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Too tall wrote:So with this added information above, can I pose the question again, is the concept of having an oximeter with an alarm set at a high level aid replace the need for the CPAP.

Hi Too tall -- I've been thinking about your situation and your question. I'd say that using an oximeter like you described does not replace the need for CPAP because CPAP is meant to treat sleep disordered breathing by preventing as many apnea events as possible -- this is how CPAP keeps your O2 levels from falling. An oximeter with the alarm set could also keep your O2 levels from falling below the level you set, but would not be treating the sleep disordered breathing. So technically the answer to your question is partly yes and partly no.

I think I understand what you're trying to do here. You're looking for a next best solution for the problem of O2 desaturations since you're having bad skin reactions to the mask (which BTW is usually silicone, not latex). And for sure your poor skin needs to heal. Forgive me if I missed this, but did you try a nasal pillow mask along the way?

In the end, I believe using only an oximeter as you described will be too problematic. Not only does it not replace CPAP but it will be causing harm over time to have your sleep interrupted so many times by the alarm. Maybe not right away, but fractured and fragmented sleep also takes a toll on health over time. So even if your O2 levels are staying above 88% or whatever level you have set the oximeter at, the interrruptions of your sleep cycles can take their own toll on your health. And the higher you set the alarm level, the greater the number of times that alarm will wake you up.

An oximeter can be a useful tool, though. It will give you information when you're experimenting with different sleeping positions, for example. I could imagine using it the way you described if I had to go a few nights in order for my skin to heal, or for some other temporary situation. But to the degree that it starts robbing you of deep stage sleep, it would likely make any existing health problems worse over time and would therefore not be a viable long term solution (i.e. replacement for cpap). I know you said that you felt like you were sleeping well before your diagnosis, but on the other hand you also said that your AFIB was caused by your apnea. So it wasn't a benign situation even though you felt like you slept well.

I hope this is the kind of feedback you're asking for. I respect you for trying to do some creative problem solving under the cirumcstances -- often people with less severe skin irritation than we see in your photo simply give up altogether, and you are here trying to think this through and ask for help. I'm glad you came back with your concerns.

Too Tall:
here are links to mask liners and fabric masks to manage your silicone irritation.
http://www.padacheek.com/
https://www.cpap.com/productSearch.php? ... leepweaver

It is a good initial idea as a temporary work around, but there are some issues with it...

When you stop breathing while asleep your oxygen concentration drops. Having an alarm to signal you will minimize the drop and you should end up with better minimum oxygen levels.

However, there is a good chance that you stop breathing when you fully relax in the deeper, restorative, stages of sleep. Having an abrupt awakening jolt every time you start to enter deep sleep may impose additional stress on your body.

The cardiac system is damaged due to having to continually process the hormones the body produces that jolt you awake when you stop breathing. While there may be some damage from the actual drop on O2 levels, processing the hormones does more damage.

While stopping breathing and having your body kick start you back up is an internal process, I am not sure replacing that with an external alarm will eliminate all the bad side effects. I can tell you that the alarm is loud and in the quiet of sleep it is very startling.

Still, it is worth trying.

The best bet is to find a way to eliminate the irritation of your mask, but that may take some time to figure out.

If your cardiologist will work with you, you can dial in a sweet spot that balances the wake ups with a decent minimum oxygen level. Depending on elevation 88-90 are good minimum levels to try, but your doctor may want to explore something a little lower in an effort to minimize the amount of times the alarm goes off.

If you are interested you can also set a pulse rate alarm...

The best solution is to find a mask or pillows that will work, but the Oximeter can offer a less than glamorous work around.

Give the oximeter a try. I have done something similar. One thing to note is if your in deep/good restful sleep you will likely never hear the alarm when it goes off or just ignore it or turn it off and go back to sleep without resetting it. As long as you can get by in light sleep where your on guard and some what aware, you will be Ok with the Oximeter. You can do this for awhile and its pretty miserable I think. You have to keep on guard and keep the anxiety high. There is a built in biology mechanism for this. You do pay a price over time as you will fall asleep easily in any situation that is calming or relaxing. You can do light sleep when your young but I don't think you can go to long when your old. Going without restful sleep doesn't allow the body to regenerate itself and so you come down with other ailments until the problems converge and it kills you. Before these cpap machines and being aware of the need for sleep, I would bet most people died of heart attacks or car accidents. Give the oximeter a try. Try to figure out what it is about the mask that is causing your problems. If your allergic to silicon try putting tape over the silicone or making a piece of fabric so that the silicon doesn't touch you. How bad are your leaks? I assume you clamp the mask down pretty tight to deal with the air leaks.

