New to CPAP - having issues

[farmapnea]

First impressions are that you're not exhibiting Central (or Clear Airway) Apnea.
The majority of events are hypopneas.  They can be improved with a little tweak of the lower range of pressure.

Likely, you need to increase the min pressure from 8 to 9 cm-water; and reduce the flex setting from 3 to perhaps 2.

I have used Trazadone off label in a sub-clinical dose to help sleep.  It worked for me.
I no longer use it.  It's a polycyclic antidepressant.  Don't use it if you can avoid it; as it takes time to reregulate receptors after discontinuation.

Thank you for looking at my charts.

I will take multiple people's advice and not look to medications to help sleep - yet. I will try to dial in my settings first.

Last Sunday I accidentally changed my Resistance to x5 and lowered a-flex to 1 -- and I had 12 AHI, a sharp increase.

tonight I will raise minimum pressure to 9 and lower a-flex to 2 and see how I do tonight.

Also wanted to mention that I have a huge beard... I have tried nasal pillows (air just shoots out of my mouth), and a small "full face" that my nose fits on and a piece goes over my mouth -- I'll look for brand names later. Neither worked. I am currently using the the most basic full face that came with my device. I can feel slight leak where it is against my beard -- I have to pull it suuuuuper tight!

[quiescence at last]

your numbers seem pretty ok.  certainly better than non-CPAP.

But, adjustments may be helpful to you, as you go.

If these were my charts, I would adjust my min pressure to 9.0.  My snoring still occurs, and seems to be aligned with my lowest pressures throughout the night.

(I could bump it up by 0.5 for  4 to 7 days to see how that helped, before bumping it up again to land at 9.)

I wish you continued recovery and good luck with your journey.

QAL

[farmapnea]

your numbers seem pretty ok.  certainly better than non-CPAP.

But, adjustments may be helpful to you, as you go.

If these were my charts, I would adjust my min pressure to 9.0.  My snoring still occurs, and seems to be aligned with my lowest pressures throughout the night.

(I could bump it up by 0.5 for  4 to 7 days to see how that helped, before bumping it up again to land at 9.)

I wish you continued recovery and good luck with your journey.

QAL

Thank you! Will try the pressure at 9 this evening and report back tomorrow.

Monday/Tues/Wednesday my AHI was between 5.6-7.9.

[farmapnea]

Last night was rough. I have to get the full face mask so tight that it is almost unbearable. Plus, my insomnia. I laid in bed for about two hours without falling asleep. Eventually just took the mask off and went to bed. 

Tonight I will switch back to my hybrid mask. It works better with my beard and still allows me to mouth breath if that happens.

[justMongo]

I assume that means no data at 9 cm? Assuming your beard is not required for religious reasons, have you considered shaving it off; at least until you get back on track? There are quite a few men with beards on the forum, and they are able to make it work. I suspect your facial hair is more coarse...

BTW -- back to your OP, Question 1. It's not scored as an event until the duration is 10 seconds. And, an Auto PAP is reactive, not proactive. They cannot terminate an event, they react by raising pressure. If you look at the Sleepyhead charts you posted, you'll see your machine raised pressure as a reaction to hypopneas -- an effort to head off more hypopneas and OSAs. The only machine capable of reacting on a breath by breath basis is an ASV. They are expensive; and generally only used by people who have central or mixed apnea.

[Marillion]

Have you guys seen Bonjour's beard? I would call it substantial! He uses the Airfit P10 and that is what I would suspect would work the best if you have a big beard. Have you tried using a chin strap? There are various kinds that you can try that all work to keep your mouth from dropping open while you sleep. Some people can still even so have air come out of their lips. In that case you could try the Ultimate Chin Strap (google it) which helps to keep your jaw closed as well as help to keep your lips relatively shut.

There is also a new product coming out (if it isn't out already) that utilizes a bio glue to keep the middle of your lips shut during the night. You remove the bio glue by running your tongue through the middle of your lips where the seal is created. Apparently that works quite well also.

I would try a chinstrap and the P10 nasal pillows first.

[farmapnea]

I assume that means no data at 9 cm?  Assuming your beard is not required for religious reasons, have you considered shaving it off; at least until you get back on track?  There are quite a few men with beards on the forum, and they are able to make it work.  I suspect your facial hair is more coarse...

BTW -- back to your OP, Question 1.  It's not scored as an event until the duration is 10 seconds.  And, an Auto PAP is reactive, not proactive.  They cannot terminate an event, they react by raising pressure.  If you look at the Sleepyhead charts you posted, you'll see your machine raised pressure as a reaction to hypopneas -- an effort to head off more hypopneas and OSAs.  The only machine capable of reacting on a breath by breath basis is an ASV.  They are expensive; and generally only used by people who have central or mixed apnea.

Thanks for the reply. I don't need to have a beard, I just enjoy having one. I am open to shaving it.

Decided to give more details on my health in case anyone else in my situation finds my post online, might help them.

Quick update:
1) my hemoglobin was very high (19.5), which was causing my  blood pressure issues -- I donated over the weekend and another phlebotomy Friday (if Red Cross lets me donate with my elevated hemoglobin)
2) research shows that those suffering with sleep apnea may have elevated hemoglobin - especially when on Testosterone Replacement Therapy
3) last night I switched to a new mask -- Amara View Full Face mask. It fits more snugly around my beard, and was much more comfortable. My AHI last night over 7 hours was 3.9!!! I do feel more refreshed and energized today

I believe raising my minimum pressure to 9 (from 8) with a maximum of 14, lowering AHI to 2 (from 3) and using the Amara View really worked for me -- at least last night. I only remember waking up once throughout the night.

