First time therapy, settings and progress

[Schernenk]

I did a sleep mask fitment at a "lab" today (basically the place that did my in home sleep study) and brought a machine home with me, tonight will be my first try with CPAP.  The person seemed quite helpful and knowledgeable and we tried a couple masks until we found something that had a good fit.  I am starting with nose pillows to begin with as they seem the most comfortable and if they are a problem i will go from there.  I have an Air Sense 10 for my 30 day trial and the settings she put in to start with are as follows;

Pressure range 5-15 (she says she will narrow that once we get some feedback from the machine)
Ramp Time - Auto
Climate Control - Auto
Tube Temp - Auto
SmartStart - On

Seems most things are set to Automatic LOL, and I don't know what that means entirely.  Any advice from jump is appreciated and I will update this thread as time goes on.  I will also endeavor to upload to OSCAR as soon as I have a second to sort that out. 

Thanks in advance

[BoxcarPete]

Ramp auto means it won't raise pressure until it detects sleep-like breathing, which is good for getting used to the pressure at a constant rate. Climate and tube temp set to auto will just manage your humidity for you, keeping it warmed up and around 80% RH which will prevent the extra air from drying out your nose too quickly.

Best of luck, I hope you take to it quickly.

[HalfAsleep]

Glad you got a good DME.

Basic tips:

--you could try out all the equipment while you're awake and reading. So you know what some basic issues are, like mask leakage, the best place to have the hose (left or right), how it goes off and on (easy to forget this in the night)....
--make sure water coming out of the unit goes up hill in the tube at some point, otherwise you can get humidity water coming at you into your mask! One method is to make sure the unit is a bit lower than your head when you're asleep.
--put the power supply on the floor until you've been at this a bit. Sometimes the power supply smells if it's too close to the unit. No idea why.
--check there's a SD card in the unit, or get one. You will need an SD reader for your computer as well.
--get your mask dialed in using the unit's mask test. Do this while you're in your awake experiment. It gives a fairly high pressure, and will indicate where you might have mask leaks in the night.

[Schernenk]

Here are the Oscar Results from last night.  The big orange AHI number doesn't make sense but I think there is old data on this card from a previous trial for a patient, so maybe that's the average?  There is a short session starting around 20:30 to 21:10, that is me sitting on the couch trying to get used to it.  I actually had it on from 22:30 to about 1 am, at which point I figured I would call it a night and try again tonight, baby steps, working up to an entire night.  

I did not sleep well last night just due to the newness of it all.  I found it very distracting trying to keep my mouth closed so I am not sure if nose pillows are right for me, I think it might be less stressful with a full face....I must be a mouth breather LOL.  Also I got rather "burpy" by around 1 am which I believe means I was swallowing a bit of air, again I am hoping a full face mask might help with that.   Any comments on the results are welcome as I am just learning how to decipher them myself.

[BoxcarPete]

Your leak rate doesn't indicate that you were mouth breathing, if you were then you'd have air looping in your nose and out your mouth and we would see that in the leak chart. FFM did not make aerophagia better in my experience, but everyone responds differently to things so keep trying to see what works. I would recommend trying to stick with a nasal mask for a little longer because you appear to be lucky enough not to have leak problems with it.

Lots of central apnea clusters, hard to say what's causing them without a little more data to go off of.

[Schernenk]

For the CA clusters, what kind of data?  I’m not sure what other data I can get, other than maybe an in clinic/overnight sleep study? 

I don’t present as someone who would typically have OA, I’m not over weight, don’t snore, etc, my in home study showed mostly hypo apneas. 

It was my first night and was a little uncomfortable so I’ll see how the next few nights go. I didn’t sleep much during the time I used the mask on, things should slowly get better as I get more accustomed to the mask I guess.

[HalfAsleep]

More nights will give plenty of data. Just keep using the equipment, record every night, and post your Oscars.

No need for an in-lab sleep study at this point.

They are finding many folks who have apneas aren’t stereotypical. Just look at the number of women who participate on this board: the stereotype is men.

[BoxcarPete]

We've seen cases before where clusters of CA, especially when interspersed with hypopnea like that, are sometimes misattributed partial blockages of over 80% flow reduction. Since the airway isn't fully occluded the machine flags it purple, but the problem isn't respiratory drive, it's airway blockage.

Try min 7, max 15, EPR full time at 3 cm H2O and see if that makes things any better.

[Schernenk]

Thanks for everything so far.  I don't feel like I am sleeping at all while I have the mask on currently, though I must be sleeping a bit it sure doesn't feel it.  Last night I left it on for a bit longer then the night before but I am exhausted today.  I suppose I must dose a little here and there other wise I shouldn't be seeing any events.  Here is the OSCAR data from last night.  I might have to take a night off just so I can function but maybe it's better to try and persevere?  

Seems as though I still have a relatively good seal with the nose pillows but my brain is having trouble keeping my mouth shut while I try and fall asleep.  I did feel less burpy last night.

I will see if I can get in there and change some settings.

[HalfAsleep]

IMO you don’t have a leak problem. You’re doing very well with that. See the narrow grey band? That’s it, pretty much. You coulda scratched your nose and caused that one.