Remee Sleep Mask (for Lucid Dreaming)

The Remee (The REM enhancing eyemask) began its life as a Kickstarter project that ended up receiving far more funding than originally requested. I didn’t jump in early – I ended up ordering one after it was fully funded and almost ready for production. My single order cost $95. This isn’t an item to order spontaneously if you’re expecting to have your own Inception going on.

So, what is it? Well, it’s a device intended to assist in achieving lucid dreams. Lucid dreams are ones in which you become aware that you’re dreaming – if you’d like to know more you can find plenty of information via Google search. It does this by flashing red LED lights at set brightness levels and with a programmed delay. The intention is for the flashing to bleed through into your dreams and effectively remind you that you are dreaming.

The Pitfalls of Relying on CPAP Machine Stats

I’ve been managing obstructive sleep apnea for several years and I’ve learned a great deal over time. One of the more recent things I’ve come to realize in the past couple of years is that CPAP machine stats aren’t the only factor that should be used to determine how effective a treatment is working.

If you take the time to browse CPAP patient forums you’ll soon learn that the various machines calculate statistics in different ways. Between two different models in the same line I can estimate there’s at least a difference of two or three units for the value of the nightly AHI numbers. For example, my wife’s S9 appears to be lower than my own S8. Obviously I can’t account for the difference in severity between our cases of sleep apnea but I’m fairly certain, based on forum posts, that the S9’s reported numbers are typically lower. In my opinion, lower values reported by the S9 make it more difficult to pin-point problems because it offers a narrower range in which swings can be detected.

There are several factors to consider. For example, though an AHI may appear low this can be misleading if the leak rate is very high. I consider the AHI value more reliable when I have a very low leak rate.

One should also be mindful of the fact that home devices do not track the same array of data that is gathered in a sleep study. It’s possible that some information won’t reveal problems that might be obvious when compared against data collected in a lab setting (O2 levels, sleep stages, etc).

Sleep stats aren’t enough and simply don’t reveal everything. The quality of the sleep isn’t something that I can track at home. Yes, I can see if there were severe problems with leaks or high AHI values, but my machine can’t really track sleep stages (these can only be inferred to a minor degree) or the quality of my sleep.

I think most experienced CPAP users will agree that statistics are helpful but the most important factor for determining effectiveness is simply how good you feel in general.

With my machine I’ve learned that I’ll feel alright with an AHI below 3 and I typically feel very good if it’s below 2. Anything consistently above a 4 will begin to wear me down. Note that these numbers are well within the “normal” range.

Updated 06/25/2012: But the stats can be very helpful at times as well. If you look at the pressure a machine is using to stop events then you may figure out that your lowest pressure setting should be increased. Over in relevant forums many users have stated that what often happens is that a machine doesn’t ramp up to the necessary pressure in time to stop many events. For example, if your minimum pressure is 6 (with a max of 15) and the majority of your logged events require a pressure of 12 then it’s possible that there are several events at or above that pressure and the machine simply isn’t ramping up enough in time. For example, if the machine is at 6 and only reaches 9 before the event naturally ends (your brain tells your body to breathe, thus disrupting your sleep) then it may not be effective enough. In such a case it may be wise to have your lowest pressure increased to a value closer to the average pressure needed to prevent events.

Using a ResMed Quattro FX Full-Face CPAP Mask

For a while I was using a ResMed Mirage Quattro Full-Face mask with my CPAP machine. It worked well for me. It certainly worked better than my first one, the ResMed Ultra Mirage.

Several months ago my wife got her first CPAP machine and mask. She’s been using a ResMed Quattro FX Full-Face mask and over a few months I noticed her sleep stats were very good. In fact, they were consistently very good. However, during the same time I was struggling with my ResMed Mirage Quattro. It was not consistent. Sometimes I managed to have very good sleep a few nights in a row and then another night I might experience high leaks and sleep so bad I didn’t have the energy to do anything more than watch TV.

I decided to go ahead and get a Quattro FX and it turned out to be a very good decision for me. When I bought the mask I was sized for a medium, instead of a large as I have for previous masks. The first few nights were a bit of a hit and miss but now my sleep is fairly consistent. I’m even getting a combined AHI below three and four on a regular basis.

