My CPAP journey

[lunaticds]

Hi All,
I'm a fairly new to the CPAP journey. I've had OSA for around a decade, and only recently decided to do something about it now that I'm old enough to realise that my health is something that doesn't fix itself.

The report attached to my polysomnogram results indicated "moderate to severe snoring" and "Severe obstructive apnea and hypopnea, worse in REM and when supine with significant desaturation", so CPAP was definitely going to be a good course of action.

I spent a month on a trial machine with a fixed pressure of 7, and over the month my average AHI was 2.6. I've changed masks around to find something I'm comfortable with (Using a Wisp, though some nights I have more leak problems than others). I am struggling a little with my sinuses and mentioned to my doctor about looking at a full face mask, but he's suggested I try nasal douching (which looks as bad as it sounds). Willing to give it a go - I have chronic sinus issues, and apparently this may help that as well. If it means I can stick with a nasal mask, then it's worth a shot.

I have a refurbished ResMed S8 Lightweight - it was cheap, and due to the nature of my health insurance, I need to self fund the purchase of a machine. I couldn't afford something decent (and hadn't really made up my mind), and buying an older, cheap unit seemed more logical than continuing to rent a unit. Also, I'd really prefer to have a unit at my partners place (a few hours away where I stay on weekends) and that can be used for travel, backup, etc., so having a backup seems to make a lot of sense. I function OK with this old machine, however I'm aware it's data output is limited and the cost of the card reader for that specific type of card is really quite expensive here so I haven't yet spent a third of what the machine cost me to buy a card reader.

I'm thinking further ahead to the machine I actually want to buy that will be my everyday machine (emphasis again on "buying" so cost is a factor).
My sleep doc doesn't like auto machines, and thinks that there isn't enough research for them to be of value to most people. My own research seems to suggest that people seem to be doing better with them.
I've been debating looking for an auto machine and seeing how close to my prescription it stays. I believe that my titration study was somewhat botched, as the computer controller they used to drive the CPAP machines wasn't working, and the technician told me outright that she didn't know how to drive the machine manually. Within 2 hours, my hose had enough fluid in it to gargle so loudly I had to take it off, so I suspect she was changing the humidity rather than the pressure.
My results after a month on CPAP had my AHI down to 2.6 so my doc says that it seems to be working where it is, however all of this testing occurred during our summer when my sinuses are pretty good, rather than for the other 9 months of the year when I'm usually suffering. I'm concerned (even with nasal douching) that I may need a little more pressure, and an auto unit would be a better investment.

I was thinking that the DeVilbiss SleepCube Auto Plus looks interesting - it's about the only auto machine I can buy here under $1000 (which is preferable as the next options are $1500+), the 5 year warranty gives me some confidence, and as far as I can tell it should be able to provide me with a reasonable level of information so I can monitor myself and start to get a clue how I'm really going.

Thoughts on whether I should actually move to an auto unit?
Anyone familiar with the data recorded by these units, and whether or not it captures enough useful information for me to monitor what is going on?

Thanks for reading (I know this was pretty long!).

[worn_out_in_lebanon]

I got the newest model Resmed A10 Autoset from Supplier #2 in the $800's. Because of my high deductible all my sleep stuff (study, equipment, supplies) has been out of pocket.
(edit - just now noticed you're in Oz..., that does complicate things)

Over the past few weeks of researching over the internet, there have been many articles I've run across saying auto-titration is just as effective as titration in a sleep lab.

[truetopath]

Welcome to the board! I'm glad you're tolerating therapy. It never hurts to give auto a try and get an idea where your pressures fall. Best of luck on your journey. Sorry I don't know much about the Devillbis machine or even the s8 for that matter.

[lunaticds]

I got the newest model Resmed A10 Autoset from Supplier #2 in the $800's. Because of my high deductible all my sleep stuff (study, equipment, supplies) has been out of pocket.
(edit - just now noticed you're in Oz..., that does complicate things)

Being in Oz definitely complicates things - the A10 AutoSets here are over $2k! Really quite sad when our dollar isn't that bad, and ResMed started out in Oz lol.

