Titration last night...not fun

I went last night for the titration. Yeah, that was not fun I couldn't get comfortable with the nasal pillows. Really hurt my septum and felt like air was blowing in my eye. Finally had him take it off. Then he put on a nasal mask with a chin strap. Felt okay to start but then I woke up having a mini panic attack feeling like that thing from Alien was on my face. Had to get it off me and splash on some cold water. Tried the nasal pillows again. Again, no. I just couldn't get to where it felt they sat right against my nostrils. Back to the other mask but without the strap. That finally worked okay except that now I have a sore on the bridge of my nose. Between all that plus the guy coming in to mess with the leads or tell me to roll over, I got no REM until about 4 a.m. I really wanted the Nasal Pillows type mask but doesn't look like that works for me but I don't want to have a sore on my face all the time.

Also, is this normal? Now I feel like I'm short of breath. I keep feeling like I need to take deep breaths?

When do you feel short of breath? On the machine or afterwards??

I have heard of some people experiencing chest soreness after the start of CPAP, but if you're truly short of breath I wouldn't play ... I'd call the doctor. Could be pneumonia ... don't assume it's related to the CPAP therapy.

About the mask issues...

All masks in a sleep center (at least this was true of the one I went to) suffer from the cleaning regime they go through and require generally a lot more strap tension to keep them in place. So, if you think you like nasal pillows except for the leakage, I'd encourage you to try again. However if you're happy with another kind of mask, that's fine too. Finding the right mask is the main trial to CPAP therapy ... some of us go through 5 or more to get there. I'm on my 3rd, just ordered two more to try. The 3rd isn't bad, but isn't perfect and does cause a little irritation.

There's always new masks coming out ... it is a rapidly evolving field.

Good luck!
-Kevin

Ah yes the wonderful titration...
Hi pandatx,

Sleep studies are soooo fun! NOT! Just wondering if you happen to know the exact brands of the masks they had you use and the sizes?
I had bad nasal bridge pressure sores from some of the nasal masks I used, and from my two Full Face masks... I found that with my current FF mask I have to modify the area around the nose with scissors. And I always use a piece of cloth under the mask, I cut them out of a sports shirt I had around, 88% polyester 12% spandex, it is soft and helps stop air leaking and does not have as much lint as a tshirt. There are also pads and cushions available, check out cpap.com... fyi I tried a gecko pad but it made more leaks for me, but some people love them.
When I used nasal pillows I had to be sure to blow my nose and also carefully dry the area that the silicone cushion came in contact with. I also had to use humidity to avoid drying in my nose. It takes some fiddling around to get the pillows in just right...
I too felt short of breath when I had a high pressure setting I think it may have to do with the lungs, and muscles, working harder to breath out causing everything to be a little worn out... but make sure to discuss that with your doctor because it could be something else.
Hope you can find the mask that works for you without too much trouble. And if you haven't gotten a cpap machine yet everyone here will recommend getting a data capable one. I use a resmed s9 vpap, it is nice because it lowers the pressure when one breaths out so it feels more natural and comfortable.
Have a great day.

simplyme

If the nasal pillow mask caused pain or leaked excessively....they weren't fitted properly...either straps were way too tight or the wrong size of nasal pillow. Do you know which nasal pillow mask they tried to use? They aren't all the same...believe me.
I bet he had them way too tight and probably wrong size too.

My titration study was the sleep study from Hell also. If that had been what using the mask and machine was going to be like in real life from now on...I wouldn't have even bothered.

In real life it isn't that difficult and it will be easier.
You might want to look at the SleepWeaver Elan mask....cloth so it won't decimated the nose.

I have a nasal pillow mask and the strap placement on my head looks nothing like the pictures. I first put the mask on as the picture shows. Nose hurt. I saw posts that said I may have had the straps too tight. I messed with the straps and I was able to get the nasal pillows to fit in my nose just right but the strap across the top of my head is actually across my forehead just at the hairline and the both straps are a lot more loose than I thought I could get away with. I actually woke up this morning and didn't think I had the mask on it was so comfortable. It helps if you can place the hose in such a way it is not pulling on your mask. I have my mask tube attached to the strap across my forehead so it looks like a snorkel going up the bridge of my nose but not touching it. I then stuck a hook in the wall above my head and the hose dangles from that by para cord. This set up helps my stabilize the mask.

