Nasal mask pressing and obstructing my nose

[aribenet]

Hi all! Newbie here.

I just went through my second night with a cpap. I know it may take time to get used to it, but I think the issue I'm having may need to be solved some other way. I got an airfit N20 medium nasal mask with the machine, and when I put the mask on (even with no hose connected), it slightly presses the sides of my nose obstructing my breathing. Once I plug the machine I manage to kind of get to sleep breathing through my nose.

However, when I wake up in the middle of the night and to go to the toilet and then come back, I don't really know why, but it's much harder for me to resume breathing through my nose. If I take out the mask, my nose is not clogged or anything. But somehow, when I resume with the cpap, I really have to struggle as if I needed for it to build pressure again. And it feels as if all the trouble is in the nose because of the mask obstructing my breathing. After a few mouth breaths, which seem to get the machine to increase the pressure, then I can breathe again through my nose and sleep again, but by then with all this process that takes more than a few minutes, I am fully awake and have to struggle to fall asleep again.

Any advise? Could a nasal pillow help me by not pressing the sides of my nose? Maybe another trick for when I come back to bed for the machine to faster adapt to my needs?

Thank you!

[zonker]

Hi all! Newbie here.

sorry you're having some complications.

my first thought is that the pressure on your machine was setup incorrectly. can you tell us what pressure you are at?

you might want to consider downloading the free software program, oscar. it will give you and the forum a lot of detail which will come in handy moving forward.

good luck!

[Pugsy]

Any advise? Could a nasal pillow help me by not pressing the sides of my nose?

It might and well worth trying. I cannot use any sort of mask that touches the sides of my nose (that nasal bridge area) because it causes immediate congestion. It's why I never bothered to even try the N20.

Maybe another trick for when I come back to bed for the machine to faster adapt to my needs?

Need more information to be able to try to answer this question...like are you using the ramp feature and what settings are you using.

[kteague]

I too am very sensitive to a mask pressing on the sides of my nose. Even though I'm able to use a nasal mask, I have found that a slight difference in placement can change it from workable to intolerable.You might want to see if a slight shift helps you. The nasal mask I'm using came with my machine, but on reorder I'll be ordering a nasal pillows mask.

[aribenet]

Thank you all for the kind replies!

Regarding the pressure setting, it's on APAP from 5 to 15. I checked with OSCAR and it seems to be reasonable, as in the longest continuous sleep (which so far has been around two hours ) it raises to around 14 and then goes back and settles around 8 (with some ups and downs, but usually around there). And I'm not using ramp, but it starts a bit low for what I need and only after a few minutes I feel comfortable breathing.

Somehow, this is alright when I first go to bed (I can more or less breathe with the starting pressure of 5 and when the machine reaches around 8 I'm comfortable enough to fall asleep), but when I wake up to go to the toilet and I plug the hose back, 5 seems like way lower than what I need to breathe trhough my nose.

I think I have the same that Pugsy and kteagye described, that I get congested from the mask touching my nose bridge, and so once that happens it's impossible to start over again with the machine starting at 5.

My plan now is to get a nasal pillow (I already requested one from my healtcare and will get it in a few days), and if it doesn't solve the issue, maybe set the machine with a higher lower pressure (maybe from 7 to 15) so that I don't have that much trouble to get back to sleep.

[Pugsy]

My plan now is to get a nasal pillow (I already requested one from my healtcare and will get it in a few days), and if it doesn't solve the issue, maybe set the machine with a higher lower pressure (maybe from 7 to 15) so that I don't have that much trouble to get back to sleep.

When you have the pressure up around 8 and have been using that pressure for a while during the night and then stop the machine to have to start all over at the pressure of 5 your body has been used to 8 and it finds 5 isn't enough.
This is fairly common and if it were me I would start at 7 or 8 instead of 5 no matter what mask I use.

A lot of people find that the 5 cm starting point leaves them feeling air starved. We won't suffocate at low pressures like that but it sure feels like we are.

[aribenet]

I'm just guessing something else that I will try tonight. What keeps me awake is that I need to struggle a lot when I come back to bed to breathe through my nose. But if I don't make any effort and just breathe through my mouth for a short while, the machine should increase the pressure until it feels natural again to breathe through my nose, right? Maybe it's just that, I should stop struggling to breathe through my nose from the first second, it will just happen naturally after a few moments.

[Pugsy]

just breathe through my mouth for a short while, the machine should increase the pressure until it feels natural again to breathe through my nose, right?

You can give it a try but the machine will only increase the pressure if it senses some sort of airway compromise and normally that shouldn't/wouldn't happen until you fall asleep and your airway starts to collapse.
So don't be surprised if that doesn't work out like you thought it would. While awake and breathing normally the machine shouldn't be increasing the pressure because it needs a reason to increase the pressure.

