Do you struggle to sleep well? Do you have trouble remembering the last time you woke up feeling refreshed from sleep, or is your snoring driving your partner crazy – or worse, driving them out of the bedroom altogether?
You might be one of the estimated 12 to 18 million people – in the US alone! – who suffer from a chronic sleep disorder such as sleep apnea. You’ve probably heard the term, or maybe even know someone who has been diagnosed with the condition. But what is it exactly? According to the National Center on Sleep Disorders Research (NCSDR), sleep apnea is a condition in which you experience breathing “pauses” when you sleep. These can last between just a few seconds, to a terrifying few minutes (try holding your breath for a few minutes and you’ll understand why this is a scary idea). After such an event your body’s natural instinct to keep you alive will kick in, meaning you’ll take a breath, but it might sound more like a choking sound.
Symptoms can vary between people, and you can be diagnosed from mild to very severe sleep apnea. However there are a number of general symptoms that doctors keep an eye out for when considering a sleep apnea diagnosis. Continue reading
During a recent visit to my CPAP supplier, they told me that ResMed had made available to them a brand new full face CPAP mask, the Resmed Quattro Air and they wanted to know if I was interested in testing it out. No need to ask me twice!
I was quite interested in the Quattro Air because it was billed as being 45% lighter than the rest of the Resmed Quattro range and fewer pieces to take apart and clean.
The best way to describe my experience with this mask is just to come right out and say it, I hated it. It was by far the worst CPAP mask I’ve ever tried.
During my first night with the Quattro Air, it lasted all of about forty minutes before I had to wake up and put back on my Fisher and Paykel Simplus. I tried it again the second night and it lasted less than half an hour the second time around before I had to get up and switch it out so that I could get some good sleep.
Issues With TheResMedd Quattro Air
So what was wrong with the ResMed Quattro Air?
Probably an easier question to answer is, what was right with it? The headgear was nice and soft and it was very easy to adjust in the darkness of night. The silicone forehead piece is easily the most comfortable forehead part of any CPAP mask I’ve ever tried – it really is a nice innovation on the part of Resmed.
And from there, it really is all down hill.
The mask was just way too narrow for my face. When I would open my mouth wide I could feel the corners of my mouth breaking the seal of the mask along the sides. I thought maybe it was just me, but my CPAP provider said when I returned it that this was the same complaint they’ve had from a few people who’ve tested the mask.
It was also really uncomfortable on my face. The silicone seal inflated under pressure, but because of how narrow it is, you have to tighten the mask quite a bit and as a result, there’s this harder plastic edging underneath that digs into your face. This was the reason I had to take it off, it actually was a bit painful to wear.
The headgear itself is great, like I said, nice and soft, but the way it connects to mask is with hooks that the headgear straps loop over the top of. First of all, it’s not really easy to strap into the mask and secondly, it just feels really cheap.
Actually, that was my overarching feeling about the Quattro Air – it just felt really cheap. The lightweight aspect of the mask contributes to that cheap, plastic feel.
Which I suppose leads me to the whole “lightweight” angle of the mask… Why? When I first heard about it, I was curious, but then after I thought about it for awhile, it just didn’t seem to make any sense to me why this would be a feature. I’m not going out running great distances in my CPAP mask. Even if I have to take it with me somewhere, the difference in weight is more or less negligible.
I really want to put this in context – the fact that over two nights, the mask got just over one hour of combined use is really rare for me. Since starting CPAP therapy four months ago, I’ve had 100% usage – I’ve never once taken my mask off during the night. So for this mask to require me to swap it out, two nights in a row after less than an hour each time was a first for me.
There is no scenario imaginable that would ever bring me to recommend this mask to someone else.
At the end of the day, the Resmed Quattro Air just seems like a bunch of solutions to problems that nobody is having.
As part of properly maintaining your CPAP mask, one of the things that all manufacturers recommend you do is clean your mask daily. To this point, I’ve been taking apart my mask and washing it out with warm water and baby shampoo then letting it air dry. This has been really effective and is the recommended solution you see most online.
I’d read about the CPAP mask wipes before but my CPAP supplier didn’t carry them, but on a recent visit, they mentioned that they’d just gotten the ResMed CPAP Mask Wipes in stock. I couldn’t pass up the opportunity to try them out.
