Soon to start CPAP - Question on dehydration

[Fats Drywaller]

That's good. I mean about being able to exchange. Also, I was sort of assuming that a low budget is necessary, just because I usually do assume that, but if that's not true for you then you're lucky and you can just go out and buy whatever masks you need or want, which is a good way to speed up finding the right one for you. Reading reviews first can help.

I've bought a few out-of-pocket and I consider it money well spent in the long run even though I can only wear one at a time and I have at least a couple that are on the shelf indefinitely now, not likely to be worn again.

Good sleep is priceless.

[picante]

Hey, I was wrong about the headgear - it does come in 3 sizes, and mine is the SM; I assume that's small!

My head isn't small, but my neck is. I'm still working on the mask fit. I don't think I've mastered all the angles yet, especially on the vertical plane. It's easy to smash my nose while getting the chin too loose. I shouldn't have to smash the mask onto my face, right? It should expand and fill some voids.

I'm suddenly wondering how crooked my nose is, since the left nostril is often visible, but never the right, haha.

Nope, DH tells me the nostrils are the same height, but the left is more spread bc the tip of my nose is displaced rightward. And for a truly crooked nose, see exhibit DH. 

[Sleeprider]

OK, I'm figuring out how to post a screenshot. The hardest part was finding the file after I hit F12

@Sleeprider: I know you said 7-10 range, but for some reason I put it on 8-10. And my aerophagia is much improved today. I actually ate eggs & toast mid-morning and some squash just now.

This is a great result.  Your obstructive apnea cluster looks like positional apnea, and we can clear that up without increasing pressure.  Let's give this a couple days to settle in, and we can go from there.  The really good news is your aerophagia is improved.  The flow limits are going to keep you near the top of any auto pressure we set, and this points to bilevel being a better alternative, but again, we want to see more sessions.

[picante]

@Sleeprider: I know you said 7-10 range, but for some reason I put it on 8-10. And my aerophagia is much improved today.

This is a great result.  Your obstructive apnea cluster looks like positional apnea, and we can clear that up without increasing pressure.  Let's give this a couple days to settle in, and we can go from there.  The really good news is your aerophagia is improved.  The flow limits are going to keep you near the top of any auto pressure we set, and this points to bilevel being a better alternative, but again, we want to see more sessions.

Oh, positional, golly! All I can tell you is I switched from R side to L side when I got up at 2:00 to rinse my sinuses and take supplements.
Oh, bilevel, golly!
Thanks for the encouragement. I got rid of the leaks yesterday, but my face was squashed around the mouth. Maybe I need to try a size M cushion.

[Fats Drywaller]

I'm still working on the mask fit. I don't think I've mastered all the angles yet, especially on the vertical plane. It's easy to smash my nose while getting the chin too loose. I shouldn't have to smash the mask onto my face, right? It should expand and fill some voids.

Another guess here: The web site says four cushion sizes for the DW F-F. Have you tried the others, or consulted the sizing guide?

Product page: https://www.sleepapnea.com/products/mask...full-face/

Sizing guide: https://www.sleepapnea.com/documents/Dre..._Guide.pdf

("sleepapnea.com" is Philips Respironics)

[Sleeprider]

@Sleeprider: I know you said 7-10 range, but for some reason I put it on 8-10. And my aerophagia is much improved today.

This is a great result.  Your obstructive apnea cluster looks like positional apnea, and we can clear that up without increasing pressure.  Let's give this a couple days to settle in, and we can go from there.  The really good news is your aerophagia is improved.  The flow limits are going to keep you near the top of any auto pressure we set, and this points to bilevel being a better alternative, but again, we want to see more sessions.

Oh, positional, golly! All I can tell you is I switched from R side to L side when I got up at 2:00 to rinse my sinuses and take supplements.
Oh, bilevel, golly!
Thanks for the encouragement. I got rid of the leaks yesterday, but my face was squashed around the mouth. Maybe I need to try a size M cushion.

By "positional" I mean a body position which usually flexes the neck in a way that restricts airflow.  For most people this can be on the back or either side, but the chin tucks towards the chest.  This causes increased resistance in  the airway and has the classic signature of a cluster of closely spaced obstructive apnea or hypopnea.  http://www.apneaboard.com/wiki/index.php...onal_Apnea

[picante]

The DME tech consulted the sizing guide. But she also said almost everyone female needs a small. So that's a question in my mind, yes.
Always question medical authority is my approach. I'd be much sicker if I hadn't learned that.

[picante]

I don't know what to make of this @sleeprider, other than sinus inflammation really messes up my therapy. But not the other way around - it's no worse than without the CPAP.
I haven't learned to zoom in yet, but yikes, this looks bad. And probably much worse (40x per hour) after I shut off the machine at 3:20 because of aerophagia. This morning my brain was in a San Francisco fog, until I had an awake session on the CPAP.
The AHI for the night is way higher than for all sessions lumped together, of course.
I lowered humidity, but my sinus inflammation was pretty bad. I have 2 docs who think it's associated with GERD, and I agree. Not humidity. Tomorrow I'll be going in for an upper GI endoscopy, and since I have polyuria, I expect to be miserably dehydrated. Nothing by mouth after 7:30 am, so if I pee out all my water, I'm up a dry creek.

[Sleeprider]

I had hoped the lower pressure would result in more comfort for the GERD and fewer events. There is more going on here than can be seen without zooming in, but your respiration rate is very low at 9.4 BPM. and long inhale relative to exhale. Events are clustered, and mixed central and obstructive. The idea is to get as comfortable as possible, and I don't feel like I'm helping here. I think increase pressure to where you don't blow up your stomach, and hopefully events are fewer. A soft cervical collar 'looks' like it might help.

[picante]

I had hoped the lower pressure would result in more comfort for the GERD and fewer events. 

It does, actually. and it's made me more functional - cognitive and physical energy. All my symptoms are erratic, and usually a bad night alternates with a good night. Yesterday was the best I've felt in many months, possibly a year or two.

Meanwhile, I still haven't heard back from the sleep doctor after leaving a message with his nurse about my dinking around with the Autoset and why I had to do that. He told me I only had 3 CAs on my sleep test. Haha, that was that night. My longest obstructive event last night was 26 seconds; my longest CAs were 31 and 32 sec.

I have Myalgic Encephalomyelitis, a post-viral neuroimmune illness. When I'm symptomatic (exertion + lag time = symptom flare), lots of autonomic functions become erratic for me. That's part of what you're seeing. I've been sick for 26 years, since I had a meningeal infection of Epstein Barr Virus. The Urgent Care docs just called it mono. They didn't catch the meningeal part, and they wouldn't have caught the mono if I hadn't insisted on a mono spot test.

Besides that low of 9.4 for resp rate, I had some super high readings, and no, I don't think they were all data anomalies. Usual for me is around 11. It just got erratic along with everything else.