zonk Wrote:It would not help if you fit your mask at the lower pressure because as you go to sleep and the pressure start to ramp up the seal might not hold so you need to mask fit at the max pressure or the 95% percentile pressure and to do that if i,m not mistaken is to set the CPAP pressure exactly the same (even if you are using auto mode) in the clinical menu .

I use the climate line in auto mode and set temp at 20/22C which is comfortable for me most of the times and any higher it would feel quite warm and sometimes uncomfortable , it is a personal preference and it varies from person to person so you need to play with it to come up with the right setting that is comfortable for you and it is the same with the other comfort features RAMP (providing it is not long at the min pressure otherwise it would feel not getting enough air to breathe) and EPR which can help with lowering the pressure at exhale .

If the cushions is too large or too small the mask seal would be affected and it should be the right size and fit at the entrance of the nose .(you might want to read mask FAQ,s)

http://www.resmed.com/au/products/swift_fx/videos.html?nc=patients&sec=true

Dolla Bill Wrote:SS- I will certainly try your suggestion. The sleep study suggested 11.8 cm/water. I originally set the pressure range at 8/12. This seemed to work well, but I wondered if it might need a greater range. So I set it at 4/20. The pressure felt a bit strong, so I lowered it to 4/14.

The machine selects a pressure average of 10.2 - 10.4. I want to be careful not to adjust too much at one time, though I wonder if that is as great a consideration with an autoset. (??)

Apparently you are using a pressure about 4 above and 2.4 below. Using these parameters I may set mine at +/- 4 or 6.2/14.2. Perhaps I should leave it there for a while (??)

The AHI is increasing. 1.4 first night. 3 the second night and 3.5 last night. Don't quite understand this, still nicely below 5, but increasing.

Mask leak has dropped from 30 to 27. Still needs to go lower. The "mask indicator" still shows smiley face/good, but I wonder. I have watched the video on mask fitting -- thanks Zonk -- and it seems to be right. The nose piece fits me well. I will check fit at higher pressures to see if the leak occurs there.

I average about two/three stops a night to "shed a tear." Should I turn the machine to "off" or leave it running when taking these bathroom breaks? I am set to "Smartset" is "on".

It seems that I read somewhere that nasal pillows do not work as well at pressures above 12.

zonk Wrote:If the pressure average 10.2 -10.4 is the pressure from the LCD screen data ? then it is the 95% percentile pressure which the machine used for 95% of the time and lower while sleeping and higher for the rest 5% of the time .If you are finding the min pressure at 8 is a bit strong then try set EPR at 3 may help or lower it by 1 or 2 cm/H2O . I would not worry about AHI it is not rocket science the machine does an excellent job and i agree with you that you have to give it time to work and leak could be lower but as you are getting Mr Smiley than it could be just for a very short time when adjusting the mask the software would tell you more but you might don,t want to go there at this stage .

Dolla Bill Wrote:Been about a month and a half since getting serious about CPAP therapy. ITS WORKING! Pressure is down to about 8.1, my average AHI is about 3.1. Getting about 7 hours per night. Feeling fantastic! A lot of other symptoms have vanished - chest pain, indigestion, headaches, "3:00 o'clock in the morning straight-ups"; anxiety, depression, and especially over-reacting to non-serious events.

The latter had disturbed me a lot. A relatively small event could evoke a very large, "over the top" reaction from me. Not happening very much any more. This is good.

A few particular behavior changes have helped.

1. Sleeping on my back. Yeah, yeah, I never thought this would work, but it can be done and is is not that difficult. Just relax and let it happen. Went from two pillows to one. I like the nasal pillows mask, small, light, easy. But also easy to dislodge unless it is so tight it hurts. But on my back? Works great! No dry eyes, or dry mouth.

2. Go to bed at a regular time. I usually wake up at 5:00 am. Now retired. Don't use an alarm clock. That is just when I wake up. So I deduct 7.5hours and bedtime works out at 9:30p. If your usual wake-up time is different, say 7:00a, you might start getting to bed at 11:30 latest.

3. Watch peaceful movies to set up my mind for sleep time. I do not watch "24" and movies like it any more. Get full of adrenaline and can't sleep. Puts my mind in a very active place. In fact, I have quit watching violent movies altogether.

4. Turn off the computer one hour before bedtime OR use a really great software (f.lux) that warms the color of the monitor. The usual blue output seems to activate wakefulness. This is very good and free! It begins to warm colors at about sundown and brings back the normal blue at sunup. Get it here http://stereopsis.com/flux/

Actually I think it is better to read a book about an hour before bedtime than have a monitor (or TV) beaming light into your eyes.


5. Eat no later than three hours before bedtime. Acid reflux often seems to go hand-in-hand with OSA. Avoid alcohol.

Yeah, no food, no drink, no exciting movies, no bight lights -- sounds boring, huh? Well I am here to tell you, that still leaves one very great human pleasure, but since this is a family forum, I will leave that to your imagination (and your wife, or Partner). Just remember, candle light is very relaxing, soft music, cuddling and afterglow really help get a good therapeutic night's sleep.

And IF you are lacking in human companionship, get a dog or some kind of pet. Relax, read your book and pet your dog or cat. There is something therapeutic about petting a dog and they do not care what you look like.

And don't obsess about your CPAP settings. Listen to the regular posters here and do what they say. Then relax and let the CPAP do its work. Don't continue to tinker every day. Settle into a routine.

This is working for me and I suggest giving it a try for yourself.