Trying again after 10 years

[davidy]

I was originally diagnosed with sleep apnea 10 years ago but I was unsuccessful with using my CPAP (AirSense 10).  I'm not really surprised as I had a bad experience with the doctor and the DME was not helpful at all.  I tried again a few years later with a different doctor and DME and again wasn't successful.  I'm trying again with a different sleep doctor a couple of months ago hoping to find an alternative treatment but was very disappointed to be told that PAP was the only real solution for me.  I did a home study and was prescribed an APAP.  I've decided that the third time will be the charm and am determined to be successful this time.

I found a much better DME and spent a couple of hours with their respiratory therapist picking out my APAP (AirSense 10 again) and trying multiple masks for fit and comfort.  I'm both a stomach sleeper and a mouth breather (my sinuses are constricted where I can breath through my nose for a while but have to breath through my mouth occasionally) so I got a full face mask (BMC Siesta).  As an aside, I was previously pushed to get nasal pillow masks, both tries, and I expect this as at least partially responsible for my previous failures.

For the last ~3 weeks, with the help of melatonin, my anxiety meds, and somewhat better sleep hygiene, I've been also to use the APAP for the majority of the night.  A benefit I wasn't expecting is that I no longer get up to use the bathroom a couple of times a night (that pattern started when I had a kidney stone during Covid and continued until just recently).  Even with sleeping through the night I usually felt worse than before I used the APAP.  I got myself setup with OSCAR and an EzShare SD card but wanted to give myself a few weeks to adjust to the APAP before I asked for help.  I also got an Contec CMS50F pulse oximeter but it was much bigger than I was expecting and I can't wear it along with an Apple Watch.  I'm still working on improving my sleep hygiene but also want to make sure my machine settings are optimized.  An OSCAR screenshot is attached, any help or advice anyone can provide would be appreciated.

David

[staceyburke]

You have high flow limits.  To help with those and get a better nights sleep try this setting.

Leave your max where it is
Min 7
EPR 3

That should make it a better nights sleep..

Also you have a couple times in the night where you were sleeping in a position where you cut off your own airway. (positional apnea) - It was very short time so don't worry about it but be aware you are doing it.  You can not use pressure to stop it only changing your sleep position will help.  Back sleeping many times is the problem or maybe to high of a pillow...

[Sleeptechmaster]

Yes I feel listed sleeping position could be important with the information posted.
Stomach sleep is typically the least severe. For you to comfortably sleep supine you may require bipap level of pressures. The data looks good but if it is only for prone sleep it could be showing a very limited data set. Part of the idea of PAP is to let you confortably sleep in (hopefully) any position!

[Deborah K.]

After three weeks of therapy, you may feel up to turning off the ramp. You get virtually no therapy during ramp, and any time you may have to get up during the night ramp will restart when you return to bed, robbing you of therapy. Turning it off will be good if you can make the change.

[davidy]

Also you have a couple times in the night where you were sleeping in a position where you cut off your own airway. (positional apnea) - It was very short time so don't worry about it but be aware you are doing it.  You can not use pressure to stop it only changing your sleep position will help.  Back sleeping many times is the problem or maybe to high of a pillow...

Amazing that you can tell this from the chart.  Thank you for taking the time to read my post and respond.  I'll change my settings tonight (I've been fight a bug and the air coming out of the mask vents don't mix with having chills).  My pillow is pretty mushy and I only put part of my head on a corner of it to begin with.  I usually (at least start the night) sleep with my head facing down at a 45 degree angle, putting part of my head's weight onto the mask.  I can't imagine that's too high, but I'll defer to the experts on the board.

---

Yes I feel listed sleeping position could be important with the information posted.  
Stomach sleep is typically the least severe. For you to comfortably sleep supine you may require bipap level of pressures. The data looks good but if it is only for prone sleep it could be showing a very limited data set. Part of the idea of PAP is to let you confortably sleep in (hopefully) any position!

I've always been a stomach sleeper.  When I had to sleep on my back after surgery I was miserable until I was finally able to return to my stomach.  I don't have a desire to sleep other ways and I don't think a PAP is going to change that.  Thanks for taking the time to read and respond to my message.  
Edit: I just had an old memory surface and I realize that I'm old enough that my parents raised using Dr. Spocks' (not Star Trek, the other one) baby book so that explains my stomach sleeping.

[davidy]

After three weeks of therapy, you may feel up to turning off the ramp.  You get virtually no therapy during ramp, and any time you may have to get up during the night ramp will restart when you return to bed, robbing you of therapy.  Turning it off will be good if you can make the change.

I previously read about ramp time not providing any benefit so I change it from Auto to 5 minutes.  I do wonder if turning off the ramp would help with something else.  When I'm putting on my mask and getting into bed the flap on my mask will snap closed and reopen a few times in a row, like pop*pop*pop.  I hate that feeling and am wondering if going straight to the minimum pressure would help prevent that.  Thanks for your suggestion, I can't wait to try it.   

[Dormeo]

You might want to look into the Falcon sleep position:

https://www. a DME-owned forum .com/wiki/index.php/Sleep_Positions

[davidy]

Oh my gosh, that's my natural sleep position, at least mostly.  I also use the raised arm to trap the mask so it doesn't scoot away from my face.  I always felt silly raising my leg but I'll go back to doing that.  Thanks so much for sharing this, I feel validated!

[Dormeo]

Well we could all use a little more validation, right?

[davidy]

Always.