Hi all -

First I want to thank everyone for making this place available.  I've probably read a hundred posts.   If I solve my apnea problem, I gotta give you guys a LOT of the credit.  I would GREATLY appreciate any advice about my situation...

I've had apnea for at most of my adult life, but was only officially diagnosed a few days ago.  I was supposed to have a "split study", where I slept for half the night, got a diagnosis, and then would try a cpap in the middle of the night is the diagnosis was positive.  This would avoid another night in the lab, so I agreed.  

Before the study began, we tried several different masks, and I chose the one that seemed most comfortable.  It was then fitted with the straps, and I tried it out (awake) for about 15 minutes.  We chose a full face mask since my sinuses are chronically stuffed (allergies and whatnot).  The mask I finally chose (and I don't remember the brand), had this nice soft expandable seal that worked great with my full beard.  I didn't like how there was resistance when I breathed out, but so long as I kept my breathing steady I was fine.  I believe it was set to 6, and it did have some variable output (less pressure when I breathed out).  Okay, so far, so good.

I started the study.  I was instructed to sleep on my back - which seemed best with all the wires - and would give them the best readings.  I ended up sleeping on my side for half the time (my wife has trained me well!).  At 1am I was awakened, informed that I did - in fact - have apnea (and hypoxnia?) and should now try sleeping with the cpap.  As soon as it was strapped on my sleepy head, I paniced.  Sheer terror is more like it.  Thye might as well put a plastic bag over my head.  Far as I knew, I had no paranoia about masks, suffocation, or anything else - but I hyperventilated and literally tore the mask off my face.  We tried several more times, but to no avail.  I went back to sleep (very aggitated) and had some more monitoring.

In the morning the doctor showed up and explained that I had moderate to severe apena, and my blood oxygen fell to dangerous levels 3 times during the night.  Although I did better on my side than my back, I still needed the cpap.  We discussed my night fear about the mask, and we agreed I'd do probably better by wearing the mask in a fully awake state, and then try to sleep.  He also prescribed some Lunesta for my visit next visit this coming Monday night.

As soon as I got home, I hit the internet.  Was I the only one with this mask problem?  Fortunately, I found you guys  

Here is my current thinking.  I have several problems with the FF mask.  First, there is the fear.  I really don't know if I can overcome it.  Even if I fall asleep okay, how will I feel if I wake up in the middle of the night?   But even if I can emotionally handle it, it doesn't seem as comfortable as a nasal mask would be.  For me to use this long term, it can't actually interfere with my sleep.  But I think the biggest issue - ultimately - will be sleeping position.  I had back surgery in 2003 and even the short time on my back at the lab started to produce pain - the first back pain I've had in probably 4 months.  The most comfortable position for me is on my side with a body pillow between my legs.  From my readings on here, this position would be a lot easier with some kind of nasal mask.

So my goal over the next few days is to figure out a way to clear out my nose so I can try some kind of nasal interface.  I'm also a bit concerned about mouth breathing - since I've pretty much slept with my mouth open for at least 30 years (and I'm only 45..LOL).

I read a message from someone on here that uses Benadryl - I'm going to get some today and see how it works.  I also have Flonase - which works pretty well, but not always.

Whew..sorry for the long message, but I want to make sure my analysis is correct.  I can see the light at the end of the tunnel and I don't want it to slip away.

you may have about as much fear with a nose only mask, there are several things available to wash out the sinuses, one is called a netti pot and is similar to a coffee pot, salt water is put in thru 1 nostril, goes thru the sinuses and eventually out thru the other nostril, one device, i forget the name, is on the net, try nasal irrigation

I suggest you wear the mask when awake, reading or watching TV to help in getting used to it
you can sleep in any position you like

Tradeguy wrote:

Hi all -

First I want to thank everyone for making this place available.  I've probably read a hundred posts.   If I solve my apnea problem, I gotta give you guys a LOT of the credit.  I would GREATLY appreciate any advice about my situation...

I've had apnea for at most of my adult life, but was only officially diagnosed a few days ago.  I was supposed to have a "split study", where I slept for half the night, got a diagnosis, and then would try a cpap in the middle of the night is the diagnosis was positive.  This would avoid another night in the lab, so I agreed.  

