New CPAP User - panic or wrong mask?

Hello everyone, this is my first post here. I've been reading for a few days in preparation for getting my first CPAP machine, which happened yesterday. I was so excited to bring it home and start getting good sleep, but I had problems sleeping last night and took the mask off after 2 hours according to the info on the machine. I thought I'd have no problems because my husband has had a CPAP machine since before I even met him (which was 15 years ago!) so I'm very familiar with the concept, plus I had no problems the night of my titration study. I thought I'd have trouble breathing out of my nose because I typically breath through my mouth at night, but I was fine during the titration study.

When I went to pick up my machine yesterday and we talked about masks, the technician asked me how I usually slept and when I said on my side or stomach, he suggested the Fisher & Paykel Pilairo nasal pillow mask. It seemed fine in the office but when I tried to sleep with it last night, I felt fine upon inhaling (maybe a bit of air hunger, but I felt this at the titration study and got over it without problems), but when I'd exhale, I felt like I was working against the pressure too much. I felt like it was because the little nostril holes are in my nostril, thus reducing the amount of space I had to breathe out of, if that makes sense.

I don't know if I should try to get a new mask right away or if I should just try to get used to this one - maybe I'm just panicking. It was comfortable when I tried to sleep on my side and even on my stomach if I kept my head on the edge of the pillow. So I like that, but I'm not sure if I'm the kind of person who can adjust to the way it feels when I breathe out of this mask. When I told the technician that I breathe out of my mouth, he said "well, you could try a full face maks, but I don't want to start you out on that," like it was a terrible idea. Is there anyone who started with a full face mask? Is it really such a terrible idea? Has anyone started with one as a way to cope with all the change of sleeping with a CPAP machine? I also have awful allergies and am generally stuffy in my nose. I don't know if I should try to fight against my sleeping position (I think it would be hard to sleep on my side with a full face mask) or my way of breathing (hard to switch from mouth breathing to nose breathing).

I'm sure not what to do - do you guys think I should 1. try to get used to it on the theory that I'm just panicking, 2. call and get a regular nose mask, or 3. call and get a full face mask?

Editing to add that my pressure is 8.

I'm pretty new myself, but some of what you write sounds familiar. I was having trouble exhaling against the pressure with my nasal pillows also. I changed two things. First, I switched from XS pillows to S size, and I changed my EPR from 2 to 3. Made all the difference.

I'm not a mouth breather, so I can't speak to that.

The other problem I had was that I felt as if I couldn't get enough air, so I increased my starting pressure from 4 to 5. That helped immensely. I use a Swift FX nasal pillow mask, and I can sleep on my side and stomach with little trouble.

Sibilance7 wrote:Hello everyone, this is my first post here. I've been reading for a few days in preparation for getting my first CPAP machine, which happened yesterday. I was so excited to bring it home and start getting good sleep, but I had problems sleeping last night and took the mask off after 2 hours according to the info on the machine. I thought I'd have no problems because my husband has had a CPAP machine since before I even met him (which was 15 years ago!) so I'm very familiar with the concept, plus I had no problems the night of my titration study. I thought I'd have trouble breathing out of my nose because I typically breath through my mouth at night, but I was fine during the titration study.

When I went to pick up my machine yesterday and we talked about masks, the technician asked me how I usually slept and when I said on my side or stomach, he suggested the Fisher & Paykel Pilairo nasal pillow mask. It seemed fine in the office but when I tried to sleep with it last night, I felt fine upon inhaling (maybe a bit of air hunger, but I felt this at the titration study and got over it without problems), but when I'd exhale, I felt like I was working against the pressure too much. I felt like it was because the little nostril holes are in my nostril, thus reducing the amount of space I had to breathe out of, if that makes sense.

