Thanks!

[macheta]

Last Friday my doctor recommended the sleep study for my poor sleeping condition. I reviewed the sleep study option and it was outside my available budget. Even though the sleep study was one of the first instructions your website provided, I really did not have choice to get the sleep study (As I have some other higher priority items going on right now).

I purchased on the open market a Philip 560P CPAP. The guy told me it had about a weeks worth of usage. A visual inspection of the unit told me it had at least a months worth of usage because of the water residue on the bottom of the humidifier. Later I found out it actually had 84 cumulative days according to the memory card.

Any rate, the automatic pressure setting is what I am using for my machine.

I just finished configuring my system and have it plugged in as I type. I plan to use the free software for trend monitoring. Keeping daily logs. I will also use the plan-do-check-act model to make sure the new change is improving my health condition.

Question #1: If I keep my mouth closed it causes back pressure. Would the automatic feature increase pressure if I keep my mouth closed when I sleep?

Question #2: The hose connects to a fitting that plugs into the nasal pillow. Should this have a small leak or should I replace the hose? Does this fitting come with hose replacements (The piece that fits between the hose and nasal pillow fitting)?

Question #3: Do you see a lot of benefit with the heating upgrade? Is it worth $75?

Question #4: The machine came with women type nasal pillows. What is the difference between women and mens types?

I would not have been able to improve my health without the information on this website. A lot of good information helped me identify a go-forward plan.

Thanks!

Macheta

[DeepBreathing]

Hi macheta, welcome to Apnea Board.

I don't really like to see people launch into therapy without a sleep study, as you are going into treatment before diagnosis. Never a good thing to do. However, with a systematic approach such as yours, it should be possible to get started. If you do have obstructive sleep apnea, that machine will help treat it, and the data will provide the basis for a reverse engineered diagnosis. However, I'd still recommend a proper sleep study when you can afford it, as there may be other underlying issues in addition to (or instead of ) the apnea.

So, to your questions...

1. You should keep your mouth closed. PAP works by building up a pressure in your airway (nose, throat, trachea etc) to prevent collapse of these tissues when you're asleep. A pressure splint, if you like. As soon as you open your mouth, the air rushes out, the pressure is lost, and your airway collapses. So it's important to prevent leakage through the mouth. For some people this comes quite naturally. Others need assistance such as a chin strap. One technique often recommended is to practice holding your tongue against the palate to form an air-tight seal.

2. What type of nasal pillow are you using - there are a lot of different types on the market. In general, all masks are vented to allow CO2 to be exhaled. Whenever the machine is running, you will be able to feel air being expelled from the front of the mask - this may be what you are experiencing. If the hose itself is leaking, that is a fault and it should be replaced. If the mask and hose have been used by the previous owner I would replace them for hygiene reasons.

3. The hose heater is designed to prevent a condition called rainout, when humidity condenses in the hose. This can cause gurgling sounds and / or you will get drops of water forced into the mask and onto your face. Whether this is a problem for you will depend on variables such as the ambient temperature and humidifier setting. If you already have a setup without the heater, see how it goes - you'll know if you need it. As an alternative you can buy (or make) a hose cosy, which is just a sleeve to keep it warm.

4. Again, what type of pillows do you have? With some models a set of pillows is provided - small, medium and large for men; very small, small and medium for women. Again, this is something you need to try and see what works best for you. A lot of members have said they get best results by going one size larger than the comfortable fit.

Hope this helps - good luck!

[trish6hundred]

Hi macheta,
WELCOME! to the forum.!
Though my machine is a different brand, I use the heated hose and find it to be a very good feature. I would say the heated hose upgrade would be a good idea, but you can also make a hose cozie out of old socks, cut the toe out of them and sew them together. Put rubberbands or elastic to hold it in place at the ends of the hose if your budget won't allow the upgrade right now.
Hang in there for more suggestions and answers to your questions and much success to you as you fine tune your CPAP therapy.

[GeoffD]

I don't really like to see people launch into therapy without a sleep study, as you are going into treatment before diagnosis. Never a good thing to do. However, with a systematic approach such as yours, it should be possible to get started. If you do have obstructive sleep apnea, that machine will help treat it, and the data will provide the basis for a reverse engineered diagnosis. However, I'd still recommend a proper sleep study when you can afford it, as there may be other underlying issues in addition to (or instead of ) the apnea.

