Does this get any easier? New CPAP user

[Uff Da]

I've been a CPAP user only four days. And I'm getting less sleep than I did before picking up the machine. I've managed to have the machine on for four hours each night, but only two of those nights did I get any sleep at all when it was on, once for an hour or possibly two hours, the second time for about 15-20 minutes. To get any decent stretch of sleep, I have to shut the machine off and sleep without the headgear.

During my sleep study the technician had me try two different nasal masks. The first one allowed my chin to drop so I was breathing through my mouth. The second, which used a chin strap, caused other problems. So I decided to get a full face mask. Unfortunately, that doesn't seem to be working either. It still allows my chin to drop enough to break the seal and cause noisy leaks every few minutes. I'd need to have a full face mask that actually went under the chin to work for me.

I suspect that I'll need to get a chin strap to use even with the full face mask. Do any of the rest of you have to do that?

Another problem I see is that it seems that any sleeping position other than flat on one's back seems to encourage leaks in the mask. I have another condition that causes pain if I lie in one position too long, so I need to be able to move. But that creates problems. Leaks every time.

I'm really disappointed that this is starting off so poorly. Before my sleep study, I was getting a lot of heart palpitations when awakened from a back-sleeping position, so I feared that sleep apnea was messing with my heart. So I was motivated to try to do something about the apnea, but so far, this is not working. Any suggestions other than "find a chin strap?"

[kteague]

I was among the many who found their way to this forum due to getting off to a rough start. I don't use a full face mask, but most masks are prone to shifting and here's some general tips to try to help that.

Manage your hose so that when changing positions it doesn't tug on the mask. Many discussions on here in the past if you search hose management. There are products you can purchase, or you can look at them and figure a DIY that works for you.

Use a firm flat pillow. For me, the firmer and flatter the better. Sinking into a pillow can push against the mask and cause its seal to break. I like to be sure my face/head is level on the pillow. If the chin is lower than the top of the head, gravity will work against you. Less chin drop when flat. There are special CPAP bed pillows with a cutout on the edge of the pillow to accomodate the mask. Or sleep on the very edge with the mask hanging over. Some on here have said they bought a cheap foam pillow and made their own cutout.

Good luck with figuring out what works for you. I remember those early days, when everything seemed such an effort. At some point things should get more routine and sleep less disrupted by the equipment.

[Julie]

You sound like someone who needs a soft cervical collar to keep your head up and jaw closed (if not lips). A forum search on it will bring up threads with discussion and pix or Google 'soft cervical collar with Cpap'.

[gwc2795]

Welcome to the forum uff da
I think you will find loads of excellent advice here. If you went through your insurance and a DME you can exchange the mask for another one during the first month. The mask is the tough part of CPAP treatment. Since you are determined to succeed let us know what mask you are using as well as the equipment (cpap machine).

[Chris8243]

Since you're only 4 days in, I think you should be able to try different masks at no additional charge?

I use the Amara View mask which goes under the nostrils and over the mouth. It does not cover the nose completely and does not go up to the forehead but I *think* it's considered a full-face mask since it covers the mouth.

My mouth naturally falls open when I sleep but this mask doesn't seem to leak at my chin unless I'm yawning - and that's just for a few seconds. I feel leaks on the sides and top (on my cheek) which wake me up because it's annoying me but my mouth is still covered.

Does it get easier? I'm 6 months in and it was easier for me in the beginning. Now I feel like I've hit a wall, using CPAP feels like a burden. I did sleep better and feel better in the beginning, now I wake up with a headache most of the time like I used to. Still using it every night, hoping it will get easier again. I'm hanging in there and I encourage you to hang in there too.

[D.H.]

It's a matter of getting the right mask and the right settings for you.

Those of us who had immediate success (I put myself in this category), were fortunate. We were just prescribed the right setting and given the right mask.

[mesenteria]

I've been a CPAP user only four days. And I'm getting less sleep than I did before picking up the machine. I've managed to have the machine on for four hours each night, but only two of those nights did I get any sleep at all when it was on, once for an hour or possibly two hours, the second time for about 15-20 minutes. To get any decent stretch of sleep, I have to shut the machine off and sleep without the headgear.

During my sleep study the technician had me try two different nasal masks. The first one allowed my chin to drop so I was breathing through my mouth. The second, which used a chin strap, caused other problems. So I decided to get a full face mask. Unfortunately, that doesn't seem to be working either. It still allows my chin to drop enough to break the seal and cause noisy leaks every few minutes. I'd need to have a full face mask that actually went under the chin to work for me.

I suspect that I'll need to get a chin strap to use even with the full face mask. Do any of the rest of you have to do that?

Another problem I see is that it seems that any sleeping position other than flat on one's back seems to encourage leaks in the mask. I have another condition that causes pain if I lie in one position too long, so I need to be able to move. But that creates problems. Leaks every time.

I'm really disappointed that this is starting off so poorly. Before my sleep study, I was getting a lot of heart palpitations when awakened from a back-sleeping position, so I feared that sleep apnea was messing with my heart. So I was motivated to try to do something about the apnea, but so far, this is not working. Any suggestions other than "find a chin strap?"

Your experience is quite common, and it's quite common as well to find what works and to quickly get used to the experience and benefits of PAP. My first week was terrible, but the first night beat all. I am a nose breather, but my mouth opens and my lips part. I began taping my lips the second night and continue the practice to this day.

