new & struggling

I'm reading stats on the low rate of CPAP users who actually stick with it. I'm determined not to be in that category, but to be painfully honest my first 6 nights TRYING to sleep with the mask on have been horrible. I constantly wake up, and when I can't take it anymore, I remove the mask. A couple of nights after doing that and falling back asleep I put the mask back on, but the same thing happened. I've always been someone who needs to be very comfortable in order to sleep (I could never sleep on planes or buses in most cases for example)and the idea of wearing a tight-fitting nasal mask scared me from the start, and now my worst fear is being realized. I am open to any and all tips, words of encouragement, etc. I definitely have hope this can get better and can be workable, but I really need some support to get there. btw--I have tried ramping 5, 10, 15 minutes, and none of that seems to make a difference frankly.

You've come to the right place for help and encouragement. I was a "beginner" a year and a half ago and now my nightly routine of sleeping with a mask on is not so bad. I like going to sleep knowing that I won't stop breathing during the night. Click on the yellow light bulb for tips and help. If you have questions, ask them on this forum...I've learned more here than from any other source. It can be difficult adjusting to the feeling of sleeping with a mask strapped to your face, but stick with it. Feeling better, and improving your health are worth it. Don't give up, and welcome.

I'm a very picky sleeper myself, so I have a lot of sympathy for your plight.

Can you analyze exactly why you are uncomfortable? Find the little issues and fix them. You have to think consciously about why you want to take the mask off. Is air blowing on you? Is it too tight? Are you sweating somewhere or feeling moisture? Etc. Find and fix each problem.

I'm not saying my approach will work for you, but these are some of the things I did.

1. I decided before I ever got the machine not to use the ramp. This will be controversial, because some people feel it helps them enormously. But knowing how picky I am, I did not want to get another "requirement" for making sleep possible for me. This way, if I wake up in the middle of the night at full pressure, it is the same process of going back to sleep as when I first go to bed.

2. I made a rule for myself--never take off the mask just because I didn't like the way it feels. I only take it off to fix a problem, or if I have laid awake for at least 4 hours without any sleep. I consider that effort enough.

3. Never go a night without using the mask. So far, I haven't. I have had only 2 nights where I took it off after more than 4 hours of trying.

4. I do not allow myself to take off the mask in the morning unless I am actually getting out of bed for the day.

For me, it's a psychological war, and these are some of the ways I fight the battle.


You might be able to wear the mask a little less tight if you used some of the Mack's silicone earplugs to form a seal around the mask. That makes it a lot more comfortable for me.

I agree with much of what LoQ said, and particularly with his suggestion that you analyze what is bothering you about the mask and post that information here to get more specific suggestions.

I feel for you as I had a lot of the same difficulty when starting cpap. Like you I don't sleep on planes or even when a passenger in a car on a long trip. I felt much worse than for many weeks after beginning cpap. For me the key was getting a mask that allowed me to sleep on my side without causing leaks. Things began to turn around for me then, and now I have very little difficulty with my cpap therapy.

I do want to provide you encouragement. There are many people here who share your fear reaction to masks and I hope you will be hearing from them on their coping mechanisms. You could consider a nasal pillows mask that would be a different experience from a "tight-fitting nasal mask." Also, many new cpap-ers make the mistake of tightening the mask straps too much causing a great deal of discomfort.

Welcome and please don't give up. Ask as specific questions as you can and we will be as helpful as we can.

maskracer, I've always felt that the mask is the #1 key to being able to actually sleep while using cpap. You may need to try many different masks until you luck onto one that is comfortable enough and leak proof enough to let you sleep.

If you have a really helpful DME (durable medical equipment -- the store that supplied you with your machine and mask) they'll let you swap masks. Some might let you swap again and again, for awhile. I'd go back to them now, while you're just getting started. Don't accept a song and dance about how "it takes time to get used to it." That's true to a certain extent, but.... finding a mask that suits you can make sure "getting used to it" much easier.

I'd ask to try these two masks in particular:

ResMed Activa (very leakproof and supposed to be worn with straps almost floppy loose.)
ResMed Swift LT (a nasal pillows mask that is probably one of the least obtrusive.)