If you don't have the budget or the medical insurance, it's certainly worth a shot. Set the machine on 4-20 Auto and self-titrate.

The issue is mask choice. At least they're starting with nasal pillows. The conventional wisdom is try pillows first. Then try a chin strap if there are mouth breathing/mouth leak problems. Then try nasal mask. Finally, try a full face mask if the mouth breathing issue can't be overcome.

My ResMed AirFit P10 nasal pillow mask comes in a package with several different size pillows. If the OP has the kit with different size pillows, that helps.

I replace the pillows in my mask as the silicon hardens. Buying a used mask, I'd be looking to replace the pillows if it turns out the mask works. If it's a P10, the pillows are $19.00 at a bunch of different online suppliers and you can probably find them a bit cheaper with free shipping with a bit of searching.

For the AirFit P10 pillow mask, I don't think there is any difference between the P10 and the P10 For Her other than color. The P10 has a boring blue head strap and no color accent in the mask. The nasal pillows are the same for both masks and the diffuser is the same.

[macheta]

Hi macheta, welcome to Apnea Board.

I don't really like to see people launch into therapy without a sleep study, as you are going into treatment before diagnosis. Never a good thing to do. However, with a systematic approach such as yours, it should be possible to get started. If you do have obstructive sleep apnea, that machine will help treat it, and the data will provide the basis for a reverse engineered diagnosis. However, I'd still recommend a proper sleep study when you can afford it, as there may be other underlying issues in addition to (or instead of ) the apnea. I plan on receiving the test after I pay off some unscheduled medical bills.

So, to your questions...

1. You should keep your mouth closed. PAP works by building up a pressure in your airway (nose, throat, trachea etc) to prevent collapse of these tissues when you're asleep. A pressure splint, if you like. As soon as you open your mouth, the air rushes out, the pressure is lost, and your airway collapses. So it's important to prevent leakage through the mouth. For some people this comes quite naturally. Others need assistance such as a chin strap. One technique often recommended is to practice holding your tongue against the palate to form an air-tight seal. Last night I used the devise for the first time; only managed in two hours on the first night. No large leakage reported. However, I will use my chin strap if I have symptoms of leakage.

2. What type of nasal pillow are you using - there are a lot of different types on the market. In general, all masks are vented to allow CO2 to be exhaled. Whenever the machine is running, you will be able to feel air being expelled from the front of the mask - this may be what you are experiencing. If the hose itself is leaking, that is a fault and it should be replaced. If the mask and hose have been used by the previous owner I would replace them for hygiene reasons.The package indicates its a swift FX pillow small. I think that I thought it was a womens configuration because the head strap was a womens type (RedMed Swift FX for her, 61540)

3. The hose heater is designed to prevent a condition called rainout, when humidity condenses in the hose. This can cause gurgling sounds and / or you will get drops of water forced into the mask and onto your face. Whether this is a problem for you will depend on variables such as the ambient temperature and humidifier setting. If you already have a setup without the heater, see how it goes - you'll know if you need it. As an alternative you can buy (or make) a hose cosy, which is just a sleeve to keep it warm.

4. Again, what type of pillows do you have? With some models a set of pillows is provided - small, medium and large for men; very small, small and medium for women. Again, this is something you need to try and see what works best for you. A lot of members have said they get best results by going one size larger than the comfortable fit. The package indicates its a swift FX pillow small. I think that I thought it was a womens configuration because the head strap was a womens type (RedMed Swift FX for her, 61540); i will try going with a larger size.


Hope this helps - good luck!

[Sleeprider]

You can buy mask components on Ebay and Amazon as well as the other DME suppliers without a prescription. The FX nasal pillows will fit in the mask frame. If you find you like nasal pillows, then consider switching to the Resmed Airfit P10 when you have a spare $100.

Good luck. You'll need more than 2 hours on the machine to feel a difference, but the 560 is a fully data capable machine and you can monitor your progress with Sleepyhead.

The heated hose adapter is something I paid for and think is worthwhile. It keeps moisture from condensing in the hose and mask and keeps the air slightly warmer. It's a comfort feature, so take your time and get used to the machine. It will work just fine without it.

[macheta]

Thanks. I'm right now working on adapting to the new system. This is my second night.