Self-treatment CPAP, need advice for first night!

[sorreljorn]

It makes a difference as to what types of events you have, and how are they distributed.  The types of events in the previous chart indicate that you may have the wrong type of machine to treat your apnea, though I obviously don't have enough info to conclude that since you haven't taken a sleep test or posted results from the settings I suggested.  

No I haven't listened to the recording, no sound on this system.

I will try your settings when my next sleep session happens. 1.8 hours of broken up sleep just isn't enough for an assessment and why I've failed two sleep tests. What I think is happening based on recordings and SO description is that my breathing is very restricted. I have permanently enlarged tonsils, adenoids, permanent sinus blockage. It's very difficult to take in breath, and when I sleep it becomes more difficult. I have had my partner tell me I stop breathing and make loud snorts sometimes, as well as teeth grinding and whatnot. The snoring however is nonstop every single night. Would this Resmed 10 Auto not be able to help with that?

[factor]

Have you considered having a tonsillectomy? I assume you have seen a ENT.

Other than unfamiliar surroundings any idea why you couldn’t sleep for the study?

If you sleep at home have you asked the doctor about a home sleep test?

Also I had not looked at your Oscar data. I was only going by the ahi 10 minus the central’s 3.3 equals 6.7. Which is above 5. Also by your strong noted historical report. Also if you had filled out both the snore score and Berlin questions? If both of those are positive it very likely you have some type of sleep apnea.

[Gideon]

The settings I provided are for 1 night only, to run as close to a sleep test as we can with your machine.

[S. Manz]

Your loud snoring clearly suggests that you have some restrictions on your upper respiratory airways while asleep, but as another member already suggested, you may well be suffering from "Central Apnea"...this is a condition when your brain simply stops sending electrical signals via your phrenic nerves (left and right) to your diaphragm in order for your involuntary breathing to continue, while you are asleep. 
As a result you keep waking up to breath instead of falling deep asleep....which can potentially explain why you feel so sleepy during the day....and NO, you will hardly ever remember the episodes when you wake up to breath...It all feels like you slept through the night when in fact you barely go though a few minutes without interruptions in your respiratory function.
So here is what you can do.:
As the other member suggested, drop your min. EPAP pressure to 4, and keep your max also low. This will help you stay asleep while you get used to your mask, but it may not be enough for "treatment" yet.
Then once you get used to wearing your mask and keep it on continuously, night after nigh for an entire week, you can start increasing the pressures by a small amount every few nights until you get to a high enough pressure that will not wake you up in the middle of the night.
Don't be shy to try different masks but given your snoring I would think that you need a "full face" mask. These are masks that cover your nostrils as well as your mouth and can come in pillow or cushion designs...Find one that you are most comfortable with.

Dry mouth is normal. You will eventually have to learn to keep your mouth shut (use a nasal spray to open your nostrils before sleep, but be careful using too much because the "rebound" effect in most off the shelf stuff, means that after a few nights of use, you will need to keep using it because your nostrils will plug up if you don't....so go easy on sprays and ONLY use once ever other night if you absolutely need to open up). 

There are also specially designed mouth tapes for CPAP use than will keep your mouth shut,. Look them up online and try a few until you learn to naturally keep your mouth shut during sleep.   
Keep your humidifier to the max...It will help and ONLY USE STERILE WATER.
Also make sure your mask does not leak and last but not least,, if you want community members help YOU MUST learn how to use the OSCAR analysis software and post your OSCAR nightly sleep charts here, so the good people of this community can comment on your sleep detail and help you get the most out of your testing of the new rental machine.

Remember, it will take a few weeks to get fully comfortable sleeping with a machine....If everyone  could just go from never using a PAP to using one the first night successfully, then there will be no need for medical experts and communities .

All the best and keep us updated.

[sorreljorn]

Have you considered having a tonsillectomy?  I assume you have seen a ENT.

Other than unfamiliar surroundings any idea why you couldn’t sleep for the study?  

If you sleep at home have you asked the doctor about a home sleep test?

Also I had not looked at your Oscar data. I was only going by the ahi 10 minus the central’s 3.3 equals 6.7. Which is above 5. Also by your strong noted historical report.  Also if you had filled out both the snore score and Berlin questions?  If both of those are positive it very likely you have some type of sleep apnea.

I was offered it when I was a teenager but my parents talked me out of it. I will eventually do one I think.

I took the Berlin test and got positive in 3 categories. I have an existing Snore Score on my SnoreLab app and the highest is 77, a lot of days it's ~55 and a few days where it's at 25-30.

Your loud snoring...

Really appreciate the very thorough response. Regarding the mouth breathing, unfortunately nothing I have tried has helped thus far. Currently I do a daily neti wash with saline + alkalol. I also do a neti sutra which is a string you run through your nose and out the mouth. I've tried OTC nasal sprays and even prescription steroids with no success. The only thing that works is really strong menthol mixtures but that lasts about 20 minutes tops. Oh and I've also given Buteyko  a try with no success. It sucks because mouth breathing alone causes a state of permanent hyperventilation - another thing I hope the CPAP can address.

[Utah Desert Rat]

Regarding the mouth breathing, unfortunately nothing I have tried has helped thus far.

Do you have an ENT? Has he/she told you what is causing the sinus blockage? I've had one sinus blocked for most of my life, then had a combination septoplasty/turbinate reduction (both sides) surgical procedure a year and a half ago -- basically an outpatient surgery -- and both my sinuses are now totally clear. It is heaven to be able to breathe again. The surgery is not fun, but it is SO worth it.

If you haven't seen an ENT, please do. Make sure he/she orders scans. Some kinds of impactions in particular sinuses can cause very serious problems down the road.

Really -- unless there are insurance or financial roadblocks, you don't have to suffer!!

[sorreljorn]

The settings I provided are for 1 night only, to run as close to a sleep test as we can with your machine.

Hey so I made three really dumb mistakes lately.

1. On my first night I uploaded the wrong OSCAR result, here is the one where I managed to get some sleep:



2. On both first and now second night I put the tubing on backwards. I was wondering why it kept slipping off my f30i every time I made a movement

3. I forgot to put in the SD card for this night so all I have is the machine data when using your suggested setting of EPR off and 4-20

[sorreljorn]

Do you have an ENT? Has he/she told you what is causing the sinus blockage? I've had one sinus blocked for most of my life, then had a combination septoplasty/turbinate reduction (both sides) surgical procedure a year and a half ago -- basically an outpatient surgery -- and both my sinuses are now totally clear. It is heaven to be able to breathe again. The surgery is not fun, but it is SO worth it.

If you haven't seen an ENT, please do. Make sure he/she orders scans. Some kinds of impactions in particular sinuses can cause very serious problems down the road.

Really -- unless there are insurance or financial roadblocks, you don't have to suffer!!

I had one a few years ago and they didn't find anything besides a polyp, which wouldn't explain the severity. I'll definitely have to get around to seeing a specialist again!

[multicast]

Your leakage is way too high.  Work on these leaks first.

[sorreljorn]

This is about as good as I can get the results. My mask simply will not stay on properly and there is nothing I can do to improve it. I think f30i was the wrong choice - I might just get the f20 as a replacement.

The AHI of ~9 and 95% pressure of 11 is about the same in the last nights. None of them have been overly successful though. Tonight I was able to get 4-5 hours of sleep with it (with high leakage), but it's never been really deep or unbroken sleep so these symptoms could be under reported by OSCAR even further.