[CPAP] stanleyjack cpap progress thread

[stanleyjack]

So I spent my first full night on CPAP.

I not long back purchased an Airsense 10 & a AirFit F30i.

Naively I bought the unit without the humidifier or the climate-hose, and soon found out this meant cold dry air was being pipped up my nostrils. Yesterday I received delivery of a humidifier and Climate-hose.

First things first, I don't have OSCAR data. This morning I removed the SDCard, but there was no folder for the 19th (only the previous days). I expect I either powered the machine off before it could fully sync, or I did not exit out of the summary screen. Next time I will definately grab the data.

My set up was a Min pressure of 7, max of 20. Ramp off. EPR 3

Now when I say 'spent the night', I actually had to remove the mask twice just to give my nose a break. This was me actually removing intentionally, not ripping off. 

Each time I forced the mask back on determined to get this to work.

Here is what I noticed.

I had some pain around my nose where the mask would dig in around my nostrils. I could relieve this by loosening the straps, however what would happen then is I would fall asleep, apnea would start and so the machine would start to increase pressure, which would result in the mask leaking and waking me up. I would then tighten to the level sufficiently to stop the air loss, but this would then be too tight and would aggravate my nose too much. I tried this tweaking process most of the night, trying to get the mask dialed in, but could not find a happy medium.

I am now not sure if this is:

A: A bad fit
B: I don't get on with this mask type
C: A+B

For A, I used the nose measurement tool from ResMed and went with a Standard fit head rig. 

The positive is that were it not for my nose being crushed a little too much, I was OK with the mask on and at times felt really cosy and content. 

I think if I can get this dialled in, I might be able to start having some decent sleep.

What options do you think I have? For the record I am self-treated, so I don't have an option of having a care specialist give me different options.

Hopefully will be able to update with a full OSCAR report tomorrow.

[cdplatt]

I suspect you may prefer a different mask type.

I started out with a full face mask F20 - recommended by the company that set me up as the most popular type of mask. Had trouble chasing down the leaks that constantly woke me up - also a brutally dry mouth - and dry mouth was always a problem before I started CPAP. Tried nasal pillows, nasal cushion, and just nasal - N20. Yes, I blew a lot of money on masks in the first few months. All the nasal types of masks just resulted in me blowing air out of my mouth and getting that dry mouth again.

I gave up because I was losing so much sleep and only had mild Apnea - but continued to get concerned as I watched my Fitbit and pulse oximeter report desaturations plunging down into the 70s.

I read the threads here about keeping my mouth shut and planting my tongue on the roof of my mouth - didn't work for me. My dinky nose usually gets stuffed up when I lie down and my mouth WILL fall open when I sleep. Didn't want to use a head strap because I have a TMJ issue and didn't want to put upward/backward pressure on my jaw.

Then I came across the mouth taping threads - WHAT? Read the concerns about vomiting/asperating while sleeping taped. Well I've never puked in my sleep and couldn't imagine that happening unless I was dead drunk - which hasn't happed since I was in my 20s. Never read a news report about anybody dying that way either. Gave it a try with the full face mask even though I felt like a dope with tape slapped over my mouth. No dry mouth! No getting up in the middle of the night to swish water around in my mouth.

Still had the leaks though, so tried the N20 nasal mask again with tape. Leaks vastly reduced. Did not wake me up anymore. Bonus - no stuffy nose - apparently the pressure was able to push through (hold open?) my narrow nasal passages as well. I sleep very well with the CPAP now. My fitbit likes it too and doesn't give those crappy sleep scores. My AHI scores have dropped below 1 (rarely dropped below 6 with the full face mask). The very few APNEA events I get are clear airway events as I'm drifting into sleep or waking up.

[stanleyjack]

 
Still had the leaks though, so tried the N20 nasal mask again with tape.  Leaks vastly reduced. Did not wake me up anymore.  Bonus - no stuffy nose - apparently the pressure was able to push through (hold open?) my narrow nasal passages as well.  I sleep very well with the CPAP now.  My fitbit likes it too and doesn't give those crappy sleep scores.  My AHI scores have dropped below 1 (rarely dropped below 6 with the full face mask). The very few APNEA events I get are clear airway events as I'm drifting into sleep or waking up.

