New CPAP User just started last night

[briansk12]

High everyone. So glad I found this forum. So much helpful information. Last night was my first go at using the CPAP machine. I made it until about 2 am before I had to take the mask off because below my nose was hurting. I put it back on about 4 for 2 more hours until I got up. I am using the Dreamwear Nasal cusion mask. Overall, it was not too uncomfortable, and I am sure it will get better as I wear it more. I am posting my OSCAR info incase anyone has any input on how I did. I know this is a long process and want to make sure I am not pushing myself too much. When the mask gets uncomfortable should I just take it off or push through? My initial settings were supposed to be 4-20 with EPR 3 but I read here that setting at 7 would be better. I could barely breath at the setting of 4 which is also the reason I turned ramp off. Please let me know if you have any suggestions.

[SarcasticDave94]

Welcome to Apnea Board, and welcome to the CPAP circus.

First, the mask shouldn't be hindering by way of discomfort. I know you said it wasn't, but then again your comment "had to take the mask off because below my nose was hurting" indicates something about the mask was ill fitting or too tight.

Next, read this wiki on Positional Apnea, HERE. Seeing those clusters of events, indicates you might be dealing with this. Check your pillow, are there several in a stack or one very thick one? Maybe reduce the thickness, or consider a soft cervical collar to physically prevent the chin tuck.

[briansk12]

I think I might have had the mask too tight. Discomfort wasn't that bad just felt like right under my nose was done with having something on it. Another factor was probably waking up at 2 with this new thing on my face did not help. Do you think my pressures are ok? Also, should I keep EPR at 3? 

Thanks

[Deborah K.]

In your sleep study did you have a lot of CAs?  If you have a copy of the study, post a copy of it with your personal information covered or blacked out.  That would help us discover why you have so many CAs now.

[SarcasticDave94]

I had forgot to ask, do those CA always have similar flag counts? And what did your sleep study details indicate both with events and count, and then the actual diagnosis?

You might want EPR 2 for a night or so to see if the CA reduce. Otherwise 7-20 pressure is OK for the time being.

[briansk12]

Attached is my sleep study. Not sure what would indicate a CA on the study.

[SarcasticDave94]

pAHIc 3% at 26 are Central events versus pAHI 3% 155, meaning you have a tendency to have some Central Apnea, but not as the majority of your events. However your AutoSet is probably adding more CA, as you can see in the chart.

So you'll have to reflect deeply on the current therapy and if it's helping. You may be better off with the bilevel VAuto to use the High trigger settings. ASV is specifically for Central Apnea treatment, so it too will take care of all events, but the report doesn't have CA at roughly half.

To get a different machine requires a visit to the prescribing physician that got you the AutoSet. You'll want to complain that the therapy isn't working as well as hoped. Comfort can become a point of discussion too. You might need to just ask for bilevel, specifically ResMed AirCurve 10 VAuto. Again you'll probably not get to ASV with insurance paying.

[briansk12]

We I am not dealing with insurance for various reasons mainly because I didn’t want to deal with them. I went through Lofta so if I can’t get control of the CA events I will talk to them and see if the doctor will change the prescription. I’ll see what EPR does for me and give myself some time to get used to CPAP. Thanks everyone for the input!!

[Phaleronic]

Welcome Briansk12 You have had good advise so far so stick with it please!