve on that, if you're talking about a burning sensation inside your nose. Dried-out membranes will tend to burn.
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CPAPopedia Keywords Contained In This Post (Click For Definition): respironics, resmed, activa, Puritan Bennett, Titration, auto

I would like to comment on your APAP question. The main reason for me to get a APAP was the understanding that the pressure requirements will change under different circumstances. And like you mention on your post, the sleep study is not a "real" situation, but using an APAP machine at home, in your own bed, with your own pillow is more natural than at the lab. I might come across like an APAP salesman, but in my opinion they are better than conventional CPAP's. If you are one of those who do better on straight CPAP, every auto can also be set to run on CPAP mode. Your choice, but you don't loose anything when using an APAP.

Ernesto

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CPAPopedia Keywords Contained In This Post (Click For Definition): CPAP, auto, APAP

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CPAPopedia Keywords Contained In This Post (Click For Definition): CPAP, auto, APAP

scottbla wrote:3) Anyone have any recommendations of masks to try out?

http://www.sleepapneasymptom.medgrip.com/cpap_mask.html

The PB 420E (auto) and 420SP (cpap) both have the software available. I have a data capable auto, and though I'm currently running it in straight cpap mode, I learned a lot about my sleep and pressure requirements through using it initially. I tend to like their software better than any other, though I liked other features of the auto machine I bought. However, for portability, it's an excellent choice, too.

Masks are important. They are also very individual. If you have a way to get good mask fittings that would be the way to go, but even then you have to try them for a few nights to really know.

There are some good posts, collected by Rested Gal on this page:

viewtopic.php?p=148179

These include links to masks and discussions of camping and battery operation. Here's the one about masks:

viewtopic.php?p=35286



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CPAPopedia Keywords Contained In This Post (Click For Definition): 420E, CPAP, auto

You mention a burning sensation. My guess is that a heated humidifier may well improve on that, if you're talking about a burning sensation inside your nose. Dried-out membranes will tend to burn.

The burning sensation is more on the skin service on the bottom of the nose...it feels an awful lot like a skin contact allergic reaction (though I don't really know what it is). I've had similar problems with glasses that have the soft silicone node pads that seem to stick to my skin.

I haven't really had problems with drying out of the inside of the nose. I've only occasionally had drying that I treated with a saline spray without a problem.

Also...

As to masks, I have also had the Activa take a bite out of the base of my nose, and I suspect that others have shared this delightful experience. I've been thinking about filling in that portion of the rigid silicone with some food-safe silicone caulk so that there's no longer an edge to catch, but haven't yet tried it.

I've tried sticking a piece of mole skin over that ridge before, but it's hard to get it to stick and it makes enough skin contact that oils from my skin didn't help matters.

scottbla wrote:Also...

As to masks, I have also had the Activa take a bite out of the base of my nose, and I suspect that others have shared this delightful experience. I've been thinking about filling in that portion of the rigid silicone with some food-safe silicone caulk so that there's no longer an edge to catch, but haven't yet tried it.

I've tried sticking a piece of mole skin over that ridge before, but it's hard to get it to stick and it makes enough skin contact that oils from my skin didn't help matters.

Oops, I think that's what you meant, not the ridge of your nose .

RosemaryB wrote:You can also put the moleskin on the mask itself.

My wife has suggested that a few times, too, but it always seemed to me that it would make it impossible to get a reasonable seal...I suppose I could always give it a try and see how/if it works

I think (but am not sure) that the main aggravation is from the more rigid material which provides a support for the more flimsy "skirt" around the edge of the mask, with the "skirt" being what provides the seal. Placing some moleskin over the rigid material, if that's what's irritating, shouldn't affect the seal.

JimW wrote:I think (but am not sure) that the main aggravation is from the more rigid material which provides a support for the more flimsy "skirt" around the edge of the mask, with the "skirt" being what provides the seal. Placing some moleskin over the rigid material, if that's what's irritating, shouldn't affect the seal.

That was my thought as well. IIRC, it didn't affect the seal when I tried that...it was also hard to get in place and did stay adhered very long.

I was talking about the comment to put the moleskin on the "mask itself" thinking that that meant around the edge of the mask where it contacts my face.

Two thoughts occur to me about the sensitivity under the nose:

1] The interface is a shade to short for your face and you need the next size larger.

2] You are pushing the interface up your nose a short distance after putting it on. That turns the edges of the "outer cushion cover" down thereby cutting into or irritating the skin. Try taking your fingertip and running it along the seam between outer cushion cover and facial skin. That turns the cushion cover's edges under again forming a better seal and not cutting into and irritating the skin.

What mask works for one may be a nightmare for another. While I can satisfactorily use the Breeze and CL2, the last few weeks I've been using the TwilightNP (AKA all those other names). I'm a side sleeper and rarely spring a leak. Some stomach sleepers on here have reported using it without a problem. It's vent is a big plus for me. That said, the reason it's working well is that I followed the lead of some others and deconstructed it, and use only 2 pantyhose tights straps to secure it. Lightweight and barely noticable.

Is it worth it to try to improve your cpap experience even after all this time? Well, if you don't think your treatment has reached its full potential, why not?

Best wishes in finding the very best options for you.

Kathy

Slinky wrote:Two thoughts occur to me about the sensitivity under the nose:

1] The interface is a shade to short for your face and you need the next size larger.

I've tried that once, I think (went from a Med to a Lg).

Slinky wrote:2] You are pushing the interface up your nose a short distance after putting it on. That turns the edges of the "outer cushion cover" down thereby cutting into or irritating the skin. Try taking your fingertip and running it along the seam between outer cushion cover and facial skin. That turns the cushion cover's edges under again forming a better seal and not cutting into and irritating the skin.

I'm sure it slides up some overnight...I occasionally lift the mask straight away from my face to let the edges reseat in their normal position. The problem with the Activa seems to be that it has that ridge inside the interface on its bottom side (i.e. not part of the seal with my face) that ends up rubbing against the bottom side of my nose. It could be that a larger mask would anchor its top tip against the bridge of my nose better (so it wouldn't tend to rid up while I sleep/move around), but I don't know if they go bigger than a "Large".