Sierra

It does take some time to get comfortable with your mask, and relax so you can get a good sleep. I have been at it for 5 months now, and am just starting to feel comfortable with one mask. I gave up on four other masks I tried. So time helps.

If you want to dig deeper it would be really helpful to download SleepyHead so you can see in detail what is happening during the night. You will find out how much your pressure is going up and down, and when exactly you are having your apnea events, and be able to compare that to when you wake up. The Dreamstation machine in particular likes to ratchet up pressure quickly and back down quickly. That can be annoying to some people, and may wake them up. And while pressure is down, you can have apnea events which are not helpful either.

An AHI of 5 is OK and considered the minimum treatment goal. It would be helpful to know what the breakdown of your AHI is. If it is mainly central apnea events, then reducing AHI is difficult as CPAP pressure doesn't stop central apnea and an AHI of 5 may be the best you can do. If it is mainly obstructive apnea and hypopnea then a well adjusted CPAP should bring events down closer to 1.0.

In short, you kind of have to dive into the detail to find out what may be causing you to wake up. You might find some of the tips at this website helpful in getting a good sleep.

I believe you have the AirSense 10 machine. If so here is a link to a pdf of the Clinical Guide for this machine. It is much more comprehensive than the user guide they give you with the machine. I would suggest downloading it and saving it as a pdf as these documents come and go on the internet. Pages 4-11 alone are a worthwhile read to just understand how the machine works. Best to grab it while you can. If you have the Dreamstation I can give you a link to the detailed manual to it as well. Just ask.

AirSense 10 Clinical Guide

Not sure what to suggest. The new Dreamwear Full Face mask was just released earlier this year and might be a possibility. It minimizes the hose protrusion in front of the face, and the mask itself is fairly small. To sleep on your stomach I think it is pretty much essential to sleep on the edge of a pillow with the mask extending out past the pillow.

Going to sleep OK, but waking up feeling claustrophobic an hour or so later might suggest the air pressure is not set high enough.

I think that getting the CPAP working would be the biggest step you could make. What are the reasons for the failure of each type of mask? Full face? Nasal? Nasal Pillow?

I am on mask number 5 and so far the ResMed AirFit P10 Nasal Pillow has been the most comfortable. I have addressed the common mouth air opening and air loss problem with a Breathewear Halo chin strap and I tape my mouth shut. Sounds awful, but I find it much more comfortable than a full face mask.

If you could update on what masks have been tried and why they failed, you may get some suggestions on what to try. If you are in the US I believe CPAP.com has a mask return policy if it doesn't work.

My wife and I manage to stay in the same bed, but not without some issues from time to time. We are considering going to a king sized bed to give more room. We both use a CPAP so snoring has been eliminated for both of us. Is your hubby using a CPAP? If set up properly it should eliminate snoring.

You may find some of the tips on addressing insomnia useful at the link below.

SleepWell CBTi

Joe,

I noticed from your bio that you are from Canada. Are you in a situation where you have bought your own machine and do not have a care provider to monitor/adjust your machine? I am in that situation and essentially look after myself when it comes to CPAP. I noticed from one of your earlier posts that you use SleepyHead. With that software it is not all that hard to see how well your machine is set up and is performing for you. If you need any help just ask. For what it is worth, I believe that taking control on one's own machine and monitoring your own results is far superior to blindly waiting and following advice from the "health care system" which does not have nearly as much interest in my health as I do.

Except that if anything the leaks make your AHI better, not worse.

Your comment about using 12 cm pressure seems to suggest your machine is in fixed pressure CPAP mode. If your machine is capable of AutoSet mode you may want to consider having it put into that mode. It would allow you or your provider to determine if there is any opportunity to limit the pressures to a narrow band instead of one fixed pressure. You may also find out that the 12 cm may be higher than necessary.

I did a trial on a F&P SleepStyle machine that had a feature that the ResMed does not. It detected when you woke up in the night and then reset the pressure conditions to the startup mode. It made it more comfortable to get back to sleep again. The same is not available to my knowledge on the ResMed. However you could do it manually by just reaching over and shutting the machine of for a few seconds. When you restart it will go back into the AutoRamp mode. That should be more comfortable to go back to sleep.

I suffer from some congestion, and use a ResMed P10 nasal pillow mask. I find if I can get my nose reasonably clear before I go to bed, I will stay clear all night. I do use a chin strap and tape on my mouth to ensure I breathe through my nose. I will occasionally use a decongestant like Otrivin in the more congested nostril occasionally but not as a matter of routine.

My experience with a full face mask (F20) was not so successful. I couldn't find the happy medium between a comfortable fit and no leaks. Also, it seemed to promote breathing through my mouth and I think that was causing a sore throat.

I find that for those who use SleepyHead and really look at what is going on, then improvements can usually be made by increasing minimum pressure and reducing maximum pressure, and quite often by increasing the minimum start pressure. Yes, people are different, but there is no way I would be comfortable with a minimum start pressure of 4 cm. It is just too low and I get a suffocating feeling.

An APAP is a reactive, not a predictive machine. There may be artificial intelligence predictive machines in development, but todays machine has to see an issue before it reacts. If you start every sleep session with 4 cm of pressure and you really need 10 cm for effective treatment, then you have to have enough apnea events in the early sleep to ratchet up the pressure to the effective level. By setting the minimum pressure at 10 cm you put your knowledge from viewing SleepyHead data into the machine. That makes the so called "automatic" method much more effective. The machine does not have to play trial and error on you every night. I think setting the minimum up in a Dreamstation is more important than with the ResMed. The Dreamstation algorithm seems to be slow to increase pressure and quick to reduce it, so it is going up and down all night, if you give it the freedom with a wide pressure range.

There is less treatment effectiveness to be gained by setting a lower maximum pressure, but some comfort can be gained. From viewing SleepyHead you can find times when the machine tends to become over responsive and push pressure up. Mild snoring and flow limitation can run it up even when apnea events are not occurring. If the individual is having issues with higher pressure such as leaks and waking up, it may be of benefit to tolerate a bit of snoring and flow limitation in exchange for lower pressure. And since apnea events are not increased, AHI stays low. My wife is in that category.

But if you set tight limits then you have to monitor your results more diligently.