Getting used to it - need tips and tricks (would like to avoid Lunesta)

[shewhorn]

Here's the last 3 days... note I've been experimenting with settings so they're a little different on each day. My original prescription was CPAP at 5.5 if I remember correctly. My most recent prescription is APAP at 5-15 (last night I set the machine to APAP, 6-13 (I've never seen the pressure go past 9 over the past 43 days).

Interestingly enough my diagnosis is OSA on the most recent study and OSA with a smudge of Central on the studies from 5 years ago but the machine is almost exclusively identifying "Clear Airway" events. Central is more in line with what I experience (if I'm understanding things correctly). I always notice these events while I'm falling asleep where I exhale, and never inhale again. It happens while I'm still somewhat conscious-ish and then I end up taking a deep gasping breath.

[shewhorn]

Ahhh... I see... 512kB limit, thus the tiny pic:

[Sleeprider]

Here's the last 3 days... note I've been experimenting with settings so they're a little different on each day. My original prescription was CPAP at 5.5 if I remember correctly. My most recent prescription is APAP at 5-15 (last night I set the machine to APAP, 6-13 (I've never seen the pressure go past 9 over the past 43 days).

Interestingly enough my diagnosis is OSA on the most recent study and OSA with a smudge of Central on the studies from 5 years ago but the machine is almost exclusively identifying "Clear Airway" events. Central is more in line with what I experience (if I'm understanding things correctly). I always notice these events while I'm falling asleep where I exhale, and never inhale again. It happens while I'm still somewhat conscious-ish and then I end up taking a deep gasping breath.

Central events during sleep transition are very common, and with as fragmented as your sleep has been this makes perfect sense. They may not be real apnea at all, and would not be scored in a test unless your EEG indicated sleep.

Your charts indicate you're very well treated at the current pressures, so I don't see too much to do with machine settings. The focus needs to be on comfort and adapting to the therapy to get some consistency and quality sleep.

[shewhorn]

Thanks, SL! Hopefully I'll get closer to better comfort at tomorrow's appointment for a new mask fitting.

[PoolQ]

"I always notice these events while I'm falling asleep where I exhale, and never inhale again. It happens while I'm still somewhat conscious-ish and then I end up taking a deep gasping breath"

This was me exactly, along with the centrals. Turns out I had COPD on top of sleep apnea. Any reason to think you might also have COPD? Ex-smoker? dusty environment? I would exhale and just sit there with no reason to inhale, quite comfortable and then a big breath. This was anytime I laid down, before sleep.

[trish6hundred]

Hi shehorn,
I just recently switch to the Fisher & Paykle Simplus full-face mask, and so far it has worked well for me, you might ask to try that one at your next mask fitting, good luck to you.

[shewhorn]

Any reason to think you might also have COPD? Ex-smoker? dusty environment?

Never smoked, wood floors most of my life (low dust).... that and I see my allergist once a month. Asthma since I was 4.

[shewhorn]

Tried the F&S Simplus, it leaked. Tried everything else they had... ended up with the Airfit F10 again... BUT... a medium instead of a small. So, it's possible they fit me incorrectly at the sleep study so we'll see if I do better with the new mask. I did try some nasal masks and the Respironics DreamWear was absolutely brilliant. Unfortunately my nose is either stuffed, swollen, or otherwise blocked most of the time but I figure... on the rare occasions that it's clear, I might get one. Also... the new machine is the Airsense. It has one feature that may make a significant comfort difference for me and that is having a humidity sensor which automatically controls humidity and the ability to override it giving me independent control over the humidity and tube temp. One thing that really bugs me about the S9 is that if you want more humidity, you have to dial up the time. I DO want more humidity (duh... New England in winter) but I really don't like breathing hot air (I'm already full of hot air as it is ).

We'll see how it goes with the new machine. Thanks for the input everyone.

[WakeUpTime]

I see your 95% inhale pressure is around 8. Went you put the mask back in in the middle of the night, the air pressure spikes up on your machine. I'm not the most qualified one on this board, that's for sure. Lately, I've had better results with keeping a consistent inhale pressure throughout the night, rather than letting the machine perform it's regulating practices. The steady pressure might also minimize leaks during the night, as well as comfort. Since most of your AHI is made up of centrals, you seem to get the pressure you need to be the obstructives. If your constant pressure was 7, I'd wonder what kind of night you'd have for several days. (One day isn't enough for a good test, as there could be many factors at work for just one night.)

I've been taking a middle-of-the-night subliminal sleeping pill with my CPAP for 2 years now. I do vary the dose depending on when I wake up. If I make it to 4am, I also go no-pill every now and then. I have no troubles sleeping with CPAP. Now, with a cold, the humidifier and warm air helps a lot.

[shewhorn]

Thanks WakeUpTime,

I'll give that a try... for now the prescription settings (APAP 5-15) are pretty much what I've run for the last few nights (6-13 but it never goes much above 9). I'm not going to futz with the new machine while I'm on the trial period because... BCBS is comprised of fork-tongued... no wait, I like snakes and that would be an insult to snakes... anyhow, I wouldn't put it past them to deny payment if the settings were changed even if the data indicated compliance and efficacy of treatment. Hopefully by the time the trial is over though... I'll have 70 to 80 days under my belt trying to get used to this thing and I'll have adapted to it, but if I'm still struggling, I'll change the settings and give that a try.