First Night on APAP--what does it mean?

[SailingAway]

Got the equipment yesterday. Had an ok nights sleep last night on it using the nasal pillows. Woke up a couple times with dry mouth and was leaking. I have the Sleepyhead and ResScan working and downloaded the first night. Please any comments on what you see. Still busy looking all the terms in the Glossary, but the little popup when I first uploaded the data said "not a very good night".

Trying some screenshots and hope I got it right.


Then the detail:




Thanks for any suggestions. Going to try full face mask tonight I guess.

[retired_guy]

Results look pretty good for a first night. AHI a little high, but not a big thing. It should come down on its own after a day or so once your body gets accustomed to its new friend.

Leak rate not bad at all. It does look like you were breathing through your mouth a bit, which would cause the dry mouth. You might consider a chinstrap applied gently to encourage your jaw to stay forward.

Other than that, I'd say just rock on for a couple of days and see if your AHI doesn't settle down.

Keep in touch!

[Mike1953]

Just have to learn to sleep with your mouth closed. That is why you had dry mouth and leaks to some extent.

[SailingAway]

Mr retired,

Thanks for the comments. I plan to just let things settle in a little. During my sleep study, when the tech put me on 10 all things settled down until my mouth drifted open again. Not sure if the variability using APAP causes/allows a few more events due to the pressure cycling. I also have the EPR off and I don't know if it was on or off during the study.

I see you are using the Airfit P10, which is what I was told I used in the study. However, when my arrived the headgear is different than what I had at the clinic. It had velcro and could be adjusted. The new I just got doesn't really adjust and felt really tight. Nose was really sore this morning. Been looking around and saw they recommend splitting the strap, but I also saw someone who said they recently changed the mask and that they liked the old style better. Is that correct? I have to find some way to loosen this thing up a little.

Thanks again for the info.

I'll definitely be in touch....

---

Mike,
I realize I have to try to learn to keep my mouth shut, but how exactly do you teach yourself to do that. I'd much rather figure that out than wear a chinstrap. On our boat, many times it is warm and humid and I'd rather not have my head wrapped if I can learn not to do mouth breath.

Thanks

[PaulaO2]

Yes, the P10s biggest fault is its stupid headgear. Some people have modified the headgear, some it fits right out of the box, some stretch the snot out of it, some give up and try another mask. If your nose is sore, is it inside the nose or the outside? Inside could be from the air (if all over kind of soreness) or it could be from the pillows being pressed against the same spot for too long if close to the outside edge of the nostrils. If outside, it would be from the headgear pulling it too hard against your nose and squishing it too long during the night.

The inside tenderness can be fixed. The outside will take headgear modification or a different mask.

Inside, you can try sitting up with it on and trying to find out where it was hitting then moving the mask so it is no longer hitting it. Or using Ayr gel to coat the inside of your nostrils before use to help keep them protected.

As for the screenshots, looks good. You will probably need a chin strap. The leak rate was minimal, though, so maybe not. See the tall, flatish spkes at 2:30 and 4:30? That's the graph showing mouth breathing. The other is just normal leak that is normal and acceptable. Anything up to about 24 the machine can compensate for. Anything over that, it cannot.

One night is just one night. You need to observe the data over time and watch for trends. You will start to see what is normal for you and what is not. You won't see that exactly 12 is your normal, but more like 12ish to 15ish or whatever. And your leaks are normally this to that-ish. It takes about two weeks of data to see possible trends. And even then, stuff will continue to change and morph because we all change and morph through life.

[retired_guy]

Do you have the P10? If so, then yes the two straps separate. That allows you to position them on your head for better comfort and fit. Also, I found that even though I "should" use a size medium pillow I do way better with the size large. So think on that.

In re: a chinstrap, I use the Carfusion Pursom Ultra (I think it's called) and I wear it under my mask straps. It's a single strap gizmo and does not heat me up like most of the other chinstraps.

If you try the chinstrap route, just remember to not overtighten it. It really only serves as a "reminder" to keep our mouth shut. Much like Mrs. R_G does during the day, but perhaps more gently.

I don't think I'd recommend you use EPR for a couple of days until you see the AHI come down a bit. That is, as long as you feel comfortable in the exhale at night. But if not, turn EPR on, and a setting of 2 to begin with and see how it goes.

By the way, a bit larger nasal pillow might assist in calming down those AHI's as well.

[Sleeprider]

I agree with the comments that you need to have a few more days to develop a trend, but your apnea events are all occuring below a pressure of 9.0 cm. I'll predict you will end up with a minimum APAP pressure of 9.0 when all is said and done, and i will drop your AHI well below acceptable levels. Also, please turn on the events for Flow Limitations and Snores (VS). Those events cause pressure increases and they are important in the graphs. Just go to File/Preferences/Events and click the left and right checkboxes on those events.

[retired_guy]

P.S............ (Paula secretly loves the P10..............) Resistance is futile.

[PaulaO2]

I really need a head banging on the desk smilie.

I disagree about the EPR though, especially with the P10. I think that's a mask that needs the extra exhale relief due to the limited exhale vent.

[quiescence at last]

kudos that is a good first night score. there are bunches of little tweaks you may be interested in making in due time. Or, maybe you are exactly where you should be. No harm staying where you are at for 10 days or more, even if you score the same the whole time.

A chin strap can be extremely simple and non-confining. I have see a minimal strap that only goes from mask frame or head gear, not clear around the head.

good luck.

QAL