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[CPAP] First week and some questions
#1
Hi all. What a great resource. I was recently diagnosed as moderate and have been hooked up for a week as of last night. Surprisingly I haven't had that hard of a time dealing with the machine and mask.

I have a few questions after reading around in the forum for the last week. I use nasal pillows and have noticed a couple times that my mouth is open. When I looked at my sleepyhead results for the last week I have several large leakage times over the "redline" of anywhere from 0.3% to 11%. However, it seems the mask pressure was constant at 7 during those. I'm sure this is mouth leakage. My question is should I be concerned about this or does it need to get much higher in percent to start trying a chin strap? Is the machine compensating for this leak by raising pressure? Would that explain why the mask pressure is constant through it or am I not understanding this correctly. Of course, my resmed MyAir scores have all been 96 to 100. Some have shown leakage, but not more than 10 ml/hr.

Second. I've read a lot on the forum about people having their machine set to a range of pressure or Auto. Mine seems to be set to constant 7 with a minumum of 4.4. Does it matter that I'm set to constant since I'm below the 5 AHI threshold each night or is this a breaking-in period that may change when I see my cardiologist and respiration therapist in 6 weeks?

I've attached a screenshot of the worst night I had for leakage.


Attached Files Thumbnail(s)
   
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#2
First, welcome.
MyAir's leak and SleepyHead's leaks cannot be compared. I would get a chin strap. And, you can train yourself to not breath through your mouth over time.

Be patient and things get better and easier over time.
CPAP is a journey like “The Wizard of Oz”. It’s a long slow journey. You will face many problems and pick up many friends along the way. Just because you reach the poppies, it doesn’t mean you are in Kansas. 
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#3
Nice start. I agree the leaks on that graph are air escaping from your mouth. This could go away on its own, or a chin strap lightly applied might help.

With regard to using auto mode, when I look at your very well presented chart (good job), I see your events are predominately hypopnea that correlate with periods of higher flow limitation. This suggests minor residual obstruction that the auto mode would be ideal to deal with. If you want to try it, I'd keep minimum pressure at 7 to keep the doctor happy, and limit max pressure to 10. You will know pretty quickly if it is an improvement or not. You are also not using EPR, and I think that is fine for now, but eventually some pressure relief on exhale might be more comfortable. I would only change one thing at at time, so if you want to try auto mode, do that first before starting EPR experiments.
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#4
Thanks for your reply Rc. I thought I saw somewhere in this forum a link to a member's instructions somewhere (maybe another thread) on how to train yourself to keep your mouth shut. I searched and can't seem to find it. You wouldn't know where that was would you? It had something to do with putting your tongue between your molars in your top palette. I think.
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#5
Tongue Suck Technique for prevention of mouth breathing:
Place your tongue behind your front teeth on the roof of your mouth
let your tongue fill the space between the upper molars
gently suck to form a light vacuum
Practising during the day can help you to keep it at night


I copied this from DariaVaders signature.
CPAP is a journey like “The Wizard of Oz”. It’s a long slow journey. You will face many problems and pick up many friends along the way. Just because you reach the poppies, it doesn’t mean you are in Kansas. 
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#6
Thank you for the reply sleeprider. I do read instuctions well usually, so it was nice to hear I had the correct information on the attachment. I tried to use imgur but I guess I did something wrong as it wouldn't let me post the link to the png.

I guess I will talk with my respiration therapist to make sure that if I make changes it doesn't upset them. Her and my cardiologist seem to know what they are doing, but it is nice to learn more in forums like this.
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#7
Your RT is unable to advise you to do anything not on your prescription, or to alter the machine settings. The doctor would need to revise his prescription to include a pressure range, and he will not likely do that before your first follow-up. Your current results are more than acceptable, and using a range, might clean-up the few hypopnea that are giving you the AHI. Your doctor might consent to using auto-mode from 7-10, or not. Once you have completed the initial period of CPAP compliance, you might feel freer to try some alternate modes. You should still be able to access EPR on the patient menu, and that would not require a doctor's prescription as these are patient comfort settings. In some cases, EPR is locked out in the provider menu.
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#8
Hi cedrorum,
WELCOME! to the forum.!
Sounds like you are off to a good start.
I wish you good luck with your CPAP therapy, hang in there for more responses to your post.
trish6hundred
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