[RogerSC]

Yes, the ResMed AirFit N20 doesn't work for me, either. Having a mask pressing down around my nose is a non-starter. The mask that I'm using, the AirFit N30, is a nasal cradle mask. The cushion goes under my nose, like nasal pillows, only it doesn't depend on my nostrils being symmetrical. The N30's been working for me for a couple of years now, one of the few masks that I can use, and find comfortable enough. Including the Dreamwear nasal cradle mask, which also works for me but is heavier and has a jet of air coming out the front. Took a while to get the leak rate down on the N30, since I'm a side sleeper, but worth the time spent.

[MikeekiM]

When you have the pressure up around 8 and have been using that pressure for a while during the night and then stop the machine to have to start all over at the pressure of 5 your body has been used to 8 and it finds 5 isn't enough.
This is fairly common and if it were me I would start at 7 or 8 instead of 5 no matter what mask I use.

A lot of people find that the 5 cm starting point leaves them feeling air starved. We won't suffocate at low pressures like that but it sure feels like we are.

Air starved is a great term. I used to refer to my experience as "suffocation".

Ever since setting my start range to 7, I have been much happier, but once in a while I still feel a bit "air starved". I have been on the 7 setting for well over a year, but I think 8 might be an even better initial setting for me.

[MikeekiM]

Yes, the ResMed AirFit N20 doesn't work for me, either. Having a mask pressing down around my nose is a non-starter. The mask that I'm using, the AirFit N30, is a nasal cradle mask. The cushion goes under my nose, like nasal pillows, only it doesn't depend on my nostrils being symmetrical. The N30's been working for me for a couple of years now, one of the few masks that I can use, and find comfortable enough. Including the Dreamwear nasal cradle mask, which also works for me but is heavier and has a jet of air coming out the front. Took a while to get the leak rate down on the N30, since I'm a side sleeper, but worth the time spent.

The N20 works for me. While I hate the headgear, I appreciate that the headgear holds down the cushion secure enough on four points that it is easy for me to move from my back to my side (and back to my back again) without the mask dislodging from my face. My biggest complaint with the N20 is that I feel a little like my head is in a "vice" and I can't scratch my nose if it itches. Oh, and @pugsy knows this from my "heated tube" thread, but I also don't love the condensation build up inside the nasal mask when I don't have my humidity settings set correctly.

It took me 18 months to get comfortable using my APAP, but now that I seem to be "there" now, I may try switching back to the P10 or N30/N30i for a more minimal mask experience. But for now, the N20 is a workable solution for me.

But I completely understand the issues with pressure against you nose (including the bridge of your nose). I had the same issue wearing eyeglasses, and developed severe headaches due to the nasal bridge pressure.

[aribenet]

As a follow up on this, and because it may help others, I managed to sleep much better with the N20 just by positioning it lower (something that seemed impossible at first but after a week I just managed to). The lower part between my upper lip and the base of my nose.

And now I just got a nasal pillow (BMC PM2, not because of recommendations, but because it was the faster to arrive to where I live) that feels great. Going from a nasal mask to nasal pillow seems like a total game changer for me (everyone is different, of course), even though I just used it for an afternoon nap so far.

Thank you all for the help and kind responses!

[zonker]

As a follow up on this, and because it may help others, I managed to sleep much better with the N20 just by positioning it lower (something that seemed impossible at first but after a week I just managed to). The lower part between my upper lip and the base of my nose.

And now I just got a nasal pillow (BMC PM2, not because of recommendations, but because it was the faster to arrive to where I live) that feels great. Going from a nasal mask to nasal pillow seems like a total game changer for me (everyone is different, of course), even though I just used it for an afternoon nap so far.

Thank you all for the help and kind responses!

you are most welcome! i've found that my p10 nasal pillow has a "cinderella" spot, as well. it has to be just so. then it can deliver the air without leaks and at maximum efficiency.

[vandownbytheriver]

Reliable sales houses give 30-day returns on masks... pretty sure they just go in the trash. I tried a medium mask... can't remember the model, it's obsolete... and it did the side thing like yours. No way I could tolerate that, so I sent it back for credit and just went ahead and got a full-face sized large.

If insurance paid it may be a different arrangement... medical appliance insurance is such a scam in USA, I don't even bother trying to fulfill a 3000$ deductible, just pay out of pocket. The cheaper places won't take insurance normally anyway.

[surf_rower]

You might want to try a nasal cushion rather than, or alternating with, the nasal pillows. Some masks take either, I believe.
The cushion is fantastic for me. I used pillows for 12 years and tended to get redness inside nostrils, probably visible to young people who don't have poor closeup vision.
The cushion stays outside the nose, and nowhere near the bridge, and is super soft.