Suffocated while side sleeping on P30i

[samurai3005]

Hello guys. Thanks to the fantastic support I received on my previous thread, I was able to get my dad to use the CPAP.

However, for the last couple of months, there's been a little problem. Once again I hope I can find a solution on here.

He's using the Autoset 10 and the P30i with a pressure setting of 7-13cm (this is the setting recommended by his sleep doc since his maximum pressure never went higher than 12).
Whenever he's lying on his back, or on his side BUT with his head lifted 45 degree, he feels comfortable and could get to sleep fairly quickly. But when it comes to around midnight onward, he'd turn around A LOT and had his head rotated 90 degree and felt suffocated immediately (especially when the pressure was currently pushed higher than the initial 7cm H2O) so he just unconsciously removed the mask.

This has been very annoying because if I wasn't there to put it back on, the mask would stay removed. On nights when I was able to stay up late I would put it back on for him (only for him to remove it 30mins - 1 hour later when I was well asleep) and get the total usage to >4hrs/night. That's why for the last 2 months, his daily usage is only 2-3 hours!

I got him to try the N30i, N20 (our Resmed distributor doesn't have P10) and he said he felt worse (even on his back) compared to the P30i. I did some research and found out about the Bleep Dreamport, which essentially is a P30i but without headgear. I want my dad to try this mask but it's unavailable in my country so I'd have to order it internationally, which would make "mask trial" impossible. So I'm asking you guys if you think the Bleep Dreamport would work on this case and be well worth a shot?

[Pugsy]

The Bleep mask would require meticulous face/skin care prep to get the adhesive to stay put and once your dad pulled it off during the night there would be zero chance of sticking the same ports back on and they aren't hard to pull off if a person wants them off even after all the skin prep is done.

I use the Bleep. I love it but there are times I admit I don't do the skin prep like I should because it's late or I don't feel good or I am just lazy and they won't stay stuck on my nose. When you are with your dad to assure things are done properly and assuming he doesn't pull them off they would stay put but I have my doubts as to whether or not it would work well depending on just how much your dad wants to mess with them during the night.

[samurai3005]

The Bleep mask would require meticulous face/skin care prep to get the adhesive to stay put and once your dad pulled it off during the night there would be zero chance of sticking the same ports back on and they aren't hard to pull off if a person wants them off even after all the skin prep is done.

I use the Bleep. I love it but there are times I admit I don't do the skin prep like I should because it's late or I don't feel good or I am just lazy and they won't stay stuck on my nose. When you are with your dad to assure things are done properly and assuming he doesn't pull them off they would stay put but I have my doubts as to whether or not it would work well depending on just how much your dad wants to mess with them during the night.

Thanks for the reply, Pugsy!

Having read many posts about the Bleep (including yours), I'm well aware of a few difficulties that come along with it. However, I think it's the only choice I have left right now for my dad.

I just find it odd that many people on here say they sleep on their side a lot and have 0 problem with the P30i. I wish the same could be said about my dad's situation. He's just removed the mask as I'm writing this reply.

I'm keen on purchasing the Bleep but I just need to have a few more advice from people who had the same issue like my dad and found resolution in the Bleep. Because if he denied the Bleep then that'd be 100$ thrown right out of the window. International shipping means no return.

[Pugsy]

Your dad might like the Bleep and not mess with it but people do weird things in their sleep and don't remember doing it.

I also have used the P10 and wish you could give it a try. It's a lot less annoying than the P30i IMHO.

[Dog Slobber]

I just find it odd that many people on here say they sleep on their side a lot and have 0 problem with the P30i. I wish the same could be said about my dad's situation. He's just removed the mask as I'm writing this reply.

Your father has ripped off every mask your've given him.

Now, when he's ripping off the P30i, he's claiming he's suffocating. He's not.

As you can see with the P30i, the capacity of each side tube is comparable to the supply hose. Add to that, significant venting occurs at the top-mounted elbow so less volume is even needed. The mask is designed so one side can be completely collapsed and ample air is still pushed through.

He's frustrated at using CPAP, taking off every mask and giving a reason that you'll accept. You're frustrating because he keeps ripping them off. A different mask is not going to change anything.

Also worth noting, past charts show a minimum pressure of 5CM.

Low pressure such as 5 can contribute to feelings of suffocation. Perhaps increase his minimum to 6.

