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Re: Husband....New to CPAP....help, please
Posted: Tue Jul 01, 2014 1:12 pm
by archangle
Don't be too afraid of the word "central." Centrals may be harder to eliminate, but aren't necessarily more harmful.
Zoom in on his graphs, see how long the centrals are, how completely he stops breathing, how close together they are, etc. If you stop breathing completely for 45 seconds, that's a lot worse than an apnea where you stop breathing for 11 seconds. Or if you get at least a few shallow breaths in the middle of what the machine calls an apnea.
By the way, why does he have a full face mask? Some lazy DME's just give everyone a FFM, which should only be used if the patient has some problem with nasal masks.
Re: Husband....New to CPAP....help, please
Posted: Tue Jul 01, 2014 2:48 pm
by robysue
Taz,
If hubby is still really restless and fighting the mask at times, I'd be willing to assume that those CAs are sleep/wake/junk (SWJ) breathing that's being scored as a CA, but may not even be a "real" event in the sense of what gets scored on a PSG
First night's data: Almost all the CAs scored were after the 4:00 and you said hubby may have been awake or "sort of awake" since his alarm goes off at 4:50.
Second night's data: The bulk of the CAs are scored in the first session (20:15 to 21:15) and after 4:00AM. It really looks to me like hubby never really got to sleep during the first session. Was he tossing and turning and fiddling with the mask between 20:15 and 21:15? Was he AWAKE but consciously trying NOT to toss and turn and fiddle with the mask? And again, it looks like the after 4:00AM stuff may be SWJ creeping in as hubby is half-dozing and starting to wake.
If this were my hubby, I'd be assuming for now that the CAs are mainly SWJ and that they'll start to disapper once he's more comfortable with the mask. And I'd have hubby track how restless he is at night. Nothing very formal or huge, but just a quick answer to "Do you remember being awake for any period of time after masking up?" each morning. If the number of CAs remains really high after a month or so of PAPing, it may be time to ask his sleep doc about them.
Re: Husband....New to CPAP....help, please
Posted: Tue Jul 01, 2014 7:24 pm
by Taz
archangle wrote:Don't be too afraid of the word "central." Centrals may be harder to eliminate, but aren't necessarily more harmful.
Zoom in on his graphs, see how long the centrals are, how completely he stops breathing, how close together they are, etc. If you stop breathing completely for 45 seconds, that's a lot worse than an apnea where you stop breathing for 11 seconds. Or if you get at least a few shallow breaths in the middle of what the machine calls an apnea.
By the way, why does he have a full face mask? Some lazy DME's just give everyone a FFM, which should only be used if the patient has some problem with nasal masks.
Hi Archangle,
Yes, it was a lazy DME but the full face mask was my husband's doing. He says he's a mouth breather because of all the years of heavy snoring. But...now he's not snoring so is he still a mouth breather?? He doesn't seem to want to explore the possibility so I guess it's a FFM.
Taz
Re: Husband....New to CPAP....help, please
Posted: Tue Jul 01, 2014 7:31 pm
by archangle
Taz wrote:Hi Archangle,
Yes, it was a lazy DME but the full face mask was my husband's doing. He says he's a mouth breather because of all the years of heavy snoring. But...now he's not snoring so is he still a mouth breather?? He doesn't seem to want to explore the possibility so I guess it's a FFM.
Taz
He might or might not still be a mouth breather. A chinstrap might help. It's probably easier to fix leaks (other than mouth leaks) with a nasal mask.
However, if he makes the FFM work for him, go with it.
Re: Husband....New to CPAP....help, please
Posted: Tue Jul 01, 2014 8:37 pm
by jencat824
Taz,
You mentioned his size from the fit guide looks more medium than large. My hubby was initially fitted with a large & his first three masks were large - all leaked. When trying another mask, DME wrongly sent a medium. They then sent the large & I was going to return the medium. Well, day two of new large mask, he woke up middle of the night very frustrated. He wanted to know if I sent the medium back & luckily I hadn't. The medium was a perfect fit. He loved that mask, absolutely no leaks, however the way that mask was made did leave nose bridge sores. So he tried the F10, size medium & loves it, no leaks, no sores or strap marks.
