[CPAP] Newbie on auto CPAP

[User1211]

Hello everyone,

I had a sleep study done at home which gave a me a diagnosis of 31.5 respiratory events ie severe sleep apnea.  . Hence I have been told I need CPAP treatment and I bought a Resmed Autoset AirSense 10 three weeks ago as well as signed up for a mask trial.

I trialed the Resmed F30 full face mask, Respironics Amara View and the F20 Nasal mask. Being a mouth breather I could not use the F20.

The initial 2 weeks was hell as I could not get use to the machine and sleeping with the mask, especially with the sound of breathing and the numerous problem adjusting to leaks etc. However I persevered and did some reading on websites particularly on adjusting the mask. I still can't get it yet but I managed to sleep better.

I finally bought a Resmed F30 Full face mask (med) once I felt that I could get use to it. Amara view was not too bad as well but magnetic clip was more convenient.

So the last 3 days sleeping (Wed 24 to Fri 26) with it my AHI was 9.19, 3.44 and 4.53. I have attached my screen shot of the last 3 therapy sessions so I can get some help from the more experience folks here.

[attachment=13908][attachment=13909][attachment=13910]

I have changed the settings to min of 10mmH20 and Max of 20mmH2O. On Fri I i manually increased the humidity to 6 but then I changed back to auto climate control on Sat.

It seems like from my limited knowledge of reading the charts, I have positional apnea which leads to quite high hypoapnea, so I tried sleeping with a small pillow under my chin on Thurs and Fri whilst waiting for my soft neck collar to arrive. The reading seems to have gone down a bit.

However, using the new F30 mask I wake up with a almost white mark around mouth area created by the mask contact on the face. I did not seem to get this with the trial mask.  I am not sure if I had tightened the straps too much to prevent the leak. Also after 3 days, the area around the mouth started turning red and has a stinging pain. so I have stopped using on Sat night which is why I don't have a reading for Sat 27.

Appreciate if I can get some advice from the folks here on how to improve my therapy session.

Thanks very much in advance.

Cheers.

[OpalRose]

I don’t use a full face mask, so I’ll let someone else advise on that.  If you haven’t already, read the mask primer.  You may find some good tips there.
http://www.apneaboard.com/wiki/index.php...ask_Primer

As far as your therapy, it does appear that a soft cervical may help.

One thing I would do is up the EPR to 3, as that will help with the Hypopneas.  

Also, you may do better to set your minimum pressure closer to your median pressure (or around 2cm lower than your 95% reading), so around 13min.  Leave the max pressure at 20.

Finally, if you need to use ramp, move it closer to the minimum pressure.  Try starting ramp at 10. Also, set it for a lesser time. 45 minutes is fairly long.
In time, you probably could do without ramp.

This is all trial and error to get where you need to be, but it looks like you’ve done some research.
Try these adjustments and see how you feel with it.

[Mike79]

That's where I started--11 years ago.  The first month was particularly difficult.  The machine mademuch more noise than I expected. 33db ear plugs--the highest rated ones I could find--kept the noise down to tolerable levels.  Because I have sensory processing disorder, the mask frame and the blind spot it created in the middle of my field of vision, were highly distracting and gave me headaches.  A blindfold solved the distraction and headache problems, but it took another three weeks to adjust to being blind and deaf from the time I went to bed until I got up the next morning.   After that month, I was able to wear my mask for the entire night without any further difficulties.

[Sleeprider]

I agree with OpalRose. Increase EPR to 3, consider minimum pressure of 11-12, and try a soft cervical collar or other means of avoiding chin-tucking.

You did your homework and are doing a good job of recognizing your needs!

[Melman]

I have used several full face masks including the Amara View. I now usr the Resmed AirFit F20 which I find most comfortable. That s\doesn't mean it would be the best mask for you. From what you describe, I think you may have the mask adjusted too tight. This is a common error in trying to eliminate leaks. There is an excellent mask primer that may help you. See the link below.

[User1211]

I

One thing I would do is up the EPR to 3, as that will help with the Hypopneas.  

Also, you may do better to set your minimum pressure closer to your median pressure (or around 2cm lower than your 95% reading), so around 13min.  Leave the max pressure at 20.

Finally, if you need to use ramp, move it closer to the minimum pressure.  Try starting ramp at 10.  Also, set it for a lesser time.  45 minutes is fairly long.
In time, you probably could do without ramp.  

This is all trial and error to get where you need to be, but it looks like you’ve done some research.
Try these adjustments and see how you feel with it.

Thanks Opal Rose, i think the changes was too drastic for me. I changed ramp time to 10 mins with starting pressure of 10. Min set to 13 and max set at 20.

I struggled to fall asleep for more than 1 hour and even the sleep quality was so poor that I woke up a few times across the night. I finally gave up at 4 plus in the morning. I also struggled with mask adjustments as it seemed that I have gone the other way where it might be too loose as leaks occurred quite easily...sigh

[attachment=13922]

I might try to dial up the ramp to 30 mins and set starting pressure at 8 tonight, min at 11 and see how it goes.

Also the soft cervical has arrived so let's see if that helps.

[User1211]

That's where I started--11 years ago.  The first month was particularly difficult.  The machine mademuch more noise than I expected. 33db ear plugs--the highest rated ones I could find--kept the noise down to tolerable levels.  Because I have sensory processing disorder, the mask frame and the blind spot it created in the middle of my field of vision, were highly distracting and gave me headaches.  A blindfold solved the distraction and headache problems, but it took another three weeks to adjust to being blind and deaf from the time I went to bed until I got up the next morning.   After that month, I was able to wear my mask for the entire night without any further difficulties.

Cheers, at least I dont feel alone in facing this problem. I so want the machine to work for me so I am definitely persevering. I kind of rely on alarm to wake me up so ear plugs might not be a good idea. The F30 is not too bad in terms on of obstructing any view so that is not a problem.

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I agree with OpalRose. Increase EPR to 3, consider minimum pressure of 11-12, and try a soft cervical collar or other means of avoiding chin-tucking.

You did your homework and are doing a good job of recognizing your needs!

Thanks Sleeprider. As mentioned above I will try these out tonight.

I have used several full face masks including the Amara View. I now usr the Resmed AirFit F20 which I find most comfortable. That s\doesn't mean it would be the best mask for you. From what you describe, I think you may have the mask adjusted too tight. This is a common error in trying to eliminate leaks. There is an excellent mask primer that may help you. See the link below.

Thanks Melman, I have read the mask primer. I will keep trying to adjust till I can feel that it is right.

[MitchS]

It may help to increase the pressure and epr in stages, allowing time between increases to get used to the new settings.

[User1211]

It may help to increase the pressure and epr in stages, allowing time between increases to get used to the new settings.

Roger. Makes lots of sense. I think I took too big of a step.

[Dormeo]

You might see if you can find a mask liner that would work to protect your skin.