Newbie APAP Equipment Trial Journal

[Snoopy.pa30]

Hello Tube Heads,

I am going to Journal my experience trialing the different equipment my supplier is lending me.  I hope I can provide some end user feedback that is beneficial to new users.

I got my trial APAP equipment yesterday.  Happy Valentines Day to me, or is it my wife as she can now get a decent night's sleep.

I am trialing the ResMed S9 with humidifier (as they did not have a rental S10 Autoset available).
For mask, I am using the F&P Brevida nasal pillows mask with an F&P Eson 2 nasal mask as a backup.

First Night Observations:
Machine: 
The S9 running is very quiet.  It sits about 18" (0.5 m) from my head. 
When breathing, It sounds like I have a LOUD TWIN breathing beside me.
There is also an intermittent whistling noise that was annoying me when I was getting settled.
I think it settled down as my breathing settled, as wife did not complain about it, and I did not hear it when I woke during the night.

Pressure Settings:
APAP 6-12 from prescriptoin
Humidity 4.5 (cool dry winter air)
Ramp Off - figure 6 was probably and OK pressure to start with.

Mask:
The Brevida is a nice soft pillow, and it sealed easily.
I did have the supply tube with diffuser turn so it was blowing/releasing air on my face.  This happened early in the night when I was still trying to get settled.
The bottom of my nose and upper lip felt a little tender this morning from the overnight pressure, but not painful.  (I am a newbie, so I assume it is nothing like what I would be feeling from a regular nasal or full face mask, but wanted to note it._
The straps stayed reasonably in place.
I did roll on to my side late morning, with no noticeable leaks.
I forgot to check my face in the mirror for strap lines and pressure marks.


General Observations:
As I sleep mainly on my back with a neck roll, my setup is fairly straight forward.
My hoses were not much of an issue, and I figure there were only a couple of times that it disturbed me.
It took me a long time to settle with the machine, mask, hose, and noises.

Results:
I don't feel much different today, perhaps even more tired... pause here while I get my coffee    
I did not take the mask off during the night, which seems like a good first night to me. 
I am surprised it took me so long to get settled.  I was (very) relaxed (it was Valentines Day after all - Nudge Nudge Wink Wink - Monty Python reference).  Probably more of a psychological thing with anxiety over new setup.
AHI of 2.79 on first night, when originally diagnosed around 30 (don't have the study results - going from memory of conversation), a GREAT improvement.

I am posting my SH results.  The first active bit is probably me trying to find the whistling, and laughing about sleeping with Loud Twin/Darth Vader (my wife and her jokes).

Going Forward:
Any suggestions on how to best trial different machines?
Should I run the same mask for several nights in a row, or alternate?
How do people run their hoses?

Comments, suggestions, hints and tips welcome.
If any experienced SH results folks notice anything, please let me know.

Here is the link to my SH results:  http://imgur.com/a/a1AgA

Sorry, messed up on the imgur posting. 
Try this.

[Sleeprider]

Not a bad first night at all, especially if we discount all that stuff in the first half-hour.  I think your minimum pressure needs to go to 7, and the OA should disappear, as well as that big pressure reaction.  Keep in mind with EPR at 3, the minimum exhale pressure is 4 with a CPAP pressure of 7.  So by increasing minimum pressure you are avoiding changes in EPR (6/4, 7/4, 8/5), and your median pressure of 7.4 is also consistent with this.   Your mask seems to work fine, and I don't see any suggestion of mouth breathing or leaks.  There are a couple leaks that look like position changes, but not a problem.  I would not be tempted to use a nasal mask instead of pillows given these results.   Other than minimum pressure, this looks like a very good start.

[Snoopy.pa30]

Did not make any changes to settings or mask last night.

Still adjusting to getting to sleep.  

Still have a whistling noise.  It was noticeable when I was exhaling.I feel like I moved around more last night.

Underside of nose and lip slightly tender in morning.  Some minor strap lines on my cheeks.

Will follow SleepRider's advice and up the Min Pressure to 7.0 tonight.

Here are the results:

[Russatrice]

You're starting with a ramp pressure of just over 4. It looks to me that then you have to breathe fairly heavily in order to get enough air, as 4 is a very low pressure. Even though you are a new user, you could easily raise that to 5 or 5.5 and probably no longer than 15 minutes.
I'm surprised at how easily you seem to adjust to this therapy, you have great results already, congratulations! Your sleep pattern will probably take some time to adjust, but you're off to a good start.

[Sleeprider]

I'm pretty sure the graph of follow-up results are the same as the first one.  Can you update?

[Snoopy.pa30]

SleepRider,

You are correct, I copied the wrong image from imgur. 

I did not make any machine setting changes from my first night. 

I am going to make changes tonight (Min Pressure from 6 to 7, and Ramp Off)

Here are the results from last night.

[Snoopy.pa30]

Made it through night 3.

I seem to be one of the lucky ones who adapt to the treatment quickly.  Last night's AHI was 1.1.

I took SleepRider's suggestion and upped the Min Pressure to 7.0 and essentially cut the AHI in half.

I took Russatrice's suggestion and modified it and just turned the Ramp Off.

I feel that I was more unsettled/woke more during the night.  

Anyway, here is the SH Chart.

[Sleeprider]

That looks great. Give it a few nights to get comfortable. In addition to cutting events, your maximum pressure dropped as I predicted. I think you will end up at a minimum pressure of 8, but no hurry

[Snoopy.pa30]

Had a Good Long Weekend at inLaws.

I upped the moisture to 5.5 with no noticeable change or issues.

Friday AHI 2.63 with a few CA's in the night.
Saturday AHI 1.33, all OA's.
Sunday AHI 1.43, all OA's.

Back Home on Monday night..

Switched to the Eson 2 Nasal mask (no problems with the Brevida, just want to try a few alternatives). Had a few drips from my mask during the night (Rainout...). Then realized I had forgotten to set the Humidity back to 4.5.

I liked how loose I could have the mask and still have no leaks. Very comfortable on my nose/face. Again only slight marks on my face from the mask, and faint lines from the straps.

I still have a bit of a psychological issue with getting started, but once I settle down, things go very well through the night.

Will keep journal going and only post results if requested, or if I have a bad night and need expert reviews.

[Snoopy.pa30]

I remembered to lower Humidity, so no Rainout last night.

Restless night, not sure if worried about the Rainout or some other stress.

I woke more often and also rolled around more.

I did find that when I tried to sleep on my side I had some issues with keeping the Nasal Mask Eson 2 form leaking.

Also had more noticeable marks around nose and on cheeks.

I would appreciate comments on the "sawtooth" sections, the time from 00:30 to 1:20 (OA time) and again around 3:30.