Sierra

My philosophy is that one good sleep of 8 hours can make up for several nights of poor sleep. The trick however is getting that one good night sleep of 8 hours. I don't believe in using naps to try and make up for lost sleep, and do everything I can to avoid them.

I think one of the issues with CPAP that resolves over time is that there is some discomfort with the mask on your face, leaks from the mask, noise from the mask air vent, and noise from the machine itself. Those issues until you get used to them can prevent you from getting into a deeper sleep and more frequent wake ups in the night are probable. I don't think wake ups are a big issue providing you don't stay awake for any significant time.

On pillows that is a very individual thing. Everyone seems to end up with something different, but if it works it works. The best pillow I have found so far is a down alternative pillow from Costco. It is fairly soft, and does not push back, so it can make room for the mask without pushing it off my face. Others let the mask extend beyond the pillow.

I agree that lower room temperature helps. I recall seeing somewhere that 18 C or 64 F is supposed to be ideal for sleeping.

I find my ResMed machine to be very quiet, but the mask vent depending on the mask can be somewhat distracting. The AirFit P10 mask I am now using is very quiet though. I hear my wife's mask more than I hear mine.

Here is a link where you can download SleepyHead, and a basic manual. You do need a PC or a Mac, and a SD card reader. Most ResMed and DreamStation machines are compatible.

SleepyHead Download

SleepyHead Basic Manual

The manual gives you a good idea what the software can do.

Both my wife's machine and my machine came with both the SlimLine and ClimateLine hoses. I believe the machine comes from the factory in a prepacked box which includes the machine, power supply, travel case, and the SlimLine Hose. The ClimateLine is an optional extra, which the dealer may include if it is part of the package they offer. So about the only way you would not get the SlimLine hose would be if the dealer opened the box and took it out. I suspect most don't, but best to ask them for the detailed list of what is included. Same with the SD card. It comes included from the factory, but some dealers do take it out, but I suspect that is mainly sleep clinics that are trying to force you to come back to them for the data.

We have used the SlimLine hose a few nights when we are traveling with our RV and not on AC power, but it really is mainly just a back up in case the ClimateLine hose fails.

I finally convinced my wife to try the mouth taping trick. This is the result in SleepyHead. Time over the leak redline went from 17% to essentially zero. She is using the F&P Brevida nasal pillow mask.

With no mouth taping:

With mouth taping:

I had a lot of difficulty getting used to CPAP. My at home sleep test was about the worst night for sleep I have ever had. The second worst was the first night on the CPAP. Both nights I was ready to get up several times to take the equipment and throw it out the window!

That was 6 months ago, and along with a number of changes and simply time getting used to wearing the equipment it has gotten much better. My wife went on CPAP 3 years earlier than I did, and I really resisted getting into it. However that is now in the past. One of the big things that has helped is using SleepyHead software to monitor how well the machine is working for me. I started that with my wife's machine, and used it from day one on my machine. The software is very helpful in seeing what is going on when you are sleeping, when you are having apnea, and what may be waking you up, or keeping you awake.

I think there are a few components of the puzzle that need attention and be eventually solved:

• Getting the machine pressure settings right. Getting a low AHI, but also reasonable comfort
• Getting the mask comfortable to wear, eliminating leaks, and disturbances that can wake you up
• Setting reasonable expectations for sleep and quality of sleep

These are all still works in progress for me even after 6 months on the machine. And after nearly 4 years, my wife is still making adjustments

One of the things I have done is lowered my target for sleep in a night. I was trying to sleep too long. I also do my very best not to nap to "catch up" on sleep after a poor night. I like to focus on a higher quality sleep while trying to limit it to 8 hours or a bit less. A site on the net called SleepWell has been a big help to me in identifying my poor sleeping habits and myths about sleep. Here is a link if you are interested. SleepWell

If you want to post what kind of machine and mask you have, and any particular problems or concerns, you will likely get suggestions from those that have gone before you down this road...

A pressure of 5 cm is low, almost too low to be comfortable. I would think with that pressure an AirFit P10 and mouth taping should work quite well.

The Nuance and Nuance Pro versions they sell in North America may be different than in Australia. From what I can see the main difference is the frame. On the Nuance the frame and frame extension is a fabric. On the Nuance Pro the frame and frame extension is silicone with a gel insert. The only part that appears to be interchangeable seems to be the nasal pillow insert. The frame and headgear is not. See this link for details.

Nuance and Nuance Pro Details

My concern about the Nuance Pro which seems to be more available (popular?) in Canada is that the silicone and gel frame may be hot and stick to the face, and also more likely to stick to the pillow and drag off while moving around at night.

That was why I was curious which version Stoaty had success with... The headgear on the Nuance masks seems to be much better than the P10.

What pressure is your machine set at, and what is it running up to during the night? More pressure does make it harder to get a good fit. That said a lot of people use full face masks at higher pressures and there must be a way to make them work. I think it must be a matter of keep adjusting them until you get it right.

Are you using EPR or Flex? When I was trying a full face I found the cycling pressure of the EPR on my AirSense 10 seemed to make it harder to get a seal. The mask seemed to walk around on my face.

Zero centrals is good. That is a good point to work from.

I read over your posts from a few years ago, and it sure seems like you have gone through a lot trying to address your apnea issues. I wish you the best of luck with this new type of treatment.

Have you tried the combination of the Dreamwear Gel Nasal Pillows and mouth taping? I have found that it takes a while for the nose to become used to the nasal pillow contact. And if the the nasal pillow size is too small it goes too far into the nose and can cause significant irritation. When they are well fitted they sit more on the opening of the nasal passages rather than inside. I have also found that if I use an over the counter 1% hydrocortisone cream on the exterior edge of the nasal passages in the AM when I get up, it helps to address the irritation. After a week or two the cream is no longer needed, and should not be used long term in any case. It also does not hurt to have another mask (and it sounds like you now have a few!) to use for a night or so to give your nose a break. But with the right size nasal pillows you should become used to it.