Tips to stop taking off the mask during the night?

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Tips to stop taking off the mask during the night?

Postby onetiredmama » Tue Jun 12, 2012 10:35 pm

I'm still in the adjustment period with my CPAP and I think I'm doing a pretty good job of falling asleep with the thing, which was what I was afraid would be my obstacle. But I keep taking it off at some point during the night, and I've been really surprised by how little the machine says I've used it some nights. I think I'm being conscious of the need to wear it when I'm trying to fall asleep, but if I wake up and it's annoying me, I'm taking it off instinctively. Does anyone have tips to overcome this??

The first few nights, I had a lot of trouble with leaks when I changed position, and I do change position a fair amount as I sleep. I've since made some adjustments to the mask that seem to be helping, but I sometimes still get leaks when I roll to my side. I suspect the mask is coming off after rolling all the way from one side to the other, which I did a lot pre-CPAP and is a lot harder to do smoothly with the extra gear attached and when I'm trying to fall asleep and do it I am prone to leaks. The first few nights I had the mask, I did take it off rather than try to adjust it when it would start leaking....then the next time I woke up and realized I was maskless, I tried again.
onetiredmama
 
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Mask: Quattro FX full face, size Medium
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Year Diagnosed: 2012

Re: Tips to stop taking off the mask during the night?

Postby greatunclebill » Tue Jun 12, 2012 11:22 pm

try tightening the straps on the fx a little here and there. theres a fine line between too tight and too loose that you need to find. mine feels pretty tight, but my leaks went from the stratosphere to near zero by playing with the straps. the main thing is to have the straps even so one side isn't pulled over more than the other side. the headgear should be centered.

as far as taking the mask off, wear socks on your hands. anything to make it hard to take it off. if that don't work, try boxing gloves.
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Re: Tips to stop taking off the mask during the night?

Postby robysue » Wed Jun 13, 2012 12:15 pm

onetiredmama wrote:I'm still in the adjustment period with my CPAP and I think I'm doing a pretty good job of falling asleep with the thing, which was what I was afraid would be my obstacle. But I keep taking it off at some point during the night, and I've been really surprised by how little the machine says I've used it some nights. I think I'm being conscious of the need to wear it when I'm trying to fall asleep, but if I wake up and it's annoying me, I'm taking it off instinctively. Does anyone have tips to overcome this??

At the beginning some folks will use a bit of tape to physically tape the mask (lightly) to their face. The idea is that the minor pain induced by ripping the taped mask off might be enough to wake them up enough for them to consciously realize what the heck they are doing and put the mask back on.

A second major thing to do is this: If you wake up at any point in the night and you find the mask is NOT on your face, then put the mask back on before you return to sleep. In other words, never consciously allow yourself to sleep without the mask on.

If you wake up and the mask is annoying you to the point where you consciously cannot stand to have it on any more, then you need to force yourself to get out of bed and go into a different room. Only go back to bed once you are both calm enough and sleepy enough to mask up again. In other words, never allow yourself to consciously remove the mask and go back to sleep without it on your face.

The first few nights, I had a lot of trouble with leaks when I changed position, and I do change position a fair amount as I sleep.
Changing positions with a six foot hose attached to your face is a learned art. It will get better as you get more experience.

I've since made some adjustments to the mask that seem to be helping, but I sometimes still get leaks when I roll to my side. I suspect the mask is coming off after rolling all the way from one side to the other, which I did a lot pre-CPAP and is a lot harder to do smoothly with the extra gear attached and when I'm trying to fall asleep and do it I am prone to leaks.
There are several standard things people try in order to make it easier to move around in bed. Here are two common strategies:

1) Hang the hose. You can sometimes route the hose over the headboard and that's enough. Or you can buy or make a hose hanger system that keeps the hose up and out of your way. For many people, hanging the hose ends a lot of the leaky mask problems caused by repeatedly turning over in bed.