Before the study began, we tried several different masks, and I chose the one that seemed most comfortable.  It was then fitted with the straps, and I tried it out (awake) for about 15 minutes.  We chose a full face mask since my sinuses are chronically stuffed (allergies and whatnot).  The mask I finally chose (and I don't remember the brand), had this nice soft expandable seal that worked great with my full beard.  I didn't like how there was resistance when I breathed out, but so long as I kept my breathing steady I was fine.  I believe it was set to 6, and it did have some variable output (less pressure when I breathed out).  Okay, so far, so good.

I started the study.  I was instructed to sleep on my back - which seemed best with all the wires - and would give them the best readings.  I ended up sleeping on my side for half the time (my wife has trained me well!).  At 1am I was awakened, informed that I did - in fact - have apnea (and hypoxnia?) and should now try sleeping with the cpap.  As soon as it was strapped on my sleepy head, I paniced.  Sheer terror is more like it.  Thye might as well put a plastic bag over my head.  Far as I knew, I had no paranoia about masks, suffocation, or anything else - but I hyperventilated and literally tore the mask off my face.  We tried several more times, but to no avail.  I went back to sleep (very aggitated) and had some more monitoring.

In the morning the doctor showed up and explained that I had moderate to severe apena, and my blood oxygen fell to dangerous levels 3 times during the night.  Although I did better on my side than my back, I still needed the cpap.  We discussed my night fear about the mask, and we agreed I'd do probably better by wearing the mask in a fully awake state, and then try to sleep.  He also prescribed some Lunesta for my visit next visit this coming Monday night.

As soon as I got home, I hit the internet.  Was I the only one with this mask problem?  Fortunately, I found you guys  

Here is my current thinking.  I have several problems with the FF mask.  First, there is the fear.  I really don't know if I can overcome it.  Even if I fall asleep okay, how will I feel if I wake up in the middle of the night?   But even if I can emotionally handle it, it doesn't seem as comfortable as a nasal mask would be.  For me to use this long term, it can't actually interfere with my sleep.  But I think the biggest issue - ultimately - will be sleeping position.  I had back surgery in 2003 and even the short time on my back at the lab started to produce pain - the first back pain I've had in probably 4 months.  The most comfortable position for me is on my side with a body pillow between my legs.  From my readings on here, this position would be a lot easier with some kind of nasal mask.

So my goal over the next few days is to figure out a way to clear out my nose so I can try some kind of nasal interface.  I'm also a bit concerned about mouth breathing - since I've pretty much slept with my mouth open for at least 30 years (and I'm only 45..LOL).

I read a message from someone on here that uses Benadryl - I'm going to get some today and see how it works.  I also have Flonase - which works pretty well, but not always.

Whew..sorry for the long message, but I want to make sure my analysis is correct.  I can see the light at the end of the tunnel and I don't want it to slip away.

Hi and welcome,

Firstly, it is not natural to have something strapped to your face all night, so you are not alone. I doubt that there is anyone who hasn't or doesn't feel a little claustrophobic from time to time.

Masks are the key to successful compliance to cpap therapy. I notice postings on this forum whereby sufferers jump ship from nasal to full face quite quickly and seem to have trouble with the full face mask.

Initially, when full face masks first became available (mid to late 90's I think) they were directed towards the 'natural' mouth breather and those alone. They were not considered suitable for anyone else and personally I believe that this is still the case, however with DME companies keen to boost sales and a growing number of GPs getting involved in sleep medicine (even though they don't have a clue) the full face mask is very much 'on the market'.

While I am not keen on surgery, if a sufferer has nasal, turbinate, sinus problems it is best to have them dealt with as it helps to increase the efficiency of cpap and may possibly help to reduce the required pressure.

The nasal mask as evolved over the past 10 years to a stage where there is a huge choice, ranging from silicone to gel, large size to the little one that fits just over the top of the nose. There are also nasal pillows and the nasal aire system (similar to oxygen prongs)

So, there is a huge choice available which should help with the claustrophobia. You need a good DME to fit you properly. Explain your position and the need to sleep on your side (this will eliminate certain masks). You also need a good ENT to help sort out the nasal problem. Now is the time to strike. With your positive attitude and a clear strategy I have no doubt that you will become compliant and reap the benefits.

