Advice needed

[shelley123]

Hi guys,

I've not visited the forum for ages. I started on cpap 6mths ago and it has been great. After a few teething problems, I've had months of fantastic sleep using my cpap and it gave me a new lease of life. However for the past month I have beginning to slip back into my old sleep pattern of waking up constantly thorugh the night and not seeming to fall into a deep sleep atall(I think I am having apnea episodes again) although I am not nearly feeling as bad as before therapy, I am starting to feel groggy during the day. I think the mask is not fitting like it should because I am feeling air in my eyes when they are open, although I can't feel this on my hand. I have put some weight on recently and I have also began smoking again (I know, I'm an idiot).

I have spoken to my sleep clinic and they have given me a new rubber for the face mask and increased the pressure twice and now it is almost at full pressure.

Any advice would be welcomed. I am beginning to feel very depressed as I cannot go back to how I felt before therapy - it was horrendous. Now the pressure has been turned up, my husband is complaining that it is whistling which has caused big arguements.

I am now dieting to try to lose weight (I am quite big) and I do plan to give up smoking.

No-one understands what it is like unless they too have sleep apnea. I'm feeling so low at the moment.

Shelley x

[Tigers Fan]

Les' Theory

Hi shelley 123

You have my sympathy! even if I struggle a bit to feel that about you giving in and starting smoking again!!!!!

Have you put on a significant amount of weight - as in, what percentage increase over your weight when CPAP was working? A couple of pounds is one thing, a stone is quite another - talking CPAP here.

Next, what was your pressure when all was well and what were the increases? Did the first increase cause an improvement in your therapy? How about the second?

I'm wondering if you have gone past your 'correct' pressure and are now suffering a decreased effectiveness of CPAP. I swear by 0.5 cm increases every four days as a maximum rate of increase of pressure when we are looking to compensate for weight - and other - changes. This fine tuning may not be available from your clinic and might need you to learn how to adjust your settings.

TF

[shelley123]

Thanks for the speedy reply xxx

Well, My pressure was 16.4 and now it's 18. It was increased twice in the last week. I do think last night (first night at 18) it was a bit better although I did turn it down at one point during the night but then turned it back up(I remembered how the technician from the clinic told me how to increase it over the telephone yesterday) I have put quite a it of weight on, more than a few pounds probably. I am wondering if there is something wrong with the mask though because it just doesn't seem to fit like it did and I am forever adjusting it during the night but this could be because I am more aware of it because I am not sleeping as good. Sorry for rambling on. Hopefully my weight will come down soon because I've joined a gym and am on a diet too.

Do you think smoking has anything to do with it?

Thanks XXX

[Richard]

Good morning, Shelley,

I wonder if I can offer a solution to your problem, certainly insofar as your leaking mask is concerned?

Leaks from the mask can result in a much lower pressure being delivered, so you are not getting air at the pressure your SA consultant prescribed as being right for you. Apart from that, your husband is getting the fart and whistle sounds the leaks produce.

I use a ventilator (not a CPAP) every night set at a pressure of 40mm Hg. This machine has saved my life without a doubt, but with the pressure so high, any leak between the mask and my face will produce an abundance of unwanted sounds throughout the night. I have used the vent. for the last 5 years.

Through trial and error I have at last reached the optimum fix and I am more than happy to share my discovery with you and members of the CPAP Forum.

The rim of the mask does not have the definition to follow closely the contours of your face; a 'gasket' is required to fit securely to the mask yet, on its other side, follow the contours of your face.

I won't bore you with details of my trials-and-errors, but this is what you need: a Remzzzz mask-liner (which you can get through James) and a pack of MEPILEX 15x15cm.surgical dressing.

Mepilex is only available on prescription but you should have no problems with your local pharmacy.

This what you do: Take the Remzzz mask-liner and spread it out over a piece of medium thick cardboard. Fix the mask-liner to the cardboard with sellotape or Pritt-stick. Cut round the edge, both outside and inside once the liner is securely fitted to the board.

You now have a Remzzz face-mask liner in stiff cardboard! This gives you a template to work with. Take one piece of Mepilex out of its packet and place the template so it fits over the film side of the Mepilex. This side is adhesive and you will see the protective film is in two parts: when you place the template on the Mepilex, make sure the join is running left to right and is furthest away from you. Take care to place the 'top' of the template facing away from you squarely onto the piece

Mark in pen around the inside and outside of your template onto the protective film. Now cut around the lines you have made.

You are left with a triangular sheet of Mepilex with a hole in the middle. Now, first making sure your face-mask is to hand, peel away the smaller piece of film and line up the top of your mask with the top and the opening of the Mepilex sheet you have just cut out, making sure you have the adhesive side in contact with the mask. Peel away the rest of the film and place it hard against your face for a few seconds.

When you come to fit your mask on for the night you may need to adjust the straps a little, once you have done that you will have a very soft, comfortable fit and NO LEAKS!

I realise that all this detail must sound tedious, but once you have done it a couple of times, and you remember to keep the template (!), it is well worth the good night's sleep it brings you and your partner. Each Mepilex liner should last at least a week, there are 5 in a box and your GP should prescribe 3 boxes at a time, that's over 3 months supply, and if you make them in batches there are always some handy.

Any problems, I am happy to give what help I can.

I hope this helps you, Shelley.

[Tricia]

Maybe RemZzz's would help stop the whistling noise if it's coming from your mask?
Lots of luck with losing weight and stopping smoking. Both can only help.

[shelley123]

Thanks for all your replies. I just wanted to give you all an update. I did give up smoking like I said I would and it would appear that it has solved the problem. So, for all you smokers out there - give up, not only for the obvious health benefits and financial benefits but also because it can interfere with your cpap therapy.

Thanks again everyone

Shelley xxx