The wipes themselves are 100% cotton, so they’re natural and non-abrasive so they’re very gentle on the mask. They are also entirely alcohol and latex free, which is an absolute requirement to ensure that the silicone on your mask doesn’t breakdown.
Using The CPAP Mask Wipes
One thing I was a bit worried about was the smell the wipes would leave on my mask, but these particular wipes are scentless. I had found on occasion that if I didn’t rinse my mask out really well, I would sometimes smell and even get a slight taste in my mouth of baby shampoo which could be really unpleasant, but with these Resmed Mask Wipes, I’ve never had anything like that.
The wipes also contain aloe vera which is great for your skin. Considering the issue I had previously with CPAP mask rash, this touch of aloe vera is something I’m quite happy about.
When I wake up in the morning and take my mask off, I pull one of the wipes out of the container, take my mask off its frame and give is a really good wipe down, paying particular attention to the silicone seal. It takes about 30 seconds all up and then I just snap the mask back into the frame and get on with my day.
A little side benefit is how well designed the actual dispenser for the wipes is. If you’ve ever had small children, you’re probably familiar with the wet wipe dispensers where you pull them out one at a time and the perforated sheets come apart one by one. Those things are a giant pain and more often than not you end up pulling out multiple wipes or like eight of them get stuck in the hole! I’m happy to report that ResMed have figured this out and they have this sort of dual action dispenser where you pull the next sheet out through a wider hole and then pull it against this other part that has teeth to catch it, hold the next sheet in place and makes it easier to tear the sheet you want apart along the perforation. I haven’t explained this really well, but I was very excited by it – Johnson & Johnson should take note!
The last point I’d like to add is that these CPAP Mask Wipes don’t replace the cleaning instructions you’ve gotten from your mask’s manufacturer, they aid in keeping your mask extra clean and well maintained. You should follow whatever instructions your mask’s manufacturer recommends.
I’ve told my CPAP supplier that I want them to keep stocking this item. For a mere $12, you get 62 cleaning sheets which is great value. Apparently, I’m not the only one who thinks so because my provider got a whole shipment of them and sold out in a couple days – thankfully they’d put mine aside for me! If you’re using a CPAP mask, these handy little ResMed CPAP Mask Wipes are a fantastic little investment.
On Saturday night at 2am, I woke up to find my Fisher & Paykel Icon CPAP machine not working. The display on my F&P Icon+ was showing a 5.03 error code and wouldn’t restart at all.
I jumped online straight away and did a quick search, nothing really about that error code.
I decided to see if unplugging the machine at the wall and making it restart entirely would get it back up and operating so that I could get some sleep and investigate more thoroughly in the morning. That seemed to do the trick and when the machine powered up again I was able to press the button and the air started to flow.
But it wasn’t normal.
Before I even laid back down that I noticed the airflow didn’t sound right. Normally when you look down into the Icon CPAP machine you can see the humidifier well lit up and the air flowing through causing the water to agitate a bit. This time, while there was some air going through, the water was very still.
The CPAP Machine’s Air Pressure Was Faulty
I put the mask back on and hooked up to the hose and tried to go back to sleep. Immediately I could tell something was wrong with the air pressure – it just wasn’t powerful enough. As I laid there with the mask on I could hear the CPAP machine labouring to force air through the hose and my mask wasn’t really inflating correctly.
I managed to go back to sleep after a few minutes, but unfortunately, I woke up again at 4:19am with the machine really struggling – it was making an awful noise, so I turned it off. I took the mask off and tried to go back to sleep naturally, but as I’ve come to discover, I actually find it odd sleeping without my CPAP mask now, so after about half an hour, I got up and out of bed at 4:45am.
For the first time since going on CPAP over three months ago, I felt tired Sunday afternoon. I’d only gotten about 3 hours sleep and with the machine on the blink, it probably wasn’t even good sleep so I decided I’d try and have a nap that afternoon using the machine.
I went through the whole pre-flight regiment of filling the container and getting everything ready just like I was going to sleep at night. The machine kicked in, sounded right and for the first time in three months, I had an afternoon nap.
But it was short-lived.
The nap lasted about an hour before it just didn’t sound right again and the air pressure was no good.
