So I have now mastered the getting to sleep part.  I still wakeup every night 2-4 hours later.  I am groggy initially, but havent noticed anything.  No hose wacking me or anything like that.  The only thing I have noticed is dry mouth.  Is that a clue?  I set the humidifier on 3 or 4, and my nose is not dry.  

Resmed s8 Autoset II with Swift LT nasal pillows, set to 11, EPR on 3.

Leak started out at .2 l/s but has been climbing over the nights.  Last two nights it was .5 and .6 which I believe is high enough to indicate some sort of issue.  Mouth breathing perhaps...which could explain the dry mouth.  But they didnt see it as a problem in my study.

Maybe I should turn off EPR...in my sleep study, without EPR, breathing through my mouth felt super wierd.  With EPR breathing through the mouth with the mask on is pretty easy.

Artnj wrote:

So I have now mastered the getting to sleep part.  I still wakeup every night 2-4 hours later.  I am groggy initially, but havent noticed anything.  No hose wacking me or anything like that.  The only thing I have noticed is dry mouth.  Is that a clue?  I set the humidifier on 3 or 4, and my nose is not dry.  

Resmed s8 Autoset II with Swift LT nasal pillows, set to 11, EPR on 3.

Leak started out at .2 l/s but has been climbing over the nights.  Last two nights it was .5 and .6 which I believe is high enough to indicate some sort of issue.  Mouth breathing perhaps...which could explain the dry mouth.  But they didnt see it as a problem in my study.

Maybe I should turn off EPR...in my sleep study, without EPR, breathing through my mouth felt super wierd.  With EPR breathing through the mouth with the mask on is pretty easy.

Artnj, I don't know all the lingo yet so I am not sure what the EPR is.  I notice you use nasal pillows, but perhaps your mouth is dry because you open it when you sleep.  This would explain why you wake up as you are losing air pressure through your mouth and that would most likely dry it out.  You may want to try a full face mask.  If you like the nasal pillows I know Hybrid makes a ff mask with the pillows and mouth covering.  This way also the humidifier will help provide moisture to your mouth.


_________________
REMstarplus, M Series with C-flex and heated humidification
C- Pap setting of 10
ResMed Mirage Quatro full face Mask
Sleep study showed 36 events per hour
Location, Nebraska

Yeap..most likely mouth breathing with the dry mouth part.


_________________
I am A ZOMBIE! 20 years+ undx'd. BiPAP Auto M 14/9. Nasal Swift&F&P Flex Fit 431 Full Face. RLS/PLMD, Primary CNS Hypersomnia, Sleep Paralysis, Parasomnia, Degenerative Disc Disease, Clinical MS, Fibromyalgia, COPD plus other past dx's..what's next?

Bummer.  DME will give me a chin-strap I'm sure.  Should I try that first, or go with some of the other stuff I read, tape or denture creme or whatever.

Artnj wrote:

Bummer.  DME will give me a chin-strap I'm sure.  Should I try that first, or go with some of the other stuff I read, tape or denture creme or whatever.

If your nose does not get stuffed up, then try a chin strap or one of the other things.  But if your nose is getting stuffy, then you will want to consider a ff mask.  You also can try a nasal rinse before bed or a decongestant if your nose gets stuffy.  If not, a chin strap may just do the job !


_________________
REMstarplus, M Series with C-flex and heated humidification
C- Pap setting of 10
ResMed Mirage Quatro full face Mask
Sleep study showed 36 events per hour
Location, Nebraska

I have a prescription nasal spray that has worked wonders.  I have only had a stuffy nose 1 time since then and pollen count was over 3,000 that day.   I thinks it's "Nasalcrom"


_________________
ResMed Auto Set II w/hi4 Pressure 9 - 20 EPR at 3 SleepWeaver, Mirage Micro, Liberty, FitLlife
Orig AHI 30.4 RDI 36 & RLS/PLMB

Artnj

Looking at the posts on this and other forums, I have found there are only a few main reasons why people have problems with their treatment. Some of these are: Mask problems, incorrect type of machine prescribed, incorrect mode used for the patient,  improperly or incorrectly set machine, or combinations of these problems, and problems that can't be solved with CPAP/APAP or BiPAP/VPAP. Also, the patient needs to be willing to make the treatment work and have the necessary support from the medical community and family.

Your problem is you awaken every few hours with a dry mouth. Dry mouth means you're breathing through you mouth and subsequently losing treatment pressure and thus waking up. You must determine why your mouth is coming open. Is it from too much pressure, or do you normally sleep with your mouth open? If you normally sleep with your mouth open, the problem can be helped with a chin strap. If the problem is too much pressure, you must work with your doctor to adjust the pressure or operating mode of the machine to better fit your situation. The chin strap may help somewhat depending on how much too much the pressure is.

I had a similar problem and fought it for three years before I determined that I could be helped more with a different type of machine. I was on a regular CPAP set at 9 cm H2O. It was blowing my mouth open and when I managed to keep my mouth closed, I experienced central apneas because of too much pressure and woke up gasping for breath. I would sleep for a couple of hours, wake up gasping for breath, get back to sleep after about an hour, sleep for a couple of hours, wake up gasping for breath.... You get the picture. In eight hours in bed, I was lucky to get four  hours of sleep.

After much reading of this and other forums, I discovered that there were APAPs that could vary the pressure as needed. I thoroughly researched APAPs and felt it was what I needed. After going through three sleep doctors that would not approve the APAP, I finally found one that would work with me and support me with the insurance company.