[samurai3005]

Your dad might like the Bleep and not mess with it but people do weird things in their sleep and don't remember doing it.

I also have used the P10 and wish you could give it a try. It's a lot less annoying than the P30i IMHO.

Initially when looking at possible options that might help my dad, I came across the P10 but unfortunately my ResMed distributor says they currently no longer market that mask. Instead they're offering me a BMC P2 (a quick google search tells it's a P10 made-in-china knockoff). But as long as it does the trick, all should be fine right? We're trying that mask tonight. Fingers crossed.

However, I'm still convinced that the Bleep would be a much better solution for my dad in the long run. I wonder if the adhesive tape would work as well on an Asian nose like my dad's. So far I haven't come across any review from an Asian user on this forum. Also my dad's face is super oily!

I just find it odd that many people on here say they sleep on their side a lot and have 0 problem with the P30i. I wish the same could be said about my dad's situation. He's just removed the mask as I'm writing this reply.

Your father has ripped off every mask your've given him.

Now, when he's ripping off the P30i, he's claiming he's suffocating. He's not.

As you can see with the P30i, the capacity of each side tube is comparable to the supply hose. Add to that, significant venting occurs at the top-mounted elbow so less volume is even needed. The mask is designed so one side can be completely collapsed and ample air is still pushed through.

He's frustrated at using CPAP, taking off every mask and giving a reason that you'll accept. You're frustrating because he keeps ripping them off. A different mask is not going to change anything.

Also worth noting, past charts show a minimum pressure of 5CM.

Low pressure such as 5 can contribute to feelings of suffocation. Perhaps increase his minimum to 6.

Yea I know it's super frustrating for me but I feel for him and I don't think he's trying to make it hard for me. I know he's trying as well so I'd better come up with something good. I even bought a contour memory foam pillow that so the headgear would be a bit free when he turns to his side but he still doesn't want to sleep with that pillow.
The setting right now is 7cm H2O minimum (with a 15-minute ramp from 5cm H2O) though.

[Julie]

A pharmacist could suggest a mild astringent (possibly wipes?) for your father to use on his face before masking - may be a better idea than soap and water (or at least do the s+w earlier).

[Pugsy]

Your supplier is flat out lying to you about the P10 being no longer marketed. They just no longer wish to stock it.
I can't see ResMed discontinuing the P10 for many many years. It's one of their top sellers. The P30i version isn't the replacement from ResMed for the P10. It's just a different kind of nasal pillow mask with a different hose routing system.

You are being lied to....big surprise...cpap equipment suppliers all over the world lying to their customers. It happens here in the US as well. They tell people "that mask is no longer being produced" when in fact they just don't want to stock it or order it for people.
Now masks will get discontinued by the mask manufacturers over time but only if they are very old and are simply no longer selling well.
ResMed still makes and sells the very first mask I used 11 years ago which is the Swift LT nasal pillow. It was a good seller back in the dark ages and it doesn't sell so well now but they still make it. Eventually it will be discontinued most likely but for now...it's still available.

The P10...huge seller for ResMed and they won't stop making it for many years. I am not a big fan of ResMed because of their business practices but I have to give credit where credit is due....they make good masks and machines.

Those Chinese knock offs....I have not seen their version of the P10 but I have seen a couple of the others like their version of the Swift FX and the silicone was stiffer and the headgear looked like it wouldn't last. Now I never used them because the silicone wasn't comfortable.

[Pugsy]

A pharmacist could suggest a mild astringent (possibly wipes?) for your father to use on his face before masking - may be a better idea than soap and water (or at least do the s+w earlier).

Let me explain in more detail about the Bleep and oily skin and trying to use wipes of some sort instead of or in addition to soap and water cleaning (which would have to be done immediately before using some sort of astringent) and at bedtime.

My skin isn't particularly oily at all and a wipe only or soap and water wash only simply isn't enough to keep the adhesive stuck all night.
The adhesive simply will not hold if the skin has any little bit of oil anywhere. I cannot cheat and miss a step in my skin prep routine or the adhesive will come loose and all it takes is a tiny bit coming loose to get a shot of air going somewhere on my face to wake me up.
A little wrinkle in the adhesive part usually means a jet stream of air shooting up to my eyelids. Highly annoying. Guaranteed to wake me up and of course piss me off since my sleep is so fragile anyway.