Now I know your hubby is having his problems with the F10, so I would suggest he either try a medium, or try another mask in a medium. Everyone's face is different, but perhaps he is actually a medium. My hubby is a real big guy, so everyone assumed he was large, so if not by a dumb-luck-mistake, he would still fighting leaks. That said, if he is going to try another mask, getting the fit parameters for it, or even better a template, could confirm sizing.
Hang in there, he will find the right mask with help from you.
Jen
Re: Husband....New to CPAP....help, please
Posted: Wed Jul 02, 2014 5:47 am
by purple
While I hate to do it myself. Shaving, washing the face before going to sleep seems to help. Also, when I get up in the morning, I shave, shower, then before drying my face, I put oil on it. This way my skin is more pliable when I crash out at night. Yes, nearly any oil my skin likes is not good for the silicon mask, meaning it makes the silicon on the mask less pliable.
Re: Husband....New to CPAP....help, please
Posted: Wed Jul 02, 2014 8:43 am
by Taz
robysue wrote:Taz,
If hubby is still really restless and fighting the mask at times, I'd be willing to assume that those CAs are sleep/wake/junk (SWJ) breathing that's being scored as a CA, but may not even be a "real" event in the sense of what gets scored on a PSG
First night's data: Almost all the CAs scored were after the 4:00 and you said hubby may have been awake or "sort of awake" since his alarm goes off at 4:50.
Second night's data: The bulk of the CAs are scored in the first session (20:15 to 21:15) and after 4:00AM. It really looks to me like hubby never really got to sleep during the first session. Was he tossing and turning and fiddling with the mask between 20:15 and 21:15? Was he AWAKE but consciously trying NOT to toss and turn and fiddle with the mask? And again, it looks like the after 4:00AM stuff may be SWJ creeping in as hubby is half-dozing and starting to wake.
If this were my hubby, I'd be assuming for now that the CAs are mainly SWJ and that they'll start to disapper once he's more comfortable with the mask. And I'd have hubby track how restless he is at night. Nothing very formal or huge, but just a quick answer to "Do you remember being awake for any period of time after masking up?" each morning. If the number of CAs remains really high after a month or so of PAPing, it may be time to ask his sleep doc about them.
Robysue,
You're analysis is spot on!!!! I went over his data with him and he said he was awake the first hour or so and was definitely awake at 4am. He said it was a miserable night and he got little or no sleep. We received the RemZzzzs liners, yesterday. He looked at them, read the instructions and said he would try them, later on. Shssssssh...Mr. Taz is stubborn & very hard headed. I'm sure he sees the liners as just something else he will have to adjust to and lose sleep over. We have a long weekend coming up so....he will try them! Here's his data from last night....he did much better but says he still was awaken several times due to leaks.

Re: Husband....New to CPAP....help, please
Posted: Wed Jul 02, 2014 10:01 am
by Taz
jencat824 wrote:Taz,
You mentioned his size from the fit guide looks more medium than large. My hubby was initially fitted with a large & his first three masks were large - all leaked. When trying another mask, DME wrongly sent a medium. They then sent the large & I was going to return the medium. Well, day two of new large mask, he woke up middle of the night very frustrated. He wanted to know if I sent the medium back & luckily I hadn't. The medium was a perfect fit. He loved that mask, absolutely no leaks, however the way that mask was made did leave nose bridge sores. So he tried the F10, size medium & loves it, no leaks, no sores or strap marks.
Now I know your hubby is having his problems with the F10, so I would suggest he either try a medium, or try another mask in a medium. Everyone's face is different, but perhaps he is actually a medium. My hubby is a real big guy, so everyone assumed he was large, so if not by a dumb-luck-mistake, he would still fighting leaks. That said, if he is going to try another mask, getting the fit parameters for it, or even better a template, could confirm sizing.
Hang in there, he will find the right mask with help from you.
Jen
He Jencat,
I agree with you, I suspect his F10 mask is a little to large but he doesn't seem to agree and is not open to trying the medium. I'm going to give him a chance to try the mask liner and if that doesn't lessen the leaks, I may just order a F10 medium and insist he try it. He's very stubborn but I can also be very "pushy" about things.
Taz