My 5th night on CPAP, a new batch of observations w/ detailed play-by-play

[PaulaO2]

And keep in mind this was only night 5. When we are handed a medication and told "it can take up to 2 weeks for it to work", wouldn't we be more patient? Same with CPAP. It takes a while to work. For some, it takes much longer. Some, just a night or two.

Give your body and brain time to adjust. Sit up with it on during the day.
Research "sleep hygiene" and practice some of it.

[AlanE]

Sad thing is, you will get so used to it that even in your dreams you are wearing a CPAP mask. :\

now if only I can just figure out why I was dreaming about being at the grocery store... wearing CPAP.

[Nicholas]

So, yes you should start out at least 6 cm.

 
Thanks. Just so I'm clear, by that you mean an initial pressure of 6 and then a ramp-up to my prescribed 9, correct?

[robysue]

My legs and, curiously, my abdominal area felt "restless."
...

3:07a - Still lying there awake, and I'm noticing (and trying to interpret) some sensations. The "restless" feeling in my abdomen I described above is now a soreness, and I'm pretty sure it's my diaphragm. I'm awake, the pressure is at 4 (hasn't ramped up yet), and I'm keeping my mouth closed and having a hard time breathing through my nose - even with with the assistance of the 4 pressure. It starts to make sense why my diaphragm is sore - it seems it's being overworked. I was tempted to open my mouth to breathe, suggesting I may be a mouth-breather (which I didn't know before). I feels like 4 is not enough - even for being awake - and I find myself wishing the thing would go ahead a ramp up to 9 without waiting on me to fall asleep. Frustrated, I removed the mask again, and breathing actually got easier, which is confusing.

If it feels as though there is NOT ENOUGH air coming into the mask to breath comfortably, either don't use the ramp, or increase the ramp setting up a  few cm.

A sore diaphragm is not uncommon for the first couple of weeks: It takes some extra effort to exhale against the positive air pressure.

[chill]

Regarding the diaphragm, I attributed the soreness to labored breathing in - it didn't occur to me that it could be caused by breathing out against the pressure. Anyhow, I thought my machine was supposed to detect when I breath out and reduce the pressure for that reason. Maybe I have that wrong.

Other than having the machine set at 4 and not getting enough airflow, you should not have problems inhaling.  The extra pressure means that your muscles actually have less to do on the inhale.

Assuming you have EPR set to 1-3, the machine will reduce the pressure on exhale but it won't reduce it to zero.  So with a pressure of 9 and and EPR of 3, you are still exhaling against a pressure of 6.  So not a huge amount of pressure, but enough to notice in the first days.  You don't want the pressure to reduce to zero as that will likely trigger airway collapse (apneas or hypopneas).  It need to keep a minimum pressure to splint it open.

You are doing well, attitude is 90+% of getting used to CPAP.

[quiescence at last]

So, yes you should start out at least 6 cm.

 
Thanks. Just so I'm clear, by that you mean an initial pressure of 6 and then a ramp-up to my prescribed 9, correct?

I did mean that you should not start out below 6 if you expect some help exhaling.

In addition, the first goal is getting solid sleeping. In order to determine best sleep setting you need sleep data (you need to be sleeping to get sleep data).

So, you can set at 6 min and 9 max, sleep, see your results (and post them), determine or ask for better settings.  Your machine can adjust fast enough to hit and stay at 9 if that is the pressure you need.

I wish for you long periods of peaceful sleep.

QAL

[quiescence at last]

[Nicholas]

I agree with the advice above, turn off the ramp, and raise your minimum pressure to 7cm.

Thanks, Opal. Please help me understand the verbiage you're using. When I first turn it on, the pressure quickly increases from 0 and to 4. It stays at 4 until I fall asleep, and then it increases to 9. Is the "ramp" you're referring to the initial increase from 0 to 4 or the increase from 0 to 9?

[Nicholas]

Don't dither about, go get Sleepyhead and let us see how things are going.  Otherwise, we are just guessing and that rarely works out well.

Thanks for the advice. Got SH installed and started going through RobySue's beginner's guide. I'm unable to locate the SD card - it's not in the slot on the side of the machine, nor is it in the case anywhere. I emailed my rep (who has been really great, btw) over at the provider to confirm whether I should have one and ask if she knows where mine might be. I also need to go get an SD card reader - will have a chance tomorrow.

[OpalRose]

I agree with the advice above, turn off the ramp, and raise your minimum pressure to 7cm.

Thanks, Opal. Please help me understand the verbiage you're using. When I first turn it on, the pressure quickly increases from 0 and to 4. It stays at 4 until I fall asleep, and then it increases to 9. Is the "ramp" you're referring to the initial increase from 0 to 4 or the increase from 0 to 9?

The lowest pressure on a CPAP machine is 4. If your pressure is set at 9cm and ramp is set to start at 4cm, then yes, it will start at 4 and ramp up to your therapy pressure of 9cm.

I'm assuming you have a straight pressure CPAP machine and not an auto CPAP, right?

Please clarify whether you have a straight pressure machine set at 9cm or an auto cpap set
at 4 minimum and 9 maximum.

Ramp and minimum pressure are not the same thing.

Did you order the clinicians manual? See my post #9 for the link.