I was recently diagnosed with OSA. On 10/3, I got my CPAP machine (Fisher & Paykel Sleep Style 234 with FlexiFit 431 full face mask). The first night, I slept pretty well. I awoke once at 330 in the morning tugging at the mask with a suffocating feeling. I realised that it was warm in the room and I can't stand warm air in my face, so I lowered the air conditioner and that seemed to help.

I do not seem to be getting a very good seal with the mask. I either have air leaking out below my goatee or air shooting into my eye. I have a pretty narrow bridge on my nose, so I assume that is why I can't get a good seal there. I tried the small mask and it didn't allow any mouth movement, but did seal over my nose. I tried the medium mask and it leaks into my eye and a bit under my goatee. I tried the large mask and it cured the leak at the nose, but leaked considerably below the chin. I keep my goatee trimmed very close, and this mask cups below the chin where there is no hair, so facial hair isn't the issue.

I called my DME and am going in over lunch today. He wants to try me on a nasal mask. I am a bit apprehensive about this, as I don't feel I have full airflow through the nose. My doctor said that if CPAP doesn't work well, I may have to have surgery to open up my sinuses. Should I accept this or demand a different FF mask? I do find myself breathing mostly through my nose as I am falling asleep, but once I get to sleep, I think I start breathing through my mouth.

Also, my wife mentioned this morning that I was snoring heavily again last night. The first night with CPAP, I slept on my side, but I know the doc wanted me to sleep on my back more, so I put a couple pillows under my knees last night to force me onto my back. Should I still be snoring with CPAP? I thought it was supposed to keep the airway open so that you don't snore.

Thoughts?

CG, I think first I'd try another brand of FF mask.  The ResMed Ultra Mirage FF is an excellent mask (imho) that suits many people.  Worth a try.

Did they give you a heated humidifier?  Many cpap users find that at least some degree of warm humidified air can help relieve nasal stuffiness and make the treatment more comfortable in many ways.

You mentioned:
"I do find myself breathing mostly through my nose as I am falling asleep"

If you're able to breathe through at least one nostril just fine during the night you should be able to receive effective cpap treatment.  It seems to be normal for many people to have one nostril or the other become congested while lying down for awhile... the stuffiness can switch from one nostril to the other sometimes, depending on which side we turn onto.

Quite a few people, with significant sinus or enlarged turbinates problems do report finding their cpap treatment can be more effective after they have that corrected.   Sinus and/or turbinate reduction surgeries seem to help many people "do" cpap more easily.  Turbinate reduction in particular gets rave reviews from most message board posters whose ENT has recommended it.

(side note):  UPPP surgery, is a whole other ballgame...nothing to do with the nostrils.  UPPP involves carving out the palate - more often than not UPPP is NOT a good idea according to some of the more knowledgeable posters who had UPPP done, to their sorrow.  I mention that only in case the ENT you visit about your sinuses were to also start making "UPPP" noises.  

You said:  "the doc wanted me to sleep on my back more."  That seems like an odd recommendation for a medical professional to give to a person with OSA, unless the doctor is looking at some other medical condition you have, unrelated to sleep apnea.   Sleeping on one's side is usually better than being on one's back, where sleep apnea is concerned.  But maybe your sleep study turned up more events (apneas/hypopneas) when you were on your side?

"Also, my wife mentioned this morning that I was snoring heavily again last night."

That could be from any number of reasons:

1.  The mask was dislodged or had a massive leak - you were not getting enough pressure going the right way to keep your throat open.

2.  If this happened soon after you turned the machine on and you are using "Ramp" with your machine, perhaps you had already gone to sleep (but your wife was still awake) before the machine had ramped up to full pressure to keep your throat open.

3.  The pressure prescribed for you is not high enough.  Or at least not high enough when you're on your back.  (That recommendation is a mystery to me!)

Good luck!  I'm not a doctor or anything in the health care field - those are just my thoughts/opinions.
    

If you'll go to the link below, and then scroll about halfway down, you'll find many good discussion topics regarding sinus and turbinate surgeries:

LINKS to surgery, turbinates, Pillar, TAP experiences

I went to the DME on Wednesday and he set me up with a nasal mask. I tried it that night and it did not work very well for me. Even with the chin strap on, I still kept getting woke up by my lips flapping in the wind, even though my jaw was closed. I think that is something that probably just takes getting used to to keep myself from doing that. The nasal mask left my nose and top lip (skin between lip and nose) hurting pretty bad, which I assume is because I have a mustache. I'm not shaving it for a breathing machine though. I didn't wake up refreshed at all, as I was awakened too many times in the night.

