Pressure questions

[somnia16]

I suffered my second awful night - two attempts of one hour each (no sleep) and ditched it. The Dream Wear mask seems to leak when I turn on my side despite all efforts to adjust it and I am really confused about the settings. Mine was set to 4-20 which I gather is v. unhelpful. So I changed it to 10-16 but I don't really know what this means. Since I can't sleep I have not been able to look at the Sleepyhead data. I find the blowing of the air through the nose really forceful - would this mean the first number should be lower or higher for me? Also having some trouble with the mouth opening as this would seem to inevitably happen during the night and then it would wake me up (tried a hybrid for the first night and that was v. intrusive). Thanks for advice! Very discouraged...can't imagine at this stage how people can sleep through the night with this! Even got a cpap pillow with buckwheat in it which is surprisingly comfortable...

[green wings]

Hi, somnia16.

I am going to go look for your earlier posts to read those, but I just wanted to say that experiencing the air flow and the noise from the CPAP machine as overwhelming when you first start using it is pretty common. It seems to just take time for your brain to get used to that sound and the feeling of the air.

If it's extreme enough, sometimes people end up going to a lower pressure than they need for a while and gradually adjusting it upward as they are get used to it.

I'm going to go look for your earlier posts now.

[Crimson Nape]

First, 4 to 20cm are wide open settings on a CPAP. This means that the CPAP will start at 4cm of pressure and be allowed to raise as needed, up to the maximum set pressure, which was 20cm in your case. By setting your machine to a range of 10 to 16, you have instructed it to start at 10cm(barring any set ramp option) and allow it to raise to a maximum of 16cm at the most.

Did you not have a titration study? If so, what was your evaluated pressure range or pressure? I can't stress highly enough that you need to obtain and use analysis software so that you will have factual data to determine your needed pressure settings. My software preference is Sleepyhead. Additionally, Your machine also allows the use of ResScan but it is a little more cryptic in reporting. Your current attempt at setting a pressure is akin to trying to hit a target without aiming.

BTW, Most people find a setting below 7cm will produce an "air starved" feeling.

[icyura10]

Not that this will solve your overall issue, but have you tried setting the "RAMP" time to the maximum amount of time (I think it's 20 minutes)?

That might help get you accustomed to the whole thing.

[green wings]

Hi, somnia. I read your other posts, but I couldn't find one that discussed setting your pressure range at 10-16, so I'm just going to tell you what I think generally about your pressure settings for right now. Some of it will be fairly obvious stuff that you may already know.

1. The range of pressures that the typical CPAP machine can produce are 4 cm to 20 cm. So when you get a new one set at a range of 4-20, it often just means that the supplier didn't bother to change the factory default settings.

2. A CPAP machine creates pressure by the amount of air it blows down the tubing to your mask. There's less air coming from the CPAP blower at low pressures than at high pressures, and there's a corresponding difference in how much noise the machine makes. When you've been using the machine for a few months, this difference will likely be hardly noticeable to you, but for right now, you can probably tell a big difference. In fact, the machine may sound very loud at low pressures to you right now.

3. I read in another post that your prescribed pressure was 5 cm. Have you had a doctor or respiratory therapist suggest a different pressure since then?

4. I read in another post where a poster said that 6-14 is a typical range of pressures. I think that sounds like a good range if you are going to go with using the machine in auto right now.

5. Another option is to put the machine in fixed pressure mode right now until you get used to the sound it makes and until you are sleeping better while wearing the mask. For that reason, I'm suggesting that you either set the machine pressure at 6-14 OR that you set both the min and max pressure of the machine at 6.0. (It's your choice whether or not to use auto mode.) I'm suggesting 6.0 rather than 5.0 because I think it might be a little easier for you to breathe with the machine at 6.0 than at 5.0. An awful lot of new CPAP users who post in this forum seem to report that they feel like they're "not getting enough air" when they have their machines set at a pressure of 4 or 5.

6. I recommend setting the EPR on your machine to a value of 2. This will make the pressure=4 just while you are exhaling.