2) If you are a side sleeper you can run the hose under the covers and slightly grip in one or both of your hands. As you turn over, the hands can grasp the hose and turn it with you. I find that I often go to sleep with one hand on the small hose near where it attaches to my Swift FX and the other hand farther down the hose. Whenever I turn over, my hand unconsciously guide the hose to come with me and prevent it from pulling the mask off my nose. Having the a hand on the hose right where it meets the mask also allows me to reseat the mask with a minimum amount of conscious effort.

The first few nights I had the mask, I did take it off rather than try to adjust it when it would start leaking....then the next time I woke up and realized I was maskless, I tried again.
First, GOOD for you that you are working on breaking the bad habit of just taking the mask off before it becomes an established bad habit

Next a suggestion on what to do when the Swift mask is starting to leak. Often times all it takes to reseal the mask is a quick pull on the mask to get the cushion or nasal pillows off the mask followed by a gentle resettling of the mask back on your face. The Swift masks use air filled cushions (nasal pillow walls) to establish the seal. By pulling the mask away from your face, you allow the cushion/nasal pillow walls) to fully inflate with air so that when you resettle the mask against your face you get a good seal. It takes far less time to do this than it does to explain how to do it. And as you get more experience doing it, it becomes far easier to do and eventually becomes a muscle memory---i.e. something you can do without consciously thinking about how you're doing it.
current settings Min EPAP = 4, Max IPAP = 8 and Rise time = 3

8/1/2010 sleep study results:
AHI = 3.9 [AHI = (#OA +#CA + #H w/desat) per hour]
RDI = 23.4 [RDI = (#OA +CA + #H w/desat + #H w/arousal) per hour]
Dx: Moderate OSA
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Humidifier: System One Heated Humidif
Year Diagnosed: 2010

Re: Tips to stop taking off the mask during the night?

Postby onetiredmama » Wed Jun 13, 2012 12:47 pm

Thank you for the tips!

I don't know if it was the determination to sleep with the mask on all night, but I did wake up wearing it. Yeah! I also went to tend a kid who was up in the middle of the night with the mask on, just detached from the hose. I think I was taking the mask off when I did that before, and probably falling back asleep without it out of habit (since I've fallen asleep maskless after waking up with kids for years...the mask is a new thing...), or being so tired and wanting to get back to sleep so badly that I was skipping the step of putting the mask back on. Keeping the thing on my face and just having to reattach the hose gave me no advantage to not starting back up with the therapy, because it's the mask that's hard to get used to, not the air, at least for me that's how it is.

I have noticed that if I put the mask on before I'm ready to sleep, I get a lot more leaks as my facial expression and breathing patterns change more (i.e. a yawn makes it leak). I think I get a little panicky with it on sometimes when I'm too awake, but if I'm sleepy, I can relax into it and be fine with the air pressure.

I liked how I could wear glasses with the Quattro FX, and did some reading and tv watching with the mask on for the first night or two. I noticed this morning, after a night when I could keep the mask on all night, that it was sitting higher on my nose than it was before...I couldn't get my glasses to rest as far down as they needed to be. I *think* the mask was too low at first and that might have been why I got so many leaks.

One more question...in the morning, I'd been looking to see how long I was wearing the mask. Is the time shown how long it was run continuously? When I got up to put a kid back in bed, I did disconnect the hose and turn the machine off so it didn't keep blowing and annoying my husband. I really thought I used the machine longer than the time shown indicated, but if it started the time over when I turned it off then on, that would explain it.
onetiredmama
 
Posts: 23
Joined: Sun Apr 29, 2012 11:28 am
Machine: S9 Escape, soon to be Elite
Mask: Quattro FX full face, size Medium
Humidifier: yes
Year Diagnosed: 2012

Re: Tips to stop taking off the mask during the night?

