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[CPAP] skot's cpap journey
#1
skot's cpap journey
Hi all

so I'm six days into my CPAP APAP journey and it's not (yet) been the life-transforming event I'd hoped it would be  Sad

I'm in the UK so was on the NHS wait list for a machine and I'm very happy to report that they sent a long a shiny new Resmed Airsense 10 with an Airfit F20 mask.
As we're still living in lockdown I've not met a sleep specialist in person so don't have a formal prescription or diagnosis - I simply received a call from a nurse saying that I had "mild sleep apnea and they would send me a machine". Nothing on paper that I can share with you, I'm afraid.

I'm a 54 year old male, not exactly slim, but then also not the heaviest I've ever been. 

I managed to get OSCAR installed tonight and downloaded my data, which confirmed that night one was horrendous, night two was bad, and subsequent nights have been upgraded to "rubbish"!

I'll detail my issues below and would be extremely grateful if anyone could provide any advice or even reassuring words. I'll also try to upload the graphs from last night via OSCAR.

The humidifier and heated tube arrived today so I'll try them for the first time tonight. I have also order an F30i mask to see if it helps some of the issues below.

  1. I suffered terrible mask leak on day one - often for ten minutes at a time, until my wife would nudge me and I would reseat it. This improved on day two, and seems less of an issue now
  2. That said, I go through phases where there is quite an audible leak through the nose / exhalation vents. When this happens during the night I will double check that it's not the mask, and it's definitely the nose vents - OSCAR confirms no large leaks so it would seem to be by design but it's odd that this is intermittent, and it does wake my wife
  3. I wake up pretty much every hour, and have done since day one. I'm thinking this is down to discomfort when moving so am hoping that the F30i, which has a top hose and is physically smaller, will help
  4. I do feel some "cold breeze" over my lips sometimes - presumable the humidifier and heated tube will help that
One major upside that I can report is that I no longer snore, which is making my wife's sleep 1,000 times better! So good news there, but I am much more tired right now with the frequent waking - hopefully you'll just put that down to getting used to the system / mask?

The graphs are from last night - any advice and also interpretation of the graphs would be most welcome - let me know if a zoomed-in section would help.

Cheers
   Scott


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#2
RE: skot's cpap journey
Welcome!  This site has a lot of very knowledgeable people who can and will help you. But your Oscar is missing a lot of info we need to see.  Please look at the link to organization of charts at the bottom of the post. 

You need to use F12 to take the screenshot and you need to leave on the left hand column. It contains the AHI, settings, event - all kinds of info needed.  Leave off the calendar and pie chart.
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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#3
RE: skot's cpap journey
Ahhh.... thanks Stacey - thought I'd got it but clearly not!

OK - retrying here. The laptop screen is quite small so it's only showing five of the graphs, however all six are in the original screenshot.

Cheers


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#4
RE: skot's cpap journey
This pretty generic and you may get other suggestions- here mine. 

4 is the lowest the machine can go and I am sure it needs to be raised. The min is your inhale pressure and most adults (same machine is used for children) need at least 8 to get enough air to not feel like you are air starved. I would set it at 8. 

EPR is exhale pressure relief. It reduces the min pressure on exhale to make it easier to exhale. I would try setting it to 3. 

So your settings
Min=8
Max=20
EPR=3

Again this is generic most people start with. Post tomorrow your Oscar and we will see how it works. I’m sure you will have other changes but this should help you sleep better tonight.
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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#5
RE: skot's cpap journey
Welcome to Apnea Board,

If you're up to editing settings, I'd consider bumping your Min pressure from 4 to 7 and change EPR to full time at level 2 in light of some Central events. Otherwise I'd say EPR 3.

The increase to 7 gives your PAP's EPR room to work. At 4, there's no more room to drop further which is what EPR does. EPR is an exhale pressure relief to increase comfort, but it is identical to bilevel with pressure support in reverse, as PS adds and EPR reduces.

