When am I going to feel better?

[CCwantstosleep]

I have been on CPAP for 6 weeks and am still struggling. I have two masks, the Mirage Activa LT (medium) and the Swift LT for her (xs pillows). I have a small face and nares, but a big nose. My nose hit the inside of the small Activa LT mask so I had to move up to the medium. The top of the mask is at the very top of the bridge of my nose, above where my glasses sit and the bottom of the mask sits just above my lip. I have had the straps adjusted correctly so they are not too tight, but I still get a red sore at the bridge of my nose that only allows me to wear the mask once before switching back to the Swift until it heals. My numbers with the Mirage are not as good with the Swift either (AHI of 5-6 with the Mirage vs less than 1 with the Swift), but I continue to wear it because I don't feel like I am struggling to breathe with it. I feel like I'm sucking a thick milkshake through a straw when using the Swift. I have to use the xs pillows because of small nares. I tried moving up to the small, but my husband said I snored A LOT!

Should I try the small Activa or do I need to leave these two in the dust and search for a third mask or is there something else I can do with either of the two I have?

[OutaSync]

If you like the Activa in all other respects, you could try one of these nose protectors.

http://padacheeks.com/PAC_Nosebridge.html

Bev

[Julie]

I'd very much like to know what your prescribed pressure(s) is, and I'd also like to know if you've ever tried a 'full face' mask in case you are losing air out your mouth once asleep.

[CCwantstosleep]

My prescribed pressure is pretty low - only 6. My doctor, who I love, said that even though my apnea is very severe (89.9), the pressure of 6 fixed it - I had a split study. I don't think I'm losing air through the mouth - I am a jaw clencher!

I just want a mask that is:
comfortable
easy to breathe with
doesn't leak
takes my AHI to less than 1

Am I being unrealistic?

[Cosette]

I just want a mask that is:
comfortable
easy to breathe with
doesn't leak
takes my AHI to less than 1

Am I being unrealistic?

Let me know when you find all that!

[torontoCPAPguy]

From one newbie to another my first statement has to be "hang in there" - be proactive and it will make a difference eventually. I had the ResMed S8 Escape II at first and I must say that it is not even suitable for travel for me. So I bought one Autoset II and was so pleased that I bought the company (no... that's a shaving commercial) I mean I bought a second one and will use the Escape II for emergencies or as a second spare while travelling. I LOVE the Autoset II and have just started tracking my data.

Masks make all the difference in the world and my first mask was the Swift LT.... hated it but didn't know any better at the time. Every time I pressed my face and nose against the pillow it smooshed my nose and consequently the Swift LT which has a VERY fragile output into your nares. Take a close look and you will see what I mean. The airflow virtually stopped and I was forced to mouth breathe. Not a good habit to pick up as one is trying to breathe through their nose 100%. I cannot use my Swift LT. So I went to the Mirage Activa LT and PRESTO! I hit the right mask on the second attempt! The Activa LT has a forehead brace to prevent cutting into the bridge of your nose and it works 100% for me. Also, you need to note that the Activa is a "bellows" type of mask which means that the air needs to be flowing in order to get a proper fit. The S8 Autoset II has a feature that gives you up to 3 minutes of full air output along with a graphic meter to show the quality of the seal. Press the on/off again and you go into regular 'go to sleep' mode. It is marvellous. For me, there may be something more comfy but the Activa is sufficient and all I need to get used to is having something over my nose and touching me while I sleep. I am getting there after only a few weeks. Love it. And best of all, if I smoosh my nose against the pillow and do happen to break the seal (has not happened yet) the Autoset II will go into alarm mode and wake me up to tell me.... but like I say, it has not happened yet while with the Swift it happened every single night.

The other thing worthy of note is that FIT is incredibly important. I tried the Large Mirage Activa LT at first and found it was 'unstable' on my face. Ordered a LARGE WIDE version and it is, needless to say, much more "stable" as the contact points are wider on my face. While no expert, I would have to say that the wider the better for stability and seal as it will also avoid the creases beside your nose... as long as it is not so big as to hit your eyes or mouth at the top and bottom. I came to this conclusion as I wear a holster on my belt and the best holster I have been able to find is the widest holster available. The wider the attachment points on my belt, the more stable the attachment. Ditto on the mask, ditto on fire engines (you will note the hook and ladder trucks all seem to have supports that come out from the sides to touch the ground making for a wider and hence more stable base).

I still have much to learn but I hope that these comments provide some assistance and comfort to you. Oh, the other thing about the Autoset II is that you will be able to pull of up to a year of detailed information such as leakage, AHI, HI, apnea events, etc. And when I looked at MY information I could directly relate my better days to the better numbers on the daily reports. Amazing. The machine will ask for a range of pressures (which you should choose in conjunction with your MD's) and it will then auto adjust minute by minute and breath by breath for maximum effectiveness and comfort. I have just looked at the past week of data and although my lseep has not been solid every night, I have had exactly ZERO APNEA events. I was amazed. The Autoset will 'predict' APNEA events about to happen by the vibration in the airflow and will ramp up the pressure and titrate it down to ensure no APNEA events, all without human intervention and all without waking you up. I am in the process of putting a UPS on the machine so even if the power goes off (and it did the other night... we are in the suburbs) you will wake up with the clocks flashing 00:00 having never noticed the power failure.

