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32 year old male, diagnosed on June 3rd with an AHI of 19. I have probably had it most of my life.
I started my CPAP therapy on July 24th. I know it is still early, but I am having a bear of a time adjusting to the machine. I can only sleep for about 2 hours with it before I wake up and have to take it off in order to go back to sleep. I am trying to get in the habit of getting into a "relaxed" state, putting it back on, and going back to sleep, but I am not always successful.
Also, I have a newborn and so my sleep schedule is extremely variable. This is making compliance difficult.
I really want to make this work: I can already see some of the benefits coming through when I get a good cycle or two at a low AHI. But I am hoping someone can advise on settings or changes that may make my experience better.
Known issues: I was given an F40 mask with a "Large" (marked L) cushion. I notice that my nose length does not fit in the "Large" box within the Fitting template for the F40, but it does barely fit into the Medium. My sleep outreach team is sending me a Medium cushion but that probably is not here until late next week. I think this may be affecting the seal.
If you have not done so, watch some YouTube videos on fitting and sizing the F40 mask. LanklyLefty27 has some good ones.
For your pressure, try the following:
Mode APAP
Min pressure 8
Max pressure 15
EPR 3 full-time
No ramp
This allow you to start at a higher pressure and with EPR reducing flow limitations it should hopefully be mor comfortable and restful. Give it a try for a few days, post some charts, and we can help start reducing the range to what works for you.
The objective is to get as good a nights rest as someone with a newborn can get.
The APAP algorithms are kind of deceiving. Patients will often believe that the machine will deal with obstruction adequately, but unfortunately it's not the case. Most important change here is to up your min pressure like Pizza said, and then we can go from there. Lots of runway ahead of us.
Ok, another 3 days under the belt; it is still very frustrating. All 3 graphs uploaded.
For context, I moved to the F40 Medium cushion for these three, that I received from my sleep coach from the doctor. It feels a lot more comfortable, but I am still having leak issues. For Day 3, I actually moved back to the Large at 0:00 in the graph, and that is where I had to remove it after 2 hours. You can see I put it on, and leaks were at zero, and then it started leaking at about 40 minutes. The holes in the nose cushion for the Large do not seem to line up with my nostrils, which makes breathing very difficult.
Looking at the graphs, leaks are leading to pressure and obstructions, which are causing pressure increases. I assume the Leaks are the big problem here. Is there a way to tell - is it leaking because the fit is bad and I am moving around in the night, or is it leaking because of potential neck flexion at night - leading to pressure increases?
I am thinking of moving EPR down to 2, since I think my discomfort came from the mask fit of the Large cushion.
08-06-2024, 12:22 PM (This post was last modified: 08-06-2024, 12:23 PM by staceyburke.)
RE: New CPAP User, Struggling to Adapt
ALL three nights show positional Apnea. . You can see positional apnea where either H or Oa events are clustered together. Getting rid of as many as you can will lower your AHI. Positional apnea can NOT be controlled by pressure changes. You have to find out what position you are getting into and cutting off your own airway. Have you changed your sleep position? Sleeping on your back? Using more (or new) pillows?
These things can cause positional apnea by chin dropping to your sternum and cutting your airway. Think of it of a kinked hose – nothing can get through – you have to unkink the hose…
IF you can’t make a simple change like changing to a flatter pillow helps then you will need a collar. I have a link to collars in my signature at the bottom of the page. It shows people who are not wearing a collar and the SAME person wearing a collar. There is a huge difference between the two.
I sleep on my back - always have. I have been using this pillow for a couple weeks - I was hoping to avoid positional apneas because I knew ahead of time that my posture was not good:
Cannot post links yet... so editing: it is the Derila Cervical Pillow.
This leads me to believe that I may be using this pillow incorrectly, or it simply does not work.
Any recommendations on collars? Looking at the apneaboard wiki page, the CorFlex looks like a good choice.
08-08-2024, 09:07 AM (This post was last modified: 08-08-2024, 09:11 AM by Sguigs.)
RE: New CPAP User, Struggling to Adapt
Ok, update here: I slept on my side last night and on an elevation (two pillows). This ended up being a really good night except for around 4am, where I have a large cluster of CAs. Is that probably due to EPR? My original at-home sleep study shows an AHI (central) value of 1. It was with a Wellue ring so I have no idea how accurate that is.
Seems like positional apnea is my big challenge - it makes me wonder if I truly need the machine or if I just need to change my sleep posture.