borgready wrote:Give the oximeter a try. I have done something similar. One thing to note is if your in deep/good restful sleep you will likely never hear the alarm when it goes off or just ignore it or turn it off and go back to sleep without resetting it. As long as you can get by in light sleep where your on guard and some what aware, you will be Ok with the Oximeter. You can do this for awhile and its pretty miserable I think. You have to keep on guard and keep the anxiety high. There is a built in biology mechanism for this. You do pay a price over time as you will fall asleep easily in any situation that is calming or relaxing. You can do light sleep when your young but I don't think you can go to long when your old. Going without restful sleep doesn't allow the body to regenerate itself and so you come down with other ailments until the problems converge and it kills you. Before these cpap machines and being aware of the need for sleep, I would bet most people died of heart attacks or car accidents. Give the oximeter a try. Try to figure out what it is about the mask that is causing your problems. If your allergic to silicon try putting tape over the silicone or making a piece of fabric so that the silicon doesn't touch you. How bad are your leaks? I assume you clamp the mask down pretty tight to deal with the air leaks.

And that should really help with the afib - not.

BlackSpinner wrote:

Too tall wrote: Ok, so let's say that I don't care if the alarm wakes me up 8 times an hour or whatever. Just accept that I want to put up with the frequent interruptions in sleep. Call me crazy. I was sleeping fine before I did the sleep test. The sleep test was mandated by the surgeon prior to my heart procedure for AFIB. So my only goal is to make sure I don't drop below 88% O2 level which seems to be the accepted lower limit of O2. My AHI I believe it's called was 8. I tried different mask and to no avail. Maybe I'm allergic to the latex, I don't know but my face is blistered.
.

Yes it is silly to think that getting woken up 8 times an our will give you any kind of sleep or help your afib.

Stop being in denial and get your act together or make sure you have good insurance and a will to take care of your dependents. This is not rocket science, kids of 4 can do it successfully. Teenagers manage it ok and even have sleep overs.

It took me all of 5 minutes, after the first time I wore my mask and got the same results as you, to do a search and find the solution, a mask liner.

I guess you didn't see the picture of my face or you didn't read my post. Your reply in not relevant to my questions?

Stormynights wrote:

Too tall wrote:

Stormynights wrote:You should reread your post to see how silly it sounds. Just get a mask and machine and get you heath back on track.

You are very rude and you don't know what I'm dealing with. Take a look at a picture I took of myself one morning just waking up. Yea, it's ugly but you say just get a mask and move on. I've been fighting this a month and have worn the mask every single night, look at my face lady. I'm not giving up, that's why I'm on this forum looking for advise. Still think I"m silly? Maybe ignorant, but not silly, I'm just looking for a solution.

https://plus.google.com/u/0/photos?pid= ... 8685784160

I do apologize for sounding rude. I meant no harm but I am now always good at expressing myself. I know what it is like to struggle trying to find the right mask. Pad A Cheek helps a lot of us. You need and deserve a good night's sleep. I wish you sweet dreams.

Thank you, I appreciate that reply.

It has been mentioned several times, but I don't see where you have answered specifically.

Have you tried a mask with pillows?

Have you tried using a mask liner?

If those didn't work, can you tell us what happened? They seem like the obvious choices, so it is hard to suggest anything else if we don't know why those haven't been tried or haven't worked.

BlackSpinner wrote:

borgready wrote:Give the oximeter a try. I have done something similar. One thing to note is if your in deep/good restful sleep you will likely never hear the alarm when it goes off or just ignore it or turn it off and go back to sleep without resetting it. As long as you can get by in light sleep where your on guard and some what aware, you will be Ok with the Oximeter. You can do this for awhile and its pretty miserable I think. You have to keep on guard and keep the anxiety high. There is a built in biology mechanism for this. You do pay a price over time as you will fall asleep easily in any situation that is calming or relaxing. You can do light sleep when your young but I don't think you can go to long when your old. Going without restful sleep doesn't allow the body to regenerate itself and so you come down with other ailments until the problems converge and it kills you. Before these cpap machines and being aware of the need for sleep, I would bet most people died of heart attacks or car accidents. Give the oximeter a try. Try to figure out what it is about the mask that is causing your problems. If your allergic to silicon try putting tape over the silicone or making a piece of fabric so that the silicon doesn't touch you. How bad are your leaks? I assume you clamp the mask down pretty tight to deal with the air leaks.

