Soon to start CPAP - Question on dehydration
Thursday I'm scheduled to pick up a ResMed AirSense 10 Autoset (for Her) and a Dreamwear FF mask. The doc is starting me out with a constant pressure of 12 cm.
Both sleep tests made my sinuses & mouth absolutely parched, and my bronchials were irritated for days. First test - no mask, second test - ResMed F10. I was surprised that I was still miserably dessicated with the mask on and humidity set at max. I was so miserable I only managed to sleep 2 1/2 hours (and on the first sleep study, less than 2 hours).
Question: Does the Expiratory Pressure Relief feature help people who tend to get parched mouth/sinuses? I get that at home, with sinus inflammation, to the point of doing a sinus rinse every night around 3:00 am. The immunologist thinks the sinus inflammation is due to my GERD. The sinus constriction was magnified at the hospital (the air is drier).
We live in a high-altitude desert (4200') just barely east of the Continental Divide. It's dry here, but our house is usually around 40% humidity, and I don't know if there is any point in using a humidifier with 40% humidity already. Especially if the airway irritation has reflux as its origin.
Thanks very much; this is going to be a learning process.
Julie
RE: Soon to start CPAP - Question on dehydration
Hi!
There isn't much you can do if your humidifier system is working properly (are you sure?) and is maxed out...EXCEPT...to add humidity to the room. This invites some problems, not least of which is condensation on the windows and window-sill mold or rot.
Forty percent humidity should be comfortable, if not 'generous', for most people. With your system set for maximum humidity, it almost leads me to suspect it ain't workin'. Is most of the reservoir water gone by morning? If so, it must be working.
Some others will respond and suggest a lozenge you can use for 'dry mouth', but if you nasal passages and throat are also very irritated, I'm afraid I'm at a loss.
RE: Soon to start CPAP - Question on dehydration
With your machine, up your humidity *and your temperature*.
Also, I have a lot less dryness when using just a nasal/pillow like Dreamwear than a full face mask like the F10.
RE: Soon to start CPAP - Question on dehydration
Along with increasing your humidity on the machine you might want to try either a soft cervical collar or a chin strap to help keep your mouth closed. This will cure the dry mouth. If your unable to use either of those than you can try using XyliMelts. They keep your mouth moist while you sleep. You can find them online.
RE: Soon to start CPAP - Question on dehydration
The dryness you describe is usually the result of mouth breathing or leaks. Learning to breathe through your nose will help. More humidity is possible by turning off the humidification Auto mode and manually setting humidity and tube temperature. Biotene or similar products may help relieve dry mouth.
EPR can increase comfort, and has therapeutic applications. It may also change the pressure in ways not anticipated by your titration test. I would suggest using an auto pressure mode Autoset or Autoset for her, which can compensate. A pressure range of 9-14 is going to be equally or more effective and probably much more comfortable. It makes little sense to prescribe fixed pressure, but feel free to give it a shot.
RE: Soon to start CPAP - Question on dehydration
Just to clarify, we don't have a humidifier. We don't know why our humidity is that high, but there's no point in running a humidifier. As you mentioned, @mesenteria, there is too much condensation on the windows already, especially when it's 0 degrees Fahrenheit! Then we're wiping ice off the windows.
RE: Soon to start CPAP - Question on dehydration
(11-27-2018, 02:28 AM)Hydrangea Wrote: With your machine, up your humidity *and your temperature*.
Also, I have a lot less dryness when using just a nasal/pillow like Dreamwear than a full face mask like the F10. Thanks, I haven't got the gear yet, so that's encouraging.
(11-27-2018, 10:02 AM)Sleeprider Wrote: The dryness you describe is usually the result of mouth breathing or leaks. Learning to breathe through your nose will help. More humidity is possible by turning off the humidification Auto mode and manually setting humidity and tube temperature. Biotene or similar products may help relieve dry mouth.
EPR can increase comfort, and has therapeutic applications. It may also change the pressure in ways not anticipated by your titration test. I would suggest using an auto pressure mode Autoset or Autoset for her, which can compensate. A pressure range of 9-14 is going to be equally or more effective and probably much more comfortable. It makes little sense to prescribe fixed pressure, but feel free to give it a shot. Sinus constriction is what restricts my nose breathing. I will ask the DME gal about manually setting humidity and tube temp. They recommend heated tubes for everyone here -- it's Montana.
I'm really glad to hear that EPR can increase comfort. I think part of the problem is pressurized air blowing at me when I'm trying to exhale. It dries me out even more.
Doc's orders are to start with constant pressure of 12. I agree that fixed pressure makes little sense. As soon as I can I will get him to change that to Autoset or Autoset for Her.
If he doesn't, I'll try it myself. After 26 years of neuro-immune illness, I've learned to automatically question doctors' orders.
11-27-2018, 04:15 PM
(This post was last modified: 11-27-2018, 04:24 PM by Fats Drywaller.)
RE: Soon to start CPAP - Question on dehydration
It's possible that the GERD will go away, or at least it's very likely that it'll become less severe, when your body has been properly disposing of the carbon dioxide for some time and your stomach pH has shifted toward normality. I suggest giving it a few weeks, using the CPAP machine as much of the sleeping time as you can put up with (ideally 100% but that's difficult at first), and seeing what happens eventually. With this stuff, everything takes time. The most important point for any newbie is to hang in there.
When I had untreated sleep apnea I had some mild GERD, and it vanished when I had been on CPAP for a month or two, and now I have an old supply of antacid tablets that I never use. But I shouldn't get your hopes up, so I think it's safest to say that you can reasonably expect a lessening of those symptoms. To some extent, it is an objective thing: the more you use CPAP, up to that ideal 100% of sleeping time, the better you'll be excreting carbon dioxide and the less of that poison will be hanging around in your system ... with predictable results. I don't know why a lot of doctors don't tell patients about that. Why would anyone assume that everything else (physiologically) is going to stay the same after being on CPAP for a sufficient time? In fact, a lot of things change for the better.
And yes, definitely experiment with the heater settings (called "Humidity Level" in the A10's menus) to find out what's comfortable.
RE: Soon to start CPAP - Question on dehydration
When they "give" (sell/rent) you your machine, make sure to only accept an auto. Otherwise you'll be stuck with fixed pressure.
As far as temps, humidity settings, and pressures... you can adjust these when you're home.
RE: Soon to start CPAP - Question on dehydration
Humidity settings are user settable. If you don't see a manual setting, then go i to settings by pushing the home button and control knob at the same time, clickmon settings and scroll down to comfort. You might as well learn now, you can't run to the DME every time you want to adjust something. Here is a tutorial https://www.apneaboard.com/resmed-airsen...setup-info
While you are there ser Essentials from On to Plus. This has no effect on hour therapy, but provides a more complete sleep report on the user screen.
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