First 2 nights

[Narcil]

Hey

Was diagnosed with 48 apneas an hour and loaned an AirSense11 this Monday. Seems i'm adapting well to it so that's nice. Main complaint was heavy snoring since i was ~10y old and that seems almost over? I'll probly try one of these apps to record see if i really stopped cuz i can hardly believe it! Tiredness was also an issue.

I have to do a titration in ~3 months to fix the pressures and prove to the insurance that the machine is helping but i doubt that will be an issue. In the mean time should i change anything?

Monday i had the mask a bit too tight and woke up with huge red marks on my face that lasted a long time. using the silicone n20 airfit. Since the leak rate seemed low i loosened it a bit more on Tuesday and leaks did increase but still fairly good? i did notice the mask started moving around a bit since i sleep on my side but i still had huge red marks on my face. Should i try to loosen it more? Or just try to get some fabric cover before i buy the AirTouch N20? Seems the leaks did some funky things to flow rate and i think the machine is fairly noisy once it ramps up already so not too keen on increasing pressure much either unless it's really needed. Should i worry about the REs at the end of the night tuesday when it started leaking a bit?

Not sure about the ramp yet, i did feel like i wasn't getting enough air the first night before the ramp but not as much the second so i think i'll try it some more before i turn it off. i think its fairly loud after the ramp and when i breathe i think i can hear the "woosh" sound from the air intake behind the machine, is that even possible given the positive pressure?

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Thanks for reading!

[Narcil]

Started ripping off the mask early morning and going back to sleep but i have no idea why. i semi remember there being a leak on wednesday night but maybe i just had my mouth open and instead of just closing it ripped off the mask? the graphs don't seem to indicate any large leaks before taking it off so i'm not really sure. Maybe i do need to tighten the mask back some but the mask fitting says the seal is good.

Should i worry about the flow limits?

[PeaceLoveAndPizza]

How did you end up with a fixed pressure of 8? Doctor prescribed, self-titrated, or YouTube?

I suggest starting with the following:

Min pressure 7
Max pressure 15
EPR 2 full-time
No ramp

That way you are starting near to where you currently are, but with EPR you will have fewer flow limitations. We want to see how far pressure rises to handle the FL’s, so giving it a range should tell us that. 

We can always adjust from there, but setting a fixed pressure without knowing why is not helpful. Sometimes you can get lucky, but I do not think this is one of those times.

I do not think your current leaks are that bad. They will affect sleep quality, but not hopefully too much.

Nasal masks like the N20 are dodgy little beasties. They work for some, but are quite finicky. If it is working for you watch a few YouTube videos on proper sizing and setup. If not, consider giving nasal pillows (ResMed P10) or FFM/hybrid (ResMed F30 or F&P Evora) a go.

[Narcil]

hey thanks.
It's how the sleep tech at the hospital gave me the machine. but he took 3 mins to setup the machine and i doubt he had a look at my in lab sleep study, pretty sure these are just the defaults. I have to do a titration in July to figure out the pressures.

[OpalRose]

I have to do a titration in July to figure out the pressures.

You can determine your pressure needs now. Put the machine in Auto mode and use the settings recommended above.

Min pressure 7
Max pressure 15
EPR 2 full-time
No ramp

This will give us a median and 95% pressure reading, and we can advise from there.

The use of EPR should also bring the flow limitation down.

[Narcil]

Thank you both for your suggestion. Did as you both suggested and it went fine. The higher pressure took a bit to get used to and i did wake up with more of a dry mouth but that's about it. Shaved before going to bed and the leaks almost disappeared..

Little bit worried how much i snored compared to the other nights. We'll see tonight but could it be related? seems unlikely. 

Still some FLs even tho the machine never reached 15 but it did get close.

[OpalRose]

Looks good, however I thought the FL would drop a bit more. If you want to try EPR 3, that may help overall, but usually the minimum should be raised at the same time.
I'll leave that up to you.

If you look at the left sidebar under statistics... your median pressure was over 10 for 50% of the night or less and your 95% pressure was over 12 or less. So you are at higher pressures during the night.

The clumps of Obstructives that occurred around 5:30 are probably positional, meaning you were sleeping in a way that obstructed your airway.

What size nasal pillow are you using? The spikes on the leak graph indicate some mask movement. Sometimes a larger or smaller size pillow fits better.

How do you feel overall? Was this a better night sleep or a restless one?

[Narcil]

The clumps of Obstructives that occurred around 5:30 are probably positional, meaning you were sleeping in a way that obstructed your airway.  

What size nasal pillow are you using?  The spikes on the leak graph indicate some mask movement.  Sometimes a larger or smaller size pillow fits better.

How do you feel overall?  Was this a better night sleep or a restless one?

Yeah first time this week i had a clump like that so hopefully it doesn't happen too often i guess.

i don't think it's a nasal pillow. it's the airfit n20 but the packaging says to put it on pillows. i'm pretty sure the leaks around 7am were because of my head pillow. i vaguely remember adjusting it to get a good seal. not a bad mask but i'd like to try a smaller one like the n30i think i will contact the hospital this week see if it's possible. i'm a bit worried about not being able to point the exhaust away from my hands and pillow tho.

honestly not that different and i'm pretty sure i could go for a nap if lay down and watch tv.. but definitely a good night.

[PeaceLoveAndPizza]

After you have used this a few nights, consider trying EPR set to 3. As OpalRose noted, your FL’s are still high. You may want to increase your start pressure as well by 1, but let us see how you do with one change at a time before digging in deeper.

[Narcil]

Here's 2 more nights. Might try EPR 3 tonight but so few events that i'm not sure FLs are really a problem?

I did rip out the mask last night no idea why and put it back on when i realized it. not very well apparently since leaks increased a lot, i undid the straps instead of using the magnets in my half sleeping state..