The day I got my APAP I slept for nearly six hours, like a rock. No waking, no gasping for breath, no blown open mouth. I finally got some rest. The difference in the pressure was only 1 cm H2O. My therapy went from 9 to 8 cm H2O and from mediocre to good. At first, my pressure varied from 6 to 13, but it has now settled down to 8 to 9 cm H2O with only occasional increases above 9.

You already have an APAP, I believe. Talk with your doctor and see what you can work out. You're already a good part of the way there. Now all you have to do is tweak your therapy.

Runningbare


_________________
I am an engineer not a doctor. All of my suggestions are from my own experience and not medical advice. All information should be discussed with your doctor before implementation.

Respironics M Series APAP w/C-Flex & heated humidifier & Optilife Mask

I have a chin strap being delivered today.  (Why is my insurance company paying for them to hand deliver it???  Talk about waste in healthcare!)

I gave up pending receipt of the chin strap.  If the chin strap fails, perhaps I'll try APAP mode.

I have a resmed elite. When I first got it, EPR was turned off. About a month later, my RT turned EPR access on. He put it on level 1. I found it harder to exhale. I don't know if I had the mask positioned wrong the entire time that I tried it, but I went through levels 1 through 3 and my AHI went through the roof. AI went up as well as HI. My husband told me that I was snoring with my mask on one morning (I think that was level 3 stage). I turned it off and my AHI went back down.
Someone else here has said they have to have EPR turned off.
I still wake up in the middle of the night though... sigh... I haven't figured that one out yet.
-me

Artnj wrote:

I have a chin strap being delivered today.  (Why is my insurance company paying for them to hand deliver it???  Talk about waste in healthcare!)

I gave up pending receipt of the chin strap.  If the chin strap fails, perhaps I'll try APAP mode.

Just a note. If you DO end up switching to a full face mask, then be careful. A patient can switch fron nasal to oral and end up being undertitrated.

runningbare wrote:

Artnj

Looking at the posts on this and other forums, I have found there are only a few main reasons why people have problems with their treatment. Some of these are: Mask problems, incorrect type of machine prescribed, incorrect mode used for the patient,  improperly or incorrectly set machine, or combinations of these problems, and problems that can't be solved with CPAP/APAP or BiPAP/VPAP. Also, the patient needs to be willing to make the treatment work and have the necessary support from the medical community and family.

Your problem is you awaken every few hours with a dry mouth. Dry mouth means you're breathing through you mouth and subsequently losing treatment pressure and thus waking up. You must determine why your mouth is coming open. Is it from too much pressure, or do you normally sleep with your mouth open? If you normally sleep with your mouth open, the problem can be helped with a chin strap. If the problem is too much pressure, you must work with your doctor to adjust the pressure or operating mode of the machine to better fit your situation. The chin strap may help somewhat depending on how much too much the pressure is.

I had a similar problem and fought it for three years before I determined that I could be helped more with a different type of machine. I was on a regular CPAP set at 9 cm H2O. It was blowing my mouth open and when I managed to keep my mouth closed, I experienced central apneas because of too much pressure and woke up gasping for breath. I would sleep for a couple of hours, wake up gasping for breath, get back to sleep after about an hour, sleep for a couple of hours, wake up gasping for breath.... You get the picture. In eight hours in bed, I was lucky to get four  hours of sleep.

After much reading of this and other forums, I discovered that there were APAPs that could vary the pressure as needed. I thoroughly researched APAPs and felt it was what I needed. After going through three sleep doctors that would not approve the APAP, I finally found one that would work with me and support me with the insurance company.

The day I got my APAP I slept for nearly six hours, like a rock. No waking, no gasping for breath, no blown open mouth. I finally got some rest. The difference in the pressure was only 1 cm H2O. My therapy went from 9 to 8 cm H2O and from mediocre to good. At first, my pressure varied from 6 to 13, but it has now settled down to 8 to 9 cm H2O with only occasional increases above 9.

You already have an APAP, I believe. Talk with your doctor and see what you can work out. You're already a good part of the way there. Now all you have to do is tweak your therapy.

Runningbare

This is a really helpful post.  Thanks, runningbare.

I am also waking up a lot and having very dry mouth and throat. So dry that it hurts. I am wanting to avoid a chinstrap but I guess I don't have a choice.

and I still woke up in an hour and a half with a dry mouth/throat...still taped shut!

WTH??  Humidifier seems to be working...I'll try jacking it up to 5 or 6 tonight.  

(If your paying attention to WHEN I post...yeah I confess I gave up for a few days...was too damn tired from extra wakeups.)  

I got a chinstrap in the mail...but since taping works, I'm not necessarily going to use it.

maf79 wrote:

I am also waking up a lot and having very dry mouth and throat. So dry that it hurts. I am wanting to avoid a chinstrap but I guess I don't have a choice.

Maf79, you do have a choice.  Is there any reason you don't try a full face mask ?  I have a nasal mask and a ff mask.  I use the nasal when my sinus is clear.  Unfortunately that isn't the majority of the time. I just decided that having a ff was easier than lost sleep.   So using a full face I don't have to worry about if my mouth is open or not.  And i also use a humidifier and I have to put it on the highest setting.   Good luck


_________________
REMstarplus, M Series with C-flex and heated humidification
C- Pap setting of 10
ResMed Mirage Quatro full face Mask
Sleep study showed 36 events per hour
Location, Nebraska

I was planning on doing a full face mask, but I tried them on at my doctor's office and they were just too much for me. Maybe I'll try a humidifier. Does adjusting the humidifier on the CPAP normally help or am I wasting my time on that? How much should I adjust it? I have mine on 2.0.