Hi,  I am struggling with my CPAP treatment.  I got my machine about the 23rd of June and I am finding every excuse not to use it.  I have the Remstar Cflex.  I have gotten two nights of about 6 or 7 hours and both times I woke up with my head feeling like someone had stuffed it with cotton and at least one nasal pasage closed.  I have had trouble with sinus since a child ( I am now 74).  Then I can't use the CPAP until I have cleared up.  I have the Comfort select mask that I have problems with leaks, so they gave me a Petie size in the gel mask.  With it I get no leaks but it so small I feel I can't breathe, also I have trouble exhaling, seems like I have to push to breathe out, although my pressure is only on 8.  I started out on 9 but had trouble with my ears feeling like they need to pop and the Dr. lowered the pressure to 8.  I am so stressed out that the treatment is all I can think of all day and I dread night time when I will have to try to use it again.  I also had trouble with marks on my face.   Seems like I have every problem in the book.   Hope someone can help or maybe at the least give me some encouragement.  I live alone and have no one to encourage me.   Don't mean to sound whiney,  I just want to get to where I can wear this thing and not feel worse than I did before I ever started on treatment.    Thanks   Faye

Hi Faye,

I suggest you talk to an Ear, Nose, Throat doctor about getting tested for allergies.  An allergy could really mess up your breathing.  I do not have any allergies, but my doctor still put me on a prescription for Flonase.  I spray it twice in each nostril one hour before bed, and it has made a huge difference.  My congestion is relieved, and I can breathe freely.  Also, I use a heated humidifier with my CPAP.  I turn it down or off in the summer months because there is higher humidity.  But, I still use it cold because the air moving across the cool water in the humidifier still helps keep my mouth and airway from drying out.

One thing that really helped me get used to the CPAP was waiting until I was very sleepy before I put it on.  That way I often fell asleep before the pressure got higher.  I'm on about 8-9 myself, and I keep hitting the delay button until I fall asleep, and don't notice the higher pressure.  I also wear it when I take naps during the day.  It took about 2.5-3 weeks for me to see a difference in my energy levels, but it was a big difference.  Now, I rarely sleep a night without it.  I have it one each night for about 6.5-7 hours.

Keep trying different masks until you can find one that is comfortable.  I went through about six, and now I have the Breeze type which is not a mask over my face.  It has two little springy cushions that fit in the end of my nose, and then the headgear goes up over my head, and the hose runs straight down the back of my head.  I find it more comfortable than the masks.  Also, if you have marks on your face you may have your mask too tight.  Consult your respiratory therapist for the best fit.  They should come to your home to work with you on getting it as comfortable as possible without leaks.

Hang in there!
Jeff

My first question is in regard to your humidification. Do you have a warm air humidifier (WAH)? This should help drying out and your sinus problems that occur when using your CPAP. If you do have a WAH have you tried adjusting the temp.. To do this hold down the button that turns on the warmer. You should hear two beeps and the display will change to a flashing number (1, 2, 3, 4, or 5). Once you enter this field use the HEAT and/or RAMP buttons to turn up or down the temp..Finally either push your START/STOP button or just leave the unit alone for about two minutes and your new settings will be saved. If your warmer is at 1 or 2 then try 3, 4, or 5. The temperature of your room or warmer can affect humidification and sometimes cause "rainout" or basically a flood of water in your mask therefore you don't want to adjust your warmer too fast. For example if it is set to 1, don't jump to 5 right away instead, increase it one number a night and stop once you see moisture in your mask in the morning. If water puddles inside the tubing during the night it will get very loud and disruptive, if this occurs turn down the temp. to the last comfortable setting. If you do not have a WAH then ask your doctor for a prescription for one, Respironics makes a WAH that is made to fit directly in front of your CPAP.(But I would bet you already have one) Also make sure you are turning on the warmer. Either turn on your CPAP or within 15 minutes of going to bed, simply push the HEAT button for 1 second, you will hear a beep and a green indicator light should turn on in the lower right hand corner.

For your ear problem try exhaling (through your nose) one deep breath as you place the pressure tubing on to the mask with the CPAP's blower turned on, this sometimes helps to keep the pressure balanced inside your ears, after one deep exhale resume normal breathing.