And that should really help with the afib - not.

kaiasgram wrote:

Too tall wrote:So with this added information above, can I pose the question again, is the concept of having an oximeter with an alarm set at a high level aid replace the need for the CPAP.

Hi Too tall -- I've been thinking about your situation and your question. I'd say that using an oximeter like you described does not replace the need for CPAP because CPAP is meant to treat sleep disordered breathing by preventing as many apnea events as possible -- this is how CPAP keeps your O2 levels from falling. An oximeter with the alarm set could also keep your O2 levels from falling below the level you set, but would not be treating the sleep disordered breathing. So technically the answer to your question is partly yes and partly no.

I think I understand what you're trying to do here. You're looking for a next best solution for the problem of O2 desaturations since you're having bad skin reactions to the mask (which BTW is usually silicone, not latex). And for sure your poor skin needs to heal. Forgive me if I missed this, but did you try a nasal pillow mask along the way?

In the end, I believe using only an oximeter as you described will be too problematic. Not only does it not replace CPAP but it will be causing harm over time to have your sleep interrupted so many times by the alarm. Maybe not right away, but fractured and fragmented sleep also takes a toll on health over time. So even if your O2 levels are staying above 88% or whatever level you have set the oximeter at, the interruptions of your sleep cycles can take their own toll on your health. And the higher you set the alarm level, the greater the number of times that alarm will wake you up.

An oximeter can be a useful tool, though. It will give you information when you're experimenting with different sleeping positions, for example. I could imagine using it the way you described if I had to go a few nights in order for my skin to heal, or for some other temporary situation. But to the degree that it starts robbing you of deep stage sleep, it would likely make any existing health problems worse over time and would therefore not be a viable long term solution (i.e. replacement for cpap). I know you said that you felt like you were sleeping well before your diagnosis, but on the other hand you also said that your AFIB was caused by your apnea. So it wasn't a benign situation even though you felt like you slept well.

I hope this is the kind of feedback you're asking for. I respect you for trying to do some creative problem solving under the cirumcstances -- often people with less severe skin irritation than we see in your photo simply give up altogether, and you are here trying to think this through and ask for help. I'm glad you came back with your concerns.

Thank you very much for your reply. This is the first reply I've gotten that actually has some substance. The CPAP people say, you've got to sleep without it so your can heal. I'm scare to do that without some sort of backup plan as I don't want to do anything to jeopardize the ablation procedure I had on the heart. I think it my heal if I left the mask off long enough but as soon as I start wearing it, I'll be back in the same situation.

I'm on my 4th mask, this time it's the nasal time you mentioned and I think it is going to work. My face is healing anyway. I'd like to do a O2 test as I'm waking up with a dry mouth and I know that's not good.

thanks for your very informative answer.

borgready wrote:Give the oximeter a try. I have done something similar. One thing to note is if your in deep/good restful sleep you will likely never hear the alarm when it goes off or just ignore it or turn it off and go back to sleep without resetting it. As long as you can get by in light sleep where your on guard and some what aware, you will be Ok with the Oximeter. You can do this for awhile and its pretty miserable I think. You have to keep on guard and keep the anxiety high. There is a built in biology mechanism for this. You do pay a price over time as you will fall asleep easily in any situation that is calming or relaxing. You can do light sleep when your young but I don't think you can go to long when your old. Going without restful sleep doesn't allow the body to regenerate itself and so you come down with other ailments until the problems converge and it kills you. Before these cpap machines and being aware of the need for sleep, I would bet most people died of heart attacks or car accidents. Give the oximeter a try. Try to figure out what it is about the mask that is causing your problems. If your allergic to silicon try putting tape over the silicone or making a piece of fabric so that the silicon doesn't touch you. How bad are your leaks? I assume you clamp the mask down pretty tight to deal with the air leaks.

The leaks are not really that bad, I can understand why my face can't handle the silicon or whatever. I'm on warafin temporarily and I think maybe that may make me more sensitive to the abrasive effects of the mask. I just got a nasal type and I'm going to give that a try. I"m optimistic as it only touches in the nostrils. Thanks for the feedback.

HoseCrusher wrote:It is a good initial idea as a temporary work around, but there are some issues with it...