Overall, the mask is more comfortable than the Mirage Quattro, though this is entirely dependent on one’s facial characteristics and ears. Yes, ears. If the base of my ears were a quarter of an inch higher I probably couldn’t use the mask. It fits fine when I put it on at night but sometimes in the morning I’ll realize that it slid down slightly and rubbed against my ears.

I’m still using Lansinoh with the new mask, which still helps with the mask seal.

This mask is a vast improvement. I’ve slept so well that I’m no longer reviewing every stat and trying to find various tweaks to help me sleep better. I still check my stats each morning but I don’t bother to log them in a spreadsheet every day.

Updated 06/20/2012: From the beginning I’ve been replacing the mask seal and headgear very frequently. Sometimes I had to change them almost once a month (which adds up to about $85 for both replacements). No more. I’m going to wear out the mask seals as long as I possibly can. The headgear may be a bigger problem but I’m going to stretch it to the max.

Updated 07/18/2013: I stopped using a full-face mask and switched to an Aloha Nasal Pillow. It required some adjustment but it is much more effective, leaks have become rare problems, and the replacement parts are considerably less expensive.

Extending CPAP Headgear and Mask Seal Life with Lansinoh HPA Lanolin (and Reducing Leaks)

For a couple of months I’ve been using Lansinoh HPA Lanolin to reduce leaks around the mask silicone seal. It’s been very effective, especially since I have beard that would otherwise lead to increased leaks.

Recently, I decided it was time to replace the headgear and mask seal. Typically I would need to replace the seal every three months and the headgear about every six months.

My experience with replacing the gear this time was a little bit different. Instead of improving my stats they actually decreased a bit. It seems that I was actually doing well with the older seal and headgear when combined with the Lansinoh. The headgear probably isn’t as much of a factor – I suspect the biggest difference is caused by using a new seal.

A new seal is much firmer than an older one. The longer a seal has been used the softer it becomes. Without Lansinoh (or a similar oil) an older mask seal would tend to leak more. However, the firmness of the new seal actually seems to create a less efficient seal. This isn’t what I expected and though it’s an inconvenience now I’ve learned something valuable – I can probably use an older seal with the oil indefinitely.

Is it less expensive to use Lansinoh with an older mask? Yes, if it works for you. A new seal for my mask costs about $55. If I use one tube of Lansinoh each month then it will cost me about $12 per month. In addition, using the Lansinoh seems to extend the usable life of the seal. I’m not sure how long a seal can be used with Lansinoh but I suspect it can easily last a year.

How effective this trick is will vary from person to person. If you’re interested in trying this then I suggest that you just buy one tube before stocking up. I also don’t recommend trying this for the first time with a new mask seal. The Lansinoh probably can’t be cleaned from the seal completely so start with an older mask seal.

Updated 06/20/2012: I haven’t figured out the perfect amount of Lansinoh to use each night but I have made progress on cleaning the oil off older mask seals. The oil really sticks and can even stain so avoid getting it on any clothing that you plan to wear in public again. I’ve previously tried dropping older mask seals into boiling water for a few minutes. It did get some of the oil off the masks but it also coated the pot that I used, which required a lot of scrubbing to clean out.

This weekend I tried a different approach. I gathered up a couple of masks (the same ones I had tried to clean with hot water) and dumped them into a mix of bleach and hot water in a plastic bowl and let them sit for a while. That seemed to do a good job of removing the oil from the masks and also breaking it down so the container wasn’t coated with residue. I’ve only done this once so I don’t know if it will be a good idea in the long term but the masks that I had used were old ones that I would have thrown away anyway. In this case, I’ll probably try reusing them. So far, the bleach didn’t seem to harm the mask seals.

Reducing CPAP Mask Leaks with Lansinoh (Lanolin)

In my efforts to improve the effectiveness of my CPAP treatment I started searching the cpaptalk.com forums for new tips. I came across one that seemed a bit odd, but does seem to be effective. In one post, and also in several others, many individuals recommended using Lansinoh Lanolin to create a more effective seal between one’s face and the silicone mask seal.

A Hard Shell Travel Case for a CPAP Device

Since my obstructive sleep apnea is severe I must take my CPAP with me any time that I travel. Otherwise, I’ll feel terrible the next morning. Unfortunately, the device came with a soft case that doesn’t provide the device, and more importantly the mask and hose, any protection from being damaged.