I woke up and sent an email to Fisher & Paykel Healthcare support to ask what the 5.03 error code on the Icon+ was and I also sent my supplier an email telling them about the trouble.
I managed to use it again on Sunday night and got about 6 hours sleep – the machine struggled at times.
Fisher&Paykel Icon+ Motor
By 9:30am on Monday I’d had responses from both my supplier and Fisher & Paykel.
The Fisher & Paykel support rep told me that the 5.03 error code on the Icon+ meant that there was a motor issue and that I should take it right away to my supplier to be assessed. My supplier told me that they’d do a straight replacement on the spot for me whenever I could bring it in.
It was a very painless process – I literally went to the supplier’s office and they setup a brand new Icon+ for me, took a data dump off the old device and twenty minutes later I was back home in the car.
One thing that we looked at was the data from the last week which has been very sporadic with my AHI fluctuating wildly, night to night and my leaks having increased by 50%. My supplier told me that he felt that the motor had probably been playing up for a week causing the air pressure to be irregular. It’ll be interesting to see if those numbers come down now with the new machine.
I’d also like to add that this is the third time I’ve had reason to contact Fisher & Paykel support and each time, they have contacted me within 24 hours of my email and most importantly, they’ve replied with sensible, coherent answers to my questions. I’m very happy with them!
Have you ever had a mechanical fault with your CPAP machine? I’d really like to hear what happened with your machine and what was the outcome? Please leave a message below and tell me about your experience.
Being an adventurous sort of person, I decided that I’d rent a Philips Respironics FitLife mask from my CPAP equipment provider and test it out for a few days to see how I liked it. The Philips FitLife has always intrigued me because it really is a full face CPAP mask covering almost the entire surface of your face. Somewhere in my thought process I just assumed it would be an easier overall experience, but honestly, I had pretty mixed results.
I’m going to start this review by talking about some of the things I really didn’t like about this mask.
Issues With The Fitlife Mask
Probably the most noticeable thing for me was that it was quite confronting when I put it on and tried to go to sleep for the first time. I suppose if you’re a SCUBA diver or something like that you might not find it so odd, but I really found it very noticeable right from the moment I first put the mask on that it was like I was wearing some kind of helmet. I was almost hyper-aware of the mask and that’s not the most conducive feeling when you’re trying to drift off to sleep. I wore the mask for about four nights and while that closed in feeling subsided a bit, it was still something I was very conscious of every time I tried to go to sleep.
Another issue for me was that I really struggled to get the mask to stay put on my face while I slept. The wider surface area means that the edges come into contact more with your pillow and over the course of the night, I kept finding the mask riding up my face and literally covering my mouth with the silicone cushion of the edge – in fact, on my third night with it, I woke up to find it sitting above my top lip and my whole mouth not covered. Needless to say, my wife said I snored a fair bit that night. I kept trying to tighten the mask to keep it in place, but then I found the headgear digging into the back of my skull and hurting.
Then there were the little annoyances with the mask:
The ventilation made a bunch of noise and on the first night when I wasn’t used to it, it actually kept me awake longer than I needed to be;
No matter what I tried, every time I put the mask on it fogged up which added to the disconcerting nature of being enclosed
The locking clasps are a bit tough to put on in the dark although they do come off easily enough
The spot where your chin and lower lip meet is where the mask sits and I found the silicone irritated my skin a bit
Strangely, on two of the four nights, I turned my CPAP machine off and removed the mask at 1:30am while asleep
It wasn’t all bad, the Respironics FitLife mask does have some good qualities as well. For example, the headgear is very well made and structurally a good design. I know I said it dug into my head a bit, but I was having to make it very tight. The FitLife was also exceptionally well behaved when it came to leaks, each night the leaks were under 35L/m which is a very acceptable.
Most importantly, I didn’t wake up tired and had good energy during the day on the days that I used the FitLife.
I really like the concept of this mask and I have to say that deep down I wanted to like this mask, but I won’t be buying one and replacing my Fisher & Paykel Simplus that’s for sure. I think the idea of the mask is great and I’m certain that over time I could overcome the odd discomfort from being so enclosed, but the problems with this mask just outweigh the good. I’d really like to see Philips Respironics have another crack at this type of mask because I don’t think they are that far away from being onto a winner and if they do produce one, I’d be really looking forward to testing it out.
