[Diagnosis] Newbie Seeking Help with setup and best practices

[RyanAD]

It has been ~6 months since my diagnosis. As per the doctor's interpretation of the below sleep test results: i have a "very severe" form of sleep apnea (saso), mixed type (obstructive and mixed) & AHI index of 73.5/h. Indication of therapy: CPAP with a "maximum pressure 14m H2O" for at least a month before any surgical interventions (for my deviated septum?), and afterwards - until weight loss (current bmi is ~33). CPAP (report) to be registered after 1 week, 1 month, 3 months, 6 months (of usage).

Until now, I've slow-paced the actual purchase of the CPAP machine, since it would entirely come out of my own pocket. 


I have decided to go ahead with the acquisition since I discovered that most of my annoying night habits were actually sleep apnea symptoms/effects. 

I managed to narrow down the equipment that i want to buy: ResMed Airsense 11 Autoset. 
Even though it's not available for purchase from a romanian retailer, i have found a few online stores in Europe that do sell this new model. Because of this: I will be doing the setup (by) myself. Please help me with the setup and refer correct settings or a link/how-to-guide. 

Since this treatment is new (to me or any of my relatives/acquaintances) What are the golden rules? (for a good outcome of the treatment), besides daily sanitizing the CPAP accessories / mask. 

Thank you for your time and patience. If you have other suggestions or tips about sleep apnea / cpap treatment / setup > please share by leaving a comment or DM me. 

PS. I didn't have the proper response to the diagnosis, since I considered that my "apnea" only made me snore... loudly. As i kept reading about this, it turns out it affects my weight gain (although i used to eat like there's no tomorrow) / liver regenerative functions / nocturia / daily sleepiness (at around 3-4pm) / night perspirations. 
PS#2. After bugging the regional cpap rental agent about which private medical insurances cover this type of treatment, he said none do (in Romania). 
PS3#. The national healthcare could cover this under very strict conditions: including which doctor can recommend the treatment, severity of sleep apnea, length of treatment should be no longer than 90 days, and within an exact budget no greater than ~500$. 

       

[Lucid]

Hi, RyanAd  Next in importance to the machine itself are masks -- finding the right for you is key to using CPAP successfully.  Many of us were able to try on different masks at the office of our doctor or CPAP supplier, and it doesn't sound as if you'll be able to do that.

You did a great job of researching what machine to buy (that would be Golden Rule No. 1, which you can check off the list), so I imagine you've been researching masks, too.  There's a mask primer on this site, and great videos on YouTube.  I found mask reviews by CPAP Reviews and The Lankylefty27 especially helpful.

I would just encourage you to prioritize finding ways to try out different masks as Golden Rule Number 2.  In the US, suppliers will replace masks within 30 days at no cost if you get one that's not working for you.  If your supplier does that, don't hesitate to take advantage.  Some people also like to have alternate masks on hand: if one starts to irritate the face or something, they can take a break from it.  Don't stint on masks, and also be sure to try on different sizes of the same mask to find the right size.  My mask, for example, comes in a "fit kit" with small, medium, and large pillows.

Golden rule Number 3 would be to download OSCAR, be sure you have an SD card in the machine to record your data, and then post screen shots here so that experienced CPAPers can help you find the right settings.

Good luck in your journey -- as you've realized, sleep apnea has so many negative health consequences, and CPAP will make a huge positive difference in your life.

[RyanAD]

Due to my work schedule and daily commute, it's difficult to visit the regional sales office and try out several masks (during regular working hours)
According to the reviews and my sleeping on the side > I'll go with the N20 or the F20/30 (if i can't handle the mouth pressure during sleep).

