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Adjusting to CPAP: Night 3
Hello everyone, I'm currently in Night #3 of using the CPAP machine. I have a few questions, probably dumb ones but this is all new to me. I was told I have severe sleep apnea and therefore they set my pressure level at 19. I've found the "ramp" feature very helpful to gradually get up to 19 and my first 2 nights went very well. For some reason, my 3rd night (tonight) isn't going so well. I'm using the nose mask with the head gear to keep it in place. Is it possible to sleep on your stomach or side with this set up? I keep thinking I have air leaking out whenever I try either of those sleeping positions. Also, I believe they told me some of the air will be steady coming out the top of the hose that connects to my mask. But, when I'm laying next to anything it sounds like a fan on high speed or something since my required pressure is so high....haven't been able to fall asleep yet tonight. I know it takes time but my first 2 nights went so well and now I'm frustrated. Thanks for any and all help!
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You may want to try a nasal pillow mask, but in any event suggest that you try to accustom yourself to sleeping on your side.

I'm only 5 months into CPAP and really the first thing that comes to mind with such a high pressure as yours is why were you not prescribed a BPAP machine, for easier comfort. I'd inquire about that because you are at a pressure that is so high, only 1cm less than most CPAP machines produce, i.e., assuming your machine is CPAP.
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Welcome snakeman, hope you can get through your current predicament. I don't have any experience with pressures as high as you are set at. ramp will be your friend until you decide not to use it.

If you get some software such as sleepyhead, you can see breath by breath account of your night. Once you get the hang of it, you should be able to tell when you are sleeping (how long it takes you to fall asleep).

As far as ramping, I think I would initially start my ramp at about 10 cmH2O (versus usual default of 4), and the ramp time initially at about 15 minutes. Since you are going from 10 to 19 this should be gradual enough to not notice as you drift off to sleep. For most folks, transitioning to sleep only takes in the range of 5 to 8 minutes (100 to 150 breaths). What helps me is to count from 99 backward to 0. I think I only made it once in 8 months (only need to use the technique 20% of the time). I lose track several times before I reach 60.

If the pressure is just too much and machine is distracting me, I can push the ramp button and it will reset and start the ramp again. That is what I do if I wake in the night to a feeling of too much pressure.


I would not start the ramp any lower than 6, and if I started at 6 I would change the ramp to 20 minutes to get the same slow steady ramp.
Dedicated to QALity sleep.
You'll note I am listed as an Advisory Member. I am honored to be listed as such. See the fine print - Advisory Members as a group provide advice and suggestions to Apnea Board administrators and staff concerning Apnea Board operation and administrative policies. Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
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Hi Snakeman, welcome to Apnea Board.

19 is a very high constant pressure and will take some getting used to. As Ted said, you should enquire about a bilevel machine which will make exhaling easier. Even better, use an autoset machine so that the pressure only goes that high when you really need it. You should discuss these options with your doc or therapist, as a constant 19 will be hard to tolerate.

It's not unusual at all to have a few good nights and a few bad ones. After all, you're learning to breathe in a new way with a plastic alien strapped to your face Shock It takes a lot of patience and perseverance and sometimes you'll think you were better off without the machine. But stick with the program and it will get better over time.

As for sleeping positions, side sleeping is better than back sleeping if you can do it. You might need to try a different pillow - I use a duck feather one which I pummel into shape to accommodate the mask when I roll over. Some people here have mentioned a pillow with some kind of grain husk filling which they say is very good.

Best wishes.
Apnea Board Moderator


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I suspect you need a ff mask at that pressure. Even then, fighting leaks can be a constant battle unless you keep the headgear fastened pretty tight. Good luck. It takes a while to get settled in on your therapy.
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Hi the1snakeman,
WELCOME! to the forum.!
I know CPAP can take some getting used to, just give it time, you've only been at it for 3 nights and you will have a bad night once in a while where nothing you do is right, and , you just can't get comfortable, but it does get better.
Hang in there for more responses to your post and much success to you with your CPAP therapy.
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First, I think that we need to find out exactly which machine snakeman has. We keep saying that he should have gotten a bilevel at his prescribed pressure and maybe he did. So snakeman, what machine do you actually have? You need to remove the humidifier water tank and turn the machine over. On a label on the bottom you should find a 3 digit model number. We need to know what that is.

There should be no air coming out of the top of the hose but there may be a vent on the elbow going into your mask or the vent may be further up on the mask proper. The purpose of the vent is to keep you from rebreathing the same air with the carbon dioxide building up to levels that will suffocate you. That is an intentional leak to sweep the exhaled air out of the mask.

I am confused by your statement that you think that you feel leakage. I generally feel any leakage that occurs. If you are not certain, feel for the leakage with your fingers. If it is real, you should be able to feel it.

I used a nasal mask for a while and never had any problem with sleeping on my side other than not being able to keep air from leaking out of my mouth.

My prescribed pressure is 20 cm/H2O.

If you get through the ramp period without going to sleep and the full pressure is bothering you, restart the ramp.

Best Regards,


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(07-09-2015, 01:25 AM)the1snakeman Wrote: Hello everyone, I'm currently in Night #3 of using the CPAP machine. I have a few questions, probably dumb ones but this is all new to me. I was told I have severe sleep apnea and therefore they set my pressure level at 19.

19 is really high for just starting out. When you start the machine up does it say "19cm" in the display?

If you have an auto machine, you might want to see if your doc would give it a range with a lower limit that might be more tolerable, and also verify if he really intended you to be running at 19cm.
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PaytonA, would the machine info on the bottom be all numbers or letters or both? I took photos but not sure if I can send them on here? It says it's a Philips Respironics, REMstar Plus, C-Flex.
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By the way, thanks to EVERYONE for their helpful responses and suggestions!! I felt like I haven't had a healthy night's sleep in years and want this to work more than anything! To respond to one of the questions asked, yes I was instructed to have my pressure at 19 and was told my machine goes to 20. PaytonA answered my question about the vent for air coming out of the bend on the hose. I think what I'm feeling is that air going through the vent on my pillow or blanket and think it's leaking from my mask but when I check my mask I feel no leaks. The air pressure coming out of that vent is strong obviously so it blows a pretty good amount. Thanks again all!!
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