This week I decided to purchase a hard shell case that would offer more protection. I didn’t want to have to keep asking others to be careful about putting their luggage on top of the CPAP case. It wouldn’t take much to break the mask or hose (though the device itself would probably fine).

Should You Change Your CPAP/APAP Settings?

Should you? Do you have a right to do this? Can it benefit you? For a more expanded opinion please visit my Living with a CPAP page.

Here’s the short answer:

It depends, but probably not.

Personally, I think patients should be able to monitor CPAP stats and make minor adjustments if the stats show areas where an improvement can be made (for example, increasing the minimum pressure supplied by an automatic CPAP device (APAP).

But here’s why you probably shouldn’t do this. If your DME and/or insurance company requires proof of compliance via downloading machine usage data then you shouldn’t change anything. Yes, it’s easy, but the insurance company might be able to declare that the act of changing settings is non-compliant (or they could claim that you’re not in compliance because you changed your settings). You might lose coverage or at the least have a lot of explaining to do.

When should you do this? My best guess is only if you’re not dealing with an insurance company or if you don’t have to report compliance data to any other party.

I hope this information helps. If you’re not sure then just contact your DME or sleep doctor.

Changing CPAP (APAP) Minimum Pressure Range

In general, I’d recommend against doing exactly what I’ve done. However, my recent journey into tracking sleep stats provided me with information that I used to determine, on my own, what might be a better pressure range.

While reviewing data from 17 nights I realized that on 14 of those nights the average pressure used was above 9. In addition, in cpaptalk.com forums I read some accounts in which several individuals suggested that lower minimum pressure settings can be a problem for some people.

Specifically, the idea is that if a pressure of 9 is needed to clear the airway, but the minimum starting pressure is 6, then it may be taking the CPAP too long to detect that a higher pressure is needed. By the time the unit ramps up the pressure the apnea or hypopnea event may already be over due to the body’s automatic response.

I’ve used this range two nights in a row and I do seem to have experienced an improvement in my sleep.

Updated 10/12/2011: My opinion regarding exercising the ability to change machine settings has changed slightly. Visit my page on living with a CPAP for more information.

Using ResMed S8 AutoSet II Stats to Track CPAP Effectiveness

If you really want to know how to change/access your settings on a ResMed S8 AutoSet II or an S8 Elite then you can find the instructions on the Change CPAP Pressure Settings page at apneaboard.com. However, I recommend that you first read my comments on this in my Living with a CPAP (Obstructive Sleep Apnea Treatment) page.

A couple of weeks ago I started tracking how I felt after a night of sleep using a calendar. I’ve since graduated to maintaining an Excel spreadsheet that logs this information using a scale of zero to five (zero = severe fatigue, five = well rested). A couple of days ago I started checking the morning’s effectiveness stats and recording that in the same spreadsheet.

A Simple Sleep Journal Via Online Calendar

In an effort to maintain awareness of my sleep patterns I decided to keep a very simple sleep journal. I don’t know how useful this will prove to be though it may help identify trends or problems caused by specific changes in my sleeping habits. My sleep doctor may find the data interesting at my next visit, when he checks up on my CPAP treatment. Rather than sign up for another third-party service, I decided to use a resource I already I had.

I’ve been using MobileMe for a while. I’ll transition to the new iCloud service once it becomes available. In MobileMe I created a new “Sleep Journal” calendar in which I enter information about how well I slept and how I felt the day after. Specifically, each day I add an all-day event with a title that describes how I feel that morning. For example, I’ll enter “Extreme Fatigue”, “Slightly Fatigued”, “Moderately Rested”, or “Well Rested” along with some other descriptions or combinations of those (some days I’m a little bit tired but somewhat rested).

I also add short notes to each entry that may include information about new equipment that I used, when I went to bed, how often I remember waking up, or even if I woke up before or after my alarm clock went off. Eventually, I may create a spreadsheet, database, or chart based on the information.

I don’t enter very many details. My goal was to make it simple and easy to access in order to help ensure that I continue to maintain the log.

Press Any Key

tech, games, or whatever else…

cpap