Last night, I used the FF mask again and slept like a baby. When I got up this morning, I felt refreshed and ready to start my day. Went to kiss the wife goodbye and she again complained that I kept her up for a couple of hours with my snoring. I did manage to get my mask to seal up pretty well, so I know it wasn't a case of it leaking and dropping the pressure on me. I went to sleep on my side and *think* I slept most of the night on my side.
*update* I just talked to my wife and she said while she was awake because of my snoring, I was on my back, and both sides and the snoring continued no matter which position I was in. She also said she was unable to hear any leaks, which are pretty noisey.

On my 2nd sleep study, the doctor made mention that if I am still having apneas after a month of use, then the pressue can be raised from 12 to 13. It also said that at 14, I had an increase in Central Apneas, so not to go that high. Will an increase of 1 likely help if I am snoring that heavily?

I may have mis-spoke about them wanting me on my back. I think that might have just been for the sleep study. But, if I am reading my results correctly, I actually have more apneas while on my side than on my back. Here are my results.

I do have a heated humidifier and am using it on the 2.5 setting.

Cybergoon wrote:

Last night, I used the FF mask again and slept like a baby. When I got up this morning, I felt refreshed and ready to start my day. Went to kiss the wife goodbye and she again complained that I kept her up for a couple of hours with my snoring. I did manage to get my mask to seal up pretty well, so I know it wasn't a case of it leaking and dropping the pressure on me. I went to sleep on my side and *think* I slept most of the night on my side.
*update* I just talked to my wife and she said while she was awake because of my snoring, I was on my back, and both sides and the snoring continued no matter which position I was in. She also said she was unable to hear any leaks, which are pretty noisey.

Hi Cybergoon,

When I used the Flexifit I noticed I was more tired, but also hearing my boyfriend describe the outcome of me using this mask got my attention.  Let's put it this way, he said it was interesting having darth vadar sleeping next to him with a mac truck driving through the bedroom in a thunderstorm.    The thunderstorm part was because we have a soundmachine to help with white noise.  Now after everyone gets done laughing (I know I did when he and I talked)...I have to say this mask didn't work for me.  No matter what position, I still snored.  Now with the Ultra Mirage full face mask I didn't snore, so you may want to give that a try.  On the plus side they have a shallow and standard size with sm, md, and large.  It might be just the ticket for you.  Best of luck to you.

Melinda

Hi Cyber,

Has your Flexifit been properly adjusted while you are laying down?  Even tension on all the straps, just enough to make sure no place leaks without too much pressure anywhere, especially the top or bottom.  If that is the case, try some other FF face masks, both ResMed and Respironics make FF masks you could try.  The issue with the other two masks is that they don't hold higher pressures (pressures over 9) as well as the Flexifit does, so they are more prone to leaks.  However, if something doesn't work, you have to keep trying.

Vicki


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

Well, I seem to have finally gotten the FF mask to seal for me the last couple of nights. Haven't been able to get much sleep though. It seems like there isn't enough pressure in the mask and I end up hyperventillating trying to get enough air. I talked to my DME and he assured me that there is no change in the pressure and that I am just getting used to wearing CPAP. I don't know if he is entirely correct. When I first got the CPAP, when I put on the FF mask, if I opened my mouth slightly my cheeks would billow out somewhat. Now they don't. Also, when I first got it, when I would exhale, the mask would push out slightly from the pressure, but now it doesn't.

I had a terrible night last night. Finally switched to my UNComfort Gel nasal mask, but was too tired to get up and fill the humidifier and ended up with a burning nose for the rest of the night. I called my doctor and talked to him about an auto-PAP because of the snoring that I am still having. He was reluctant at first, but I let him in on some of the great info I get from these forums, as well as let him know I had already talked to my DME about it and he finally agreed and wrote a perscription for an autopap. I will be getting the software and card reader to go with it, since I'm a geek like that. My DME said that he will initially set the machine for min/max pressures that the doc specified, but that he will provide me the manual for changing them to suit myself, since I seem to be well hearsed in what I am talking about.

So, I will be switching to a REMstar Auto with heated humidifier. DME said that it will be in in about a week, so I gotta put up with what I have for now.

Got the new machine tonight. Couldn't believe he called me and had one in already for me. Pressure range is set to 5-20, so it might be a long nite.