Postby robysue » Wed Jun 13, 2012 1:52 pm

onetiredmama wrote:I don't know if it was the determination to sleep with the mask on all night, but I did wake up wearing it. Yeah! I also went to tend a kid who was up in the middle of the night with the mask on, just detached from the hose. I think I was taking the mask off when I did that before, and probably falling back asleep without it out of habit (since I've fallen asleep maskless after waking up with kids for years...the mask is a new thing...), or being so tired and wanting to get back to sleep so badly that I was skipping the step of putting the mask back on. Keeping the thing on my face and just having to reattach the hose gave me no advantage to not starting back up with the therapy, because it's the mask that's hard to get used to, not the air, at least for me that's how it is.
That's the whole reason the mask is designed to make it easy to disconnect without removing it! This is a GOOD habit to establish!

One more question...in the morning, I'd been looking to see how long I was wearing the mask. Is the time shown how long it was run continuously? When I got up to put a kid back in bed, I did disconnect the hose and turn the machine off so it didn't keep blowing and annoying my husband. I really thought I used the machine longer than the time shown indicated, but if it started the time over when I turned it off then on, that would explain it.
That compliance time on your S9 Escape should be the total time the machine was running with breathing detected during a period that started at noon the previous day.

To make myself clearer. The S9 machines gather data in 24 hours that run from noon on day 1 to noon on day 2. And so if you turn the machine on at 10pm on day 1, turn it off at 2am on day 2 (in the middle of the night to tend the kid), turn it back on at 2:30 am and then turn it off at 6:00 am, the compliance time when you check the data sometime between 6:00am and noon on day 2 should be 7.5 hours since 7.5 = 4 (the time from 10pm to 2am) + 3.5 (the time between 2:30 and 6:00).

Sleeping past noon however messes everything up: Then you only see the hours accumulated after noon on the day you wake up.

So--if the machine is consistently showing that you have far, far fewer hours of compliance than you think you should have, it's worth finding out whether the machine's clock has been set to the correct time.

For example: Let's suppose the machine's clock is exactly 12 hours off. And you sleep from 10pm to 2am, get up to tend the kid and go back to bed at 2:30 and sleep until 6:00am. Now, with the S9's clock set to be 12 hours off, "midnight" in real time is equal to "noon" on the S9. And hence, when you look at the compliance number at 6:00AM, the machine tells you that compliance is only 5.5 hours---because the two hours of sleep from 10pm to midnight went into the previous day's data because the machine thinks that sleep occurred from 10am to noon the previous day.

It's been a very long time since I had an S9 machine. As I recall, resetting the time on the S9 requires getting into the clinical menu. But there may be a way to check the time from the patient's menu. I just don't know for sure.
current settings Min EPAP = 4, Max IPAP = 8 and Rise time = 3

8/1/2010 sleep study results:
AHI = 3.9 [AHI = (#OA +#CA + #H w/desat) per hour]
RDI = 23.4 [RDI = (#OA +CA + #H w/desat + #H w/arousal) per hour]
Dx: Moderate OSA
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robysue
 
Posts: 1301
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Machine: PR System One BiPAP Auto
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Humidifier: System One Heated Humidif
Year Diagnosed: 2010

Re: Tips to stop taking off the mask during the night?

Postby onetiredmama » Thu Jun 14, 2012 12:54 am

Thanks for the info! I'm not going to worry about the time right now, since there is an S9 Elite on order for me and I hope to swap it out soon. A clock discrepancy could explain things.
onetiredmama
 
Posts: 23
Joined: Sun Apr 29, 2012 11:28 am
Machine: S9 Escape, soon to be Elite
Mask: Quattro FX full face, size Medium
Humidifier: yes
Year Diagnosed: 2012

Re: Tips to stop taking off the mask during the night?

Postby onetiredmama » Thu Jun 21, 2012 3:03 pm

A follow up to this...after talking to the RT about leakage problems with my mask, especially in the first week or so that I was using it, she said the low usage time reading could be because the mask was leaking so much it wasn't registering the time. That very well could explain the low numbers some nights!
onetiredmama
 
Posts: 23
Joined: Sun Apr 29, 2012 11:28 am
Machine: S9 Escape, soon to be Elite
Mask: Quattro FX full face, size Medium
Humidifier: yes
Year Diagnosed: 2012



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