Help for my husband - still snoring with CPAP?

I'm looking for some help. The DME provider and the doctor haven't been much help and we are both at our wits end!

My husband has always snored but it got really bad lately. I finally got him to go to the doctor and have a sleep study and they found he does in fact have sleep apnea.

The first two nights the machine worked but it hasn't worked consistently since. He's tried 4 different masks. The pressure has been increased.

Is it possible to still snore with the CPAP? He's not snoring as bad but it's still enough to keep me up all night. In addition, he's not feeling any better.

Anything and everything you could tell me is appreciated! Thank you!

I see this is your first post. Welcome to the forum. Fill out your equipment profile so we have a better idea of what he is using. Upper left of screen select User Control Panel, click profile tab, then select Edit Equipment. Choose the text version.

It would be interesting to know what the settings are on his machine. Do you have a copy of the prescription. It could be that the data available from the SD card would be helpful in knowing how effective his therapy is. There is much to read here. Keep asking questions.

To get some targeted advice, give us his exact and complete machine name and what pressure he is using, his mask, etc. The first step here is to see if his treatment is therapeutic. This may be a quick discovery, or may take a bit more probing. Hopefully he has a machine that reports data so it won't be such a guessing game. Once you give us some specifics, I'm sure people will come along with suggestions. Here's my first thoughts...

Is there any chance his mask does not cover his mouth but his mouth is opening while asleep?
Could a bad leak problem be keeping his airway from getting the pressure it needs to stay open?

Beyond this it will be a matter of checking data. Good luck.

I am sorry, I will fill out the info.

He has this machine: Fisher and Paykel ICON™ Novo CPAP Machine

And he's tried these masks:

Resmed Mirage FX
Respironics wisp
Resmed Mirage Liberty (has nasal pillows)
And one more on the way but I'm not sure what it is... So he's only tried 3.

Going to fill out the profile now but I will say that it's definitely leaking. If he doesn't move, it does okay....

kteague wrote:To get some targeted advice, give us his exact and complete machine name and what pressure he is using, his mask, etc. The first step here is to see if his treatment is therapeutic. This may be a quick discovery, or may take a bit more probing. Hopefully he has a machine that reports data so it won't be such a guessing game. Once you give us some specifics, I'm sure people will come along with suggestions. Here's my first thoughts...

Is there any chance his mask does not cover his mouth but his mouth is opening while asleep?
Could a bad leak problem be keeping his airway from getting the pressure it needs to stay open?

Beyond this it will be a matter of checking data. Good luck.

Sometimes his mouth opens and Often it's closed. I know his machine reports data. Is there a way to access this? Sorry for all the questions but we were never told how to get the data. His follow up appt. isn't for another month.

I just checked janknitz's website http://maskarrayed.wordpress.com/ and it appears that the F&P Icon Novo does not report treatment data, only the number of hours the machine has been used. Does anyone know if it even shows AHI?

kaiasgram wrote:Does anyone know if it even shows AHI?

Compliance hours of use only.
http://www.fphcare.com/CMSPages/GetFile ... e397e717f6

TaylorWilkes wrote:Sometimes his mouth opens and Often it's closed. I know his machine reports data. Is there a way to access this? Sorry for all the questions but we were never told how to get the data. His follow up appt. isn't for another month.

No way to evaluate anything other than how many hours it is used each night because the machine doesn't collect anything else.
If you were told it reported anything else you were told a whopper.
You need to read the blog that Kaiasgram linked to especially the part about "what to do when you realize you have a brick".

To answer your question...yes it is possible to still snore while on cpap therapy. It usually means that the therapy is sub optimal.
Snores are an indication of a reduction in air flow. While a little bit every now and then may not be the end of the world we have no way to know if his therapy is optimal or not. The Icon Novo can't tell us anything useful.
Since you haven't had it very long I would think that you need to get a machine that offers full data so you can monitor leaks and therapy pressure effectiveness.

Your husband is using a nasal mask and it sounds like he is a mouth breather. If that is the case you'll need a full face mask or try using a chin strap with his mask.

He's probably losing most of the Cpap air out of his mouth so a FF mask should be looked into. Chinstraps are good, but not always effective (lips can still allow air out).

This is an interesting, but not uncommon situation.

Patient says they are having some problems, and they end up getting a pressure increase.

Pressure therapy taxes the upper airway. In response the sinuses may oversecrete and/or swell up. Though manufacturers extol the virtues of humidity, the resulting flow limitation can cause recurrence of the symptoms; or you just feeling like your equipment doesn't work.

The posts regarding mouth breathing or blowing bubbles could certainly cause the snoring. Before going to a full-face mask, I wonder if the mask just needs to be cleaned. You say it did work for the first two nights.

Originally masks were glued in place with a medical silicone. This prevented little leaks which are problematic as you can't hear them, but they still deplete the circuit of moisture.

Good luck. Keep posting. Will be wonderful to hear what finally works.

Regular cleaning helps the mask keep its seal.
If leaking/squeaking is disturbing his sleep, a mask liner may silence that.
(DIY mask liners)
Some newbies wear the mask too tightly--make sure the cushion is allowed to inflate fully--wrinkles make leaks.

I didn't realize the machine didn't report data. I'm not sure if they told him it did. Are some machines better than others in that maybe it isn't working because the machine sucks?

Speaking of the pressure increase, can the increase work against him/hurt him?

He moves around so much at night. I think if be could stay still it might work...

Thanks again. I feel like I'm learning a lot here and hoping it will be better soon. My hubby is waiting for a call back from the DME and he's going to request a full face mask... Any suggestions?

They certainly don't have good information to work from with that type of machine. Depending on your copay with your insurance you may be better off getting your own full data machine by purchasing it outright. Are you in a situation where you can go to any equipment provider? Some insurance plans lock you into only one. Your present DME has given you the least expensive possible unit they could get by with. This increases their profit margin.

I would ask for an Auto CPAP that collects data like the ResMed S9 Autoset (be certain it is not the escape auto) or the Respironics DS560HS. These machines will provide you with data. You can use free software to make reports that will assist your doctor with your therapy decisions. You will also be able to receive suggestions here from other members.

If you can not get it through insurance you can buy them from our forums sponsor cpap.com. Or look for units being sold here and on Craig's list. I have a new one with the humidifier for $400. Feel free to PM if you want more information.

If he's losing therapy through mouth breathing, increasing pressure will make it worse, but you don't know yet if that's the case, or are you aware that he does sleep with his mouth open?