The other night I didn't feel well and was lazy and didn't want to take the time to wash my face and I hadn't worn make up that day or used any moisturizing creams or anything like that so I just used my usual alcohol wipe down thing for skin prep. The adhesive failed within 15 minutes. I keep a P10 on the bedside table just for situations like this. I only need to use it when I try to cheat and I am lazy with the skin prep.

I don't use a facial soap that is a moisturizing soap...they have oil in them. Around my nose I use a rather harsh soap but I might wash my entire face with a moisturizing soap and save the last step of washing the nose with the rather harsh soap. I am 68 years old and I don't really like the wrinkles I see.
I also look carefully at the ingredients in any of the "astringents" out there because most of them here in the US have some oil in them. I was looking at a bottle of witch hazel to maybe try but it has a kind of oil in it.
For now alcohol works well as the last step for me and I don't have particularly oily skin. Certainly nothing like men might have.

Proper and adequate skin prep is absolutely critical to the success of the Bleep staying stuck. The guys with oily skin...even more critical and there are different skin preps out there to maybe help out. Some are like what are used by people who have to wear colostomy bags because people for sure don't want those coming loose. So better than alcohol for sure and an option for people but they are very pricey.

Soap and water wash with a soap that is a non moisturizing kind of soap is the first step and must be done at bedtime.
Then a wipe down of the nasal area with some sort of additional cleaning prep...alcohol works for me but my skin isn't particularly oily.
For the guys with oily skin they are going to have to use something a lot stronger and more longer lasting. Like maybe something used for people who wear colostomy bags.
And they probably will have to use additional tape on top of the port adhesive and it's trial and error finding a tape that will stay stuck.

Khauser had this problem. It was a struggle finding just the right combination of all things to get him to where the ports would stay stuck. We found out the liquid soap he was using to wash his face actually had some oil in it so had to change facial soap. Then had to find a different skin prep as well to use after the soap and water wash.

All this sounds like a lot of work and some people will say "way too much work for me" and that's fine but I look at it like this
I need to wash my face at bedtime anyway don't I?
And I don't like strap marks on my face in the morning ..do I?
And I like the freedom the Bleep gives me..
And wiping down my nose with an astringent of some sort takes maybe a second at the most (I just used a bottle of alcohol and a wash cloth because wipes cost a lot more than a bottle).
And I have it down to maybe 5 seconds for the port application part of things including the connecting to the frame/hose part.

The really hard part is dealing with finding the skin prep that works and will last all night. The skin produces oil during the night and the people unlucky enough to have oily skin are going to have a much harder job finding the right combination of facial soap and additional skin prep to keep the oil production down to a minimum so the adhesive will stay stuck. The least little bit of adhesive failure even if it doesn't come totally off will cause leaks of a magnitude it's guaranteed to wake us up.

A soap and water wash earlier and a mild astringent for a guy with oily skin simply won't do it. Heck, it probably wouldn't even do it for me and I don't even have oily skin. If anything my skin tends to be on the dry side even my nose.
The soap and water wash has to be done at bedtime and the astringent wipe has to be strong not mild.

[Pugsy]

I wonder if the adhesive tape would work as well on an Asian nose like my dad's. So far I haven't come across any review from an Asian user on this forum. Also my dad's face is super oily!

There are some special skin preps available to reduce oil production and there are some tapes available that could be applied over and around the Bleep adhesive to reinforce things.

Do you know about the skin preps that people who wear colostomy bags use? I used a wipe of one of those once and man does it ever let the Bleep adhesive stay stuck. It's expensive but it works. I can look up the name and I do think it comes in a bottle which is cheaper than buying the wipes. There is also a tap that Stuart recommends which can be used over the Bleep adhesive to reinforce things and it stays stuck well.

Skin prep will be critical though....

So if the Chinese knockoff doesn't work out ....we can try the Bleep and I will get you some options to try.
Where exactly are you located?

Oh...not worried about nose shape or nostril shape at all. We can work around that easily enough. The oily skin is going to be the major issue to deal with.

[khauser]

I know I've posted this elsewhere, but here are the two products I use:

• https://www.amazon.com/gp/product/B002Z ... UTF8&psc=1
• https://www.amazon.com/gp/product/B0009 ... UTF8&psc=1

Both products work great, and for me both are necessities. These were recommended to me by Stuart at Bleep (and again, I urge anyone have any issue to contact this extremely nice and helpful man).

