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03-18-2024, 09:47 AM (This post was last modified: 03-18-2024, 09:50 AM by juniper.
Edit Reason: typo
)
Juniper's questions
Hi. I am new to CPAP.
Background: Recently retired female. Suspect I have had apnea for many years, if not decades. Very light sleeper and low energy as long as I can remember. Daytime fatigue eventually became disabling. Could not get doc to order sleep study because I am a thin female. Both sisters diagnosed with sleep apnea. Switched doctors. Got the study. AHI 14.2 Family has genetic problem that leads to joint laxity, muscle tension, and joint injury. I sleep flat on my back to minimize injury. This cannot be changed. My lax jaw can shift out of place, causing facial pain and difficulty with masks.
Using Resmed airsense 11 autoset machine. Been struggling with finding a comfortable mask. My DME was not helpful. Switched DME and found a helpful person who suggested Resmed airfit N30. I also use a Knightsbridge chin strap, but just one of the straps. The elastic strap puts too much pressure on my face. I generally like this machine and this mask and the strap the way I am using it. I do not like how much hair I am losing (pulled out by the roots) every night, I'm guessing from friction somewhere.
Before last week I was practicing with various masks during the daytime. I did notice quite a few centrals. I had no centrals during my sleep study. I have managed to keep the mask on my face for 3-5 hours/night this past week. I keep having centrals. I have been investigating OSCAR and have bought one of those little cards to put in my machine. Now I have a couple of nights of data. I'm not very tech-savvy. I just managed to get the data up on my screen. I have no idea what all of it means, what is important, etc. I did figured out how to get into the controls, so I can change things as needed, I don't know what is needed. I'm concerned about the centrals, but don't know if I should be. I am also wondering if the chin strap is actually working because I am not using it the way it is meant to be used.
I wonder, should I just be focused on keeping the mask on all night right now before I worry about these other things? I haven't been able to do that yet.
03-18-2024, 10:46 AM (This post was last modified: 03-18-2024, 11:03 AM by HalfAsleep.)
RE: Juniper's questions
Welcome!
Joint laxity sounds like a difficult condition. I have jaw issues, but laxity would test my stamina.
Don't worry about centrals while you're awake. We don't have especially regular breathing while awake, unless maybe you're a yogi. Sure, some of us are inclined to hold our breath more than others while awake or under certain conditions (like watching a scary movie) but you'll breathe when you have to. Asleep, that's another issue.
Finding a mask that works well is quite the process for most anyone. I agree it might be more problematic with joint laxity, but one detail is the same for everyone: do not tighten the mask too much. Masks get leaky if they're tight.
On my mask, I like to use pads to cover the straps. These might give you some relief, too, for your jaw and hair. I got some fun ones from a "cottage shop". There's a big online site that sells "cottage shop" types of things with a gazillion options.
Incidentally, I do use my CPAP sometimes when I'm awake: I use it to allay a panic attack, which, you guessed it, is irregular breathing.... But this is "off-label", a serendipitous find.
Don't worry about what the Oscar data means: you will be helped here. Are you able to follow the directions to get screen shots and attachments? No worries if you don't get it quite right the first time or two: a poster will guide you on how to finesse. Put something up, so we know where help is needed.
Without the Oscar data, it's difficult to tell whether issues are isolated to the mask, body positioning, settings, or all of these.
First off, for centrals, how many is "quite a few" in events per hour? It's pretty common to have a few peppered in there, it's not unheard of to have as many CA events per hour as you logged in your initial study. It's called treatment emergent central sleep apnea, and it's only a problem if your events per hour are more than 5-10 and/or it doesn't go away as you get more accustomed to the machine, typically anywhere from a few weeks to a few months. It comes from your body's internal breathing regulation system receiving a different set of inputs because of the way you breathe when on CPAP compared to how you were breathing before starting it.
There are some step by step instructions here on the Apnea Board Wiki that can help you make sure you are capturing the important data in the OSCAR charts you post.
Look, I'm an engineer, not a doctor! Please don't take my opinion as a substitute for medical advice.
There's a recent screen shot. I'm not really sure what any of it means. I'm still trying to keep the mask on all night. It was rubbing on and bothering my nose so I was taking it off, but that has been getting better so I'm going to try to keep it on longer. Is that my goal? Keep it on all night so I have better data?
Your chart looks pretty good. I think if you stick with this for a little while you will start to notice fewer CA events, and then your sleep will be even better. I would agree that your goal right now is working on the physical comfort of your mask and whatever else you are using with the machine so that you can use it for longer each night.
Look, I'm an engineer, not a doctor! Please don't take my opinion as a substitute for medical advice.
I wore it 5 hours last night. The mask makes my skin on the end of my nose irritated, but it seems to be lessening little by little. Perhaps my skin is toughening up.
Could someone explain about the benefit of the "for her" setting on the airsense 11 autoset? I don't think it is on. I think "soft" something is on, not that I understand either of those things!
Also, I do not understand the ramp feature. How does it work? Does it ramp from zero to minimum? Or does it start at minimum and ramp to maximum? I don't quite understand this. I have the ramp set on auto. Is that a good setting for a newbie?
When I get up to go to the bathroom and I leave the machine running, does it know I took the mask off and start the ramp over again when I put the mask back on?
Ramp is a feature that restricts the pressure when the machine is first turned on. In autoset mode, the ramp will be a linear increase from your "Ramp" pressure up to your "MIN" pressure. In case these numbers are the same, it will simply hold at that value until the end of ramp. Auto ramp will set a 30-minute ramp, but also attempt to discern the difference between sleep breathing and wake breathing. Once the machine detects that you are sleeping, it will cancel the ramp early and go up to your MIN pressure. If you have auto start/stop enabled, the machine will turn itself off when the mask is removed. You can start it back up by breathing deeply once you have the mask back on. This will start a new ramp period, but it's not a huge deal if you are on auto because it should cancel it quickly once you are back asleep. If you don't have auto start/stop enabled, you will be running a leafblower on your bedside stand for a few minutes, and may have trouble getting it all settled back on your face when you come back.
The "for her" setting gets mostly negative reviews, as does "soft" response. Standard generally provides the most effective therapy, but if you find that fast increases in pressure are waking you up and a high maximum pressure is a requirement for you, it's possible to try the others and see if they help. Otherwise, you could restrict the maximum pressure so that it doesn't rise so much, and this may be the best solution for you. I wouldn't worry too much about these in your case, as you are showing very few remaining obstructive events.
Look, I'm an engineer, not a doctor! Please don't take my opinion as a substitute for medical advice.
On my mask, I like to use pads to cover the straps. These might give you some relief, too, for your jaw and hair. I got some fun ones from a "cottage shop". There's a big online site that sells "cottage shop" types of things with a gazillion options.
Does anyone know what kind of straps would help stop hair pulling out? I see satin types that are smooth, and something like fleece that is more cushion-y. I'm not sure what to get.
