Got a VAUTO 6 weeks ago. I haven't been able to fall asleep.

[squado]

So, in a stroke of luck I got a VAUTO in like new condition for dirt cheap from someone. My hope has quickly diminished...on most days in the past month I've tried to fall asleep while using it, and haven't been able to. I do read this is normal for some people, but I get the feeling like I'm not really getting closer to being able to actually use it? IDK. 

Background: I am what I call an "uncomfy" person.
I believe I have UARs because my RDI is super high, I needed nose surgery for breathing issues years ago (and it did help a bit) and I also have issues with jaw misalignment. I'm also skinny and young. I do have a mild AHI too. 

I have usually 0 issue falling asleep, it's often instant. However sometimes (rarely) when I wake up hours early I find it IMPOSSIBLE to get back to sleep no matter how exhausted, how dead I feel. My body just feels so...uncomfortable and painful. The only good sleep I've ever had was weird. I had talked to a friend all night outside in a weird recliner, went inside to my bed, slept all day, and woke up feeling alive for the first and only time in my entire life. Even the dark circles I've had since I was 12 were gone. Ironically, I find it impossible to nap or day-sleep normally. I felt great that whole day...I went to sleep...I woke unwell again. 
My sleep schedule is straight edge on 99% of days; 11PM-7AM. 

Anyway so...now to my problems in the past month after I got my Aircurve VAUTO 10.  
The first hurdle was realizing the factory default settings was hurting me, it was too high. I changed it. Right now IPAP is at 8, EPAP at 4. PS is at 4. 


I have a Dreamwear silicone pillow mask. It feels fine. However, the frame itself is a medium, and the pillows a small. They push against my upper lip a lot and it's not painful, but it is uncomfortable. I have no idea if this is just normal or if, somehow, a larger pillow would suit me better (wouldn't it just push against my lip more?). My financial situation makes it a bit hard for me to just sample new masks.  


Out of desperation I've taken to downing a lot of chamomile tea at night which does help zone me out, but I'm pretty much at a loss for what else to do and getting kind of depressed.

I really, really...really wish I had OSCAR data to share, but I don't because I haven't at all been able to sleep on my VAUTO.

EDIT: Just saw the mod note! I think I'll keep all my therapy information in this thread. If I do manage to finally get to sleep on my VAUTO I'll change my title/post accordingly.

[David Clark]

If you're wearing your mask and using the Vauto go ahead and download OSCAR and share the data anyway whether you're sleeping or not. If you have the machine on and there's a SD card in it there will be data on it. It could give us more insight than just your explaining what is going on.

[squado]

Ok I am actually really confused. I already had OSCAR downloaded so I imported my data and the AHI is way worse than it was in my sleep study (my primary issue is RDIs) but I assume it's because I kept taking off the mask, tossing and turning, etc? Just a fluke. I think the seal is okish when I'm still. Please excuse me if I posted the wrong data or maybe not that good of days.

Anyway, I am 99% sure this data includes 0 sleep. Also part of it is from before I adjusted the settings to be lower--the change was very helpful and at least made me feel as if maybe someday I'll be able to sleep on it.

[Sleeprider]

Your sessions are so short that it exaggerates the AHI. We can make some changes and probably improve results. There are two things going on here. First, you have some obstructive clusters that appear positional. This may be the use of multiple pillows or a sleeping position that results in your airway being bent and obstructed. You can read the positional apnea and soft cervical collar wikis linked in my signature for some ideas. Secondly, you have a number of CA events, that is likely from being over-ventilated by the bilevel therapy. You are using PS 4.0 in the charts above, so we're going to cut that back to PS 3 to see if that helps, and you can change the timing of pressure support by changing trigger sensitivity to high or very-high. In summary:
Mode: Vauto
EPAP min 5.0
Max IPAP 12.0
PS 3.0
Trigger Sensitivity: High or Very-High

Watch out for excess pillows or consider other means of protecting your airway from chin-tucking or hard angles where your head is turned at an angle to your neck and body.