I don't know if I should try to get a new mask right away or if I should just try to get used to this one - maybe I'm just panicking. It was comfortable when I tried to sleep on my side and even on my stomach if I kept my head on the edge of the pillow. So I like that, but I'm not sure if I'm the kind of person who can adjust to the way it feels when I breathe out of this mask. When I told the technician that I breathe out of my mouth, he said "well, you could try a full face maks, but I don't want to start you out on that," like it was a terrible idea. Is there anyone who started with a full face mask? Is it really such a terrible idea? Has anyone started with one as a way to cope with all the change of sleeping with a CPAP machine? I also have awful allergies and am generally stuffy in my nose. I don't know if I should try to fight against my sleeping position (I think it would be hard to sleep on my side with a full face mask) or my way of breathing (hard to switch from mouth breathing to nose breathing).

I'm sure not what to do - do you guys think I should 1. try to get used to it on the theory that I'm just panicking, 2. call and get a regular nose mask, or 3. call and get a full face mask?

Editing to add that my pressure is 8.

Thanks for your reply! I also increased my started pressure from 4 to 5 last night and that did seem to help a bit.

The Pilairo is a "one size fits most" mask, so there are no different sizes of pillows. Maybe I just need to switch to a different nasal pillow mask?

I don't know what EPR is and I'm trying to figure it out with no luck - can you point me in the right direction?

I believe the EPR stands for "Exhalation Pressure Relief" of something very close. On my machine, there are three settings (1-3) which tell the machine how much of a reduction in pressure to provide when you are exhaling, so you don't struggle to do so. Mine had been set at 2, which I believe means that the machine was providing 2 cm less pressure on exhalation. I changed mine to 3, so I get a 3 cm reduction in pressure.

Someone will come along who knows lots more and can probably explain how it may work for your particular machine, and how to adjust it since its usually in the Clinician's menu.

Sibilance7 wrote:Thanks for your reply! I also increased my started pressure from 4 to 5 last night and that did seem to help a bit.

The Pilairo is a "one size fits most" mask, so there are no different sizes of pillows. Maybe I just need to switch to a different nasal pillow mask?

I don't know what EPR is and I'm trying to figure it out with no luck - can you point me in the right direction?

Finding a mask is often the hardest step - you may need a different one, though i'd try to tweak your current one first.

Try setting the EPR/C-Flex to 2, or maybe 3, and then see how it goes. Maybe the mask is OK. You want to usually just try changing one thing at a time.

I found the same problem when first using the CPAP. First thing I did was turn the ramp OFF! I was in panic mode until I did this. Getting the EPR right took a little longer, but that's just a matter of getting used to.

After 2 years of CPAP, I still spend a few minutes (an episode of Jeopardy) watching tv and tweaking my mask until it barely feels like it's there. This works great for me.

Cheers,
xena

If you're really got a Respironics "Plus" machine, the first thing you need to do is to fight to get a real CPAP machine. In my opinion, you got screwed by your DME. If you had a real CPAP machine, you could look at your data and see your breathing all night long. You could see if you were breathing well when you took the mask off. With the machine you've got, the only thing the machine records is when you had the machine turned on.

Check the links in my signature line about how to not get screwed by your DME.

Sibilance7 wrote:I don't know what EPR is and I'm trying to figure it out with no luck - can you point me in the right direction?

Hi Sibilance -- EPR is not a relevant term for your machine, it's a ResMed term. The equivalent is the Flex setting on a Respironics machine. Respironics users (I'm not) can help you with this.

Thanks, everyone - this is very helpful. I checked my machine and it says C-flex is "disabled," so it looks like the first thing I need to do is find out how to enable it. It didn't seem that I could as it was, so I think ughwhatname is correct about it being in the clinician's menu.

archangle - no, I have a Pro machine. That was just me getting mixing up the two words. I made a list of the good machines before I went to pick my machine up so I could make sure I got a good one.

Sibilance7 wrote:archangle - no, I have a Pro machine. That was just me getting mixing up the two words. I made a list of the good machines before I went to pick my machine up so I could make sure I got a good one.

Great. Another success for well informed patients.

Have you got the software to check your data yet? Check and see if you were having any particular problems before you took the mask off.