Deployed new CPAP user needs help

[Toasty]

Hello all!

I've been browsing this forum the last few days trying to get a handle on this but I can't. I got diagnosed with sleep apnea in December, but didn't receive my machine until the 15th of February, a day before I deployed. 

So my condition, sleeping in a tent with climate control but unknown humidity. Using a dreamstation Pro (the 500 series) with a heated tube and a nasal mask. Some FP BREVADA thing. Only water access I have is bottled .I clean it with soap every day because of this . I've been monitoring with dreammapper software .

My AHI has consistently been 8.7-9. I only used it once before deploying and I ripped the mask off after a few hours. Since then it's given me nothing but problems .

My pressure rating is 8, I use a slight ramp of 6 for 15 minutes. I tried turning flex to 1 and thought it was better but my apnea's and ahi increased .I've played with humidity heat and tube heat going from 1-5 on different nights. I never notice a different though, my nose runs and the mask feels wet. 

I don't know what to do. At this point I'm not going to wear it tonight because it's so uncomfortable and my apnea's and hypopneas are still occuring. I have 6 Central apnea's a night consistently 10-20 apnea's and about 45 hypopneas. Sleep length has been anywhere from 4 hours (jet lag) to 9 . 

I've ordered a different mask cause this one just feels so uncomfortable now, my nose is raw. I have a beard and idk if that's contributing in any way, it didn't during the study .

Please help! I need some advice .

[PaulaO2]

Without viewing your data, we're aiming in the dark.

My first suggestion would be to try the Auto-trial option on that machine. This will basically self-titrate you and let you know what pressure you need. If you do not have the clinician manual, get it.
https://www.apneaboard.com/adjust-cpap-p...tup-manual

If you cannot do that because of where you are, my next suggestion would be to raise the pressure. You can try 9 for at least a week and if they don't go down, try 10. Note the data for each day in a log so you can keep track of how it is going.

[ajack]

It sounds like it is is fixed pressure? please get the clinical manual above and I'd also download the free program sleepyhead, to see all your data.
For tonight, you could have auto mode, min 8 max 20 and see what the report on the pressure is, on the machine screen tomorrow morning. Then set 2 under that as your minimum, till you get to auto trial/titrate
https://www.apneaboard.com/dreamstation-...structions

ps, with bottled water, I'd rinse the tub and wash once a week, you don't need to wash every day. (I'm not saying I do, I haven't washed my tub for many weeks now. I just give it a rinse.)

[Walla Walla]

I agree with the above. You might also want to review the mask primer on the link below. Just wondering where your deployed?

[Toasty]

Thanks for the replies! It is fixed pressure. I'll go ahead and set it to Auto trial tonight at 8-20. I'm going to elevate it too as it's sitting close to the ground which is considerably colder than the rest of the tent. Hopefully that'll help with the auto humidifier and wet nose .

I've downloaded sleepyhead so I can publish results to the board. 

The FP brevida is a little too intrusive i think on the nose, too deep, or the wrong size hah. I might try removing the diffuser tonight. I contacted my provider to try a nasal mask or other pillows, but it'll be at least a month before it gets here. 

I can't say where I'm currently deployed .

[Sleeprider]

You don't even need auto "trial". Your DSX500 is an auto CPAP machine. It frankly sounds like you were set on a fixed pressure that was completely wrong for you. My recommendation woutld be a minimum pressure of 8.0 and see where the machine wants to go for maximum pressure by setting maximum to 20. #Sleepyhead will be a great help to you (and us) to help optimize the therapy. Do not remove a mask diffuser, or you will end up with a large leak and uncontrolled pressure. I encourage you to request a Resmed Airfit P10 nasal pillow mask. They are inexpensive and the least obtrusive and quietest mask on the market.

Best of luck, and thanks for your service to our country.

[Gideon]

Never ask a deployed service member where they are deployed.  
In WW2 our Submarines were virtually impervious to Japanese depth charges.  
The a Senator announced that this was the case in a news conference, and it was because the Japanese did not depth charge deep enough.
We lost many submarines after that incident.

Toasty,  stay safe (as possible) and much thanks for your service.  If we ever meet up we will share a beer or 3,4 10   . . .    you get the idea.

Fred
(MM1(SS))

[Walla Walla]

Sorry I asked. I just assumed he wasn't military due to the beard. I would assume he's not special forces deployed with a CPAP. Also he wouldn't be posting on a public web site.

[OpalRose]

Toasty,
Welcome to Apnea Board and thank you for your service!

For clarity, would you check the model number of your machine and correct your profile if needed.

The DreamStation DSX500 is an Auto Cpap.
The DreamStation Pro DSX400 is a straight pressure machine.

[kiwii]

...The FP brevida is a little too intrusive i think on the nose, too deep, or the wrong size hah. I might try removing the diffuser tonight. I contacted my provider to try a nasal mask or other pillows, but it'll be at least a month before it gets here.

Is it possible that you've made the headgear too tight, causing the cushions to be further into your nose than they should be? Here is a video that shows fitting: https://youtu.be/yy2Oiop4MNg?t=1m4s

Also, once you put your mask on and start the machine, pull the mask away from your face and allow the air to fill the cushion. This 'should' help get those prongs positioned more comfortably.

For your sore nose:

- saline gel helps (one brand name: Ayr Saline Nasal Gel)
- lanolin helps, but may be harder to find (one brand name: Lansinoh, for breastfeeding mothers, but any lanolin would work)

It is hard to tell if the soreness you are describing might possibly be caused by a lack of humidity. Do you have a humidifier chamber?

Saline nasal spray may help 'pamper' your nose a bit during this transitional period, or if you do not have access to more humidity.

Just don't use anything that degrades silicon. Not sure what that would be -- petroleum jelly is probably not an option.

Something to relieve gas (like simethicon) would probably be smart to have on hand too, in case you get aerophagia. (one brand name: Gas-X)