Daniel


_________________
The untreated Sleep Apnoea sufferer died quietly in his sleep.......
Unlike his three passengers who died screaming !!!!!!

(Anon)

Hi TradeGuy,

As an allergy sufferer, I can tell you from years of experience what has worked for me.  First, exhaust all options with an allergist before you resort to surgery.  I had sinus surgery because of allergies and I wish to heck I had seen the allergist before the ENT.  Your nasal tissue is covered with cilia and anytime they slice, dice and scrap sinus tissue, the scar tissue which grows back is not ciliated and therefore your nose doesn't work as well did previously.

I take Zyrtec, but there are several Rx anti-histamines available such as Clarition, Allergra. etc.  For a Rx steroidal nasal spray, I use Nasonex, but others available are Flonase (which you said you tried), Rhinocort, etc.  If any of these Rx meds. don't work for you, try another.  As you probably know, you have to use the steroidal nasal sprays  for awhile and consistently to work.

Finally, because of my sinus surgery, I have to irrigate my sinuses at least once a day to keep from getting sinus infections.  However, sinus irrigation is a great way for anyone to decrease sinus congestion, ward off infections and decrease allergic symtoms.  The following link describes sinus irrigation protocols and recipes.  Read the whole post because it isn't as complicated as it sounds at first.

Post how you are doing!!

Vicki

Sinus Irrigation How To


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

Thanks for the advice!

I had a far more successful sleep trial with a nasal pillow setup (Swift), and I slept thru the night!  Had a nice 2 hour REM too...lol.

Well, it's been 2 weeks at home with the device - Swift nasal pillows with a Respirtronics system (w/ C-Flex).  I used the ramping for the first 2 nights, but found I much preferred the full pressure (I wasn't falling asleep until it went to full).  I'm on a 9 setting - which isn't too bad, though I might ask to have it upped to a 10 (clogged nose).   I really love the C-Flex feature, which seems to figure out my breathing pattern and really helps me exhale - which seemed to be my biggest fear.  

I've been very suprised at how well it's worked out.  After about 3 nights, it seems almost natural.  When I wake up, I often forget I even have it on.  

My sinuses have been my only problem, and I've been trying a lot of different ideas.  I take my Allegra religiously, and also use Flonase.  But that doesn't always do it.  My device tech recommended "Ocean" brand saline mist - it's very gentle and I can use it many times a day or night.  Sometimes it's just what I need to stay clear.  If I can get my sinuses reasonably clear before bedtime, the cpap itself does the rest.  I've also tried benadryl for those really bad nights, but it might be drying out my nose too much (so I'm trying to avoid them).   It's kinda cool to wake up every morning and take a deep breath through my nose    - something I haven't done in years.

The first few nights dried out my nose really bad, so I increased the heat on my humidifier from a 2 to a 3 setting (out of 5).  That seemed to do the trick, but now after 2 weeks my nostrals are quite sore - not sure if it's dryness or irritation, but I just upped the heater to a 4 for tonight.  I'm in North Florida, but it's been rather cold and dry this last week, and when we run the gas house heat, it gets even drier.  

I've checked the tightness on the head-straps, and I don't think they could be any looser without just falling off my face...heh.  OH - the pillows work wonderfully for sleeping on my side - which I do for most of the night.  No back pain  

But the best news is that I'm really feeling GREAT!  I haven't had an afternoon nap since starting the cpap - and I've had my daily join/muscle pain only one night - and that wasn't until nearly bedtime.  Yesterday I felt like I was on a caffeine buzz - all day.  It's so unusual to NOT feel tired, I'm going thru as much of a psychological adjustment as a physical one.  The days just seem so much longer, and I'm just eating thru chores.  I even got our Xmas lights up the weekend after Thanksgiving (my kids are thrilled).

I'm also feeling better in the mornings.  I thought I'd feel refreshed after using the cpap, but I actually had great trouble waking up.  Instead of my normal  morning "twilight" sleep, I am in full deep REM every morning when my alarm goes off at 6am.  I haven't actually woken up to my alarm in probably 10 years.  But my body seems to be adjusting, and I felt a lot better this morning.  My tech says this is all normal - my body is just trying to catch up for a lot of lost sleep.

