neocharles's Therapy Thread

[neocharles]

Good Morning -

I am very new on my CPAP journey and wanted to see if someone could look over my results and see if things look to be working appropriately.  I have a message out to my sleep doctor, as I need to have a follow up appointment sometime in the next few months for insurance compliance, so being more educated during my appointment would be great (plus, if there's some obvious problem that I can address on my own right away seems like a no brainer).

My diagnosis was Mild Sleep Apnea:

A total of 98 apnea events occurred for an apnea index of 11.3/hour. 28 hypopnea events occurred for a hypopnea index of 3.2/hour. 126 apnea and hypopnea events were observed during the analysis period as follows, 98 obstructive apneas, 0 central apneas, 0 mixed apneas, and 28 hypopneas for an apnea/hypopnea index of 14.5/hour. There were 42 oxygen desaturations that occurred during the study. Desaturations were based on 4% or greater drop from baseline. The lowest SpO2 was 88% with an average of 93%. Last, the minimum SpO2 value associated with a respiratory event was 88%.

The average heart rate during sleep was 70.4 bpm.  

I am using the AirSense 11, along with a Simplus full face mask.  The idea of the full face mask doesn't bother me at all - this all began with me snoring terribly so I imagine I am very much a mouth breather, and I don't think I like the idea of having to tape my mouth every night (with facial hair, and the potential skin reaction to skin tape every night... I think a full face mask is fine for now).  I am also a side sleeper (I often try to fall asleep on my side, but can find myself on my back sometimes).

I just received my CPAP on 5/17, and after the first night I noticed really bad red marks around my nose and mouth.  That prompted me to look into some mask liners.  I would up getting the RemZzzz mask liners off Amazon (knowing they were a bit cheaper - but wasn't sure if my mask would stay the same and/or if they'd even help) and it does seem that they have alleviated the reaction to the silicone on my face - but - I've noticed that my leaking has varied.  I started using the liners on 5/20, along with getting the recommended CPAP pillow from Lunderg.  The silly thing is it took me a few days to realize "how" to use the pillow the right way, and to put my head in the right location.  So some of those results may be skewed.

I've been trying to adjust the straps to be the most comfortable along with minimizing leaks, and the night of 5/23 I think I had it dialed in.  I moved the mask a little higher on my nose and it seemed to settle into a good spot.  I did notice on 5/24 it felt a little tight and not sitting quite right on the side of my mouth, but pushed forward with it.  Last night, 5/25, I did loosen the straps around my forehead a little, along with loosing the ones on the side of my mouth a little, and it felt more comfortable, so that's where it stands right now.

Within my first 30 days, I am told that I can swap my mask out for another mask.  However, I am then stuck with that mask for 90 days before insurance will cover a new mask... so I am torn if I try to get a hold of the F20 mask with Memory Foam (which in theory should allow me to not have to use the mask liners, allowing a more consistent seal?), but will it stay in place if I lay on my side?  I don't want to be stuck with a sub-par experience for 3 months until I can go back to a different mask.  If I plan on keeping this mask, then do I pursue getting better mask liners that are reusable from the site everyone suggests?  I didn't want to shell out $75 on a 3 pack not knowing yet.

Overall, just sort of want to check in on how things are doing, if there's any red flags, any tips that maybe I'm missing to improve all of this, etc.  Thanks for your help!!

Attached is last night's OSCAR screenshot, but I've put the entire week up on my dropbox if you wanted to reference them for any trends: dropbox.com/scl/fo/w0sc2pazyss1yl1jch0at/ABNTIdSSFsEUdOzxrGjdZKA?rlkey=0wj40qfq3qmfcbeex4hadsxsz&st=men7xg52&dl=0

[Narcil]

looking good, think you could raise the min pressure a bit, 5 is too low for most adults and your median is above 7. maybe with some EPR outside of the ramp for comfort and to reduce some CAs?

min pressure 7 
max 15
epr 2
epr full time
response standard.
ramp off or auto.

something like this.

don't have experience with memory foam masks, i've hold off since everyone seems to agree they don't last as long as silicon ones. just remember they are modular, you don't have to replace the all thing if it doesn't lasts the 90 days.

[neocharles]

I have not made any adjustments yet, as I've been investigating power options for a trip coming up at the end of the month; seeing what impact sleeping without the humidifier (night of 5/31) and with the humidifier but without the heated tube (night of 6/1).

There's been a few nights where I do wake up in the middle of the night, but I happened to remember what time it was when I looked at the clock last night (back to humidifier & heated tube on) - it was right around 4:44am.  

Is there any way to tell from this what may have caused that?  It also seemed like the air flow didn't feel quite as normal as it does when I am initially falling asleep.  I attached a more zoomed in look at that time window along with the full night's sleep.

Thanks!