My titration was a nightmare!!! Inexperienced tech strapped on a poor fitting nasal mask WAY to tightly!! I was in so much pain I kept waking up during the study and was crying at one point.

Actually using my machine at home is nothing like that! I use the Sleepweaver Elan cloth mask and also tried the Swift FX for her. Both are soft and comfortable. It will be all right - hang in there

I cannot thank you all enough for the replies. I feel so much better just reading them. I think my feeling earlier was a combination of anxiety, fatigue, and caffeine. Feeling more like myself now, just super tired. My ENT already has the results from last night and should call me this afternoon with the next step, which should be getting the machine and mask for home. This whole process is really confusing. My ENT referred me (at my request) to the Sleep Center. Apparently she insists all her referrals get their information from her. Meanwhile, the sleep center doc also wants to see me. When I left this morning the tech said they'd be in touch after the Dr reads the results and set me up to come back in to their office to get my machine and mask. My ENT led me to believe they'd suggest DME's. Sheesh. Such a runaround.

Just want to reinforce what was said about not accepting a machine that doesn't give you the treatment (efficacy) data you need. If it is a ResMed machine, accept nothing with Escape in its name. If it is Respironics, nothing with Plus in its name. Call before going in and ask the complete and specific name (Brand and Model) of the machine they intend to dispense so as to avoid getting there and feeling pressured to nake a quick uninformed decision just to "see how it goes". Also, ask for a copy of your sleep report - not just the 1-2 page summary. It should be several pages and break down position, oxygen levels, sleep stages, etc.

The titration night is likely not representative of how you will do at home. Whatever mask you use, report any specific problems here and other users who have mastered the idiosyncrasies of that mask might have some tips for you. Good luck going forward.

Time to do a bit of reading so you know what you are up against with DMEs and machines and such.
http://maskarrayed.wordpress.com/what-y ... me-part-i/

http://maskarrayed.wordpress.com/

I would suggest contacting your insurance company and get yourself educated on how they do things and which DME is in your insurance network (assuming you have a preferred network list). Don't rely on anyone else to get this information for you...DMEs don't always tell the truth.

The DME that your doctor wants you to use...they might be top of the line so don't rule them out totally just because the doctor pushes them. Just always have Plan B on the back burner in case they want to give you trouble about what you want.

I know when I first started with cpap a few years ago, my chest felt very sore, as if I'd been coughing non-stop or something. It was a weird sensation, almost like being short of breath after running. I don't get it anymore, unless they increase my pressure, and then it's not as much. Small price to pay for a good night's sleep in the long run!

However, I also get the same sensation when I'm coming down with a cold or pnuemonia. Sooooo....

Like has been mentioned, check with your doc to rule out anything like that. One thing to keep in the back of your mind, is that you've now got this pressurized air pushing stuff down your windpipe, out your ears, etc. You need to pay attention to things like colds, sinus infections, etc, to make sure you don't end up with secondary infections. For the longest time I was getting recurring ear infections, and finally a different doc told me that "Oh, that's common with cpap users." Not that he had any suggestions to prevent it, but at least I didn't feel like a hypochondriac anymore. lol Using a neti-pot to keep sinuses clear a little while before bedtime has done wonders for me. I haven't had that problem in months now.


Regarding getting your new machine and masks: Oh, I hated the mask they made me wear during my last titration. I love my mask I have now at home, but of course I couldn't wear that because it wasn't standardized. I was thinking, but this is what I'm going to be using every night, shouldn't you test with it? whatever.

So when I was going to be getting my first mask and machine, the sleep center wasn't very helpful in recommending a mask. But the DME they sent out to my home to deliver the machine and mask WAS helpful. I called them and told them what I had looked at online and what I thought I could wear and what I know didn't work after that night at the sleep center. I didn't get my way on the machine, as my insurance only had a limited selection they'd pay for. But they brought out at least a dozen different types of masks, nasal/full face/ pillows, and helped me try them on with the machine and everything until I narrowed it down to two masks. They let me try those two for free for 60 days until I decided which one worked best.

My last DME did that as well, as I wanted to switch to nasal pillows type masks, because I was having trouble with pressure on my sinus areas. I ended up with the Nasal-Aire II which I love love love.

Definitely ask the DME or whoever is providing your mask to give you a selection to choose from, and to be able to try them on WITH the cpap running (have a pillow handy to squish against whichever side of your face you sleep on). And if you can't decide between two, ask to try them for a month or so before they bill your insurance. Might turn out you don't like either one, and need to ask for different ones to try. But don't give up -- just keep trying different ones until you finally find that perfect one.