When you stop breathing while asleep your oxygen concentration drops. Having an alarm to signal you will minimize the drop and you should end up with better minimum oxygen levels.

However, there is a good chance that you stop breathing when you fully relax in the deeper, restorative, stages of sleep. Having an abrupt awakening jolt every time you start to enter deep sleep may impose additional stress on your body.

The cardiac system is damaged due to having to continually process the hormones the body produces that jolt you awake when you stop breathing. While there may be some damage from the actual drop on O2 levels, processing the hormones does more damage.

While stopping breathing and having your body kick start you back up is an internal process, I am not sure replacing that with an external alarm will eliminate all the bad side effects. I can tell you that the alarm is loud and in the quiet of sleep it is very startling.

Still, it is worth trying.

The best bet is to find a way to eliminate the irritation of your mask, but that may take some time to figure out.

If your cardiologist will work with you, you can dial in a sweet spot that balances the wake ups with a decent minimum oxygen level. Depending on elevation 88-90 are good minimum levels to try, but your doctor may want to explore something a little lower in an effort to minimize the amount of times the alarm goes off.

If you are interested you can also set a pulse rate alarm...

The best solution is to find a mask or pillows that will work, but the Oximeter can offer a less than glamorous work around.

Thanks very much, I'm not going to give up on the cpap but would like to have something for a backup while my face heals a little. The sleep doctor put me on a belt that doesn't allow you to sleep on your back since my sleep test showed no apnea while on my sides. However when I got the belt, I had more O2 drop than without it. He told me to go back to the CPAP so I did. After 3 mask, I received a nasal pillow, I guess it called, and this might be the answer. I'll know in a few days. thanks for the info.

zoocrewphoto wrote:It has been mentioned several times, but I don't see where you have answered specifically.

Have you tried a mask with pillows?

Have you tried using a mask liner?

If those didn't work, can you tell us what happened? They seem like the obvious choices, so it is hard to suggest anything else if we don't know why those haven't been tried or haven't worked.

I just got the nasal pillow and it looks like this might be the answer, I've on had it a few days but I am waking up with a dry mouth. But I did that with the other mask also. I didn't try a liner, I did try some sort of silicon pad they gave me but the leak was too much. thanks for your opinion.

Definitely the warfarin will make your skin fragile.
I have tried the Pad a Cheek liners, and they are so soft, and even quieter than naked silicone.
You can cut a gasket out of old, clean t-shirt fabric--just trace around the cushion
and then add a bit all around and inside before cutting. (maybe a half inch)
Never cut with the cushion nearby--you can nick the cushion (or is that just me?)
A liner is also nice and warm when that helps--but cool and dry when that matters.

Too tall wrote:Thank you very much for your reply. This is the first reply I've gotten that actually has some substance. The CPAP people say, you've got to sleep without it so your can heal. I'm scare to do that without some sort of backup plan as I don't want to do anything to jeopardize the ablation procedure I had on the heart. I think it my heal if I left the mask off long enough but as soon as I start wearing it, I'll be back in the same situation.

I'm on my 4th mask, this time it's the nasal time you mentioned and I think it is going to work. My face is healing anyway. I'd like to do a O2 test as I'm waking up with a dry mouth and I know that's not good.

thanks for your very informative answer.

You're welcome Tt. I'm glad you're already trying a nasal pillow mask. Two additional thoughts for the sensitive skin issue:

-- The skin where the nasal pillows enter the nostrils is "virgin territory" -- not used to friction -- a lot of folks use a little dab of pure grade lanolin on the skin to help prevent soreness and chafing. Some use it with the mask at night (just a tiny bit) , some also dab a little on during the day. This is what most of us use, Lansinoh.



You can usually find it in the drugstore baby aisle with breastfeeding supplies. Pure grade lanolin does not degrade silicone. It helped me when I was starting with cpap but I no longer need to use it.

-- Also, I discovered early on that not all silicone is created equal. I found the silicone on the Swift FX mask irritated my skin but I did not have this problem when I switched to the Aloha. Just something to file away in case your first NP mask is too irritating.

Hang in there.

TT,

Sorry if you covered this but have you tried a sleep weaver cloth elan mask? Not sure how it would work with your irritated nose but maybe once it is healed, this could be a good solution? Also, I would look at the Sleep Weaver FF Anew mask which might help.

I definitely understand your situation regarding the choices you have to make. Hopefully, you can find a good solution that enables you to start sleeping on the machine again.

49er