When I had my sleep study they told me I could bring my own pillow.  So, I showed up with my wedge pillow (props upper body up some) and they said I couldn't use it as it would effect the sleep study -- the wedge pillow tended to help keep the airways open.  (well, yes).

Sleep study showed I had mild apnea, though that led to "moderate fragmentation of sleep continuity and oxygen desaturations to 86%"  Sleep Efficiency was 56.  I was in atrial fibrillation at the time and don't know how that affects the results (I understand that there has been some study that shows atrial pacing helps apnea, so maybe my afib was doing that for me!)

Anyhow, I am curious whether anyone has done a sleep study with and without a wedge pillow.  I know that I cannot sleep well without it, so perhaps it does help with the apnea.  If it does the trick, it certainly seems easier than the CPAP machine.

Second issue, and I have read the faqs on it here, etc. I went in and got fitted for a mask though the fitting was not nearly what I would have asked for now that I've read more.  My doctor likes you to get used to the mask before doing the CPAP titration study, so I am supposed to try sleeping with the mask on.  My first night I woke up with these large welts on my cheeks.  It took 4 hours for them to go away and the skin around my nose/cheek is quite red still.  It feels irritated and sort of numb.  Last night I tried the mask again, but the pressure and heat of the mask on the irritated skin was very uncomfortable and I took it off.  I am really very depressed about this as I did want to try the CPAP and see whether it would help me.  I have had severe atrial fibrillation for the last year or so, nothing seems to help it, and my pulmo was the one that thought perhaps I had apnea.  I knew I was tired all the time, but blamed it on meds and the afib, nothing else.  Now I'm wondering whether my little wedgie pillow is all there is (which means that I won't get my afib helped as I was already using that).

One thought is that it could be the pillow that is making so much pressure on the face.  I tried hanging over the pillow, but it really seems to me that it is just the weight of the mask when you are on your side, you can feel it mashing your face (well, I didn't notice it until the skin there was so irritated).  I am definitely a side sleeper -- maybe with CPAP I can change, but I cannot sleep on my back.

I hope someone has some encouraging words here -- I need them.  I called the guy who fitted the mask and haven't heard back from him though he said to "call if I had any questions".

I do feel a little at my wits end.  

Judy

I had welts, and even started to get a callous on my upper lip--- my headstraps were too tight.  I treat the irritated skin (which then healed up nicely) with a high end cosmetic product for chapped lips-- works great on nostrils, too.  Once I loosened the straps a little, I stopped looking like I'd been wearing a scuba mask all day.  I sleep on my side, with my mouth closed-- sometimes I need the left side of the mask strap pulled closer to my nose than the right side, but it works. And I have breathed through my mouth for the last 50 years-- used to drool so much I'd wake myself up.  Good luck!

I would have some concerns about sleeping with a mask that isn't hooked up to continuous airflow.
Masks exhalation ports are designed to wash out the exhaled CO2 in combination with the airflow.  Did he have you make some allowance for adequate ventilation of carbon dioxide?  
  As for your question regarding the wedge, gravity factors into the apnea equation.  Sleeping elevated and/or on your side may reduce the number and/or duration of apneas and hypopneas.  Many people find breathing while sleeping easier when sitting in a recliner.  However, positional therapy alone would not be adequate treatment for most people.  
  As for the face soreness, first loosen the straps.......and there are many styles of masks that put less pressure on your face.  When you go for your titration ask to see the activa and a nasal pillow system like breeze or swift, which do not seal around the nose, but only at the nostril opening.
  As for the pillow pressing against your mask, there is a pillow designed for side sleepers who use cpap, just google, or froogle for PAPillow. It is shaped to allow for sleeping with mask over the curved edge like you mentioned.  Some cpap side sleepers also like memory foam or buckwheat hull pillows or even the ones with microbeads.  Down pillows are also more shapable than fiberfill pillows if you have no allergies.

Hi Judy,

Your wedgie probably isn't going to make a big difference with your OSA.  I sleep on and off a wedge too and had my recent sleep study with my wedge.  It didn't matter much.  The wedge might make it a little easier to breath and help you if you have gastric reflux.

Vicki


_________________
That which does not kill you makes you stronger-Friedrich Nietzsche
Friedrich must of had apnea.

Thanks for all that replied.

I am glad that someone had it done with and without wedgie.  I talked to my doctor yesterday and he didn't seem to think that would help either.

I loosened my straps way up last night and still had the same effect.  When I took the mask off it was moist around the edges.  I'm not sure that if you put a moist piece (no doubt salty from sweat or something) of plastic on my face skin for any amount of time that I wouldn't get a rash.  

I'm not sure how much of the moisture is due to not having a CPAP attached.  When he tested it with a CPAP I was okay and it felt very stuffy without it.  My complaint about that did get him to take off a couple of little plastic pieces.  I did check my O2 sats and they did not go down -- I did that as I really felt like I was O2 deprived with the mask on.  However, perhaps not being attached to the CPAP is the reason it is warm, moist, etc.  I remember the cpap as sort of a cool feeling.

Does anyone have more trouble in hot weather?

Judy

Hi Judy,

Sorry, I didn't read all the way through your post.  I'm pretty sure your main mask problem is from not having the CPAP attached.  When it is attached, you will have air flow through there that will keep you from sweating and building up moisture.  The mask is not designed to be used without a CPAP.  I don't think sleeping with a mask without a CPAP is a good idea at all.  If it is a nasal mask, then all it will teach you is how to breath through your mouth with your mask on since you will have to open your mouth to get air, which is the last thing you want to learn.

