This is my first post (even though I have been lurking for some time) so please be gentle. I should apologise up front for my lack of brevity in this posting, but I need to get my story across. Now, where do I start?
I have been using CPAP for about 3 months now with very mixed results. My unaided overall AHI was 32.8 while in supine 67.6. Later my titration night indicated a pressure of 8 cm. Overall the diagnosis was “severe obstructive sleep apnoea with mild hypoxaemia”.
Since I am a mouth breather I elected to buy a Full Face mask (Resmed F10) even though the titration was done using a Nasal Pillow. The other reason for choosing a FF mask was that my nose was quite sore after the night with the NP. I also purchased a PR Remstar Pro C-Flex+ with the Humidifier (a constant pressure machine).
My provider set up the machine to the recommended 8 cm and off I went expecting ‘perfect’ results. That was the 9 March and a resulting AHI of 12.3, well sort of ok for a first night I thought, it can only get better. But the following night AHI was 33.2 and for the next four weeks or so varied between 20 and 30, not good I thought. So I upped the pressure to 9 cm and for the next week my AHIs hovered between 11 and 20. I’m on to something here I though so again I upped the pressure to 10 cm but little changed.
After telling my equipment supplier about all of this I received a friendly ‘rap over the knuckles’ for changing the pressure without reference to anyone. They then advised me to up the pressure to 12 cm which brought the AHI to between 6 and 12.
My equipment supplier then suggested I should try an auto machine to see if we could ascertain the right pressure. The PR Auto machine was setup for 6-16 cm but I soon found that the FF mask leaked uncontrollably at the higher pressures. On advice I reduced the pressure to 4-14 cm, but the leaking remained. During this time my AHIs were all over the place from 5 to 25.
I have had a feeling about the FF mask for some time so I asked my equipment supplier if I could borrow a Resmed P10. Having also noticed the friendly banter between P10 users and Pilairo users on this board I asked if I could also try a Pilairo. As happens they didn’t have a P10 available but its predecessor, but they did have a Pilairo. They were kind enough to loan me both NPs.
So last night I tried out the Pilairo with the pressure at 12 cm. I couldn’t believe it this morning when after about 8 hours sleep I looked at the screen to see an AHI of 1.6. Checking with SleepyHead there was only one obstructive event for the whole evening. I am sure however that this low AHI is a result of my mouth breathing. So now at long last to my questions.
1) At one stage I awoke with a very dry mouth, this seems to indicate to me that I was mouth breathing during the night. I notice with SleepyHead that the Flow Rate for about 10 minutes prior to waking is quite asymmetrical unlike the ‘normal’ roughly symmetrical wave shape. Is this an indication of mouth breathing?
2) I have been given a chin strap to help with mouth breathing but it seems to be somewhat elastic so how tight should that strap be?
3) I am experiencing a lot of difference between using a FF mask and a NP and the transition is quite difficult particularly the placement of the tongue - move the back of my tongue and the air flows out of my mouth regardless of the chin strap. I guess this is normal?
4) I woke this morning with one of my nostrils sore from the NP even though I used a moisturiser before putting the mask on. Will this nasal aggravation reduce over time as I become used to the device?
Well that’s about all the questions for now, all help appreciated with thanks.