Thanks again!
Rich

I am new to this experience and just picked up my CPAP yesterday - last night was the first night.  Unfortunately, despite all the advice on this site, I did not shop around very much.  I did try on the gel mask and the nose pillows at the clinic but the technician veered me to the gel mask (even though I had a bad experience second night of my sleep study).  She did tell me I could try the nose pillow mask within 30 days so I said I would go with the gel mask first.  As I was about to leave, she informed me that if I tried the nose pillow mask (don't know what brand - the whole system is Respironics) I could not go back to the gel mask unless I paid another $100.00.  My first night last night was rough.  It took me more that 2 hours to fall asleep and woke up often.  The gel mask got very wet around my nose, I broke out into frequent sweats and had problems sleeping on my side.  The ramping and Cflex helped but when it got to the high pressure I could feel and hear a hissing sound.  I did force myself to wear the thing until I finally fell asleep and I think I slept for 4 hours.  I would like to hear peoples experience with the nose pillow system and how it was better for them before trying it and giving up the gel mask - subject to the second $100.00.  Thanks


_________________
Janice

Well, my only experience is with a full face mask at the clinic, and the nasal pillows for 2 weeks at home.  The FF mask had some problems with my full beard (and I had to wear it VERY tight), and it made a really annoying whistling sound.  In sharp contrast, the nasal pillows don't seem to leak at all - and the straps feel rather loose.  I'm not sure how it does it, but when the pressure starts,  they seem to your lower nostrils and seal well enough so that even a strong exhale doesn't seem to leak.

The only time I've even sensed any leakage is when I'm on my side and not being careful with my pillow.  I'm still getting used to using the edge of my pillow so I don't bother the mask.

Last night I turned my humidifier heater to 4, and it worked great.  My nasal pain was, in fact, from excessive drying.  Not just from the cpap, but also from all the different meds.  I backed off on the benedryl (still take the daily Allegra), and only used the flonase before bedtime.  Although the my nose was rather sensitive going to bed last night, it felt almost normal when I woke up this morning.  Right now it's almost completely pain-free, so something I did worked.  Oh...I also used a tiny bit of petroleum-based antibiotic ointment just inside my nostrils yesterday and today to prevent any infection.  Overall, I think I'll be fine tonight  

Even with the heater turned up (and I used up more than half of the water supply last night), there was no wetness or water accumulation with the pillows.

Hope this helps!

Here's a couple of ideas I use for nasal problems which seem to tear me up sometimes. I use Zicam nasal spray, that always opens me up and keeps me open most of the night. I also have a script for Flonase, but it doesn't decongest when my nose is dry. I tried something new last night and maybe it is not a good idea ( responses are always welcome), I put a drop of vapor liquid in my humidifier water, and this morning when i got up I could have driven an 18 wheeler thru my sinuses they were so open!

I switch back and forth between nasal pillows and a nasal mask. I prefer the nasal mask because the pillows make my nose sore inside and around the rim where the pillows touch. Ayr nasal gel helps, but I still have an annoying permanent bump inside my nose from the last set of pillows.

[quote="Tradeguy"]Thanks for the advice!





The first few nights dried out my nose really bad, so I increased the heat on my humidifier from a 2 to a 3 setting (out of 5).  That seemed to do the trick, but now after 2 weeks my nostrals are quite sore - not sure if it's dryness or irritation, but I just upped the heater to a 4 for tonight.  I'm in North Florida, but it's been rather cold and dry this last week, and when we run the gas house heat, it gets even drier.  

Hi rRich,

I assume it is the nares of your nose that are sore. I believe there are 3 different sized pillows supplied with the ResMed system. Which size are you using ? Is there a larger size ? If so you should use it.

I don't use nasal pillows but sore nares are a common enough problem early on, usually down to the fact that the DME, think they know everything, and persuade you that the small or medium pillow is right for you, but isn't. The larger sized pillow usually sorts out the problem.

If that doesn't work, contact your sleep clinic as there are a number of gels and creams for dealing with this.

Daniel.


_________________
The untreated Sleep Apnoea sufferer died quietly in his sleep.......
Unlike his three passengers who died screaming !!!!!!

(Anon)

Daniel wrote:

Hi rRich,

I assume it is the nares of your nose that are sore. I believe there are 3 different sized pillows supplied with the ResMed system. Which size are you using ? Is there a larger size ? If so you should use it.

