Spouse and APAP machine's noise level; mouth breathing

Hi all, I was originally diagnosed with sleep apnea nine years ago but it was regarded as sufficiently mild at that time not to require treatment. More recently, though, I was retested and was issued an APAP -- a Respironics Remstar Auto Aflex Model DS560S with a humidifier heated system Model DS6H. At first I tried it with nasal pillows, but it appeared that my mouth was hanging open at times and my wife heard a constant "whoosh," so they switched me instead to a full face mask -- a ResMed AirFit F10.

After a few nights' adjusting to it, things are going fairly well. However, my wife says that sometimes if she is awake during the night, the machine seems fairly loud -- just the breathing pattern, i.e. Darth Vader-like in and out. Has anyone found good ways to reduce this (apart from earplugs for the spouse)?

Also, one other question. Overall I found the nasal pillows more comfortable than the full-face mask, and was sorry that it didn't seem to be working out. I think part of the problem is that I incline toward nasal congestion, which may result in breathing through my mouth. I'm trying a few treatments (nasal rinse, allegra, etc) to see if I can do anything about this. However, I see some mention in various places of "chin straps." Are these intended to prevent mouth breathing? Is this something I might bring up with my doctor if I want to give nasal pillows another try?

I have the same machine and mask. I also bought the P10 nasal pillow mask. When I first received the machine, I placed it on the bottom shelf of my night stand. My night stand is actually an end table, and has an open shelf on the bottom that is exposed on all four sides. At that level, the bed did a good job of muffling the noise of the machine. I have since raised the machine so that it sits on top of my night stand, and it is a good deal louder. I wouldn't say it is loud really, but I can understand why your wife might object. If possible, try moving it so that it isn't as exposed.

I started with a full face mask as I too am inclined to have nasal congestion and tend to mouth breath. I found that a humidifier setting of 4 helped me to breath easily through my nose. Play around with the humidifier settings and see if you breath easier at any particular setting. When I first tried my P10, I too would open my mouth. Not so much out of need, but more like my mouth would plop open while I was asleep. So I bought a chin strap, and love the combination of it plus my P10. Now if only my nose would stop chaffing.

Anyway, I hope this helps a little.

Thanks, interesting information. Coincidentally, I also have my machine on the bottom shelf of my night stand, which is an end table with an open shelf on the bottom exposed on all four sides. I'll have to experiment with the position. Overall, though, my wife doesn't mind too much -- she says the sound is preferable to snoring or apneic events.

The APAP's variable air pressure is interesting. Sometimes when I wake up the pressure is very gentle, but other times I awake in the night and it feels as though a fire hose of air is hitting my face. I assume that the machine lowers the pressure when it concludes I'm breathing correctly, but it amps up the pressure if I don't seem to be breathing evenly?

Thanks for the info on nasal pillows. So far I've been issued two full-face masks (first they tried me on a medium, but then bumped it up to a large), and I don't know that I'll be able to persuade them to issue me nasal pillows again. (They gave me a set to try during my initial trial, but apparently they threw them out after they thought they weren't working for me.) I don't mind paying for a set to try myself, but I'm also having a hard time getting a written prescription out of my sleep clinic.

I only started changing my settings last night. I'm using my F10 again while my nose heals, and that means I'm back to sleeping on my back. So I changed my machine from CPAP at 10 cm H2O to APAP from 10 - 14 cm H2O in order to better control events in the supine position. From looking at my data in Sleepyhead this morning it appears as if you are correct. Pressure ramps up when the machine detects certain things, and then ramps down again. I'm sure someone more knowledgable will correct me if I'm wrong. By the way, my wife also prefers the noise of the machine to my snoring. I started therapy three weeks ago, and she is just now starting to sleep without ear plugs. We've been together for 16 years, and she has been using ear plugs all that time.

As far as getting a copy of your prescription, remember that it is yours. They can't deny your request. If they continue being recalcitrant, request a copy of your sleep study's findings. My report contained the results of my titration, and the recommendation for the machine and mask. My PCP then wrote the prescription, and was able to give me a copy when I asked.

SleepyHead looks like a nice app. Do you remove a memory card from the APAP and put it in your computer to transfer the data, or is there some other way of getting it there?

I'm going to be seeing my primary care physician this week for other reasons, and will see if he can help with the prescription.

Dyssomniac wrote:SleepyHead looks like a nice app. Do you remove a memory card from the APAP and put it in your computer to transfer the data,

yes.

You might consider investigating using the Oracle mouth mask. Solved all my problems.

Thanks for the suggestion of the Oracle mask, that sounds worth checking out.

Meanwhile I downloaded and used SleepyHead for the first time this morning, which also concided with my first night of using a larger model of full-face mask. It was certainly an eye-opener to check out all the data! On a positive note, my AHI was lower with the new mask than with the old (I realize, though, that AHI can change a lot from night to night, so it's probably too early to draw too much of a conclusion). On the other hand, the data showed quite a bit of leak with the new mask, that I generally was not aware of while using it. I guess as a starting point I'll look at judiciously tightening the mask to see if that improves the seal. If that doesn't work, then I probably need to look at other options.

Adjusting the mask is sometimes counterintuitive. The tighter you make it the more it leaks. Most masks are designed to float and inflate to create the seal. If you have leaks you may actually need to loosen the straps or adjust the position of the mask.

Look into Pad-a-Cheek(.com) liners designed by a member here - they go under the mask, help stop leaks and red marks and are all around pretty good things.

Thanks for the suggestions. I know that tightening a scuba mask can often make it start leaking. I'll have to check out Pad-a-Cheek.

Sometimes the exhaust from the mask will strike bedding,
making a sound like Darth. Rearranging the blankets may help.

Thanks for the suggestions. Actually with my new (larger) mask, my wife is reporting that the noise is much less, so that is seeming like a win.

On the leak front, I tightened the straps a bit last night, and SleepyHead indicates that I had a very low leak rate with 0% time above the large leak threshold. Ironically, though, my AHI went from 4.55 the night before (when the leak was larger) to 9.39 last night. I understand this can vary from night to night, and there are just those nights when it seems as though the aliens paid a visit. I guess I should keep an eye on this, though. One thing I want to try to look at more closely is how much time I spend on my back vs. sleeping on one or the other side -- I gather that even with the machine, apnea events still have a higher tendency to occur sleeping on one's back?

Dyssomniac wrote: I gather that even with the machine, apnea events still have a higher tendency to occur sleeping on one's back?

It's easy to forget that the "O" in OSA stands for obstructive. When you're on your back, gravity takes its toll and your throat tissue obstructs your airway more readily.

By the way, the machine you have usually is extremely quiet, so I would keep looking at mask issues or even machine issues if the sound level continues to be high.

Thanks. I'm pretty sure the noise issue was just the ill-fitting mask, but that's fixed now.

Maybe I'll have to attach a tennis ball to my back to keep me on my side?