New User - Bleep does work with APAP. The majority of all end users are on APAP, as it can be adjusted to fixed pressure CPAP very easily. What is your pressure? Have you ever used a nasal mask before? If so, how did you do? Most likely you will need to have your PAP Max pressure reduced to account for the switch to nasal from full face. Most full face users making this transition have seen a 3-5 centimeter drop in MAX pressure. Everyone is going to be different and will take a few weeks to find a new optimal pressure that keeps your AHI stable and helps reduce the air accumulation in the stomach. I would tell you to go on to CpapTalk.com and discuss with end users there how to make the appropriate adjustments. Happy to have a call as well. 919-619-7170.
I have a similar issue. I don't think it's specific to Bleep since I have the same problem using a nasal pillow. My mouth drops open every time I am about to fall asleep, causing air to forcefully escape and wake me up. As with most people, I have found chin strips to be useless. But mouth tape such as Somnifix works really well. But then I have a new problem: Just as I'm falling asleep my tongue changes position slightly (or something) and suddenly my mouth explosively fills with pressure. It can't leak out, thanks to the tape. But it gives me chipmunk cheeks and wakes me up every time. Since I haven't heard a lot of people complaining about this I wonder if it's specific to certain anatomies. My pressure is 9.0.
What is your AHI at 9? You are on fixed pressure? Is the chipmunk cheeks on your back or side?
My AHI is about 2 at a pressure of 9. Last night I reduced the pressure to 8, and found that I was still getting a violent burst of air in my mouth each time I started to drift off. It's uncanny how precisely this tracks to the moment I start to fall asleep. It's not that I'm consciously trying to hold my mouth in a certain way. But something unconscious happens at the earliest moment of sleep onset. My tongue falls back slightly and/or my mouth changes shape. After about an hour of the bursts pushing outward on my lips I noticed the Somnifix strip was developing leaks around the border. Since my entire mouth deforms (pushes forcefully out) when it inflates, I switched to a big fat piece of stretch tape wrapping from cheek to cheek to keep the whole area from inflating. I used this stuff: recommended by YouTuber "TheLankyLefty27": https://www.amazon.com/dp/B01F9JFBBY At first I thought it was working. But it was just that I wasn't drifting off to sleep. Thus, my mouth / tongue was staying in a position that avoided the bursts. After about an hour I started to drift off , and was awakened by another burst. At least this time there were no leaks around the tape. But it still woke me up. I also felt a lot of pressure in my ears now that my mouth was properly sealed (especially noticeable for me since I wear wax ear plugs). This gave me an idea: When I'm exhaling, the total pressure is extra high since it's the combined pressure from the blower plus exhalation. Years ago I turned off "flex" (aka "exhalation relief") since it seems to cause strange breathing patterns, apparently due to some kind neurotic competition with the machine for when I will take my next breath. I tried turning it back on to reduce the total pressure on exhalation. This worked somewhat. The bursts of pressure in my mouth were now less violent. I use a Respironics machine in CPAP mode. The options are CFlex and CFlex+. The latter theoretically makes the pressure adjustments less noticeable, so that's what I chose. There is also a numeric value, which I set to 3, meaning it drops the pressure by 3 on exhalation. I stayed the course for the remaining 3 hours or so of the night with my mouth fully taped up, the pressure at 8, and flex reducing it to 5 on exhalation. I feel as though I barely slept. The milder mouth inflations still caused disruptions. But perhaps I can get used to those. If I can train myself to stop noticing flex bating my breath maybe I can get used to it too.
I just checked my AHI from last night with the above settings, and was surprised to find it was the highest I've seen it in a long time: 3.8. Usually when I barely sleep the machine reports an artificially _low_ AHI like .7 since it has no way of knowing whether one is actually asleep, throwing off the average by hours of wakefulness (during which time one isn't having AH events). I have tried switching between a pressure of 8 & 9 in the past without a significant effect on AHI. So I assume last night's results have something to do with "flex" making the machine less effective (or maybe interfering with how it reports AHI).
Give me a call to discuss. I've got some suggestions. 919-619-7170
Before switching to bleeps, I started using a c-collar to deal with positional apnea. It also had the unexpected bonus of significantly reducing mouth leaks -- keeps my jaw from dropping. I bring that up, because I have experienced that "air exploding into my mouth as I fall asleep" - on those rare nights I don't wear the c-collar with my bleeps. Might be worth checking out. YMMV On different subject, but brought up by clint, everyone is different, but for me my AHI is always higher on bad sleep nights. It's called sleep-wake-junk (not sure if that's a "real" term, but that's what they call it on cpaptalk.com). Apparently I hold my breath when I'm awake and tossing and turning. Who knew? Good luck!
Interesting. I had not heard the sleep-wake-junk term. Presumably for most people AH events only happen when they are asleep. So if they're awake half the night dealing with mask issues (or plain old insomnia) the machine will report abnormally low AHI since it is simply counting AH events and dividing by the number of hours the blower was on (not the actual time you were asleep, since it doesn't know that). Hopefully this will be addressed in the future by CPAP machines that include some kind of unobtrusive EEG to know when you're actually asleep. Next best would be a system to infer sleep from heartbeat, movement, etc. like many fitness & smart watches can do.
I have gone from APAP to fixed CPAP at a pressure of 7. I experienced air in the mouth and raised by EPR to 3 which took care of it. I also mouth tape. AHI is always under 5 and my leakage is down to 0. Very happy with Bleep. Been using for over 6 weeks. Have never slept better.