burps216 Therapy Thread

[burps216]

Successful first night with CPAP! Now it's time to start optimizing...

Diagnosed mild OSA w/ 8 AHI, mostly supine, but also on side. Struggling to get copy of test from doctor's office, but still bugging them...

Machine was delivered w/ default pressure range of 4-20.

First night wins:

• Made it 6.5 hours with the mask on; goal was 4
  
• The machine and mask were so quiet that my husband actually asked if I had even turned it on...
  
• No mouth breathing - I chose the F30i because I tend to breath through my mouth, but I'm hoping that I may actually be able to tolerate a nasal mask
  

First night struggles:

• Trouble w/ air blowing from nosepiece into eyes - as much as I fiddled I couldn't see to resolve this leak. It didn't bother me at lower pressures, but got very annoying as the night went on.
  
• Mask was too tight - Again, not an issue at lower pressures, but at higher pressures it felt like my face was stuck in a vacuum. The more I messed w/ it, the worse it got, so at that point I called it a night (you can see this in the graphs starting around 3:30 AM).
  

OSCAR data is attached. Questions:

• Any tips/tricks on the air blowing into the eyes?
  
• How do I balance getting the mask set w/ changing machine settings - I don't want to be changing too many variables at once
  
• Any additional insights? I am still familiarizing myself w/ all the data and how to interpret.
  

Thanks!

   

[alimo11]

I have the same mask and seem to have the air leak issue more when side sleeping, do you still notice it getting in your eyes when sleeping on your back?

That seems to work better for me. I will note that my first month with it I was concerned I had a leak and it wasn't until asking around that I learned that there are some small holes on the opposite side of the nose piece that act like a vent. Don't make the mistake I did and readjust constantly trying to fix a nonexistent leak.

As for settings and oscar stuff sorry I'm pretty knew with all this as well and won't be much help there, hopefully someone else chimes in

[Deborah K.]

I too started with the ResMed F30i mask.  Like most full-face masks, leaking was a problem.  One mistake lots of people make is strapping it on too tightly.  The mask should just sit on the skin because as the air flows in it will fill the mask, making it adhere more to the skin.  Try that tonight.

Your low-pressure setting is too low for most adults.  I suggest that you raise it to 7. This should provide more comfort and better therapy.  I notice that you have a lot of CAs.  Did you have a lot of CAs in your sleep study?  If not, they are treatment-emergent and will lessen as time passes.

[hwnboy]

I just started as well; tonight will be the end of my first week.  I also started with the F30i. Last night was the first night with a different mask, F40.

What Deborah K. said here was dead on!  "One mistake lots of people make is strapping it on too tightly.  The mask should just sit on the skin because as the air flows in, it will fill the mask, making it adhere more to the skin."

I started way to tight and loosened it every day and it always kept the seal.  I had it pretty loose the last few days, but it still came off like it was suctioned to my face.  And I had it very loose in comparison to the first night. I never had any leaks during this past week.

I like the mask, but it was tearing up my nose, so I thought I would try something else, and thus last night's F40.

Good luck with your journey, you have come to the right place!

[burps216]

Second night in the books...

Thank you to everyone who responded yesterday! I would be lost without such a generous, welcoming community to help navigate this process.

Night 2 (6.5 hours) - AHI 6.38 - CA 5.69/OA 0.23/H 0.46/RE 0.23
Night 1 (8.75 hours) - AHI 5.55 - CA 4.47/OA 0.77/H 0.31

Changes -

• As per @Deborah K & @hwnboy recs, loosened the mask. HUGE comfort difference! Although I did wake up at one point unfastening it in my sleep...
  
• Upped min pressure from 4 to 5; I'm too much of a weenie to change the minimum too quickly, so figured I'd take it slow
  

Thoughts -

• I did feel as though I couldn't cleanly exhale through the nosepiece - thinking maybe it wasn't lined up enough? I had also had a slightly stuffy nose throughout the afternoon/evening, so not sure how much that played into it.
  
• As far as I know I did not have any Central Apneas on my initial sleep test (still trying to get a copy of it), so guessing/hoping these are treatment emergent and will sort themselves out...
  

[b]Plan for tonight -[/b]

• Up min. pressure to 6 or 6.5
  
• Turn off auto-ramp and figure out a good ramp time (just keeping it on until I adjust to the overall sensation)
  

Questions!

• Is it worth bumping humidity from 4 to 5 to help w/ nasal irritation? Worried about causing rainout...
  
• For anyone who has dealt with treatmment-emergent CA, how long did it take to sort itself out?
  
• Also interesting on the CA's - when I dig into the data, nearly all CA's are preceded by a disturbance in mask leaks (example posted below). Anything to that?
  
• Is there a tagging mechanism in OSCAR? I'd love to see how things like exercise or alcohol affect my results. If not, I'd love to submit that to the feature backlog!
  

Thanks, y'all!

   
   

[burps216]

Night 2 (6.5 hours) - AHI 6.38 - CA 5.69/OA 0.23/H 0.46/RE 0.23
Night 1 (8.75 hours) - AHI 5.55 - CA 4.47/OA 0.77/H 0.31

These should be reversed... Night 1 6.5 hours and Night 2 8.75 hours. Whoops! 

[Deborah K.]

If you request a copy of your sleep study, the doctor is legally required to provide it to you.

[burps216]

Hi everyone!

Coming up on one month w/ CPAP and I feel like I've hit a bit of a wall and having a hard time consistently staying under 5 AHI. I've had some mornings where I wake up feeling great, and others where I don't feel a difference...

Does anything stand out that I could try changing to nip those pesky OAs and Hs? The majority of my event each night are CA, which I am thinking are treatment-emergent (I had 4 total CA on my sleep study for an Index of .6).

Current settings
Min 8/Max 20
EPR 3 Full-Time
5 minute ramp (for getting settled at bedtime)
N30i mask w/ chinstrap

Thanks all!

   
   

[burps216]

Back with a couple more nights of data... Anything we can glean from the night with 1.36 AHI? Felt fairly good waking up both mornings, although there is still room for improvement.