Here's a link to discussions about many masks:
LINKS to MASKS - nasal mask, nasal pillows, nasal prongs
viewtopic.php?p=35286

And a link to save for future use, in case you need to tweak a mask that suits you pretty well but has something about it that needs work, to customize the way you want it:
LINKS to Lab Rat Trophy awards
viewtopic.php?t=15104

maskracer wrote:I'm reading stats on the low rate of CPAP users who actually stick with it. I'm determined not to be in that category

That determination and the help you'll find on this message board will get it done for you, maskracer.

I'm a big believer in comfort. Start trying as many masks as you can. I hope the DME will let you try more masks -- while sleeping at home -- not just sitting up in a chair at the DME store.

Your Elite II machine will show overnight data on the LCD screen if viewed before noon the next day. I'd start checking that each morning and keeping a record of each night's AHI, AI, HI, and leak rate. I'd make notes about things that could affect the leak rate... for example, if much time was spent with mask off and machine still running.

Welcome to the forum! Not to beat a dead horse...or at least not too much...but I echo what others have said. It takes a while to get used to sleeping with a thing on your face that blows air up your nose or in your mouth or both. It took me at least 6 weeks and 8 different masks to be able to use my machine all night every night. Another of our members says 8 weeks. Even now I have the occasional bad nights, like last Friday.

I'd see if your DME has a variety of masks that you can try on while you're at their office. I'm about to try mask number 9 and I have high hopes for this one!

Hang in there. It does get better and easier.

Hello and welcome.

Early on the mask was a major aggravation for me. Fortunately I fell asleep almost the instant my head hit the pillow, but I woke up frequently. The very second I was awake I felt it had to come off or I'd or I'd freak out. No such thing as lying awake and waiting for sleep to come. And I took it off in my sleep a lot and woke up to find it beside me on the bed.

All I can say is it's likely the more you use it the sooner it won't feel so foreign. Reminds me of when I got a tooth crowned - I was very aware of its presence and how odd it felt and ran my tongue over it constantly. At some point I ceased to even notice it. If I wake up at night now I don't even think about taking my mask off.

By all means troubleshoot in case there's a specific reason the mask bothers you. Chronic leaks, shifting, and discomfort are counterproductive to your goal to get some good sleep. If attempts to address the issues aren't working, move on to the next one. The familiarity part just takes time. In retrospect, I may have been better off to take a little something to help me during the adjustment period so it wouldn't have taken so long. Oh well, it happened in spite of myself.

You might also try some St. Johns wort (Hypericum perforatum) extract. It's mildly relaxing herb medicine that might help
you to fall asleep. It's been used for ages and is known to have practically no side effects and I guess it mixes with
most of other drugs. I have absolutely no medical background, but you could ask your pharmacist.

In Finland that stuff was moved to pharmacies a couple of years ago (I guess someone have shown it's effect clinically)
and you still get it without prescription.

maskracer wrote: I've always been someone who needs to be very comfortable in order to sleep (I could never sleep on planes or buses in most cases for example)and the idea of wearing a tight-fitting nasal mask scared me from the start,

I'm the exact same way. It's gotta be my own bed in my own house. I have to have my fan on and I need two pillows propped in just the "right" way, a stuffed animal which goes under my chin, my blankets, wearing a hoodie with the hood up, there can't be any noise or light and everyone needs to be in bed as well. It's a whole ritual (not always successful) so needless to say the CPAP was a huge adjustment. It took several months and several mask changes to get used to it. I still sometimes have a hard time, but that's mainly because I get an itch on my nose that keeps coming back all night long. But most of the time I don't even know the mask is there. There have been times I wake up and sorta freak out like OMG I fell asleep without putting on the CPAP! And I start feeling around for it only to realize it's on my face and working!

Me too, me too!!!

Here are additional things that worked for me:
Not having the maks on too tight -
Hanging the hose from above
Getting rid of the annoying smell of strageness - the filter on my loaner smelled of disinfectant, I washed it. Nowadays you can try the scents from http://www.pur-sleep.com
Telling myself: OK, this sound will not go away. Think of it as the waves at the seashore. Don't wait for it to abate.
O.