I'll continue to keep posting in this thread with updates

I appreciate all the replies I have gotten - means a lot. Thanks!

---

Have you guys seen Bonjour's beard?  I would call it substantial!  He uses the Airfit P10 and that is what I would suspect would work the best if you have a big beard.  Have you tried using a chin strap?  There are various kinds that you can try that all work to keep your mouth from dropping open while you sleep.  Some people can still even so have air come out of their lips.  In that case you could try the Ultimate Chin Strap (google it) which helps to keep your jaw closed as well as help to keep your lips relatively shut.  

There is also a new product coming out (if it isn't out already) that utilizes a bio glue to keep the middle of your lips shut during the night.  You remove the bio glue by running your tongue through the middle of your lips where the seal is created.  Apparently that works quite well also.

I would try a chinstrap and the P10 nasal pillows first.

I am going to keep using the Amara View for now, as I purchased it sometime ago and only gave it one shot. Do not currently have the funds to buy anything else. Others have had success on this forum with the Ultimate Chin Strap and the nasal pillows -- so I will definitely try these if I continue to struggle! Thanks Marillon!

[Sleeprider]

Congrats on the improvement. I also have borderline polycythemia with TRT. I think it's not particularly relevant to your sleep apnea. Your improved results are encouraging, and is probably one of the best things you can do overall to resolve the issues. With TRT, you need to keep therapy levels as low as possible, while maintaining functional levels of hormones to be able to do what we do. I use 40 cc T-cypionate 2000/10mL using a 25 GA x 5/8 needle weekly. Higher frequency and lower doses helps with a number of issues including the polycythemia. I gotta tell you, the small gauge, short needles for SC injection in the butt is a lot easier than stabbing yourself in the thigh with a 1-1/2" larger bore needle, and it all accomplishes the same thing.

[farmapnea]

Congrats on the improvement. I also have borderline polycythemia with TRT.  I think it's not particularly relevant to your sleep apnea. Your improved results are encouraging, and is probably one of the best things you can do overall to resolve the issues.  With TRT, you need to keep therapy levels as low as possible, while maintaining functional levels of hormones to be able to do what we do.  I use 40 cc T-cypionate 2000/10mL using a 25 GA x 5/8 needle weekly.  Higher frequency and lower doses helps with a number of issues including the polycythemia.  I gotta tell you, the small gauge, short needles for SC injection in the butt is a lot easier than stabbing yourself in the thigh with a 1-1/2" larger bore needle, and it all accomplishes the same thing.

Last night my AHI was 3.1! So it keeps getting better and I feel really good again today.

Btw, I have been doing once weekly injections of 200mg Sustanon. 3 days post injection my TT was 909, which I am comfortable with, but like you said, maybe shoot for lower? Starting the end of this week I will being 75mg cypionate twice week and subq. I am going to attempt a slinpin though, so that might take a lifetime lol!

Thanks for replying and sharing what you do - means a lot!

[jasonarmstrong]

Congrats on the improvement. I also have borderline polycythemia with TRT.  I think it's not particularly relevant to your sleep apnea. Your improved results are encouraging, and is probably one of the best things you can do overall to resolve the issues.  With TRT, you need to keep therapy levels as low as possible, while maintaining functional levels of hormones to be able to do what we do.  I use 40 cc T-cypionate 2000/10mL using a 25 GA x 5/8 needle weekly.  Higher frequency and lower doses helps with a number of issues including the polycythemia.  I gotta tell you, the small gauge, short needles for SC injection in the butt is a lot easier than stabbing yourself in the thigh with a 1-1/2" larger bore needle, and it all accomplishes the same thing.

interesting post.
I started seeing a hematolgist in 2001 as my hematocrit was 57, hydrated 54. one pint usually lowered it 1.5 points, at the time the doc wanted me below 50 so it was a lot of blood donations at the hematology clinic. who are way better than the vein butchers at the red cross. I was competing at the time and taking anabolics, sleep study revealed no apnea which at the time threw them for a loop because at 21 inch neck and 310 lbs they said I was a walking case for COSA.
I stopped competing in 2005 after tearing my patella tendon falling off some stairs, but continued on doctor administered IM HRT after that, hemo was always high end of range at 50..but would donate twice every 60 days at a hospital blood bank and red cross each 30 days apart.  for those that read my thread on my story I started therapy in 2008, it was just a full blown CPAP, but in the next few years hemo started to rise again and my doctors took me off testosterone and made me take HCG and clomid. Long story short I changed endos and he put me back on testosterone and hemo rose again, so the option he gave me is come off cold turkey or go to a hematologist again who told me after every test known to him, bone marrow, EPO levels, even a test here the withdrew blood mixed a radioactive isotope with it injected back in and then scanned me bone marrow. Bottom line is he told me my normal range was 55 and I was a big guy and anytime I drifted above 55 they'd drain a pint off.
sometime in the last year and a half I did a ton of research on sub q test injections and was amazed at the results with lower doses when injected frequently.
I take 20 mg ED and it keeps my test level above 750 ng/dl where the endo wants it. He is anxiously awaiting the new sleep machine and study i had done to see if it helps my hypoxia as he called it from apnea -"treated") and to see if the doses can be raised a bit.
Whole different world on sub q half the dose of IM injections, less estrogen conversion and sides as well....always felt up and down on the rise peaks and falls on 300 mgs of test cyp over 2 weeks.
Bottom line was the apnea I developed as I aged was a double edged sword with the IM HRT.