I think I must have jinxed myself when I posted about my low AHI score the other day. Within 24 hours I was coming down with cold and flu like symptoms – just generally feeling rotten.
There was however, a bit of morbid curiosity wondering how my sleep apnea treatment with CPAP would work if I had a cold.
Would I be able to sleep with the mask on?
Would a runny nose during the night create difficulties with having to remove the mask to wipe or blow my nose?
What would the impact on my AHI be?
I had a ton of thoughts racing through my head about my sleep would be impacted by the onset of this cold.
Well, the reality of it was quite interesting…
Did The CPAP Mask Actually Help My Cold Symptoms?
First of all, the cold turned out to be fairly minor. It never really turned into anything really severe, a bit of nasal congestion, sore throat and some phlegm in the throat. I actually attribute this faster recovery to my CPAP machine in some respects – I feel that the forced air helped keep my sinuses and nasal passages more clear, but also I just slept better and my body recovered properly.
Secondly, related to the first point I suppose, but my nose never really got runny so the whole dirty nose into the full face mask thing I was dreading never really became a problem. For a head cold and sore throat, my nose was surprisingly clear!
Finally, I do think my sore throat and the phlegm has been wreaking a bit of havoc on my sleep numbers. I’ll start by saying that my AHI for the last 7 days is 8.9 and it has averaged in excess of 12 for the last four days – last night was 13.4!
There are also some other interesting statistics that are worth looking at that help round out the story:
My leaks are way up from an average of 35 to 58
The 90th percentile pressure was 18! Normally it is 13.
SensAwake kicked in just 6 times, which is normal for me
Here’s my hypothesis… My breathing is being interrupted and having problems because of the sore and swollen throat. I know I’ve mentioned phlegm a couple times, but it really is just stuck at the back of my throat and even when I’m awake it is causing my breathing to rattle a bit.
I think the machine is seeing this as a reduced flow of air, is hiking the pressure to compensate and because of the stuff going on with my throat, the flow isn’t improving. With that happening the pressure is staying really high and that sustained high pressure is causing an increase in leaks.
I noticed it last night when I woke up in the middle of the night because of the air leaking into the corner of my eye – the pressure was unlike anything I’d ever noticed before with my Simplus mask. As I adjusted the mask a bit, it started making “fart noise” and squealing sounds. I ended up just tightening the straps really tightly and falling back to sleep.
It will be interesting to see if my numbers go back to normal over the next couple days as my condition improves. The upside of the whole thing is, despite the cold, I slept really well and with minimal disruption.
I’d really like to read about your experiences with your CPAP Mask and having a cold or flu, so please leave your comments below!
I mentioned the other day that I had to replace my Simplus mask because the headgear was having some issues and the silicon seal was a bit floppy.
I thought this would be a good time to update everyone on how it is performing so far because I passed a bit of a milestone – I had the lowest AHI score that I’ve ever had since starting CPAP nearly three months ago!
My AHI average for the last 7 days is 5.1 which is the lowest week I’ve ever had for a seven day period and last night I had an AHI of 2.9. My average should even be lower because two nights ago for some reason my AHI jumped up to 9.0 which was the highest it had been since about the second week of my CPAP experience – first week I was averaging between 11 and 13 as I learned to adjust the mask, we were playing with the starting pressure, etc.
A Random AHI Increase
The AHI of 9.0 the other night doesn’t really bother me because I think it is just a random AHI increase and having looked at the data in the past when these occurred it was more “flow limitations” than even apneas or hypopneas.
More importantly than the AHI scores though is the fact that I just feel good when I get up and start my day. Last night I went to bed really late, woke up at 6:45am naturally as usual and I feel really good despite only getting 5.3 hours sleep. Ultimately, that’s what the whole CPAP machine and the mask are meant to do, improve my sleep so that I feel better.
On an aside, one thing I’m thinking I’m going to do is buy a second set of headgear and rotate my usage a bit. I like my mask really tight and I think what might be happening is that the straps and stuff on the headgear are stretching as I use it over time. My thought process is that we can wash one of the headgear and let it dry out for a week, then swap it back in and wash the other, letting it dry for a week. It may shrink back in to shape. Just a theory at the moment.