Didn't even have a titration study...my sleep study was such a nightmare, that my doctor decided to just put me together with some good equipment and try some initial settings using his past experience as a guide (he's very experienced and respected in the area). Starting from there, my AHI was about 1.6 statistically for the first month, so I guess we both got lucky. Since then I've done some tuning, and my AHI generally runs around 1, more or less. So I'm happy that I didn't have to put up with another study, especially after what I read here about people being turned off by ill-fitting masks. Seems like titration studies often are more frustrating than they're worth, even put some people off cpap, although apparently some have a good result.

I've read a few postings from people that say that it was their best sleep for a long time, at their titration study, but I wonder if it's really worth it. It isn't done where you'll be using your cpap, and most likely not the mask that you'll end up with, anyways (seems like). There must be a better way to get there.

When they called to make my appointment for titration (we didn't do a split night the first time) the Tech who did my earlier study was such a wonderful person I requested that she do my titration. They were like "Well, OK, we usually don't get requests, but she is working that night...". She is a very patient, soft-spoken low-key person who really was able to put me at ease and understood that I was NOT OK with having that "thing" strapped to my face. the 39 wires and 2 straps around my chest were bad enough, now I was getting "The Blower".
Some things were different from an earlier study about 9 years ago, this time, she tried me on straight CPAP for only about 5 minutes and when I complained about the effort to exhale, immediately switched me to BiPAP. they didn't do that in the long-ago study, nor did they reset to Ramp when I woke up to go to the bathroom. They did that this time, even though I only needed to get up once.
It took me 4 hours to fall asleep. I was used to staying up past midnight, but I figured the sooner I went to bed, the sooner I'd be freed from the torture device. We started off with a full-face mask, I think a Mirage, and that was OK, except it kept climbing up my face and leaking into my eyes. So she put a Quattro on me and I finally fell asleep and slept 4 hours straight. She told me she got a good solid 4 hours of data.
So much different from the early study..
I've been on it a month and I'm now fully compliant, get between 5 and 8 hours of sleep with the machine, don't use the ramp feature any more and when I wake up in the morning I don't feel like I have any pressure on. I have to pull on the mask to check. My biggest problem is getting my butt in the bed early enough to get more than 6 hour's worth.

My sleep tech was awesome. We chatted as she wired me up, and that helped put me at ease. She asked if I was a mouth breather or nose breather, and I told her mouth, definitely. She fitted me with the Quattro FX. I didn't know the name. I actually looked it up later and printed off a photo to take with me to the DME. She fitted it perfectly, so it never leaked.

I did the split night study, and during the diagnosis phase, I woke up and had to use the bathroom. About an hour in. I was lying there embarrassed, and thinking should I try to sleep again (knowing I couldn't) or should I speak up and ask the tech to come unhook me. Bless her heart. I realized later that she must get this a lot. She came in, saying that she noticed I was awake and needed to adjust a wire. All of my data was fine, so I think this was an icebreaker so that I could ask for the bathroom. She probably sees people awake and knows they don't want to ask for stuff.

Later, once I met the criteria for the titration pahse, she woke me up gently, told me they had enough data, and asked if I would like to use the bathroom before starting the titration phase (smart tech). Then she hooked me up, I rolled over, and I woke up 5-6 hours later.

Not only did she give me a really good sleep study with accurate results; she also set me up to start well with cpap. I had a good experience with a well fitting mask and no problems. Even though I did have problems at first with the mask, I knew it would work well because it already had. So, that helped me keep at it.

pandatx wrote:I really wanted the Nasal Pillows type mask but doesn't look like that works for me but I don't want to have a sore on my face all the time.

Hi,

How about trying a different nasal pillow mask? Every face is different, and different people have success with different masks. I have tried 5 different nasal pillow masks. Only the Swift LT worked for me. Others have great luck with the Swift FX, but I couldn't get it to work at all for me. Even though the LT isn't perfect, the freedom and comfort that it offers me is well worth the extra effort and sometimes hassles. I am looking forward to trying the Aloha next...other folks here have given it great reviews. Another option for you might be a hybird mask.

-john-

So, how do you know what mask will work for you? I mean, say you choose one and use it for a few weeks and its not working? Do you just keep buying different ones online (w/o trying on or anything) until you find one that works?