Overtightening can create leaks (in 'other' places from the initial ones you were trying to fix) and be uncomfortable, so don't think it 'has' to be tight, never mind that it may well be the wrong mask and/or size for you.

Maskracer,

Welcome to the forum! Yes, lots of people fail at CPAP therapy, but lots make it as well, and there are a bunch on this forum with a great deal of success and knowledge to share. Focus on being one of them. Determine now that you WILL make it work, and half the battle is done. Your struggles are ones that many others have had, and have overcome, so know that you can get through them and succeed as well.

As a general rule, most changes to your therapy should be made one at a time, with a few days in between changes to track if they are working for you or not. I think your ramp goes up to 45 minutes, so you might try extending it out as long as possible and seeing if that works. Some have had success using a product called Pur-Sleep, available at http://www.pursleep.com, which adds a soothing, relaxing aroma to the air you breath, replacing that rubber and plastic hospital smell the new equipment often has. It sounds a little strange, but you could also try wearing the mask for a couple of hours during the day while not trying to sleep, just to allow your subconcious mind to become more accepting of it. The key is consistentcy, making wearing the mask part of your sleep routine that you always, always do. Stick with it and it will happen. Set a goal of keeping the mask for X amount of time tonight, then X+ 15 minutes tomorrow, then X+ 30 the next, etc. until you are up to eight hours. Time, and finding the right mask as others have suggested, equals success.

I would also try to get a better machine than the Escape you have. If you haven't been on CPAP for long, take it back to the DME and ask for at least an Elite. They will likely tell you you don't need one, but you should politely insist that you do. You need a machine that will record and let you access your nightly average leak, pressure and AHI data. This is almost the only way a person on CPAP can succeed. For me, seeing my nightly numbers gave me a reason to feel good about something every morning. If my AHI was up, at least my leak rate was down, or vice versa. The more information you have, the better able you will be to manage your treatment.

Hang in there, and best of luck to you!

Thank you so much for all the great responses and suggestions - I truly appreciate the support.
And Rested Gal, I will certainly check out those alternate masks.
As for the specifics that are troubling, I think it's simply the pressure of the straps, esp the forehead piece, the outside of the nasal mask pushing against my face...I feel like I have now loosened the straps just enough to be somewhat comfortable while maintaining a seal. Leaking isn't so much a problem, though I have woken up a few times and had to make an adjustment. The overall feeling of something hugging my head - even if not too tight - is primarily it. It's that constant sensation that's tough to deal with.
I have to say however that after I posted my message last night, I kept it on longer than I have so far. About 4 hours.
Is there any value in getting the fleece cover for the hose, or the pad a cheeks (and does insurance cover any of that stuff)?
Thanks again, everyone.

turbosnore wrote:You might also try some St. Johns wort (Hypericum perforatum) extract. It's mildly relaxing herb medicine that might help
you to fall asleep. It's been used for ages and is known to have practically no side effects and I guess it mixes with
most of other drugs. I have absolutely no medical background, but you could ask your pharmacist.

In Finland that stuff was moved to pharmacies a couple of years ago (I guess someone have shown it's effect clinically)
and you still get it without prescription.

St John's Wort is a supposed herbal antidepressant.

It does NOT mix well with a lot of drugs, including oral contraceptives, certain benzos, antiretrovirals and immunosuppresants, warfarin, lithium, buspar, most antidepressants, stimulants and several opioids.

Valerian is the herbal relaxant with very few side effects and drug interactions. Unfortunately, it smells of rotting feet.

You can also try melatonin.

Hi Maskracer-----yes, I was a newbie about a year or so ago----and I do remember all that same stuff that you are having right now. The FLEXIFIT 407 is a great mask --that is one of the ones I actually used the longest before I switched to a nasal pillow system. You might want to try the ResMed Swift LT (a nasal pillows mask) --it is so wonderful, small, easy to put on and off and it that is probably one of the least obtrusive like Restedgal said above. The right mask will be the key to your sucess in wanting to stick with the CPAP therapy. I am pretty happy that I had good insurance that let me switch masks whenever I wanted to try something better.

Good Luck --keep at it!!
Carrie