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1st night on the machine, not so great

I survived the first night on the machine.  It really didn't go so well.  Ended up taking it off after about 2 1/2 hours.    I would say the mask was fairly comfortable.  It's going to take some adjustment to get used to the noise.  I think my biggest problem last night was just the newness of it all and that it wasn't what I am used to.  I will adjust and will keep at it.  

During my sleep study they started me at a pressure of 5, then 6, and then 7.    They had me at 7 for 173 minutes and in that time only recorded 5 central events, no obstructive, no mixed, no hypopnea and only 1 RERA.

So, I setup my machine last night with a pressure range of 4 to 10, with a 10 minute ramp and the exhale relief set to 1.  Humidity was set to 3 only because I chose the setting in the middle of the range.

Looks like my pressured ran into that upper limit several times.  But these charts still are mostly just raw data to me, I still can't interpret most of it.

Here's my chart.  Would love to hear some thoughts.
Also, if the chart isn't showing what it should or you want to see something else, let me know.


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Those results look very good for a first night, except you need to get the usage hours up. What we see is a 15 minute ramp at 4 cm, then the machine increases pressure over 8 cm resulting in a large leak. Things settle down until 22:40 when there is an increase in pressure from flow limitations. This could be a period of REM sleep, at least the latency is about the right time. At this point you hit maximum pressure, and experience a hypopnea and OA followed by several respiratory event related arousals (RERA) and persistent flow limited breathing. This passes, either because you're awake or in a different sleep stage, and therapy is quiet until 00:50 when you have a couple more OA. After 1:00 you appear to be awake prior to ending therapy.

A couple pointers to help. Set your ramp to 5.0 cm so you can feel a bit of pressure, and use the Auto Ramp rather than a set time. Set your minimum pressure to 6.0. A minimum of 4.0 isn't going to do anything to address your needs, you almost never had less than 8.0 cm pressure, and the higher minimum may keep the machine from going quite so high. Once you can tolerate the pressure, I think your minimum needs to be 8.0. It appears your maximum is going to end up at 12.0 cm. You can choose when to implement that. For me the obstructive events and RERA are much more disruptive than the pressure, but for now, you should do what is comfortable for you to maximize use.

[Image: dF5JodV.png]
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Thanks for the detailed response and suggestions.


 I do know I need to get the usage up and will definitely be doing that.  Last night was just a struggle to get comfortable with everything.  It will work, I just need to get used to everything I think.

I'll make some changes and hope for the best tonight.  The weather is going to be great here today so I plan on spending most of the day working outside.  Hopefully that will get me good and tired so I can get some better sleep tonight.

Thanks again,
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Night #2 complete.

Nose and throat are pretty dry this morning.   Mask seemed to stay in place well thru the night.

I changed my settings to a min of 7 and a max of 12.  I also changed the ramp to auto and set it at 5.

Any thoughts or pointers would be appreciated!

[url=[Image: 8AFM4uW.png]]
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Interesting that the OA has been reduced, but now there are CA events not seen the first night. That may be sleep disruption from the pressure moving higher, but doesn't seem to be central events. If you felt more restless last night that would explain it. A maximum pressure of 11.0 is sufficient if you want to cap the maximum pressure. Again, not so bad for 2-nights in.
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