I don't use nasal pillows but sore nares are a common enough problem early on, usually down to the fact that the DME, think they know everything, and persuade you that the small or medium pillow is right for you, but isn't. The larger sized pillow usually sorts out the problem.

If that doesn't work, contact your sleep clinic as there are a number of gels and creams for dealing with this.

Daniel.

Hi Daniel -

Well, I'm about to start week #4 and I think I'm doing alright  

My nostrils (are those "nares"?) are no longer sore, my sinuses don't feel dry, and I no longer wake up with a dry throat.  I did find that a heater setting of 4 caused some "rain-out" - so I backed it off to 3.  I think in my case it was a combination of things.  

1 - Too many nasal decongestants - a little flosnase at night, 1 allegra in the morning - the rest of the time I just use the Ocean saline mist.
2 - Humidifier at 3 - that seems good at least for now.  No excess water, and seems moist enough.
3 - That Ayr Nasal Gel worked wonders!  For the last few days I've been using it several times a day, and my nostrils feel perfect.  They were simply dry and "crusty" - and apparently that's enough to cause a LOT of sensitivity and pain...LOL.  

I tried on the larger and smaller pillows - the mediums seem to fit just right, so I'm sticking with that

A few other things I've noticed...

The chest pains I was experiencing are gone.  I was told it had something to do with changes in how I was beathing,
My ears still pop on occassion, but at least they don't stay that way
Apparently I need almost exactly 7 hours of sleep - no more, and no less.  I am no longer able to "sleep in".  After 7 hours of "cpap sleep", I am now wide awake.  I did a little test last night and went to bed at 10pm.  Been up since 5:15 am.  No more naps, no more joint pain.

I'll be perfectly honest here, and try to say this without hyperbole...but I haven't felt like this in a very very long time.  Who knew that a lack of good sleep could make such a difference...

Tradeguy wrote:

Daniel wrote:

Hi rRich,

I assume it is the nares of your nose that are sore. I believe there are 3 different sized pillows supplied with the ResMed system. Which size are you using ? Is there a larger size ? If so you should use it.

I don't use nasal pillows but sore nares are a common enough problem early on, usually down to the fact that the DME, think they know everything, and persuade you that the small or medium pillow is right for you, but isn't. The larger sized pillow usually sorts out the problem.

If that doesn't work, contact your sleep clinic as there are a number of gels and creams for dealing with this.

Daniel.

Hi Daniel -

Well, I'm about to start week #4 and I think I'm doing alright  

My nostrils (are those "nares"?) are no longer sore, my sinuses don't feel dry, and I no longer wake up with a dry throat.  I did find that a heater setting of 4 caused some "rain-out" - so I backed it off to 3.  I think in my case it was a combination of things.  

1 - Too many nasal decongestants - a little flosnase at night, 1 allegra in the morning - the rest of the time I just use the Ocean saline mist.
2 - Humidifier at 3 - that seems good at least for now.  No excess water, and seems moist enough.
3 - That Ayr Nasal Gel worked wonders!  For the last few days I've been using it several times a day, and my nostrils feel perfect.  They were simply dry and "crusty" - and apparently that's enough to cause a LOT of sensitivity and pain...LOL.  

I tried on the larger and smaller pillows - the mediums seem to fit just right, so I'm sticking with that

A few other things I've noticed...

The chest pains I was experiencing are gone.  I was told it had something to do with changes in how I was beathing,
My ears still pop on occassion, but at least they don't stay that way
Apparently I need almost exactly 7 hours of sleep - no more, and no less.  I am no longer able to "sleep in".  After 7 hours of "cpap sleep", I am now wide awake.  I did a little test last night and went to bed at 10pm.  Been up since 5:15 am.  No more naps, no more joint pain.

I'll be perfectly honest here, and try to say this without hyperbole...but I haven't felt like this in a very very long time.  Who knew that a lack of good sleep could make such a difference...

Terrific.

You certainly have a good grip on your OSA and its therapy. I'm delighted for you.

Daniel.


_________________
The untreated Sleep Apnoea sufferer died quietly in his sleep.......
Unlike his three passengers who died screaming !!!!!!

(Anon)

I have a ff mask and a nasal mask and when I mentioned this to my wife she said I snore with the ff mask but not with the nasal mask