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**James @ Intus** · 13 February 2009, 07:49

Hi Oliver,

Welcome to the group.

It's quite normal for it taking a while to get everything comfortably right. Mask selection is key and you won't be the first, or last, to need a couple before settling on one. You'll simply have to continue tweaking everything until you find your own personal balance.

There are a few clever products that can help avoid leakage.

Most leakage comes either from the mask being interfered by the pillow or the hose pulling on the mask. The SleePAP Pillows has special cut-outs where the mask goes to avoid the mask pushing into the pillow, preventing leaks and pressure marks. The CPAP Hose Lift is a hose suspension system which allows for plenty of slack in the hose to avoid mask pull.

It's worth putting in the effort to get it right as the rewards are tremendous. There will be plenty of handy tips and tricks you can pick up here.

**leswaller** · 13 February 2009, 09:52

Hi Oliver
As James has said, getting the right mask and the right fitting is the secret. It does take a lot of fiddling about for most people but it is worth the effort. It probably took me about four months of trying different masks and different strap tensions before I got the knack, but now I am sleeping 7-8 hours every night without interuption. After a while you develop a sixth sense whilst asleep if the mask starts leaking as the sound from the air changes. You soon learn to just move your face a little and it will reseal automatically. This was a particular problem to me as I tend to sleep on my stomach with my head buried in the pillow. I can recommend James' special pillows that have a cut out in them for the mask to settle into which prevents the mask being dislodged.
Keep at it, the end results are definitely worth the effort

**ciderborg** · 15 February 2009, 02:30

hello Oliver,

Whilst all that has been said already is beyond reproach, I can ony hope that my personal testimony might be of some use to you.

First, no matter what you do, the mask is going to leak air. It's just something to get used to. I find these days (after three years as a hose-head) that I pout in my sleep so as to minimise the effect and believe me, you get used to it. Some nights the damned thing seems hell-bent on being uncooperative, whilst other nights you wont even notice it's on your face. The CPAP parafanalia is a means to an end and while it is by no means perfect, it beats the sleepless alternative. Knowing that its helping you is the first step you take towards better days.

Second, without proper insulation, your tube will gurgle if you have a humidifier and every now and then you will experience "rain out" which is the term of choice for those moments when water runs down your cheek or squirts in your eye. Sadly this is something about which you can do little except spend money. If like me that does not sound appealing, take solace from the fact that you WILL adapt to it, and once you've gone a couple of weeks with regular sleep, these tiny inconveniences will seem trivial. It's just a case of recognising where the benefits outweigh the inconvenience.

Thirdly, and finally, persist with it. Soon it will become as natural to you as wearing pants. For me it was an overnight success story so I guess I was lucky, but then again, I went 10 years undiagnosed before restfull rejuvinating sleep was possible. I miss sleeping on my front I suppose, but being a nocturnal Darth Vader sure beats passing out unexpectedly during the day. All of us hose-heads go through it so remember that you are not alone and before you know it, you'll ditch the ramp and find the bliss of sleep.

Good luck.

**Tigers Fan** · 15 February 2009, 12:24

And also ......

MIght you be blaming your movement for the leakage when some of it, at least, is due to your machine cranking up the pressure when you have an event. If your base/CPAP pressure isn't high enough, you'll be getting too many events, them (according to which machine) the pressure goes up and you get leakage.

What sort of machine do you have and what are you min/max settings?

Tigers Fan

**Mr Stefan** · 15 February 2009, 17:24

Leakage

Hi Oliver
Just to say you are not alone I am on my second week and although I can now settle down with the mask in position it is all the other things that happen, like leaks condensation etc, which take some getting used to, I have found this website forum a vital portal for information from experienced users who freely offer advice to novices like us.
Stefan

**musotech** · 15 February 2009, 19:43

Hi Oliver,
Just keep going, as Ciderborg said some nights there's no problem, others a complete nightmare! I've been on CPAP since November and I still have night where I could quite cheerfully throw the thing from the bedroom window! Mind you, the experience has been life changing, no longer do I see only the beginning and end of a film, I stay awake in boring meetings (well that could be a down side

) and I have far more energy!

**OLIVERABBIE16** · 19 February 2009, 14:37

Hi
and thank you to everyone who has responded to my plea. I must admit that I was at a low point but reading all the advice on this forum has helped me see what to expect. I think the most important point is to know what can be fixed and what to put up with, as ciderborg said the benefits far outway the problems, knowing this helps when I have one of those bad nights, but with time and by adapting to the mask I 'm sure these will become fewer.

In response to Tigers Fan I've got a Remstar Auto M Series / A Flex. at the moment my 90% average pressure is reading 15 and I think I have managed to set the max to 16, the lowest setting is 6 but I think this is the 'highest of the low' settings. If I'm reading the thing correctly I'm getting 14 events per hour. I'm all a bit unsure about these things and there was no advice forthcoming from the clinic. Do these figures mean anything to you?
I have a full face mask with nasal 'pillows' which Iam beginining to get used to and developing that 6th sense about.

I would be interested in finding out about the Sleeppap pillows that James and leswaller talked about.

Any way thanks to all for the great information , I have found this to be a great resource many thanks to all

**Tigers Fan** · 19 February 2009, 16:03

AHI too high

Hi OLIVERABBIE16 (have you thought about changing your name to include some lower case?)

If you are getting an AHI of 14 (events per hour) with a base pressure of 6, I suggest you need to increase the base pressure. You could probably tolerate a jump to 8 and then increase in 0.5 cm steps till you AHI is 5 or under.

Don't forget to increase your ramp start pressure according to base pressure and to keep your max pressure above your base pressure.

Increases in pressure mean adjusting your mask straps but don't over tighten - just enough to hold the set pressure when laying down in sleep position and a tad more. Less is more when it comes to strap tension.

Your 'M' Series is definately a one for cranking up the pressure and keeping it there when you have an event, so a low AHI is even more important and that means increased base pressure.

What oh! what is the name of your full face mask with nasal pillows? What with a mask like that and an MPAP somewhere else, I clearly have a lot to learn!

Tigers Fan

**James @ Intus** · 20 February 2009, 06:35

Originally posted by OLIVERABBIE16 View Post

I would be interested in finding out about the Sleeppap pillows that James and leswaller talked about.

You can find some more info here: http://www.eu-pap.co.uk/sleepap-pillow-o-20.html It's a shame they are so bulky to import, and with the dolalr rate changing the price has gone up unfortunately. We are working on a UK made pillow to achieve the same at much lower cost. A couple of you have been trialling a version of it. Once we're happy with it, they'll become available. Hopefully in a fortnight or so.

**OLIVERABBIE16** · 20 February 2009, 14:01

Hi Tigers Fan

not sure what you mean;
My mask is 'ResMed Mirage Liberty Full Face Mask'.

thanks for the advice on base level pressure I'll give that a go.

Oliver

**Tigers Fan** · 20 February 2009, 14:12

Oops!

Hi OLIVERABBIE16

Oops! Sorry! I'd forgotten that's how they are described. I have one as well but have stowed it until warmer weather arrives and I'm not tempted to pull the duvet over my head. I find them just too easy to dislodge.

'Full face' is normally used to describe a mask that fits over the mouth and nose - the best I can think of that can't be misunderstood is as was worn by Spitfire pilots, in the movies at least, but clear plastic as in hospital masks.

My current facourite full face is a Mirage Quattro which is doing fill in duty for my regular Mirage Ultra. I suspect you'd find either of these to be easier to get on with than a Mirage Liberty - but that's only because I do!

I have a Classified Ad posted looking for a swap of my Small or Large nasal prongs for Medium size.

Tigers Fan

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