hwnboy therapy thread

[hwnboy]

Hey Sleeprider, I really appreciate your help!

I loaded Oscar with my SD card and was surprised to see no leaks. I looked around a bit trying to find out how to change the time zone; the data is showing me ahead by 2 hours.

I normally go to sleep around 9 p.m., and I'm lucky to get 4 hours of sleep. A good night is 5. Typically, I wake up several times during that time frame.

For the first few hours, I was hating my mask (F30i). I felt like it was squeezing my mouth into that small space. I dealt with it by watching TV for a bit and then, around 9, shutting the lights and TV off. I remember seeing 10:15 on the clock before; all of a sudden, it was around 1am. It was wild as I slowly gained consciousness and noticed how slow my breathing was and how deep my breaths seemed to be. 

I figured it was a good time to hit the bathroom, so I turned off the machine and disconnected the hose at the elbow joint on top of my head.  My plan was to get back in bed, reconnect, and try to get back to sleep. So far, so good. I knew I had hit my 4+ hours and was hoping to add some more data to my SD card.  Being the extreme newbie that I am, I figured I would turn it off to eliminate the chance of a huge leak while I stepped away from the machine.

Back in bed, I laid there awhile, thinking I wasn't going to get back to sleep, but I did somewhere along the line. One of the moments I was awake during the next few hours, I remember feeling a burst of air on my neck.  I thought there'd have to be a leak. 

Not knowing how time is calculated, I thought, let me see if I can get another 4+ hours in.  Does the day count from noon to noon or midnight to midnight?

So, at 5:40 am, I got out of bed.

The My Air app came online finally, and I was shocked to see no leaks with a score of 100. Again, here on Oscar, no leaks.

I'm not sure on the EPR feature; I left all the settings alone from the way the clinician set them, and she had everything on Auto.

One thing I'm curious about is: once I start tweaking the numbers, will they see that? Not that I care, but I wonder if that affects the compliance issue.  She gave me a kind of meh, shrugging shoulders look when I mentioned Oscar, saying My Air was all I would need. 

I figure I'm not going to be happy with this mask, but with no leaks, I guess I should give it a few more days.

Thanks again!

[Sleeprider]

You're on the right track, but need to move minimum pressure to 7.0. With EPR 3, that results in a minimum pressure of 7.0/4.0 (inhale/exhale). Your Autoset is actually a BiPAP when using the EPR feature, so you get separate inhale/exhale pressures, and I will often use this notation. The lowest pressure of the device is 4.0 cm, so to keep your machine responsive to obstructive events, we need the EPAP (expiratory) pressure to rise when needed. It's currently stuck at 4.0 until your IPAP (inspiratory pressure) rises above 7.0. You got good time in therapy, and the higher minimum pressure will make the pressure more consistent and effective. Your obstructive events are often clustered together. Please read the Positional Apnea wiki article to better understand why this may happen and how to avoid it. https://www.apneaboard.com/wiki/index.ph...onal_Apnea

[hwnboy]

Awesome! Thank you so much, Sleeprider

[hwnboy]

I put on the mask at 8pm last night, intending to go to sleep at 9pm. I turned off the TV around 8:30. The good news is that I fell asleep before my wife came to bed at 9pm.

I woke up around 12:30 am; my nose was sore, and I didn't feel the intake breathing was as smooth as prior night.  Even though we had dialed up my minimum pressure, hmm. 

I knew I hit my minimum hours for compliance, and with my nose not feeling great, I just got out of bed.

I almost feel like maybe my nose was butting up against the inside of the mask. Not sure. I will take closer note of it tonight when I come out of Night 3.

I look forward to sleeping longer and feeling rested when I rise 

I slept on my side last night, and what a difference to my AHI from the night before. I didn't strap the mask down as tight as Night 1, thinking I was probably going to have some leaks, especially when making a point to side sleep. Still 0, wow.

[Sleeprider]

Side-sleeping seems to work a lot better for you. The pressure was very constant, and I don't see anything that says to make a change. Very well done! Hopefully you'll sort out the nose pressure.

[hwnboy]

Cool! Hopefully, it's just something I need to get used to.

[hwnboy]

I'm not sure what went wrong tonight. It's 1 a.m. and I am exhausted. I went to bed at 8 on Saturday night and couldn't fall asleep for a few hours. I remember seeing 10:15 on the clock before I finally slept. The mask sounded different tonight; I was hearing every breath, unlike Night's 1 & 2. I awoke a little after midnight, and nose was sore, so went to the bathroom. I should have taken a selfie but didn't want to wake the wife. The silicone of the cushion was tightly surrounding my nose, and it didn't look right, so I decided at that point to call it on the session.  I was in 4 hours and 15 minutes at that time. I grabbed the SD card as I was curious about what had happened.  I don't really know what I'm looking at yet in Oscar, but I see that there was a lot more activity in the leak section.

[hwnboy]

I think I know what my issue was...

After writing the above at 1 am, I was so tired that I thought, Let me try and put this mask back on and get a few more hours of sleep.

When I put it on earlier, I don't think I had the nostril holes in the silicone lined up just right. The reason for hearing the breaths maybe?

I tried to be more deliberate in the location and turned the machine back on.

I got a couple more hours of sleep. Here is an updated Oscar file.

The poor application of the mask must have been the reason for the first 4 hours of the night being a nightmare. I see the second half of the night with no leaks.  I had a few CA's, OA's, and H's. I was on my left side for 99% of the night.

My nose is jacked, but it did do better on the second part of the night.

Please find the two Oscar files from last night below

[Sleeprider]

Are you sure you need a full face? If so, look at the Resmed Airfit F40 as an alternative. The headgear fits completely differently and does not yank the cushion up into your nose, and no air tubes by your ears. If you can tolerate a minimal nasal pillow, the the Airfit P10. The pain is not worth it, and you should be able to try something else if your F30i is not working out.

[hwnboy]

I think the reason I was drawn to the F30i was that the hose was attached on top of the head. I thought it would help with me turning side to side during the night.

The way you describe it is dead on; it is being yanked into my nose. 

I read a bit about the F40 recently, and the pure silicone cushion sounded more comfortable. I wasn't sure how I would deal with the connection at the face, thinking I might get tangled up in the hose.  I 100% want to try it.  I would love to try the P10 as well, if I can control my mouth breathing, seems like that would be ideal.

I'm not wild about my DME at this point. I've only met with them once so far, when I got the machine and mask.  I was disappointed with how they handled the mask fitting. I read here that you want to try the mask lying down and under pressure.  They did neither. I felt like she guessed at the size, slapped it on, and sent me on my way.

When I corresponded with the front office prior to the visit, they said you could try several masks during the 30 days. Since the in-person visit, it's more like, "Please stay in contact with us so we can help provide your care and maybe a new mask."

So I'm getting the vibe that they want to keep the mask count down as much as possible. Understandable.

I should be able to do the F40 and the P10, at least.  I'm still in the first week of the 30 days.

As much as I do like the connection on top of the head (F30i), and with my limited knowledge of Oscar, my numbers seem to be promising. The pain is not promoting a long, restful sleep.

I really appreciate your guidance.

Thanks Sleeprider!