Newbie CPAP issues

Greetings everyone! I'm new to the world of CPAP, and I found this wonderful website via Google looking for mask and machine info. Go Google!

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So, I'm sure there's lots of users here who've been through what I've been through. Years of waking up with headaches/groggyness, getting out of bed being a chore, chronic daytime sleepiness, snoring, ect. My wife noticed my breathing not being quite right and me gasping for air when I was asleep, all the while I never knew untill she told me.

So anyway, fast foward past the sleep studies and prescription of CPAP.

At the sleep studies, I used the nasal pillows since they seemed the most invasive, so that's what I wanted at home. (I had to disable the flex pressure thing though. It felt like I was suffocating without continuous pressure) The first few mornings were awesome! I woke up refreshed (and on time!) for the first time in years! However, a few days in, the nasal pillows started, well, biting into the interior of my nostrals. I tried the small and large ones but they leaked air so I stuck with the medium. I figured I'd develop a calace or something similar, so I kept with it since the therapy was working wonders. After a few weeks, that never happened. Every morning the nasal pillows felt like they had melded with my nostrals, and taking them off felt like I was removing a scab. On top of that, throughout the night after the first week or so, my wife would be awoken to a hissing sound, which was me, with my mouth slightly open. She'd close my mouth and that'd be the end of that, but I noticed that I wasn't quite waking up refreshed.

So, after finally giving up on the nasal pillows, I called my equipment provider and asked for a full face mask (Resmed Quattro) since the pillows were hurting and I'd have my mouth open. A few days later (two days before my followup with my sleep Dr) they came with a full face mask. The lady thought I might need a medium, which they were all out of, but a large one apparently fit my face well since I have a 'long' face. I slept, eh, ok I suppose, for the two days before my followup and the Dr was thrilled after looking at the memory chip data (Phillips Resperonics machine) that it was working so well. My apnea index went from something crazy like an episode every few minutes, to one or two every hour.

Well, the large full face mask didn't turn out too well. I had a hard time waking up and daytime sleepiness rose from the depths of nomore-ville. On top of that, I couldn't get it to stop leaking no matter how tight I had it. If I moved a certian way, air would 'fart' out. I put up with it for a couple of weeks, and during that time, I developed a nasty sore/infection/blister on the top of the bridge of my nose. I got it under control, but had been sleeping with a band-aid over it.

So I got a medium full face mask (Resmed Quattro again) from my provider. This one fit like a dream. It just feels perfect. No leaks, no complaints. After the first night with it, I got another sore/infection/blister just below the previous one. Apparently the skin on my nose doesn't like being suffocated by the 'poof out' part of the mask that fits the contures of my face and makes the seal. And to add insult to injury, I'm still waking up groggy.

To top it all off, I wake up with horrible gas from both ends because I can only assume I'm swallowing alot of air with the full face masks.

So, here I am, two months on CPAP. I've tasted waking up refreshed, so I keep at it, even with the nuances and knowing I'm still going to wake up groggy. I guess I hope it's just going to 'kick in' one night and I'll be good to go.

Anyway, gas and nose sores aside, I feel like the pressure on the back of my throat isn't the same as it was when I was using the nasal pillows. I think that's why the full face masks aren't quite working.

Does anyone have any advice for any of this?
*Full face mask gas
*Full face mask nose sores
*Full face mask pressure not the same as nasal pillows
*Nasal pillows hurting nostrals
*Nasal pillow mouth hissing

I'd switch back to the nasal pillows if I could solve those two problems.

Any and all replies are appreciated.

Go and check out the Innomed Hybrid - nasal pillows with mouth cover. Nothing on the nose. DO DO DO watch the video on how to fit it and check on line here for the threads on "fixes". It is a bitch to fit but once you get it right it is a dream mask.

Also check out Remzzz's mask liners that help prevent skin reactions, or check the threads here for homemade versions. You will want to keep the quatro around for when you have a cold or bad allergy reaction.

If you get some "Laninsoh Lanolin" and just put some on the sore areas in your nostrils a couple times during the day and at night when you put on your nasal pillows mask, you should find that heals up quite nicely. It is natural stuff and will not harm your mask in any way.