Adjusting The CPAP Straps
One thing I’ve also noticed is that I’m not adjusting the straps all the time anymore. I set the straps on this mask up the first night I used it about ten days ago, played around with them for ten or fifteen minutes while I started going to sleep and haven’t touched them since. Everything just seems to fit nicely.
Overall, the progress with my CPAP therapy is going really well. I still feel good, my comfort levels with the mask are great and now the stats seem to be backing that up.
Have you been told by your medical practitioner that you should start singing? Although it seems like a fairly strange suggestion, it has now been shown that singing exercises can help alleviate the symptoms of obstructive sleep apnea.
A recent clinical study conducted by Exeter University and the Royal Devon and Exeter NHS Foundation Trust, concluded that exercising the muscles in the soft palate and upper throat – the muscles that are often in weak in patients with obstructive sleep apnea – can greatly reduce the severity and loudness of snoring and cases of apneas during sleep.
The study used patients who were considered to be chronic snorers as well as patients with mild to moderate sleep apnea. The best thing about the results? The singing exercises were easy and quick to do so that the majority of study participants were able to complete their exercises routinely without problems for 3 months. Basic exercises that help to strengthen the muscles in the throat are practised by professional singers and can be learned by anyone. And if you get good, you could even start your own local choir!
Finally, the header on the Simplus started to have some material issues.
With all of that going on, I took a trip to my CPAP equipment provider to discuss the situation with the mask and see if we could find some kind of solution or remedy.
The Simplus mask that I was using was only about six weeks old, so it wasn’t like I’d been using it for a year or so which made the whole situation even odder. Over the last week of using it, I started noticing that the silicone seal had become a bit looser and “gummier”. The looseness was also exactly where I was getting leaks. What seemed to be happening is the air pressure on the seal was causing it to blow out when pressure would increase while I slept and was having events. My theory was, these little leaks were causing me to wake up slightly and adjust my mask in a half-conscious state and exacerbating the number of hypopnea and apnea events I was having, thus explaining the increased AHI.
The headgear issue was a bit more troubling, not from a CPAP therapy perspective, but purely from the quality of the product I’d bought. The mask tightens by ways of six velcro straps: two on top of the head, two on the forehead and two on the side by your cheeks and under the ears. The straps on the cheeks started having real problems. The Velcro adheres directly to the material of the headgear, but what started happening was the actual material started peeling away from the foam structure underneath. The obvious problem here is that the straps are longer secure, they float around as the material peels away from the underlying structure of the headgear. I wish I had taken pictures, but I forgot.
The Problems With My CPAP Mask
My CPAP equipment provider said she’d never seen anything like the problem with the headgear before and it was something she was going to keep an eye on. She pointed out something I’d not noticed, a slight discolouration of the fabric where it was peeling away. I thought perhaps it was sweat or something, but it was on the outside, not the underside where it came in contact with my skin. I told her that it looked like the industrial glue that they use to adhere the material to the underlying foam structure of the headgear may have liquified and broken down causing the material to come away.
The issue with the silicone was also something she’d not seen in such a new mask. She really had no explanation for that one.
My provider then immediately called the Fisher & Paykel sales rep they use, explained the problem and the sales rep immediately told her to do a full warranty replacement of the entire mask and headgear.
I’ve now used the CPAP mask replacement for a few nights and I’ve noticed straight away that the headgear is “stiffer”. My original CPAP mask was right out of the package as well, but the headgear was loose and malleable. I don’t really have an explanation, but the new mask’s headgear just seems to be better constructed, we’ll have to see how long it lasts.
Have you ever had your CPAP mask or headgear fail or deteriorate within a few weeks of using it? I’d like to hear about your experiences, so please feel free to post a comment below.
I really like my Fisher & Paykel Simplus CPAP mask because it is very comfortable and I get consistently good results with it. In an earlier post, I talked about a bout of CPAP mask rash that I’d gotten because of some skin care products that didn’t like the silicon of the Simplus mask. The other small irritant I’ve started to notice with my mask is the whiskers on my face when I don’t shave for a few days.
I’m the first to admit that I can be a bit slack about shaving. I don’t like doing it. It really is that simple. My skin is pretty good, I’m not one of those guys who suffers from bad razor burn or anything like that, I just dislike shaving.