7. The DreamWear mask. You may find that it doesn't leak if you are using a pressure of 6.0.

8. Learning to turn from your back to your side while wearing a CPAP mask and not have it start to leak can take some practice. You have the type of mask (nasal pillows) that's least likely to leak when you switch from your back to your side. If you continue to experience leaks from the mask, I would read some reviews about it or look for a YouTube video about how to adjust and fit that particular mask. Sometimes it's not easy to know if you have the mask adjusted just right.

9. More on noise from the DreamWear mask. I read a lot of reviews of this mask back in the spring because I was considering getting one. I noticed that lots of people complained that the tubes up the side where the air vents were noisy and that they sometimes got squished during side sleeping and then were even noisier. Just as many people thought the mask was super quiet. So that's just something to keep in mind if you are still finding the mask to be extremely noisy in a couple of weeks.

10. This is not a suggestion, but just a general comment about how difficult it is to choose a mask from reading reviews. I started using the mask I have now a couple of months ago. I absolutely love the headgear. Yet, if I read reviews of the mask, about half the reviewers are talking about how much they hate the headgear. The other half are talking about how much they love it. I suppose it's because there's so much variation in head size and shape.

11. You have a really good CPAP machine. Unless it's defective and therefore making more noise than it should be, as you get used to it, it should do really well for you.

12. Once you find a pressure that lets you breathe comfortably and you are able to keep your mask from leaking so much, if you find then that the only thing keeping you awake seems to be the noise from your CPAP machine, my recommendation would be to either a) tough it out for the 2-4 weeks it's probably going take you to get used to the sound or b) sleep meds. Quiet a few people who don't otherwise take meds to help them sleep do use them for the CPAP adjustment period. It sort of depends on how you feel about using sleep medication and how much sleep deprivation you may be looking at otherwise. Just something to keep in mind.

13. Humidity. I'm assuming that you're using it. If you find yourself waking up either with congestion or with dry nasal passages, you may need to adjust the humidity down or up. Some people are extremely sensitive to the humidity setting and have to find their "just right" number.

14. If you wake up and find that you've taken off your mask or turned off the CPAP machine in your sleep, don't be alarmed. It happens pretty often when people first start using CPAP.

15. SleepyHead. Even if you haven't slept, you can still look at your data. You'll be able to see values for leaks and what your pressure is doing (if you have the machine in auto).

This has gotten really, really long (as my posts tend to do.) I just started using CPAP last winter, and the details from the adjustment period are still fresh in my mind. I started off at a pressure of 7.0, and I had a difficult time adjusting to the sensation of pressure, exhaling against pressure, to the noise from the machine, and to avoiding leaks from the nasal mask that I was using.

I'm glad that you've found this forum. It's a great resource for support in using CPAP.

I suffered my second awful night - two attempts of one hour each (no sleep) and ditched it. The Dream Wear mask seems to leak when I turn on my side despite all efforts to adjust it and I am really confused about the settings. Mine was set to 4-20 which I gather is v. unhelpful. So I changed it to 10-16 but I don't really know what this means. Since I can't sleep I have not been able to look at the Sleepyhead data. I find the blowing of the air through the nose really forceful - would this mean the first number should be lower or higher for me? Also having some trouble with the mouth opening as this would seem to inevitably happen




[quote='somnia16' pid='172886' dateline='1471532003']
I suffered my second awful night - two attempts of one hour each (no sleep) and ditched it. The Dream Wear mask seems to leak when I turn on my side despite all efforts to adjust it and I am really confused about the settings. Mine was set to 4-20 which I gather is v. unhelpful. So I changed it to 10-16 but I don't really know what this means. Since I can't sleep I have not been able to look at the Sleepyhead data. I find the blowing of the air through the nose really forceful - would this mean the first number should be lower or higher for me? Also having some trouble with the mouth opening as this would seem to inevitably happen during the night and then it would wake me up (tried a hybrid for the first night and that was v. intrusive). Thanks for advice! Very discouraged...can't imagine at this stage how people can sleep through the night with this! Even got a cpap pillow with buckwheat in it which is surprisingly comfortable...