Change pressure or new mask?

[DavdM]

I just got my ResMed Airstart 10 w Nasel mask. Set at 4-20 I am told. Ramp up time is 35 minutes. When I start to sleep it's fine but is soon as I open my mouth a large gush of air comes out and wakes me up. Is it set to high or do I need a full face mask ? It also feels hard to breath out through my nose so I exhale through my mouth and wham I could blow out birthday candles from across the room....Signd Dave.

[Sleeprider]

Hi David, welcome to Apneaboard. Many people are issued an auto CPAP and instructed to self-titrate...or not. The machine settings are the minimum and maximum settings available, and will need optimized to give you the best possible treatment. The ramp is a comfort feature, and with a minimum pressure of 4 is completely unnecessary. So first things first. Go to this link and ask for the setup manual for the Resmed Airsense 10 Autoset. http://www.apneaboard.com/adjust-cpap-pr...tup-manual The quick setup instructions are here: http://www.apneaboard.com/resmed-airsens...setup-info . You can enter the therapy settings and turn off ramp, or change it to AutoRamp which is better than a timed ramp. Also, if you feel starved for air when first starting, just increase the minimum pressure to 5 or 6 and it will be more comfortable.

You should also download #Sleepyhead. It is a free software that will show you exactly how your CPAP therapy is going, including any apnea, hypopnea and leaks. It can be a big help in getting started. The links in my signature describe how to organize and post charts on the forum for detailed help. The 4th link in my signature is a discussion of CPAP masks. You are using nasal pillows, and if you find you can't keep air out of your mouth it won't work well. Many of us are able to suck the tongue up to the roof of the mouth, much like you do when you swallow. That blocks the air. Some just can't get there, and a full-face or hybrid mask may work better. Again, just see the Primer.

Once you have some data, and at least 4 posts, you can post some charts and we'll be glad to tell you what they mean. Good luck!

[OpalRose]

Hi DavidM,
Could you clarify if you have the AirSense or Airstart?

If you have the AirStart, that is the newest "but very basic model."   You will not be able to get much data from the AirStart, only basic compliance data.

I do agree you should narrow the pressure range.  At least move the minimum up to 7cm, and set EPR to 2.  This will help with the exhale pressure.

I do hope you have the AirSense. Let us know.

[Gailp]

I do agree you should narrow the pressure range.  At least move the minimum up to 7cm, and set EPR to 2.  This will help with the exhale pressure. 

I, too, have an Airstart (not Airsense) 10 with exact same issues as David. How do I make the suggested changes? It seems I can only change ramp time and humidity.

Thanks!

[DeepBreathing]

G'day DavidM. Welcome to Apnea Board.

Air leaking from the mouth is a common problem for people who use a nasal mask or nasal pillows. You can train yourself to seal the airway by putting your tongue against the roof of the mouth to form a seal. Some people have found a chin-strap helps while others use a soft cervical collar to support the jaw. Yet others actually tape their mouth or use a combination of the above. Personally I wouldn't want to tape my mouth - I like having a back-up breathing system if my nose fails.

The simplest way is just to go for a full-face mask which eliminates all this nonsense. That's what I decided on and it works well for me.

[DeepBreathing]

G'day GailP. Welcome to the forum.

You can obtain the clinical manual for your machine here: http://www.apneaboard.com/adjust-cpap-pr...tup-manual Be sure to follow the instructions carefully as there are a LOT of manuals available and you want to get the right one. Once you have the manual, you'll see the instructions for adjusting your settings if necessary.