I’m also pretty lucky that I’m not constantly dealing with customers or clients in my line of work, so if I haven’t shaved for two or three days, nobody really cares.
Unfortunately, I sometimes let that stretch out to four or five days and that’s where the problems begin with my CPAP mask.
Beards And CPAP Masks Don’t Get Along
The first thing I notice is that my face gets itchier in the night and I find myself half awake poking my fingers inside the mask scratching my chin or my top lip. That breaks my seal, causes leaks and just generally makes things annoying.
Unlike many people, I don’t really have a problem with tightening my Simplus mask up really snug. Waking up with indent marks from the straps on my cheeks isn’t a big issue for me, so when the leaks start from me jostling the mask, I just tighten it up.
The second problem is a bit more of an issue and that’s the heat. All of that extra fur on my face makes it quite a bit hotter under the mask, so I sweat around my mouth a bit which tickles and causes me to scratch more. This perpetuates the whole itching and leakage issue even more. Cue the tightening of straps.
The last issue is just that whiskers cause the mask to slip and move around more. That leads to more leaks and more nocturnal irritation… And cue the tightening of straps.
Like I said, the tight straps don’t bother me but they do wake up my wife sometimes and they disrupt my sleep and that’s more annoying than shaving.
I have no idea how men with full blown beards tolerate wearing full face CPAP masks. To my more facially hirsute CPAP brothers, I salute you!
I think the simple answer is, in my battle to stay atop my sleep apnea, I’m just going to have to shave more… Or hope my face becomes desensitized, either way works for me.
I’ve been on CPAP therapy now for over two months and as I’ve mentioned elsewhere, my AHI Score went from the mid-70s during my sleep study to somewhere in the five to seven range while using my CPAP machine. For the second time though in the last month I’ve had a really strange anomaly – my AHI score jumped up to over 13. The first time it happened my score went from 6.4 to 15.3 in one night and I was a little bit concerned. Was I going to be tired that day? Is this the new normal for me now? Then the other night, I came home from work and checked my Icon+ CPAP Machine and it showed that the previous night’s AHI was 13.1. I checked the leak numbers and my SensAwake figure and nothing seemed amiss. I just rolled the shoulders and carried on. The most important thing that I’ve discovered with trying to overcome my obstructive sleep apnea is to focus on how I feel rather than the statistics. When I first went got my CPAP machine I would worry about the results every single day, hoping that my “numbers were good”. The truth of the matter is, I felt great, I wasn’t tired, no more inadvertent naps or falling asleep in front of the TV at 7:30 at night.
Checking Your Sleep Data
One of the idiosyncrasies of my Icon+ machine is that it doesn’t write or update your data on the USB stick until noon each day. That makes some sense when you think about it because Fisher and Paykel are trying to ensure that if you have multiple sleep sessions during a 24 hour period, they capture the entire day and are able to calculate the figures for the full 24 hour period. On the other hand, that means I can’t check my sleep data before I go to work or when I first wake up in the morning. And you know what? I actually like that. I really think that if I had the ability to roll over in the morning and bring up my AHI numbers on the display, I’d be thinking about it all day and I think it would have some kind of impact on the way I felt that day. Without knowing the numbers, I just get on with it and check when I get home from work. I suppose I still haven’t answered the question about why the numbers on a couple of occasions suddenly spike up? Well, I have a pet theory about this.
The SensAwake Feature
I think the spike is down to the “auto” algorithms in the machine. The SensAwake features and the auto-titration elements of the CPAP machine adjust the flow of air based on “feedback” from your breathing patterns. My feeling is that maybe I’m just sleeping more lightly or something and am having more hypopneas rather than apneas and therefore the numbers might be elevated. This potentially could wreak havoc on the machine’s algorithms which try and make the airflow comfortable by making small adjustments rather than massive increases in titration when you start having events. I’m going to look at the data a bit more closely this week. The good folks at Fisher & Paykel don’t make their InfoSmart software available directly to patients, so I’m not able to see the detailed sleep data easily. I’ll probably spend an hour this week looking at the open source, SleepyHead software and see what that can tell me. Hopefully, some more detailed data will either confirm my theory or give me more insights. Either way, I’m not too concerned about it because like I said, I feel so much better now that my odd AHI scores are just a curiosity piece for me more than anything else.