[CPAP] turbopenguin CPAP progress thread

[turbopenguin]

After 6 long months, I finally received my CPAP machine (Resmed Airsense 11 Autoset) 2 days ago.
Night 1 - I was unable to sleep with it because I couldn't get a good seal. My ears also kept popping like I was on an airplane. It was a very uncomfortable sensation. 
Night 2 - I spent a couple hours during the day just getting used to things. I figured out how to clear my ears & get a decent seal. I was able to sleep for ~ 5.5 hours (oscar data attached). 

All I can say is that this CPAP is an absolute game changer for me. Despite the short amount of sleep and high leak rate, I cannot remember a time in my life I woke up well before my alarm, felt rested, and was not in a grouchy mood. Part of me worries this is too good to be true, but my gut and everyone I've talked to says CPAP changed their lives. My main complaint right now is my face mask.

I told the doc that I snore so they started me off with the F20 mask (tried both silicone and foam versions). I feel I only breathe with my mouth because I snore, and I only snore because I have sleep apnea. Logic tells me if the sleep apnea is treated, then the snores go away. If the snores go away, then so should the mouth breathing? Is there something I'm missing there? 

Anyways, the foam version was very uncomfortable and dug into the bridge of my nose, but the silicone was manageable. It is also worth noting I have a full beard, trimmed down to a #1. Regardless, I ordered the P10 which should arrive tomorrow, so hopefully that will give me a better seal & comfort. 

I would appreciate if anyone has any tips or additional insight into my graphs to improve!

Thank you!

CPAP configuration used: 
PAP Mode: APAP
Min 6.0 Max 20.0
EPR: Full Time; 2
Humidity: 6
Temp: 74 F

[turbopenguin]

Forgot to mention, I was diagnosed with moderate sleep apnea with an AHI of 28.6 back in October 2022.
Initial pressure settings set by my doctor were 5-20.

[turbopenguin]

4/6/23 (night 3)

Adjustments made: 
 - up pressure range 6-20 > 7-20
 - up epr 2 > 3
 - up temp 23 > 25
 - lower humidity 6 > 5
 - lower ramp time 45 > 5

I gave the foam mask another shot and it felt better/less leaky than the silicone. Adjusted it to sit a bit higher, pretty much brow level with the bottom of the mask just below my lower lip. Still getting used to the pressure so a 5 minute ramp from 4 to 7 worked well. 
Session cuts off after 3 hours because of rainout. The gurgling woke me up and I was too lazy to do anything so I turned the machine off and went back to bed with the mask on and slept terribly. Wife woke me up about 3 hours later because I was snoring. I emptied the water that was sitting in the hose and got about another hour of sleep with the machine on. The chart looks wacky so I'm not including it here. On the bright side I'm getting more used to wearing the mask. 

Probably too many changes for only the third night, but I was happy with the results, until the rainout. Really looking forward to getting at least 7-8 hours of uninterrupted sleep. 
The only changes tonight are switching to auto climate control and changing masks (F20 > P10). 

[Deborah K.]

You are adjusting very quickly and already feel better.  That is wonderful!!  Your 4/6 AHI is great!  I think you will like your P-10 even better than the other two masks.  Your leaks are high, but wait until you try the P-10.  You will probably leak more with the P-10, but that is because your mouth will not be covered.  The leaks can be fixed in a couple of ways, so don't worry.

[turbopenguin]

Thank you Deborah! As a data analyst by profession, I am LOVING this.

4/7/23 (night 4)

I got my p10 today and I gotta say it is 1000x more comfortable than the f20. However, I was unable to use it because I had a hard time exhaling. It felt like there was way too much resistance on the exhale. I tried numerous things -- EPR 1,2,3; lower pressure settings; ramp on/off; headgear adjustments; all tip sizes -- and it always felt like a labored exhale. I made sure the tips were just at the tip of the nostril and not inside my nose. Hell I even tried pushing them farther up my nose and ironically it felt easier to exhale when I did this. I will say I get a bit stuffed up in my bedroom specifically (I tend to breathe better out in the living room) so maybe that is the issue or it could be my nose structure, or simply a psychological barrier. I have 30 days to try it out so I am definitely going to be giving them another go. Any tips or suggestions on this?