Your head moves as you fall asleep. You lose tone all over, including in your neck and facial muscles. Some manage to keep their chins up and mouths closed enough that, even with pillows or nasal masks, they get good therapy and few leaks. Many/most will find that their masks leak as they sag into sleep. In my case, I make accommodations prior to falling asleep by tugging on the straps near my jaw and tensioning the one strap likely to let go with head position. Don't know if that makes sense...I don't mean tightening the strap, just tugging on the already positioned/adjusted strap rearward a bit and then forcing my head into the pillow without the mask making contact. If there are no leaks, off I go to sleep. Maybe you could teach yourself to do that. It happens several times each night, but sleep returns inside of seconds often.

Good luck. Do fiddle, do thought experiments (worked for Einstein), try things, but above all persevere. It's worth it.

[zonker]

welcome, uff da!

it does, indeed, get easier. however, it's not the same for everyone. each of our experiences are slightly different. what works for one person might not work for another.

with that said, i use a soft cervical collar in combination with some hair bands to help keep my big yap shut. a fellow user posted this-

viewtopic.php?f=1&t=112758&st=0&sk=t&sd ... i#p1086296

helped me from the first night i used it.

maybe it will work for you!

[Janknitz]

Try reading my blog post "Taming the Mirage Quattro". Even if that's not your exact mask (please fill in your equipment) the directions will help you.

If your jaw tends to drop, try fitting the mask with your jaw open. It should be a little tighter at the chin.

For a long time I couldn't sleep on my back, but I do now sometimes. I have a soft neck pillow that I tuck under my chin when I sleep on my back. It gently holds my jaw in place but it's not as uncomfortable as a cervical collar.

The other option is to use surgical tape over your lips to help maintain a seal. If you search for "tape" you will find instructions.

You can also try training yourself to keep your mouth sealed by practicing ALL DAY every moment unless you are eating or talking to keep the tongue on the roof of the mouth and the lips sealed. This works for some people.

[Uff Da]

Janknitz - I'm curious as to what size and shape of neck pillow you use that works for you. Sounds like it just might be more comfortable than a cervical collar, though that sounds like a possibility I hadn't originally thought of, either. Neither item is expensive, so I just might order one of each to try, since I'm continuing to have problems. Plus I'm going to order a chin strap to try. The numerous headbands I have on hand don't look like they are going to work for me.

I managed to get my four hours of compliance time in again last night. It was in two shifts, about two hours early in the night and another two hours from 4:00 to 6:00 AM. And I did get some sleep both times. I'm guessing about an hour each time, so roughly half the time sleeping and half awake. I still had over 20 events per hour recorded on my machine. Since on the nights I didn't sleep at all, the machine recorded between 5 and 15 events an hour, that would mean the number of events during actual sleep was getting up there.

I just don't understand how I can be having so many "events" even when I'm just laying there wide awake. I don't detect it. And during the day when the doctor uses the oximeter in the office, my oxygen level is always way up, usually 98%. A few weeks ago it was even 100% - for the first time in my life. So what the heck happens as soon as I lie down?

[Pugsy]

I just don't understand how I can be having so many "events" even when I'm just laying there wide awake. I don't detect it.

You have to understand that these machines don't measure sleep...they measure air flow.
Our awake/semi awake breathing is often very irregular when compared to our asleep breathing and when the breathing is irregular the machine will often misinterpret that irregular breathing as some sort of apnea event and it really is nothing more than some sort of awake breathing irregularity getting the flag by mistake.
We often will pause our own breathing while awake and we don't even notice the pauses but the machine will notice.
When we have trouble falling asleep we are going to toss and turn and sigh and whatever....and the machine will flag that irregular breathing but it doesn't mean much since we are awake.
We call those awake flags...sleep/wake/junk or SWJ for short. We just have to ignore them and the numbers that correspond to awake breathing.

Right now don't worry so much about the numbers and instead worry on fixing whatever it is that is making it so hard for you to fall asleep and stay asleep. Try to isolate whatever the problem is so that you can work on fixing the problem.

[chunkyfrog]

. . . I have a soft neck pillow that I tuck under my chin when I sleep on my back. It gently holds my jaw in place but it's not as uncomfortable as a cervical collar. . . .

I have used a little "squish" pillow for this--nice!

[Uff Da]

Right now don't worry so much about the numbers and instead worry on fixing whatever it is that is making it so hard for you to fall asleep and stay asleep. Try to isolate whatever the problem is so that you can work on fixing the problem.

Well, there is one number I do need to worry about. Leaks last night were recorded as 51 L/min. And the noise of the leaks is definitely a part of the problem of why I can't sleep. Another part of the problem is the pain from another condition, and that is not likely to change soon. I'm likely to be awakened at least once every two hours.

It's another week before I see the gal at the DME place again. I'll talk to her about the possibility of a different mask. However, I'm not going to hold my breath that they'll have anything that will work better. This is a small rural community and from what she said when I picked up my equipment, it sounds as though they have a limited number of mask styles in stock compared to larger centers. So it would probably mean having to order something.

In the meantime, I'm ordering a chin strap and cervical collar. Hopefully, I'll get them in time to try them out with the current mask before I see the lady.