Newbie questions!

[rememberyes]

Hi all! I was diagnosed about five weeks ago with mild obstructive sleep apnea (AHI of 12, mostly hypopneas), which was a bit of a surprise as I'm 32F with a normal BMI, no snoring, no hypertension, no smoking. But I did have severe fatigue, moderate daytime sleepiness, and I got up 4-10 times a night to pee, so my doctor sent me for a sleep study and here I am.

I rented a RedMed AirSense 10 AutoSet for Her for about a month after my diagnosis on Sept 14th, which was set to APAP for 2 weeks (I think the pressure range was 5 to 15, EPR at 3), CPAP mode for two weeks (pressure at 6, EPR at 3), and last week I bought my own machine - a ResMed AirSense 10 Elite, because buying the Auto machine was going to cost me something like $950. I've been tinkering with some of the the settings and just had a couple of questions as I get used to this. I'm seeing my sleep doctor for the first time since beginning treatment next week and this time I'd love to do more than stare blankly at her and stammer something about how I thought I had insomnia.

I woke up the first morning after getting my new machine with the WORST stomach cramps - I seriously thought I needed to go to the hospital, they were so bad! I realized that it was probably aeriophagia, and checked my EPR, which was set at 1, rather than 3 (although my AHI was the lowest it's ever been, around 0.91). I bumped it up to 3 again, but my AHI rose a little over the next few days, between 1.1 and 2.4. Sleepyhead shows that I'm having mostly "clear airway" events, but there weren't any central apneas on my PSG, so I think bumping up the EPR is perhaps also bumping up my CAs. If that's valid, then I think I should see if an EPR of 2 might help? Or is this a case where the machine/Sleepyhead sees a hypopnea and misclassifies it? I would LOVE to get my AHI back under 1 - that was my best night of sleep in 3 years.

Also, if anyone has any tips for traveling with a machine, I'd love to hear them. I've got a conference this weekend that I'm flying to on Saturday and while I travel a LOT for work, I've never had to deal with medical equipment before.

Thanks for reading!!

Lauren

[DeepBreathing]

G'day rememberyes. Welcome to Apnea Board.

The Elite is a good machine and will provide reliable service and all the data you need. However, it won't be able to adjust pressure automatically as needed, so requires a bit more work to dial in an optimum solution.

If your pressure is set at 6, then the effective exhale pressure (EPAP) which splints your airway open is only 3 if EPR is set to 3. That is a very low pressure, however if it is treating your condition, then that's OK (but I will bet you end up increasing it somewhat).

It's not unusual for new users to get some central apneas ("clear airway") which are brought on by your system reacting to lower levels of CO2 in your bloodstream. Usually these will go away with time. Reducing EPR can help get rid of the centrals, but it's a trade-off between the centrals and your comfort (and aerophagia). As your AHI (including centrals) is still quite low I don't think it's too much of a problem. By all means adjust the EPR to find the most comfortable and effective level. If you want to post a Sleepyhead screenshot, that will help us give more specific advice.

Re travelling: I always take my machine in its carry bag with a red label that says "Medical device - to be kept with passenger at all times".  Generally a CPAP is not counted as part of your hand luggage, but as an additional entitlement. Keep your CPAP and its accessories with you, but don't put anything else in that bag. At hotels, it's sometimes hard to find a spare power outlet in a convenient location - I always carry a power strip with a short extension lead and a couple of country-specific adapters, so that gives added flexibility.  If the tap water is safe to drink, it's safe to use in the humidifier, otherwise use bottled water. But don't forget to empty the tank before you pack it up!

[trish6hundred]

Hi rememberyes,
WELCOME! to the forum.!
Good luck with CPAP therapy, hang in there for more responses to your post.

[rememberyes]

DeepBreathing, thank you so much for the detailed reply! And thank you Trish6hundred for the welcome!

I was worried the pressure was too low too - but it does seem to be treating my apneas, and my OSA is mild, so I'm not keen to tinker with it while I'm getting good results. And since I'm seeing my doctor next week, I figure she'll advise any further adjustments.

I did tick the EPR down to 2 last night, and my AHI went down to 0.8, which was awesome. I have a little bit of aeriophagia this morning, but no pain, so that's definitely a tradeoff I can make. That's great to know about the centrals; I was getting a little worried.

Did you make the medical device tag yourself? I feel like that might be something good for me to have, especially when my travel abroad resumes... I'm relatively comfy with the idea here in Canada, but my next trip is probably Ghana, which is a different story! I was also thinking of slipping my prescription into the device case, although I don't know how compelling that would be.

[sonicboom]

I have the A10 autoset and travel with it.  The comforts of home on the road!  I carry a letter from my doctor and the Resmed FAA certification  letter available here:

https://www.resmed.com/us/dam/documents/...er_eng.pdf

Your machine is listed.

[rememberyes]

Sonicboom, that's perfect! I can print that with the rest of my conference stuff. Have you ever had anyone challenge you on your machine? Security, flight attendants, etc? If so, how did you handle it?

[sonicboom]

Never been challenged anywhere at any time. The only times I was even asked to take the unit out of the case was at security in Canada even though I'm TSA approved and was in that line. Small matter. Goes in the tray, thru the scanner and back to me on the other side. I keep the unit wrapped in a plastic baggie to keep dirt and dust out if it ever needs to come out of the carry bag during travel. Let us know how you make out during your travels.

[ajack]

You need to check, I just went to bali for a month. The airline I went with, allowed the extra carry on bag, but counted to the total 7KG carry on weight. If I got a letter from the doctor and used it on battery while during the flight, then it wouldn't be counted to weight.

[HalfAsleep]

You get the luggage tags from e.g. Supplier #1, or go online and print your own.

Consider taking a dual voltage surge protector. Definitely take a compatible outlet plug.

Say hi to Maxwell, Kofi, Kwesi, Adjuana, Divine, Clarissa......my childhood friends and classmates. Ghana is a treat.

[dracus]

Thanks, this will really come in handy.....