Over time, it may get tought enough so you don't need the lanolin. You just need a very small amount to really heal the sore area and to keep it from getting bad again.

You may want to ask your wife to get the Laninsoh Lanolin. It is in the baby department at the drug store and is for nursing mothers!

To top it all off, I wake up with horrible gas from both ends because I can only assume I'm swallowing alot of air with the full face masks.

Well, I have this problem (2 1/2 weeks into therapy) even though I'm using nasal pillows. It's bad enough at times that it's created problems with getting to sleep and eating during the daytime. At my husband's insistence, I've called the doctor's office about this and other issues. The nurse I spoke to thinks several of my problems might be that the pressure is set too high, so they've faxed an change in script to my DME. Tomorrow the machine's settings will be changed from straight CPAP to AutoPAP, but I don't yet know what the range on the script is. If the gas is really causing problems, you might want to report it to the sleep doc's office and see if you can at least talk to a nurse about things that might be done to help this.

Also second the Lanisoh Lanolin cream idea for sore nostrils.

And I'm still waiting for a taste of "waking up refreshed"

Welcome JMan!! I'm a newbie here too. My issues were something along the lines of yours except I started out on the full face and I could NOT deal with the sores and red marks, etc. I decided to start Googling ( yeah way to go Google!!) to see what else was out there for CPAP users. I found this board and some other helpful sites and my quest began for a nasal mask and chin strap. (I too would breathe through my mouth and had horrible bloating and gassy feelings. To the point I was miserable pretty much all day. Before it was all said and done it took me close to 14 months to get it "right". Now I sleep very well, feel very rested and no daytime sleepiness at all!!!

What finally worked for me is the Covidien Breeze SleepGear Interface with DreamSeal Mask Assembly and a cheap comfy chin strap. Good luck on your search!!!

Overtightening can worsen leaks. I recently tightened my nasal pillows too much and the leaks increased. The leaks lessened when I loosened the headgear. A tiny amount of Lanisoh helps the seal; too much and the nose pillows can slip around. The Lanisoh should also help avoid the "scab"-like removal.

A chin strap or taping your mouth may resolve your mouth leaks.

3M paper tape (or a bandaid, as you discovered) can help the bridge of your nose. You might try progressing from a bandaid, to the 3M paper tape, to using Lanisoh on the bridge of your nose. You would want the 3M paper tape with weak glue, for sensitive skin.

Best of luck to you.

what nose pillows did you try?

the opus 360 can be rigid and take a long time to get used to..

the swift fx is soft and super comfy...

I hate all the full face masks..

if you go back to nose pillows you can train yourself to keep your mouth shut by taping it shut for awhile with delicate latex free sports tape..

I swallowed air when my pressure was too high..

do you have positional apnea?

is your machine an auto?

what is your pressure, or pressure range?

Thank you for your responses! I wish my provider told me about the Laninsoh Lanolin. I thought about using antibiotic cream but it didn't feel like the right answer.

The gas from the full face mask isn't bothersome, to me anyway. I find it funny, but my wife doesn't. Man, I could win some contests. It's usually gone after 30 minutes of being awake.

Why didn't I think of a chin strap? I might have stuck with the nasal pillows had I thought of that. Would it be feasable to make a home made version? That Papcap one looks a bit overkill.

(man, I can't preview and submit without a new reply. Thanks guys! )


what nose pillows did you try?
The Resmed swift FX I believe.

the swift fx is soft and super comfy...
Soft? Yes. Super comfy? Until the nostrals started hurting.

if you go back to nose pillows you can train yourself to keep your mouth shut by taping it shut for awhile with delicate latex free sports tape..
That's an idea.

do you have positional apnea?
Nope.

is your machine an auto?
I don't believe so. I have the one in my signature.

what is your pressure, or pressure range?
Doc had it at 6, which was fine for the nasal pillows. When I had the full face mask, I upped it 1cm a night till I got to 12 and just stopped it there. Nothing changed at all.

Jman2010 wrote:
what is your pressure, or pressure range?
Doc had it at 6, which was fine for the nasal pillows. When I had the full face mask, I upped it 1cm a night till I got to 12 and just stopped it there. Nothing changed at all.