If you have red marks on your face in the morning, that indicates you are over tightening your mask. Start over and loosen your mask completely. Adjust the bottom straps first and then the top straps, you should do this with your CPAP turned on and with you lying down in your normal sleeping position (if you have such a thing). A last resort option would be to boil the gel of the mask for 3 min., cool off for 10 to 15 seconds under cool water, then wear your mask for 5 to 10 minutes. It is not necessary to have your CPAP attached to your mask at this time. This should help customize your mask for your nose. If this doesn't work suggest a different mask, such as nasal pillows which may not leak as much, a very popular mask at the time is the Swift nasal pillows made by Res-Med.

Link

You may have some difficulty returning your mask due to reimbursement for a new mask but your doctor should be able to arrange some help with this matter. Medi- care will pay once every 6 months for a mask replacement, once every 2 months for a cushion replacement.

Are you aware of the Ramp function? This will turn your pressure down to 4 and within a set period of time (5, 10, 15, 20, 25, 30, 35, 40, or 45 minutes) it will increase to your prescribed pressure.

As you work out these bugs and start to adjust to sleeping with your CPAP you should find that exhaling does not need to be so labored, this is just your lungs trying to exhale the CPAP air along with your normal respiration, this is a common response and usually will subside as soon as the patient relaxes and forgets about breathing, allowing respirations to occur naturally.

Hope this helps out let me know if you need more information. It may take sometime for a response back from me but I will try to give you as much information as I can. Sleep well and be happy. A.C.Wallace R.PSG.T

Also, you machine has CFLEX which should make exhaling easier, your DME can set it to 1, 2, or 3. If you are experiencing labored exhale try 3.

Hi Faye,

I have had my machine since June 6th and thought I would go nuts at first but am slowly getting used to it. I tried a nasal mask at first and felt the same way...like I couldn't breathe out and felt like I had to push my breathe out. Then I tried a full face mask but it leaked to much so now I have one that's called a Mirage Activa Nasal Mask and I find this one much easier to breathe out. It fits lose on your face and when you turn it on the suction keeps it close to your face but without feeling the tightness of the other masks.  And like awallacerpsgt said I think a heated humidifier will help. My machines pressure starts at 5 then within 45 minutes it goes to the pressure I need of 11....that 45 minutes gives me time to get to sleep. I found that at first I would wake up during the night and feel panic to get the mask off and a lot of mornings would wake up with it beside my night stand. So I am still trying to get used to it myself so hang in there like I'm trying to.


_________________
*** Linda ***

Hi Faye,

You're not sounding whiny at all.  If your nose won't let air through, it just won't.  If nasal sprays can't keep it open, you might need to look into sinus and/or turbinate surgery.  Might be the only way you can get comfortable, effective cpap treatment, other than using a full face mask and breathing through your mouth.  If you go the Full Face mask route, the ResMed Ultra Mirage FF suits many people.

Check out the "Nasal turbinate and Sinus surgery experiences" topics about halfway down the page at this clickable link:

LINKS to surgery, turbinates, Pillar, TAP experiences

I want to thank all of you for your information and help.  Makes me feel better just to have someone to talk to about my problems with CPAP.  I went today and got the Comfort Curve by respironics.  It fits on the end of nose but does not have the nasal pillows.  I haven't used it yet.  I am waiting for my sinuses to clear.  I am hoping this will be better.  Thanks again for all your input.  I intend to keep trying, at least for the time being.    Faye Eubanks

I too, made many excuses when first getting accustomed to my CPAP.  I use the breeze headgear and RemStar Plus with passover humidifier.  I went through a problem with severe allergic rhinitis for a while.  Every time I wore the CPAP, I would wake up with uncontrollable sneezing and allergic reactions in the nose.  After replacing EVERYTHING but the machine itself - I still had the problem.  So I slept without it for several months.  Eventually, I got around to getting a new machine with allergy filters and BOY am I glad I did!  No allergy problems with the new machine, and I feel much better during the day.
 
Also, I have developed atrial fibrilations over the last few years, and am hoping that staying on my CPAP every night will help to minimize, if not eliminate that terrible feeling.
 
I guess you have to accept the fact that no matter what discomforts you may experience while getting accustomed to wearing a CPAP, the benefits of doing so will far outweigh any inconveniences during the initial weeks/months of treatment.
 
Good luck, and HANG IN THERE!!!!  It is well worth it.