Increasing EPR's active time and that pressure increase also address your flow limits. You'd not want to see the shaggy grass look, this indicates breath restriction not long enough to be labeled Apnea.

PS the edit Stacey mentioned with 8 is fine also.
And you get to clinical menu to change these, you need to click and hold the Home button and the Dial at the same time for 5 seconds.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#6
RE: skot's cpap journey
Hi *waves* another relatively recent UK PAP user. Smile

The people on here are great, and yes, the vents are designed to leak some air - it's probably where the pressure is rising that more air is leaking out, so it's more audible. That's as designed.

Otherwise, I'll leave the analysis to these wonderful folks who know far more than I do. LOL


See my comparison of Viatom/Wellue and CMS50F oximeters here.

Not a doctor, definitely not your doctor, all advice is given as-is and represents simply my own understanding as a fellow patient and OSCAR user.
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#7
RE: skot's cpap journey
Welcome Scott. Just dropping by to say the recommended range of 8-20 EPR 3 is going to give you some of that transformation you're looking for. The Airsense 10 delivers pressure very similar to a bilevel machine, and EPR is the equal of pressure support in many ways. It treats flow limitation which gives rise to the RERA and hypopnea that are prevalent in your chart. The F20 mask is not something I'm very excited about, but your leak rate looks very good and it seems to be working out well. Good luck with the new settings.
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: skot's cpap journey
(05-19-2021, 03:28 PM)ab skotl Wrote: [*]That said, I go through phases where there is quite an audible leak through the nose / exhalation vents. When this happens during the night I will double check that it's not the mask, and it's definitely the nose vents - OSCAR confirms no large leaks so it would seem to be by design but it's odd that this is intermittent, and it does wake my wife

It could be caused by small droplets of water plugging some of the exhalation ports (holes). Try running your fingers across the surface to dislodge the water droplets that are trapped in the tiny holes.

You will start to feel better as you adapt to the CPAP therapy. It's normal for a lot of us to feel worse when we begin CPAP therapy. The hose and the mask and blowing air are all unfamiliar and they interfere with our sleep, so we end up feeling even more tired than we did before we started CPAP therapy. The good news is that we humans have a spectacular ability to adapt. You will start to have at least some days where you feel better-rested, even if that feeling doesn't more than a few hours. The hose and mask and blowing air will stop bothering you. As the days, weeks, and months go by you will have more and more of those good days. You'll feel better than you have in years.

The only thing that can get in your way is you. You have to make the commitment to use your CPAP machine every time you sleep, even for naps. This is necessary because it will make you adapt faster. You'll reduce your chances of cardiovascular disease and stroke and have a better life.
Sleepster

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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#9
RE: skot's cpap journey
Hi all

what a fantastic response! Thank you very much, to everyone who has taken the time to read and respond.

I got the humidifier and heated tube yesterday and used it for the first time last night and that made the whole experience so much more comfortable.
I woke up, pretty much as usual, around 3:30am but the plus is that I slept through from 10:30pm to then so that's 5 hours, which is definitely progress!

It does seem like this is when these "central events" happen so hopefully adjusting the settings as above will start to address that. Breaking off at a slight tangent, I decided to take up welding around ten years ago and joined a welding forum - I spent the first few months being totally confused by the terminology and maths but now I can give the impression that I know what I'm talking about and help the newbies with advice. I feel the same way on here, not knowing what central events, AHI, EPR or anything else means but I'm sure I'll learn!

So...

Min pressure = 8
Max pressure = 20
EPR = 3

On it - will set these for tonight and report back on progress and OSCAR tomorrow.

Special thanks, too, to @sleepster for the reassuring words. Look forward to proving you right!
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#10
RE: skot's cpap journey
I have recently experienced early morning arousals like your 3:30 awakening. I now keep two 5mg melatonin tablets at bedside and find I can finally quiet my mind and sleep through to 7:00 or so and awaken without drowsiness. You might want to give it a try.
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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