When you make a change you need to stick to that pressure for a week. 6 is really low but one has to watch it, higher pressure can create something called "central apneas" . You can't see that if you don't have a data capable machine. I would go back to 7 and try it for a week before trying a higher setting.

Also get a copy of your sleep study summaries - they are yours by law and must give them to you, they may make you pay but it is worth it. You can then post them and people will help you understand them.

I use a Resmed Mirage Liberty mask, after my first six months using the Quattro full face. I've gotten much better results with the Hybrid. I do find, based on a suggestion on this forum, that I need to use paper tape to hold my nasal pillows in place. Not tight, but enough to keep then from moving "off center" from my nostrils

Also, I see quite a few people have recommended Lanolin cream - just a heads up, some people are allergic! Like me!

BlackSpinner wrote: When you make a change you need to stick to that pressure for a week. 6 is really low but one has to watch it, higher pressure can create something called "central apneas" . You can't see that if you don't have a data capable machine. I would go back to 7 and try it for a week before trying a higher setting.

Also get a copy of your sleep study summaries - they are yours by law and must give them to you, they may make you pay but it is worth it. You can then post them and people will help you understand them.

I did not know that. What's wierd is that when I woke up, it felt nothing like when I first turned it on. Is that me getting used to the pressure, or something my machine may be doing? I'll go back to 7 tonight just for kicks and giggles and see how it goes. My machine, the Phillips one, has an SD card, but I don't have the software, nor the money to buy it, to read the data. Would that be more helpful than my sleep study summaries?

On a side note:

I don't mind the full face mask or nasal pillows, given those nuances can be taken care of. Seems like the gas problem is the only thing that can't be solved? I'd like to keep the full face mask if at all possible, for the sake of sparing my provider another trip, and also that occasional cold or two. Come to think of it, I think the gas started with the higher pressure, I'll have to take notes since I'm starting over with 7.

I think I swallowd a lot of air in the beginning when I was leaking out of my mouth..

it went away when the leaks stopped, and the leaks caused the higher pressure for me..


the nose pillows can REALLY hurt if you have your straps adjusted a tiny bit too tightly.. just wee bit, and its a disaster.

its a very fine art to adjust them.. once I washed my mask, and it took me seven days of adjusting every night before i could get them
to fit so they would not hurt again..

they are supposed to genly rest against your nose, and there should not be any pressure so that it hurts or wrinkles your nose..

also, size is important.. I wore a medium with opus and small size with fx..

tbh, I couldn't tell if I had the nasal pillows strapped too tight. My nostrals were kinda sore after the first night, then progressively got worse. A few days in, when it was hurting as bad as it could get, I noticed depending on how I turned my head one of the pillows would leak a little. I tightened it just a little and that seemed to stop it. Again, no clue if it was too tight.

Something else I wanted to tell you and forgot earlier. The 14 months that I was searching for the right mask I had a brain tumor removed during that time and a 19 inch scar that looks like a question mark on the right side of my head. So I didn't wear/use my CPAP for about 4 months due to staples and sorness and oozing. So really all in all it was only about a 10 month struggle. I'm sure you'll notice typos and grammer errors from me but that is one of the side effects of my surgery.

Also I'm a stomach with head to the side sleeper or either I sleep on my left side. One of the things I think that helped me most was buying a Contour CPAP Pillow. That made a huge difference in when or if the mask slipped around and leaked. I have used the nasal pillows as well but found that I tended to open my mouth more for whatever reason.

The Swift FX nasal pillows should not have hurt you that much. They are really cushy and comfortable. I am thinking you had your straps way too tight; also don't go too small on the nasal pillows because they can enter your nose too far and cause soreness. The pillows are just supposed to rest against your nostrils, not get jammed inside them.

I tried the Mirage Liberty mask and found it very uncomfortable. I asked my sleep doctor about the Hybrid and he told me he's tried it on 10 different people and got it to work once. Hmmmmm. Anyway, I'm working with the FP Forma right now to see if that can be my alternate mask.

Good luck with your search for the right mask for you. It takes some experimentation, I do believe!