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First Night of CPAP Therapy - Oscar Help?
#11
RE: First Night of CPAP Therapy - Oscar Help?
Good afternoon! Results have been about the same but I have ordered some new supplies. Ordered the coreflex cervical collar over the weekend but has an ETDD of Oct 18-22. Size Medium F20 is out for delivery today, and I also ordered him a couple more masks to try out (Amara View and the Resmed P30i). He def opens his mouth at night but we figured we might as well try a nasal mask since he's getting the collar anyway. And got some xylitol tablets for dry mouth which is a big pain point for him. His AHI past couple days are in the 2.5-3.5 range, always starts off with minimal leaking that become large leaks throughout the night. Will post OSCAR with Medium F20 tomorrow.

I did have a two questions in the meantime - Though he was off to a good start at 6.5 hrs of wear his first night, he has not been able to get more than 5-7 hrs (closer to 5) since then before taking the mask off. If he is still tired, can he sleep a couple of hours without the CPAP or is that potentially deadly for him?
As his sleep test showed low oxygen (lowest was 51%, 20.5 min. @ <70%, 62.3 min. @ <80%) and when his AHI was 92.

He was struggling with this for a few years now, do we need to be concerned about any permanent damage that might show up in the future? He's still trying to make lifestyle changes but it's a slow process.
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#12
RE: First Night of CPAP Therapy - Oscar Help?
Edit; it was a WatchPAT test so it was a finger oximeter.
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#13
RE: First Night of CPAP Therapy - Oscar Help?
I have an update with cervical collar and new masks which were finally delivered yesterday. First off, I ordered the Coreflex collar and ordered the wrong size which he wore last night but was super uncomfortable. I ordered the shorter size and it will probably take another week to arrive. 

With the F20 w/o collar his AHI was about 2.5-3.5 per night (after the correct size mask arrived), and last night wearing the collar & P30i mask he had his lowest AHI yet at 1.31, additionally his average pressures decreased by a lot. I had to increase the min pressure originally as he was choking during the ramp while we were waiting for the collar but looking at the chart from last night I should probably decrease the min to 6 again? F20 and P30i charts both attached. 

Some issues with the masks we've tried:
Airtouch F20 - finally stopped leaking but have to wear the straps more tight than is comfortable. Loosening them cause more leaking. He also finds it hard to sleep on sides. 
Amara View - he hated this when tried on, the two parts surrounding the nose piece dig into his face. Refused to wear overnight and we couldn't get a good seal anyway. 
P30i - most comfortable so far, however this morning he said his nasal passages were incredibly painful like when you have to blow your nose a lot when you have a cold. Humidity and heat set to max already on the machine. Any advice on alleviating this? This is the best mask he's tried. His snoring was also the best so far.

P30i chart w/ cervical collar is the one with 1.31 AHI.
F20 chart w/o cervical collar is the one with 2.36 AHI.


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#14
RE: First Night of CPAP Therapy - Oscar Help?
Hi sg131,
Some have posted that they switch back and forth among masks as needed.  If the F20 is uncomfortable, you might try the Fisher&Paykel Simplus.  I've used this mask successfully for several years, and it doesn't need to be particularly tight to get a good seal.  I also use Remzzz mask liners with it to help keep the silicon off my skin, and diffuse any small leaks, particularly around my eyes. 

On the sore nostrils, I seem to remember others posting they used some cream like Lansinoh.  I've never used it, so not sure if I have the name right.

Good luck with the issues, and don't give up.  The solutions are out there waiting to be found.  It is important to commit to not sleeping at all without the mask - until you do, the process of acclimating is only delayed.
A.Becker
PAPing in NE Ohio, with a pack of Cairn terriers
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#15
RE: First Night of CPAP Therapy - Oscar Help?
(10-20-2020, 10:08 PM)becker44a Wrote: Hi sg131,
Some have posted that they switch back and forth among masks as needed.  If the F20 is uncomfortable, you might try the Fisher&Paykel Simplus.  I've used this mask successfully for several years, and it doesn't need to be particularly tight to get a good seal.  I also use Remzzz mask liners with it to help keep the silicon off my skin, and diffuse any small leaks, particularly around my eyes. 

On the sore nostrils, I seem to remember others posting they used some cream like Lansinoh.  I've never used it, so not sure if I have the name right.

Good luck with the issues, and don't give up.  The solutions are out there waiting to be found.  It is important to commit to not sleeping at all without the mask - until you do, the process of acclimating is only delayed.

Hey thanks for this advice! I will check both those masks out and the cream you mentioned. I think I have seen that cream before but I'm not sure if it's his nostrils that are hurting or the air passage where we can't reach. He is generally good with the mask but wakes up at 7 AM sometimes and takes it off due to discomfort, and stays up, which means he only gets about 5 hours of sleep those days. Yesterday I put the medium P30i instead of the large P30i and he said it was "marginally" less dry; when I checked the leakage rate it was improved so I think that helped a bit.
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#16
RE: First Night of CPAP Therapy - Oscar Help?
Here's the new OSCAR chart from last night. He used the P30i nasal pillows and cervical collar. I am a bit confused because his AHI is much higher than the night before, and he got clusters of apneas even though he wore the collar all night. The collar is stiff and I am positive it was holding his chin up. 

I decreased the pressure down to the original settings when he first started - min EPAP 6, max IPAP 25.  It's also showing two central events and he did not have any central events during his sleep test. Even though I set the pressure lower than the previous night (min 6 instead of min 8), his average pressures used were higher than when he had the min EPAP of 8.

Is this AHI fluctuation a normal part of treatment? Or should I adjust the pressures back up. Any guidance is appreciated  Smile


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