6 Days on my own, then DME (Olivander's Mask Shop)

[ragtopcircus]

I intended to get a travel machine from the beginning, so I already bought a Dreamstation GO and a few masks (P30i, N30i, F20, F30). My prescription pressure is fairly high (13), so I spent 6 days getting used to the pressure and trying to get a mask to fit right. Of those three, the F30 was best, but of course not perfect.

Today I had my appointment with the DME for the machine my doc wants me to use (Dreamstation Pro CPAP). It's very similar to what I already have except bigger, but I'm trying to keep the  doc  happy for now, and cooperate with the tech. It's rent to own, so we'll see ....

I was looking forward to the mask fitting. If you've seen the first Harry Potter movie, it was a lot like the visit to Olivander's Wand Shop. Apparently the tech has never had to pull out EVERY mask they have before, but I seem to have a difficult nose. Some she rejected as soon as she held them up to my face. Others seemed to fit fine fine, but we couldn't stop the leaks. We went through the P10, Wisp (her usual go-to for difficult fits), Dreamware FF, Amara View, and many others I don't remember the names of. I think the F20 was on her list, but I had already found that medium is too small and large is too big. In the end, we settled on ... the F30. 

Well OK, at least now I know not to waste any time or money on the others. Since a mask was included anyway, I still took the F30. When I get home, I'll match the strap lengths on mine to the one adjusted by the tech.

She also told me not to use my collar or strap for now. I'm pretty skeptical - my own data suggests that the collar is pretty important, but I guess I'll cooperate for now and let them do their job. If we have to crank the pressure higher just to avoid wearing the collar though ....

My sleep test AHI was 69.9 overall (worse on my back). With the GO, I've been able to get it under 2 some nights, when I'm not fighting mask and position problems. 4:30am to 5:30am is always worse though.

[OpalRose]

She also told me not to use my collar or strap for now. I'm pretty skeptical - my own data suggests that the collar is pretty important, but I guess I'll cooperate for now and let them do their job. If we have to crank the pressure higher just to avoid wearing the collar though ....

How would she know whether or not you were wearing your collar?

[ragtopcircus]

She also told me not to use my collar or strap for now. I'm pretty skeptical - my own data suggests that the collar is pretty important, but I guess I'll cooperate for now and let them do their job. If we have to crank the pressure higher just to avoid wearing the collar though ....

How would she know whether or not you were wearing your collar?

Oh, if I still end up using it, I will *tell* them I'm using it. I expect the data to tell the story though, and if it doesn't and I'm proven wrong, that's ok too.

[jaswilliams]

Just a note the CPAP Pro is a fixed pressure machine. I think you would do better with the Dreamstation Auto or a Resmed Autoset

[ragtopcircus]

Just a note the CPAP Pro is a fixed pressure machine. I think you would do better with the Dreamstation Auto or a Resmed Autoset

The doc is NOT a fan of auto machines, so I had no lucking with getting anyone to consider alternatives. Another reason I may be turning this machine in early.

My Dreamstation Go is Auto though. After using it for 6 days, it looks like the Rx pressure based on the home sleep study (13) is pretty close to the mark. Oscar charts will be posted soon, but I ended up tightening the range to 12-15 (with C-Flex+ on 2).

Fwiw, the Dreamstation Pro is actually auto (and probably the same exact machine as the Auto version), but it is normally locked in fixed mode. However, it can be switched to auto for 30 days in the provider menu. I assume that could be done monthly by someone in possession of a provider manual <cough>.

The ResMed Autoset is definitely on my radar though ....

[jaswilliams]

The 30 day thing can only be done a limited number of times before it’s permanently disabled I don’t know how, many times

[ragtopcircus]

The 30 day thing can only be done a limited number of times before it’s permanently disabled I don’t know how, many times

Good to know!

[ragtopcircus]

In daytime awake/relaxed experimenting, reducing the Flex setting from 2 to 1 seems to reduce my susceptibility to positional issues. Other than requiring slightly more effort to exhale, is there any potential downside to reducing it (anything I should watch for in the logs)? Is CA affected more by inhalation or exhalation pressure? In my sleep study, there were no CAs. With the pressure hovering in the ballpark of 13, whether auto or fixed, I'm typically seeing just a handful of CA/PB events, which I gather is normal when starting.

[jaswilliams]

In daytime awake/relaxed experimenting, reducing the Flex setting from 2 to 1 seems to reduce my susceptibility to positional issues. Other than requiring slightly more effort to exhale, is there any potential downside to reducing it (anything I should watch for in the logs)? Is CA affected more by inhalation or exhalation pressure? In my sleep study, there were no CAs. With the pressure hovering in the ballpark of 13, whether auto or fixed, I'm typically seeing just a handful of CA/PB events, which I gather is normal when starting.

CA’s are often reduced by a lower flex value if you are happy with 1 stick with it for now

[ragtopcircus]

So, I was still struggling with the F30. I had two identical masks, both new, both adjusted exactly the same (measured repeatedly). I even shaved in the middle of the night, hoping to improve the seal and stop the "raspberries". Tweaking the straps or nudging the mask around didn't help. Each time I thought I had it fixed and tried to relax, I would start feeling a bubble move under the edge. After a few seconds, the farting (so to speak) would start. Finally, I dug the spare out of the box and tried it. Bingo, I slept fine for the hour or two left before my fiancee's alarm went off, and went back to sleep for a bit after she left. That afternoon, I sat down with both masks, trying to figure it out. One mask was not finicky at all; it just worked. The other was impossible to adjust. I carefully matched them again, still no dice. Then I noticed that one had sort of a wrinkle in the edge of the seal, right where the leak always started ... aha!

All screenshots are from Oscar v1.1.0-testing-4.

This is last night with the "good" F30 mask, 15mm tubing, Dreamstation Pro, pressure fixed at 13, C-Flex+ 1, no ramp, no cervical collar, but a "My Pillow" small travel pillow on top of a fairly flat feather pillow for side-sleeping. From 69.6 diagnosis to AHI 1.67, and my first night of essentially sleeping all night since, well, I really can't remember when (granting that I did go to bed late because we had company). If I'm interpreting it right, there was at most one "real" CA event, ignoring some sleep/wake junk.
   

3am - small cluster of OA events. I think this was when I rolled onto my back without moving the travel pillow. I'm going to try rotating it sideways so I roll off of it when on my back. I think I partially awakened and moved it at the end of the cluster.
   

3:57am - there's an OA, CA pair that look almost identical to me except for a slight difference in amplitude. Is one of these events misidentified by the Dreamstation? Which one?
   

5:58am - there's a CA event flagged, but could it be "junk" from being partially awakened? My daughter typically wakes up around 5:45, dresses, and leaves her room around 6:00.
   

6:50am - another CA event that might be more partially awake junk. That's about the time my daughter leaves for school. She's not quiet.