I mentioned the general stuffiness I tend to get in my bedroom, and last night I actually slept in the living room because even with my f20 it felt harder to breathe last night.
I still felt constricted with the p10 in the living room, but at this point it was nearly 3 am and I was getting anxious, so I went back to the f20 memory foam and was able to get to sleep. I loosened up my headgear quite a bit to get comfortable which lead to a lot of leakage. 

This night is actually a good test between living room vs bedroom. I slept 5.5 hours in the living room, and then an additional 2 hours in my bedroom.

First image shows both sessions. Any insight as to what happened around the 9:20 AM mark? Pressure starts to climb and flow rate gets choppier. I'm not entirely sure what flow limit means but that starts to increase.

Second image is zoomed in around the 9:20 AM mark. 

Third image is zoomed in on the hypopnea event. The flatlining of the flow rate jumps out to me. Is that indicative of a CA; where I'm essentially holding my breath?

[turbopenguin]

4/8/23 (night 5)

Woke up feeling really tired. 

First image are 2 sessions of me relaxing with the p10. First session is with the large pillows, second session is with the medium size pillows. I felt both sessions started okay but the pressure just kept rising. Once it got to 8-9 it became very uncomfortable. Any thoughts on this?

Second image is actual sleep with my airtouch f20. I had the mask just tight enough to get a good seal on 6 pressure. Once the pressure started to rise so did the leak rate. What triggers the airsense 11 to increase/decrease pressure?

Thanks for everyone's help thus far, I really appreciate it!

[turbopenguin]

4/9/23 (night 6)

Finally got a full 8 hours. Still feel tired though. 

[ferrus]

I started about 2 months ago with a Swift FX Pillows, an older version of the P10. I am a 'mouth breather' so I got a chin strap to hold mouth closed. I found I woke up with a sore spot under my nose. I tried a F20 and that worked really well for me except I ended up with a sore spot on the bridge of my nose. I'm currently using a F30, which some people object to, and get a "normal" nights sleep.

It took me about a month to get to the point of getting a sound sleep, and I generally don't have trouble falling asleep. I do get occasionally woken up by leaks on the F30 from the hose impinging on the mask. I wish there was a swivel available let the hose move around some without putting force against the mask. A complaint on the F30 that I read here is O2 drop and folks waking up with headaches. I bought an O2 ring and haven't seen anything scary. I showed charts from O2Ring to docs last week and they said it was fine. I used to wake up in a fog with headaches but wake up clear headed now. There is a big long thread on the F30 here. I'm generally happy with the F30 and am sleeping about how I used to before CPAP.

If you are happy with the pillows, stay with them. A friend uses those and says he sleeps fine, although occasionally he uses ambien. The technician that initially chose the Swift FX for me uses CPAP for last 10 years, and he loves the pillows. You just have to find what works for you and your contours.

[turbopenguin]

4/10/23 (Night 7)
Bumped ramp pressure to 4.4 and set a max pressure of 9.
I turned the humidity down to 3 because this thing just runs through distilled water. Felt fine with the lowered humidity. I live in a very humid climate as well. Also turned the temp down to 78 F.
I remember waking up a couple times and wasn't even sure if the machine was on. The pressure felt natural.

Feel much less tired this morning compared to the last 2 days.
Did a cardio workout last night before bed that I think helped. Been a while since I've worked out.

First image is full session.
Second image is a zoom of a hypopnea and a couple CA events (no CA events presented during my sleep study). Should I be worried about these or is it normal?

[Crimson Nape]

You are not doing yourself any favors by starting at 4 cm.  Most adults need at least 6 to 8 cm to eliminate the air starvation felling.  I would turn off the ramp feature.  The ramp may also be causing a pressure change arousal when moving up to your therapy pressure.

- Red