[Nyre]

Welcome to the board. Lots of great info to learn from here.

[kmar92]

Lunaticds have a look at the supplier list link at the top of this page. Both suppliers #2 and #10 ship to Australia and you will find the prices far better than purchasing locally here in Australia. I have purchased both complete CPAP machines and also supplies from there with no problems at all.

[trish6hundred]

Hi lunaticds,
WELCOME! to the forum.!
It's good to hear that you are treating your sleep apnea.
Supplier #2 on the suppliers list at the top of each page here on the board has great deals on either open-box or gently used machines, you might take a look at them. I'm not familiar with the machine you asked about.
Hang in there for more suggestions and much success to you as you continue on your CPAP journey.

[lunaticds]

So, it looks like I'll be able to finance my way into an auto machine soon. The F&P Icon+ Auto seems to be at a good price if I get one from the US, so that's looking like a viable option. (Thanks for the tip Kmar92!!!!! Save a fortune importing one).

Just curious - given my sleep doctor is somewhat anti-auto, and he has me set to 7cm, any suggestions on what I should set the range on an auto unit to initially? I'm a sucker for details

[lunaticds]

So time for an update (this could be boring, noting this for myself as much as anything).

I have an F&P Icon+ Auto now, and seem to have nailed down 7 to 14cms (I really should update my profile) as my ideal pressure range.
I'm happy with the machine, and I'm finding it a lot better than the old ResMed S8.

A few nights ago, I tried the Respironics ComfortGel full face mask. That was the only night so far where my AHI has gone over 5 (5.19), and I had a lot more leaks. It wasn't the most comfortable thing I've ever worn, but I wanted to see how I managed with it once the cold & flu season gets under way, as no doubt, I'm going to need it. Given how it doesn't seal, I might need to try cutting a piece of fabric and putting it between the mask and my face to see how it goes.

I went to the dentist for an extraction a couple of nights ago, and that turned into a 2 hour surgical extraction, so the first night I had some major leaks with my Wisp, and last night I changed from the large to the small/medium mask to see if that would improve the leak issue. It seems to have, as my "time over leak redline" was 0.000%. The small mask isn't as comfortable, and by the the time I get my "morning congestion", exhaling was difficult. Hopefully once the swelling goes down, I'll be able to move back to the large mask.

In other PAP related events, I have a 100AH deep cycle AGM battery + box on the way, along with an inverter and charger. I spend about a week a tent (I go to a car racing event at a place called Bathurst, the holy grail of Aussie motorsport), and I'd like to take my old ResMed S8 with me. Having experienced it without the humidifier for a couple of weeks, I've decided that I definitely will need to use it, so I need mains power as 12v won't drive the humidifier.
I've bought a charger capable of charging at 12v 10A as well as doing maintenance charging, so hopefully a few hours on the generator each night should get the battery charged. That battery should give me 2 nights at 8 hours and still maintain the 50% safety margin according to ResMed's battery guide. We usually run the generator for 4 or 5 hours per night, so I should have enough juice to keep it charged and still have some reserve. It won't be a pretty rig, and it will definitely be heavy, but at least I'll have it for when I need it. I should also be able to run the F&P on it as well, so it will be handy to have in case the power goes out (unlikely here, but just in case, it's nice to know that I will be able to sleep).

Oh, I'm also addicted to buying mask wipes on eBay, because I can get them so much cheaper than normal. I already have 6 months worth

[Mark Douglas]

but he's suggested I try nasal douching (which looks as bad as it sounds). Willing to give it a go - I have chronic sinus issues, and apparently this may help that as well. If it means I can stick with a nasal mask, then it's worth a shot.

I use a battery powered nasal lavage - WaterPic Sinuesense with buffered salt and an admixture called neti-wash and find it does a world of good. When I have an active sinus infection I also add some colloidal silver. (IWHLIWT?) I know the idea is less than fun but nasal lavage is proven therapy. Use water about body temp and it reduces the yuk factor greatly.