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Another New User
#1
Another New User
Want to thank the users and admins for this board. It has been a tremendous help for me. THANK YOU !!!

A little background.I have Afib, congestive heart failure and high BP. My cardiologist suggested I have a sleep study. The results were Severe Obstructive Sleep Apnea, with 50.6 events per hour. Recommended a CPAP.
i am also considered 100% disability by the Veterans Administration for exposure to Agent Orange. I sent my sleep study results to the VA and they agreed with the diagnosis and approved my CPAP request.

Due to the current virus situation the VA is not seeing patients in person. I had a "phone" appointment with a Physician Assistant who went over basics of a CPAP and said they would send me one with instructions. It came last Friday, 7/17. The ResMed AirSense 10 Autoset. There was the User Guide and a list of web sites for more info. This site was not included. I was completely lost with this new "toy" I had just received. Finally after getting it setup  and doing a lot of reading I gave it a try on Sunday night. I did not change any settings at all. I lasted about 2 hours. At one point it about blew me out of bed. Spent all of Monday on the web watching all the youtube videos I could find. Finally found this site and have been here reading ever since. I have been able to get up to 7 hours use and am comfortable using the machine.

Some things I have set differently than the defaults.
- Set the Ramp Time to "Auto"
- Set humidity level to "4"
- Selected correct mask type
- Turned EPR "on" set to "full time - 1"
- Set min pressure to "4"
- Set max pressure to "10"  was set at 20
- Downloaded "myAir" and getting results
- Downloaded Oscar but haven't gotten data into it

The last few nights have been ok. Able to get usage between 4-7 hours, events 7-15, mask seal 6-22. i am feeling comfortable using the machine and look forward to progressing with it.

The mask is still uncomfortable and my throat is very dry in the morning. I have the humidity now set to "6".
The pressure seems fine. Once I get some data into Oscar I will post it.

Do you all have any suggestions to help get through this break in period? My biggest problem now is the mask and dry throat in the morning. This has been a unique learning experience for me.

Thank you
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#2
RE: Another New User
They sent you a very good machine. It sounds as if you may have to do some trial & error in regards to finding the right mask. I can't help you with the technical stuff, but there are plenty on this forum that can / will. 

I use a hose hanger / holder with my set-up. It makes a world of difference in hose management and user comfort. I use a hose cover as well. 

My air settings are 6/12, and I'm kind of an auto-mode guy when it comes to settings, such as ramp and humidity control. 

As far as a dry mouth goes, I'm a mouth breather and a side sleeper. I use a ResMed AirFit F30 FFM, and have had good luck with it. I too, get a dry mouth at times, but it doesn't bother me. 

It'll all get easier as you continue your therapy.
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#3
RE: Another New User
Many people find less is better.  If you can use a pillows mask, they are VERY light and you hardly know you have a mask on.  There are many out there but the ones I like have the hose coming out of the top with 2 flat air tubes on each side of the face.  I am a side sleeper and I never could find another mask that would not have leaks that just drove me nuts.  The Pillow masks made it so I can sleep on my side without any problem.  Many people don't think they can wear them because the "mouth breath".  You can actually train yourself to breath from your nose only.  If not there are collar and mouth guards if you can't train yourself.  I would give it a try and see if you can use one, it makes it a lot easier. There are several youtube videos that show and review these.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed 
Cervical Collar     Dealing w DME     Chart Organizing
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#4
RE: Another New User
I don't have experience with any mask but the nasal cushion AirFit N20, over-the-nose only.  I soon found that I mouth breathe unless I somehow keep my lips from opening during sleep and allowing air to whoosh out of my mouth ("Can you say, "desert tongue?")  Unless it's patently impossible, could it be that your lips open and either let air out, or in, or both, even though they and your nose are under the one mask?  If so, more humidity, or change to another style of mask.
Serial Tapist
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#5
RE: Another New User
I’m looking forward to seeing some Oscar results. If you have your sleep study it could be very helpful for you to post a copy with personal information redacted. With your comorbid conditions we will look for potential central apnea and Cheyenne-Stokes respiration. It would be good to eliminate that anyway.

It’s good to hear you are getting more comfortable with the machine. Just a tip, set your minimum pressure equal to your current median pressure.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#6
RE: Another New User
   
(07-27-2020, 03:17 PM)Sleeprider Wrote: I’m looking forward to seeing some Oscar results. If you have your sleep study it could be very helpful for you to post a copy with personal information redacted. With your comorbid conditions we will look for potential central apnea and Cheyenne-Stokes respiration. It would be good to eliminate that anyway.

It’s good to hear you are getting more comfortable with the machine. Just a tip, set your minimum pressure equal to your current median pressure.

I am getting more comfortable and I think improving. I have included an attachment from Oscar fro you to look at. This is my first attempt so I hope it is what you need. Appreciate your help.

   
here is another attachment.
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#7
RE: Another New User
Hi Marbles, I don't know what I was expecting from your results, but I have good news and bad news, depending on how you look at it. First the good news, this is really easy to fix and for you to get great results very quickly, the only downside is you're going to need a soft cervical collar to make it happen.

Your chart shows that with settings of minimum 5.0 and maximum 8.0 with EPR 1, your pressure immediately goes to 8.0/7.0 and stays there due to flow limitations. You have very distinct clusters of obstructive apnea which is the signature of positional apnea (chin-tuck), and most of your other events consist of RERA (respiratory effort related arousals) and hypopnea, both of which are the product of flow limitation. So for starters, take a look at the positional apnea wiki http://www.apneaboard.com/wiki/index.php...onal_Apnea and the Soft Cervical Collar wiki that resulted from that http://www.apneaboard.com/wiki/index.php...cal_Collar

In addition to addressing your positional apnea, you need some different pressure settings. Let's start with minimum pressure 7.0 and maximum pressure 12.0, and set EPR on full-time to 3. The new minimum pressure will result in a starting pressure of 7.0/4.0 (IPAP/EPAP), which is probably too low, but is the minimum we can use to make your new higher EPR work properly. The higher EPR will help give your respiratory effort more support during inhale which should be comfortable, and greatly reduce flow limitation and the associated RERA and hypopnea. The maximum pressure of 12.0 will allow pressure to rise only to 12.0/8.0 and that should feel similar to what you have now, except more comfortable and effective. You can implement the new pressure range immediate and get a collar as soon as possible. Once you have the collar, and have tried these new settings, let's take another look at results. I expect them to be much better, and we can then decide if you need a bit higher minimum pressure. Good luck!
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#8
RE: Another New User
Thank you
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#9
RE: Another New User
   
   
   
Hello, I have done as you suggested and have gotten a collar and used since since Saturday. Ad justed pressure to 7/12 with EPR full-time @3. Here are the last 3 nights data. What do you think?
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#10
RE: Another New User
Wow!

What we need now, unfortunately because it means yet more effort and time on your part, are several close-up images of places where your machine says you experienced 'clear airway', obstructive, and hypopnea events.  In that second chart, please get some images of the onset of the 'Cheyne-Stokes' events.

The instruction on how to expand the timeline so that we get more discrete indicators of pressures and flow limits is in the OSCAR tab in the top marquee.

You're doing a great job of learning and complying with our instructions. In turn, we'll do our darnedest to eke out some useful observations from what you post next and see if we can't get you fine-tuned.  Please be aware, now, that it could mean some substantial re-thinking about how to treat you, all the way up to a new machine that is better suited to treating you successfully.  Hang in there...
Serial Tapist
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