My Routine ... takes a total of 5 minutes (not including drying time):

• Wash face ... I am using Cetaphil ... as Pugsy said, I had been using 'Method' which turns out to have some oils in it.
• Let dry (I plan the wash from the next step to have at least 10 minutes between them)
• Skin Prep (it's really easy) ... while that dries...
• Cut 4 strips of adhesive tape: One 5mm, one 15mm and two 20mm strips (the tape has 10mm divisions on the backing)
• Apply Dream Ports (note: I trim off the long edge of the dream ports, which I use in the next step). Be sure to smooth down with decent pressure
• I use the cut-off parts (which are kind of triangular) to 'solidify' the adhesive from the dream ports between my nostrils, one from the bottom pointing up, the other from the top pointing down.
• The 5mm strip goes under the nose and seals the dream ports on the bottom.
• The 15mm goes across the tip of the nose to seal the dream ports on top.
• The 20mm strips go on either side.

The tape forms a triangle, the bottom on my upper lip, and the sides angling up to just under the bridge of my nose. When I'm done, all of the edges of the dream ports are secured with tape.

This is what I have to do, because I sweat and have oily skin. It's probably overkill for many.
Also, since I have a beard (and more to the point a mustache) I have to trim about 1/8" under my nose. No one notices. Thanks again to Stuart for this, who also has a mustache.

So that seems like a lot, but it really isn't. It just looks that way because I broke it down step by step.

Maybe one day when I am feeling sufficiently extroverted I will create a short video of this...

[chunkyfrog]

I believe your best bet would be the p10.
I tried the p30i, and find the p10 a 100x more secure--especially with the adjusting clips.
The "suffocation" feeling comes because the whole thing is so flexible
the pillows slip a tiny bit out of place and close up, stopping airflow.
The p10 is worth getting, no matter how you have to do it.
Insist the dealer order ir for you or you will get it elsewhere (and maybe never return)
Or just get it elsewhere.

[samurai3005]

So we've been trying the BMC P2 out (FYI, it's a cheaper version of the Airfit P10, you can check out a comparison made here: https://sleepright.com.au/cpap-masks/re ... cpap-mask/. To my surprise, the mask is quite well-made, considering it's made in China). The price for the P10 is $200 (plus I have to wait 1 month for shipping because they "no longer market that mask"). The BMC P2 is around $100.

My dad is able to sleep on his sides now, no more complaints of suffocation when turning like when he used the P30i. I guess the headgear flow thing is a massive turning point for him, maybe he's just too sensitive to changes in flow when changing position. Anyhow, this is the results from 2 nights with the new mask on.

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Compared to the last time with the P30i.

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However, he still removed the mask here and there (which explains the interruptions displayed in the OSCAR reports) due to feeling of itchiness, which he said has existed since the last few weeks with the P30i. I'm changing the filter in the machine as well as doing a full clean-up of the room to make sure the air he breathes in isn't too dusty.

I really appreciate khauser and Pugsy's advice regarding the Bleep Dreamport. I've bookmarked these posts so that I could get back to it if somehow this mask wouldn't work anymore. For the time being, I think we'll stick with this "cheap P10". I hope that with time, my dad will get used to the new mask and increase his daily usage because so far we've only been able to get ~ 4 hours/night, which is suboptimal.

[samurai3005]

I believe your best bet would be the p10.
I tried the p30i, and find the p10 a 100x more secure--especially with the adjusting clips.
The "suffocation" feeling comes because the whole thing is so flexible
the pillows slip a tiny bit out of place and close up, stopping airflow.
The p10 is worth getting, no matter how you have to do it.
Insist the dealer order ir for you or you will get it elsewhere (and maybe never return)
Or just get it elsewhere.

Since you're a long-term user of the P10, I think I may need a few advice. Has the pillow cushion ever cause itchiness (particularly the skin on the nostrils where the pillows go in)? If yes, how did you fix that?

[zonker]

Since you're a long-term user of the P10, I think I may need a few advice. Has the pillow cushion ever cause itchiness (particularly the skin on the nostrils where the pillows go in)? If yes, how did you fix that?

lanolin cream. brand name of Lansinoh. works a treat and helps prolong the pillows life span, in my experience.

pardon me, but i've forgotten if you are in the united states or not. it's available in the states, in the infant care section of grocery or drugstore.

it's used by nursing mothers to sooth sore nipples.