I must also say that we have installed in the house power failure lighting so that if the power fails at night, wee lamps come on at the power outlets in several locations so that we don't trip and fall on the way to the bathroom. We reduce the temperature in the house slightly and we kill all the lights these days so that we get a better sleep. We have bought a good mattress and a great duvet comforter as well as new pillows. In other words, we have invested, based on the best scientific evidence, in getting a good night of sleep. Nothing to drink within an hour of bedtime. No salty foods at supper. Visit the washroom just before going to sleep (get out of bed for this one). And an agreement within the family that everyone will do the same so that we don't have squeeky feet at 3 a.m. although I am sleeping much deeper these days. We have installed a Class A alarm system so our perimeter is protected, have a dog that will bark before our perimeter is compromised and can sleep soundly knwoing that we are in our 'castle' with an early warning system (named 'buddy') and that we are well able to protect ourselves in the event that all fails. We sleep well in terms of comfort and security now. They are issues that are off the table. So it is down to the apnea alone as well as any emotional baggage from the day.... which we try to limit and put to bed before us.

I am sure that more experienced voices will chime in here. I cannot begin to thank my cpaptalk friends for their public and private words of encouragement and advice. It has made a huge difference in my life thus far and I am expecting and hoping that better things are to come yet. In closing, I just want to reinforce that a good night of sleep is not simply the "apnea stuff' although that is VERY important. I have highlighted some of the other things that we have changed in our lives to make better sleep a possibility. Once everything is in place I would be willing to bet that you will get a better if not a great night of sleep. YOU and only YOU must be proactive in getting a good night of sleep and you have to be your own advocate because if you are not you will miss things that are sitting right in front of your nose.

DO NOT give up. Better sleep and better days are indeed ahead but it is not going to happen like magic as I have discovered. Only you can make it happen and you will make it happen. I cannot begin to tell you what being proactive has done for me these past few weeks. simple things like making sure I get to bed at 10:30 p.m. and asleep by 11 p.m. so that I have a shot at 8 - 10 hours of sleep. (I don't get it every night by a long shot yet... but I will get there I have no doubt). Things like making sure that my better half comes to bed by midnight (otherwise I wake up to find out what is going on); things like making sure the doors are locked, the alarm system set, the lights are out, temperature down, etc. All of these things will contribute to a better night of sleep totally seperate from any APNEA or other obstruction or central issues, which can also be dealt with. I also have been diagnosed with fibromyalgia and arthritis which both affect my sleep. I am awakened by pain in the night. Yet I cannot begin to tell you the difference that the other half of the equation is beginning to make after only a few weeks.

Keep at it and begin 'taking care of business' in an overall sense. Stop taking "dunno" for an answer and start insisting on other things being investigated if they might be a bother. Research "a good night of sleep" on goodle and make the changes you need to make in order to eliminate THAT side of the equation too. And before long you will be sleeping like a baby. If anyone had told me that I could (in my wildest dreams) sleep ELEVEN hours straight I would have said they were crazy.

One last thing. If you are taking narcotic pain killers for any reason you are going to have to wean yourself off of them. I was on oxycontin at one point, every four hours. DUMB. Oxycontin, if you want to look it up, is 11 times more adictive than heroin and has the same side effects, which include effects on sleep. I now take Tylenol for my arthritic pain and it works sufficiently to allow sleep without the side effects. My doctor wanted me to go to a methadone clinic to get off the oxycontin when I told him that they were not for me and I was going to get off them. NO clinic. I weaned myself off oxycontin onto Percocet (a howitzer to a peashooter) and now off Percocet onto Tylenol (a peashooter to a butterfly). No sleep medications any longer either. All artificial and the fastest way to get you out of their office. Educatge yourself and get ready to feel better because I can almost assure you that you will feel better and you will be amazed at how simple it was and how it was sitting there and staring you in the face. BE YOUR OWN ADVOCATE. Good luck. All of your newfound friends on this board are rooting for you I can assure you.

[billbolton]

Am I being unrealistic?

In a word... yes.

Firstly forget about a numerical target, that way lies madness!

Secondly, the "doesn't leak" target is very tough (especially as you want comfortable as well). Just go for minimal leaks.

Your other two targets are pragmatically reachable, but you may need to work through a few masks to find the best basic type/brand for you, then work on tuning the details around that one, as suggested above.

Cheers,

Bill

[cotech50]

Started 11/24/09 and now at 11-14 pressure. I have fought and overcome the leaks for the most part and accept whatever numbers I can get. I just focus on how I feel and what kind and how much quality sleep I can get, the rest pretty much takes care of itself. Hang in there I know some hate the FF mask but I would not five up my Quattro.

Good luck

[terrydk]

My prescribed pressure is pretty low - only 6. My doctor, who I love, said that even though my apnea is very severe (89.9), the pressure of 6 fixed it - I had a split study. I don't think I'm losing air through the mouth - I am a jaw clencher!

I just want a mask that is:
comfortable
easy to breathe with
doesn't leak
takes my AHI to less than 1

Am I being unrealistic?

I am fairly new to the xpap scene as well, since 12/21, and for me and AHI of less than 5 and AI of less than 1 is good. I have finally these last three weeks been able to get consistent AI's of less than 1, even one night of .1 but usaully in the .4 to .8 range. I am using a full face F&HP Forma and am having better results with it than I did with the Quattro but I don't know that I gave the Quattro a fair shot or not being a newbie. I tried the Mirage Liberty but felt like my breathing was being restricted through the pillows.