Interesting. I have mouth taped in the past (pre-CPAP) and got on reasonably well with it, so I am comfortable doing this. I also wonder if it might be that my upper pressure limit is to high. Hopefully I get some OSCAR to play with tonight. Thanks for sharing your story cdplatt, this is all golden stuff to hear others path.

[cdplatt]

With the Airsense 10, I wouldn't think upper pressure limit would be a concern.  The device won't go there if it isn't necessary to push through an obstruction.  Oscar will tell you how high it's actually going.  However, based on the Oscar reports, I did raise my lower limit.  My original prescription had the lower limit set at 4.  I noticed that after I fell asleep, the Airsense 10 went right up to seven or eight and didn't come back down, so I set the floor at seven.  My pressure readings now swing between 7 and 14 at the highest, but will hover between 7 and 10 or 11 most nights with theN20 mask.  With the full face mask they routinely went up to 14 (the upper limit setting), and I'd start to get a lot of leaks that woke me up.  I tend to be a very light sleeper; wide swings in pressure will wake me up, so I try to keep the pressure range as narrow as possible and I don't use the ramp setting.

[sunlight]

Hey stanleyjack, good to see you getting underway in earnest!

Regarding the SD card workflow, I haven't lost any data so far which may be to do with my morning routine. I take off the mask and let it auto-stop therapy after a few seconds, remove the humidifier and take it with me to the bathroom to dump the remaining water and do my ablutions. I come back and reinstall the humidifier, long pressing the power button to turn off the machine completely and then finally eject the SD card. I think this gives the machine ample time to complete any pending writes to the storage, flush caches or whatever it needs to do so that I'm only removing the card once the filesystem has been cleanly unmounted and the machine is off.

I can't directly comment on the F30i but would definitey echo cdplatt that finding the best fitting mask can be challenging and I've also already been through a few trying to find the goldilocks mask. I think a lot of it comes down to a combination of facial / nasal shape, the positions you sleep in, facial hair, etc, when deciding what works best. OSCAR data also helps with identifying leaks. There is also a bit of an art to getting the mask tight enough but not overly tight, particularly when there are multiple points of adjustment (top and bottom) which can change the angle at which the mask rests on your face, particularly as you shift positions or open your jaw. All I can say is be patient and also consider external variables like pillows, tube snagging, etc.

[stanleyjack]

Turns out I do have the results from the 18th, it was chaotic night though, attached..

Seems to be suggesting central sleep apnea perhaps?

[OpalRose]

Not sure what's wrong with the statistics. It just show zeros. Try rebuilding the data for that day and repost.

[sunlight]

Good that you managed to get some data. As you know I'm a fellow CPAP noob so please take what I say with an appropriately sized pinch of salt.

Your Leak Rate chart looks really choppy. You can compare with the charts in my thread to see how my relatively small number of events often appear to correlate with mask leaks. I don't know whether these are all real events or potential false positives in my case. In any case, the machine having a stable interface with your airway seems like a basic prerequisite for therapy so that's where I'd focus my efforts if I were you.

I don't understand why your stats data isn't populated. Maybe someone with more experience with OSCAR could chip in? ETA: OpalRose beat me to it whilst I was posting.

On an unrelated note, is there any reason you decided to start with Soft response instead of Standard?

[cdplatt]

If you had a significant obstructive apnea problem, it's certainly well controlled with your settings, but there are a surprising number of clear airway and hypopnea events.  Mask pressure didn't go very high.  Did the mask leaks, pressure changes, and getting used to the pressure keep you awake most of the time?  Perhaps those CAs will reduce when you get more comfortable with the therapy.  Did you have a sleep study, and if so, what, if anything, did it say about central apnea?

[stanleyjack]

Result of my sleep test. I got a pAHI of 34.2