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2 weeks on CPAP and questions
I posted here a week ago or so just after I started. At the time I was using the N10 mask with the Resmed 10. I have since also tried the P10 mask and the Wisp. I have two burning questions from my experience:

1. With each mask I get different results except for two main things. My API stays around 1-2 and I really only seem to record CSAs but only about 6-12 throughout a 7hr sleep and each only of 10-30sec duration. Do these really count or mean anything? Their lengths seem small (sec) and number seem inconsequential.

2. my mask experience has been "interesting". I found the N10 noisy and generally not a brilliant but horrible experience. My experience (albeit one night) with the Wisp was I always felt I couldn't breath and my nostrils were blocked. I changed from the med to the large (although the measuring thing said Med) but I woke up in the middle of the night with the large really hurting the bridge of my nose and changed to the medium. In the morning I had purple bruising on my nose. Funny thing was my stats were awsome - no leaks, virtually no AHI. What was I doing wrong? I had the top straps loose and the bottom ones tighter. I did have the air running over my head and that possibly pulled the mask up and increased the pressure on the bridge of my nose. (?)
The P10 I have found good and very comfortable and unobtrusive. But I have found my Centrals have come back. (albeit small amount). Also, whilst I don't breath through my mouth I have found a few instances were a bubble is emitted through my mouth (really weird) which opens my lips a bit and causes air to flow out with my Leaks L/min at around 30. Is that bad?

any feedback would be great as I have no idea. Whilst I have felt better (heaps more energy and low fatigue) I am wondering whether the fact my AHI has dropped down so markedly that i don't really have Apnea. My sleep study had me at 17.

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first of all, you should look at your info in a software program (sleepyhead or ResScan). You can see what your pressure range is while you are sleeping among other things. When you install the one of your choice, we can help you with what you are looking at.

Secondly, why is your pressure set wide open (4-20)? Did you get a copy of the sleep study results? What was your diagnosis? OSA, mixed or central or something else?

If you have a diagnosis of central apnea, your machine will NOT treat it. Sometimes when just beginning treatment, sometimes you can have centrals until you are used to the pressure. How long have you been on cpap?

About your mask....everyone is different. I use the wisp and really like it but others do not like it or have a preference for another mask. It is so individual. I think that there is a possibility you had the headgear too tight and maybe there wasn't enough slack in your hose and it was causing some issues. Try and give the hose a little more slack (I just let my hose go across my body and not over my head) and loosen your straps a little bit and see how it goes next time you sleep. watch it for a few days and see if there is improvement.

You really need to download the software or get something done about your pressure settings and we can help you with that once you download the software and give us some information from it and also why your pressures are set as they are.

Stick with it. You will most likely be glad that you did. we are here to help.
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The fact that your ahi has dropped down markedly is precisely what the therapy is supposed to do. If you ever had apnea, and apparently you did, you still do. But you're doing a good job controlling it.

The CA's will come and go everytime you change stuff. Once you establish a set regime, and stay with it awhile, the CA's should calm down.

So pick a mask. Probably the P10, and stay with it for a couple of weeks minimum. Learn to control the leaks with it, using a chinstrap if you need to.

Also, I see your pressure settings are 4 and 20 blackbirds. I always call it that because 4 and 20 is only good if you're making a blackbird pie. You need to download the software and begin monitoring your results in order to establish a better and tighter range. For instance you may discover your events are taken care of with a pressure of 11 or 12. So you would want to raise your minimum and lower your maximum to surround that pressure setting. But you can't do that until you get your results. So the software comes first.
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Don't worry too much about central vs. obstructive. Centrals aren't necessarily more harmful, just harder to eliminate. Worry about how many or how long they are.

Get the free SleepyHead software here.
Useful links.
Click here for information on the main alternative to CPAP.
If it's midnight and a DME tells you it's dark outside, go and check it yourself.
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thanks for all the responses. I have been using the rescan software. Its showing I am only having centrals but my sleep study had both but my centrals are very minor I think. I assume, given my AHI is down to 1.7 that I generally have it under control, I guess. Given it dropped so rapidly I do wonder about the original sleep study. If it wasn't that I am feeling more normal now (lower daytime fatigue than previous) I would think the study was inaccurate.

The only thing is I am working on making each night comfortable. Its probably my fault also that I have been jumping around with the masks. I want to try the Wisp again to see that I can get it to work well. I feel, probably with some hubris, that I am good now with the N10 albeit I have some leakage due to my mouth opening at times (mountain shapes on the air leaks and not spike shapes on the graph).
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Hi Dafod,
You might try a chinstrap to see if that helps you keep your mouth closed.
Just stick with your CPAP therapy, it will get better over time.
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(02-27-2015, 04:58 AM)Dafod Wrote: Its showing I am only having centrals but my sleep study had both but my centrals are very minor I think. I assume, given my AHI is down to 1.7 that I generally have it under control, I guess. Given it dropped so rapidly I do wonder about the original sleep study. If it wasn't that I am feeling more normal now (lower daytime fatigue than previous) I would think the study was inaccurate.

G'day Dafod. Yes, the fact that your AHI is around 1.7 means that the machine is working well and successfully preventing many apneas from occurring. If you stopped using the machine your AHI would jump straight back to 17.

Generally the target is an AHI under 5 - that is the total central & obstructive apneas plus hypopneas are less than 5 per hour. Your 1.7 is well below that, so you're doing well.

With all things CPAP there will be good and bad nights, and you need to watch for trends rather than single night results. Generally if you make a change, only change one variable at a time and wait 7 - 10 nights to see the trend. That goes with the masks too - though if the mask is causing pain or distress then obviously you need to make an immediate adjustment.

As some of the other replies noted, your pressure setting of 4 - 20 is a default that they will start you out on. However you'll have a more comfortable experience and more efficient treatment if you can close that range up a bit. Once you are feeling reasonably stable, post a screenshot showing the events, flow, pressure and leaks - from that we'll be able to suggest a better pressure setting to try.

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