Night number on CPAP

[Emaz]

I have a million questions. Definitely a mixed bag for me, but on balance, I guess I did pretty good? I have no idea if my experience is typical or atypical.

I decided to try it out for about 10 minutes in the late afternoon. I laid down, had no trouble putting on my mask. And the sensation of air into my nose didn’t bother me at all. I really thought at that point that this was going to be some kind of miracle for me.

It was a little bit different when I had to sleep with it the entire night. I really had no mask problems at all. I definitely had a good seal. And the seal was not impacted by my sleep positions. Maybe I’m lucky in that regard.

I also used a chinstrap and had no problem with it at all. Another stroke of luck.

A few things surprised me. Number one is that I still woke up many times throughout the night. But maybe I woke up for a different reason? Previously I assume my wake ups were after an apnea event. But I don’t know. I was kind of surprised that I was still waking up. Maybe this time though I was waking up just because of the mask. I’m really not sure, but this was probably my biggest disappointment. I was really hoping to just sleep through the night, or at least large chunks. That didn’t really happen.

My other big disappointment is OMG does it hurt my nose. That was a surprise because when I tested it out it didn’t hurt at all. But the accumulation throughout the night starts to really make it hurt for me. My nose just feels sore. Is this going to change? Or this the price I pay?

Was my mask too tight perhaps? I didn’t adjust it at all. I know I could have, but it actually felt the right amount of snug when I put it on. I mean I literally used it out of the box. The nasal pillow size of medium seemed right. The default mask adjustment seemed right. I had a good seal and it felt fine. Is the sore nose an indicator that it was too tight? Or is it just the price I pay?

And it also made my throat feel very dry. Throat feels slightly sore this morning.

So it’s a mixed bag. According to the machine I did great. AHI 0.6 and perfect seal. But I still woke up many times throughout the night, and I’m wondering if during this every night is going to create bruises on my nose. Ouch. 

I’m anxious to see if I will feel less tired throughout the day. Obviously that’s a key thing.

I would love to have feedback. Also, I don’t know how to set up Oscar. I admit I haven’t looked yet. I’m actually a software developer so I’m not too worried about the set up, but from the little that I’ve looked I wasn’t sure if there’s a Mac version available. If it’s PC only then I’m out of luck.

I know I’m rambling, this is kind of long, so let me just reiterate my actual questions.

- Is the waking up just part of getting used to it? Or maybe it just doesn’t matter, and I will find that I did indeed get better sleep.

- My sore nose. Part of the price we have to pay? Or does that indicate my mask is too tight?

- Dry, slightly sore throat. I’m guessing this is common and there’s not much I can do about it.

- Oscar - i’m going to go look now, I’m hoping it’s available for Mac.

- Overall how did I do for a first night? I guess AHI going from 28.5 to 0.6 is pretty good. Or should I expect close to zero? I have no idea what is a good result.

Thanks everyone.

[Gideon]

Welcome to the forum.

As you have likely found out OSCAR is available on a Mac.

Without knowing what mask you are using it is impossible to provide specific help so here is some general help.

Straps too tight is a common problem.
Take a look at your mask. See that flap around the edge?, Well that is what actually makes the seal and it is pressure from the CPAP that seals it. The straps are basicly there to hold it in place.
Try this
Without using the straps hold the mask on your face with a hand and turn your CPAP on. Move the mask around make it leak then stop it lightly. Move it up, down, left, right, even angle it slightly. That should give you a good feel for it. Now hold it in the best position you found. Note how the mask feels on your face. Now put the straps on to match that feel.

That should help.

On your wakenings, not enough info. Post your OSCAR charts so we can see what is going on.

[srlevine1]

Not enough information to even render a guestimate. I suggest you follow Gideon's advice to provide OSCAR data and your humidity settings.

[Emaz]

I’ll have data today, hopefully.

But I’m also looking for general knowledge. If my untreated AHI went down by 10-20x, shouldn’t that alone correlate with feeling better, i.e., less tired? Or is that not necessarily true?

And what’s a good AHI with treatment?

And do most people have a slightly sore nose from a nasal pillow? Will that improve?

[Gideon]

That much reduction should help but is it enough. Keep in mind that apnea is something many of us have had for years, even decades prior to diagnosis, rarely is relief quick.

[Emaz]

So here's my first night of data. After reading the Oscar wiki I'm not clear what all this means. What is Clear airway? Probably when I took my mask off for the bathroom? Do hypopnea events matter? I have so much to learn. :-(

[SarcasticDave94]

When it comes to Apnea treatment, clear airway and CA, both really refer to Central Apnea. You might have some of the treatment emergent CA when starting PAP as there's a tendency for the added pressure to make exhaling CO2 more efficient and triggering a few CA.

Hypopnea are roughly a half Apnea and typically resolve with a bit more Min pressure. Your default 4-20 pressure can be made more tailored to yourself which will help address events. I suggest Min 7 and adding in full time EPR 3. You'll still start at 4 but the EPR is on exhale only. This edit should make comfort increase and addresses events better, a 2 for 1 win.

[Gideon]

+1
What Dave said.

[Emaz]

I appreciate the response. How do I make these changes? I’m technology very literate, but I don’t know anything about this device. Do I just go into clinician mode?

Also, what’s a good result? Was that a lot of events for default settings? Or pretty good? I feel pretty good. I’m just trying to gauge how I’m doing. Is all of this just the fine-tuning?

I know that this is extremely variable individual to individual. But I’m just trying to gauge against other peoples experiences.

[Melman]

I appreciate the response. How do I make these changes? I’m technology very literate, but I don’t know anything about this device. Do I just go into clinician mode?
Yes. Instructions can be found here  https://www.apneaboard.com/resmed-airsen...setup-info

Also, what’s a good result? Was that a lot of events for default settings? Or pretty good? I feel pretty good. I’m just trying to gauge how I’m doing. Is all of this just the fine-tuning?
The results you are getting are pretty good. The recommendations from Dave will make them a Little better. Increasing EPR will also improve your comfort level.

I know that this is extremely variable individual to individual. But I’m just trying to gauge against other peoples experiences.