Brand new (to CPAP and the forum)

[angiessa]

Thanks, Trish!

[angiessa]

Well, that was illuminating. Put the machine on automatic last night, setting the minimum at 6 and maxing the high end. Average pressure was 13.94, max was 18, and 90% pressure was 16.20. Machine definitely wasn't set high enough the first two nights. I slept like a rock for the first time with it - up once in the night for a bathroom break, but otherwise out cold. AHI was 2.15, which I'll take since I'm still getting used to the machine.

I definitely need a new mask, though. The Respironics comfort gel nasal mask is probably super comfortable for back sleepers...but I sleep on my side and I've got bruises forming on my cheeks from where it digs in. After looking up every review I could find on it, I ordered the Dreamwear this morning - excited to try something different.

I want to give a huge thanks to you more experienced members for your great advice yesterday. I already feel better -- this is the first time in YEARS that I haven't felt like going right back to bed when I get up in the morning.

[DariaVader]

Finding the right mask is the hardest part, especially if your pressures are on the higher end. The pressures may not be so high though if you get the leaking under control. Masks and their parts also need to be replaced on a regular basis; was your mask second-hand? It also may just be a poor fit...

[angiessa]

Nope, it's brand-new -- I'm a little paranoid with germs, so using a secondhand mask was a no-go for me. I think I just don't like the style -- but I definitely don't like the look of a ffm. Hoping something lighter will feel better.

I also found out last night that I'm not as active a sleeper as I thought...when I'm actually sleeping. My constant shifting positions was due to not breathing/sleeping well. Last night, with good sleep, I turned over only once that I know of (and my back is a little sore because the second position I settled in was a little wonky). So I'm hoping that will help make the Dreamwear a better fit (was initially worried about yanking or dragging it off in the middle of the night).

[kaiasgram]

I already feel better -- this is the first time in YEARS that I haven't felt like going right back to bed when I get up in the morning.

Great news!

[angiessa]

Second night on auto setting. I want to give it a whole week before tinkering, but it looks like I'll be eventually raising my minimum pressure from 8. My 95% pressure is above 16 two nights in a row, and my pressure graph doesn't dip below 12 after the initial ramp period. So I'm thinking a minimum of...10? Again, I'll wait until I've got a whole week's worth of data. AHI was 1.63 last night -- happy with that either way.

Plus, my Dreamwear mask arrives tomorrow. Hoping it works well for me (still HATE the PR ComfortGel nasal mask's rigid frame digging into my cheeks). We'll see what kind of difference (if any) it makes on the numbers.

Mostly talking to myself right now - sorry. Still very thankful for this forum and all of the great advice/support here, though!

[OpalRose]

Your doing great angiessa! An AHI of 1.63 is very good, and as long as you feel good, your headed in the right direction.

Your 95% pressure means you were at and below 16 for 95% of the night, and if you aren't going below 12, then a good place to start your pressure would be 10.

I don't know where you have your ramp start at, but if you are staring at 4, you should raise that when you raise your start pressure, many to 6.
You don't want a hugh gap between your ramp pressure and your starting pressure.

Alot of us don't use ramp, so eventually you may not need it, but do whatever is most comfortable for you.

You are doing this the right way. Give it a couple weeks, then look at your data before making changes.

Edit: if you are going to trial masks, I would not change my pressure at the same time.
If you make too many changes at once, and your numbers change, you won't know if it's the mask or pressure changes.

[angiessa]

Edit: if you are going to trial masks, I would not change my pressure at the same time.
If you make too many changes at once, and your numbers change, you won't know if it's the mask or pressure changes.

Point well taken. I'll wait until I have the new mask and, if it works for me, give it a full week with the new mask before thinking about adjustments.

Thank you!

[DariaVader]

If you find that pressure changes do not create CA events (from your AHI, it doesn't) then set your aflex or cflex (they differ on when in the breath cycle to apply relief) to maximum relief. At the pressures you are seeing, this can be very helpful for both comfort and to relieve symptoms like water retention. You may consider bipap with a greater expiratory pressure relief. This would help you to tolerate a higher inspiratory pressure at the start of therapy for the night, and it sounds like you will have higher pressures. what are your median pressures running? a median pressure of 14 to 16 is considered an indication that bipap would be beneficial.

[angiessa]

Median pressure last night was 14.8; 14.2 the night before. You may be on to something.

I currently have the a-flex set at 2, which is comfortable even when I wake up and the pressure's still high.

Trying my first Sleepyhead screenshot:



There are a few CA's listed, but some are preceded by a breathing spike. According to a YouTube video I found from an RT, those are likely a sigh followed by a short pause, which reads as a CA to the machine. And anyway, they don't seem triggered by pressure increases, so I'm not super worried about them yet...unless someone disagrees with me? (Again, this is after only 2 nights, and using a mask I dislike enough to fiddle with occasionally throughout the night.)