109AHI, starting 2nd week on CPAP, have some questions

[OpalRose]

I'm late to this thread, but also think a bilevel may work better for you.
Those are high pressures to deal with.

I know for myself, I have to be careful not to spend a lot of time on my back. I use a body pillow to prop up against my back, so if I start to roll over, it reminds me where my place is.

Am curious to see graphs after a couple days using the higher pressure.

[DariaVader]

My Observations:
your starting pressure of 8 is just a fast ramp to 16... looks like 15 or 16 is your bottom number --- however if you can make the pillows work, that number might go down. Many pillows users can use lower pressure. I think you will be better off with bilevel too... it will give you a higher max, and allow for pressure support (if the PS doesnt create centrals)

In your charts, you should turn off the VS2... consensus around here is that it's meaningless noise the rest will be easier to see then.

Help to stay off the back = tennisball pocket on your shirt, or wearing a backpack to bed... Your leaks don't look horrible. They seem to be timeboxed not an all the time thing

[toinewi]

Well, don't know if I was having problems staying on my back, or if it was mask issues or what. Woke up with super sore teeth and had an 18AHI night after the pressure change to 15-20. I know I was having lots of problems with small mask leaks throughout the night, and it seems at one point the mask must have slipped off, as I slept through the night.


https://drive.google.com/file/d/0B0SbFMF...sp=sharing

[Sleepster]

I think you should try a full face mask. I know the conventional wisdom is that full face masks are more likely to leak than nasal masks, but often the pressurized air is escaping through your mouth.

[toinewi]

I think you should try a full face mask. I know the conventional wisdom is that full face masks are more likely to leak than nasal masks, but often the pressurized air is escaping through your mouth.

Will revisit a full face next week when I go in for a mask refit. I know initially I had beard issues with the full face mask.

[toinewi]

Well, tried a couple full face masks. Those did not work out so well, tons of leaks, and over the course of the night the mask would work it's way up my face until my mouth slipped out of it, potentially a result of my beard. I had other comfort issues as well.

I went back and got my Eson back, and will go and try out some other options on Tuesday.

[toinewi]

Just wanted to update. I've tried a number of different masks, and am still looking for the right one.
The full face masks I tried all failed, either due to leaks or worse, due to complications as a result of me drooling when I sleep sometimes.

Went down a size on the eson, and while leaks are better, I'm still seeing unacceptable AHI levels. I'll be meeting next week with my sleep doctor to go over things in depth.

[PoolQ]

Thanks for the update, do keep in touch

[icyura10]

Welcome... I can commiserate with your numbers.. mine looked like: AHI= 127.3 an O2 level of 62% with notations of me having cyanosis

All this time I always thought sleep was completely over rated! and completely unnecessary

I never sleep on my back or stomach so I've got that going for me.

I started with a CPAP at a constant 18 cmH20 and a nasal mask. Seems like the pressure would escape around the bridge of my nose, blow into my eyes and wake me up. Grrrrrrrr....

Switched to a ResMed P 10 pillows mask. While they were really comfortable, they were always leaking badly.

A pal of mine suggested I use a sailine gel product (called AYR) and you can get it at many of the superstores with pharmacies in them or actual pharmacies. Getting it at a "superstore" with a pharmacy seems to be more cost effective.

What you do is to put a really small bead of the gel on your finger and run it around the flanges of the P-10 pillows. Then insert them into your nose. Unfortunately, at a constant pressure of 18 cmH20 the pillows would push away from my nostrils and the gel would dry out. When the gel would go away, it would wake me up.

My sleep Dr switched me to a bi-level AirSense 10 Vauto. IPAP=20, EPAP = 12, PS = 8 and also switched me to a Phillips Respironiscs DreamWear under the nose nasal mask. This new mask comes in Small (S), Medium (M), Medium Wide (MW), and Large (L). I'm using a MW. While it's very comfortable, the air port being on the crown of your head is somewhat of a pain in the tail.

This new mask seemed to handle the constant 18 cmH20 much better on the CPAP but I was going to get the bi-level machine a week later.

Now, I'm on the Bi-Level machine, using the Phillips Respironiscs DreamWear under the nose nasal mask with the prescribed settings. My AHI's have dropped significantly, but the story is my sleep pattern is like a fractured fairy tale. I did try the ResMed P-10 pillows with the bi-level and they worked better, but when it hit the upper pressures, they came undone like they did with the CPAP at a constant 18 cmH20 pressure.

I get 30 mins here, 45-60 mins there, maybe a couple hrs here once in a while I hit 4 hrs of contiguous sleep, it's really rare. So I'm sleeping all hours of the day and night anywhere from 6-14 hrs per day.

I'm usually up at 06:00 and frequently taking naps anytime after 10:00 AM. Then again any time after 14:00 and frequently after about 20:00... and as you can see I'm awake now (I've been awake since say about 02:00)... and I'm fixin' to lay back down and see if I can inspect the inside of my eyelids for any significant amount of time.

BTW, because I can't get any real continuous sleep I've been placed on disability because I have a hard time concentrating and it seems my short term memory is shot.

So you might want to try the Phillips Respironiscs DreamWear under the nose nasal mask device. If you find any other masks that work, I'd be interested....

maybe some of my experiences will help you ..

[toinewi]

Here are a few of my results. Just took the first and last couple, plus a handful of random ones over the course of the month. It looks like I have some leak issues after I've been moving around for a bit over the course of the night, as well as some pressure issues. I'm still working on a solution, and have a meeting with my sleep doctor in a couple weeks.






















These last two sum up one of the bigger problems I've run into. The first half of the night I do well. It seems to be the last 2-3 hours where I have some real issues. I don't know what the cause is.





photo libre