[RyanAD]

Just a little update:
1. Ordered the A11 Autoset + Humidifier from Belgium / Linde HomeCare. The package was ~2-300 EUR cheaper than other reliable retailers in Europe.
2. Ordered the F20 from the Vitalaire Romania HQ (although initially i was going with the N20, but it was unavailable, and the backorder date was unsure according to the Linde sales support)
The Vitalaire agent informed me that officially the A11 is not yet approved/implemented in the Romanian healthcare system > thus some features may not work. He mentioned that he didn't want to discourage me, but i should have purchased the A10 machine.
3. I have created a myAir account. Although the app may not be available in my area > i can just google com.resmed.myair.eu1 apk and install it anyway.
4. I have bookmarked the AirSense 11 setup guide @ www apneaboard.com/resmed-airsense-11-setup-info
5. I have bookmarked OSCAR guide: www apneaboard.com/wiki/index.php/OSCAR_-_The_Guide
6. Although i have SD cards around the house, i will purchase one for the sole purpose of using with A11.

Found some guides, although the remote setup may not be applicable for my case.
a. document.resmed.com/documents/products/machine/airsense-11/user-guide/airsense11_user-guide_amer_mul.pdf
b. document.resmed.com/en-us/documents/products/sleep/resmed_remote-setup-checklist_amer_eng.pdf
c. document.resmed.com/en-us/documents/products/sleep/resmed-guidebook_remote-cpap-setups_amer_eng.pdf

[btbderek]

Sounds like you’ve done your research, you picked a great machine and mask to start. I would like to echo what Lucid mentioned, definitely look into the Lanky Left and CPAP Reviews on YouTube, these channels have really helped me learn and have been very helpful. Between that and the kind folks on this forum that will be very beneficial to your therapy. I’m a few months into CPAP therapy myself and there’s a lot of little things and issues that can arise that you would never think of, and these three resources are a great help!

[Brazen]

I can't think of any features of the AS11 that would need Healthcare system approval/implementation in your case. Did the person at the supplier explain what they meant?

Since you purchased it on your own you don't need the machine to send compliance data for insurance purposes. 


I think the F20 is a decent mask to start with, it can be finicky so be sure to read the mask primer wiki to help with fit.
Nasal masks are tough for many - preventing mouth leak, ie: tongue placement, takes practice. 

The myAir app is barely useful.
It's the quick snapshot, limited data, that some docs and insurance companies take as evidence your treatment is effective.
Many folks find it takes fine tuning treatment with help of OSCAR reports to actually feel better.

[RyanAD]

I received the machine yesterday and its menu is in French/Spanish/Dutch/Portuguese... but no English ) It's not going to be a problem since "as per my LinkedIn profile" I understand basic French 


Setting up the myair app was a little tricky since either the app APK was  from the wrong region (US/Australia) or the phone Bluetooth connection wouldn't be recognised to finish the app setup. Eventually I got it sorted with an older android tablet. (On iOS changing the region still wouldn't allow me to download the app) 

I test drove the machine and with the pressure set at 14 (as per the doctor's recommendation) the already snug mask F20 would leak heavily (so my current pressure setting is 12 to 16... Although 20 is the maximum)

During my first night I noticed that
1. breathing out requires a little bit of an effort (due to the mask positive air pressure) & the mask vent noises are more noticeable when I am lying on my back opposed to my lying on the sides.
2. my chest feels *pumped (like an overly inflated balloon?)
3. breathing in makes a sound similar to Darth Vader breathing (probably generated by the standard hose and CPAP machine)

Hopefully I will get used to the above and start enjoying my sleep (since I tried not get the mask hose tangled or squashed or kinked). I didn't wake up with extra energy, but I am probably having very high expectations from the first night.

PS. No night sweats or nocturia though.

[RyanAD]

Another update after a few days of using and getting the flu:
1. my skin gets irritated unless i clean the mask (contact edges?) with an antibacterial wipe (a full 8hours of sleep with it)
2. i modified the pressure range to 11-13 and the humidifier to 3
3. since i got the flu (+coughing +stuffy nose) i stopped using the machine... and the night sweats and nocturia returned (like magic)