Vicki


_________________
That which does not kill you makes you stronger-Friedrich Nietzsche
Friedrich must of had apnea.

Well, I am less discouraged now.  I understand why the doctor suggests it in that he wants people to be used to the mask when they get their titration done.  I would think he would have run into people that had the same problems as I am having though.  Maybe most of his patients have alligator skins!  I don't really breathe through my mouth with it on -- I have myself pretty well trained about not breathing through my mouth, so certainly when I am awake enough to control it, I don't do it unless I have a cold.

I was going to push for a nasal pillow system with the stuff going over your head.  I saw one where it looked like there was very little skin contact at all.  Don't know how I would like the stuff up my nose as oxygen cannulas annoy me in certain circumstances.  I do have pretty sensitive skin.  Could be, though, if I let this heal up I could just go in and do the titration.

I'm amazed at the idea of a doctor thinking it would be a good idea for you to try to sleep wearing a mask that is not hooked to a cpap.   Occasionally putting on a mask for a few minutes while awake in the daytime can help toward acclimatization if a person were having claustrophobia problems, but that's not the case for you.

The doctor's idea about using the mask sans machine during sleep to get used to wearing a mask sounds to me like one of those ideas that look good on paper, but not so good in actual practice.

Oh, and let me take a wild guess.  I'm betting that the mask you're struggling with is manufactured by Respironics.  

I agree with Vicki's comment:

Quote:

The mask is not designed to be used without a CPAP. I don't think sleeping with a mask without a CPAP is a good idea at all.

And with okie's:

Quote:

I would have some concerns about sleeping with a mask that isn't hooked up to continuous airflow.
....
When you go for your titration ask to see the activa and a nasal pillow system like breeze or swift, which do not seal around the nose, but only at the nostril opening.

Good luck, Judy.  You're certainly trying to do your part.  Personally, I'd forget using that mask.  I'm not a doctor, but I'd wait until the night of the titration before a mask would touch my face.  Despite that doctor's way of going about all this, most people do not use a mask until being titrated. Most of them manage fine that night.

Thereafter, it can be another kettle of ..."masks"...  lol.  It can take quite a bit of trial and error to find one that suits any of us.  Swift nasal pillows, Breeze nasal pillows, and Activa nasal mask are very good ones to start trying...when the time comes.  The time is not now, imho.  Not without a machine going.

Well, for sure now I will stop beating up on myself for being a wimp!  Actually they may have done exactly the opposite of the plan with me, as now when I think of the mask I think of the discomfort of the rash breaking out while I was trying to tough it out.  I put some cortisone cream on that last night and hopefully it will soon be better.

The mask is a Resmed.  Just says Resmed on it but the straps say resmed mirage or ultra mirage.

Judy

The Resmed Ultra Mirage has a thin membrane "skirt" that contacts the face.  When worn WITH a cpap, the "skirt" fills with air, providing a thin cushion of air between the face and hard shell of the mask.
With no flow generator (cpap,bipap,apap) attached, the skirt is not inflated and the hard plastic is left to press into the face. No wonder you are sore and hurting!!

The Activa mask takes this "inflation" to the next level, providing a much deeper inflation chamber/below/baffles for the mask to float on.  You should ask to try the ACTIVA at your sleep study, if you don't plan to use a nasal pillow interface.

Again, I would NOT sleep with any of these masks without it being connected to a flow generator to flush the CO2 and prevent rebreathing.....and the comfort of inflating the mask!!

Wow, Okie --

I had observed that thin layer and also how hard the plastic was underneath it.  I knew the hard plastic was pushing against me but didn't realize that wasn't the design.  I stood there in front of a mirror playing with adjusting it to my face and wondered how it would ever be comfy!

I am beginning to think users are far superior to doctors and respritory therapists as far as getting fitted out properly.  That is sad, but I am sure glad I found this group.

And to you and others commenting on the CO2 -- I hadn't worried about that either, though it makes sense and is probably what is contributing to the feeling of not getting enough air.  I told the therapist about that and he said I should be getting just as much as without the mask as it is open.  I am beginning to wonder about this group, though I have been awfully happy with the pulmonary doctor who is involved in the whole thing.

Judy

Back to the "sleeping on a wedge", this article quantifies your question.
Snoring and OSA are usually worse when the patients sleep on their backs. This is because gravity promotes collapse of the soft palate and the tongue, especially during deep NREM, and REM sleep when the muscles are most relaxed. A common complaint of patients is that their bed partners are always poking or shoving them on to their sides. For patients with OSA who are very obese, sleeping with the trunk elevated at 30 degrees relieves the pressure on the diaphragm from the abdomen and improves the patency of the upper airway. This measure alone can reduce the severity of OSA in these very obese patients by ~ 20%.
http://www.sleep-breathing.bc.ca/treatme2.htm
 
So having read this article, and owning an autopap, I decided to check my required nighttime pressure when sleeping on a wedge vs. my usual position.   Well, being a short round person, all I was able to document, was that keeping me on a wedge was like trying to position an inflated beach ball on a slope....I just seemed to roll right down.  
 After a few nights of waking with my feet dangling, and mutliple climbs back up on the wedge each night, I gave up on my experiement and decided I just wasn't meant to be a scientific researcher, LOL

I did talk to my doctor about the sleeping on the wedge taking care of it, and he said the problem was people "fell off the wedge".  I don't really fall off, but I do scoot down on it so its effectiveness is no doubt not consistent at all. It sounds like you were scooting also though the image of rolling down it is much more fun!