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First few nights not looking so good?
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ImReallyTired Offline

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Posts: 32
Joined: Nov 2012

Machine: BiPap AutoSV Advanced
Mask Type: Nasal mask
Mask Make & Model: Quattro FX
Humidifier: System One Heated
CPAP Pressure: EPAP =14, PS= 3-10, BPM =Auto
CPAP Software: SleepyHead EncoreBasic

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Sex: Male
Location: Connecticut

Post: #1
First few nights not looking so good?
Hello everyone. New forum user and new CPAP user. I've been diagnosed with moderate to severe obstructive sleep apnea and got prescribed a CPAP machine. Actually what I have right now is an Auto CPAP. My second night at the sleep center, the one where they have you wear the mask so they watch throughout the night and adjust the levels, did not go so good. I finally fell asleep at around 4 am, they got me up at 5:30, so, not enough time to dial things in, hence the auto pap.

Anyway, I just installed Sleepyhead and I'm a little confused/worried about what I think I'm seeing. For example, over the 5 days I've been using the machine my AHI has gone from a low of around 16 to a high of around 28!

The pressure is also all over the place too, at times throughout the night it's all the way up 19, about to blow the mask right off my face.

I've tried both a nasal mask and a full face. With the full face mask I seem to get a lot of leaks, especially when the pressure is really high. With the nasal not so many, but the AHI is just horrible with that one. I'm thinking of trying a chin strap along with the nasal as my mouth keeps opening as soon as I fall asleep, does anyone know if that would help overall?

Sorry for the somewhat long post, I know I'm all over the place but I've been looking forward to getting my sleep apnea under control for a really really long time and now that I have the machine I'm really bummed out that it's not doing what I think it should be.

Advice? Any other numbers I can provide that would help?

Thanks
11-25-2012 10:14 AM
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trish6hundred Offline

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Posts: 6,436
Joined: May 2012

Machine: Resmed S9 AutoSet for Her
Mask Type: Full face mask
Mask Make & Model: Fisher & Paykel Simplus
Humidifier: H5i Heated Humidifier
CPAP Pressure: 10 - 7-20 Cm H2O
CPAP Software: Not using software

Other Comments: I started CPAP in 2008. Totally blind since birth.

Sex: Female
Location: Missouri, USA

Post: #2
RE: First few nights not looking so good?
Hi ImReallyTired and WELCOME! to the forum.!
I'm sorry you are having such a rough time of it right now with your CPAP therapy but I just encourage you to stick with it as it can take lots of PATIENCE. The mask is the hardest thing about the therapy.
You could try a chinstrap with your nasal mask and see if that would help you, asfull-face masks are very proned to leaks.
Hang tight for more answers to your questions and best of luck to you and don't give up.

trish6hundred
11-25-2012 11:03 AM
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jgjones1972 Offline

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Posts: 516
Joined: Nov 2012

Machine: ResMed S9 AutoSet
Mask Type: Full face mask
Mask Make & Model: ResMed Quattro FX
Humidifier: ResMed H5i
CPAP Pressure: 18 - 20
CPAP Software: ResScan SleepyHead

Other Comments: CMS50I PulseOx

Sex: Male
Location: Ohio - USA

Post: #3
RE: First few nights not looking so good?
It's only natural that your AHI will be high until you can adjust your mask and settings to the point that they are working effectively. If you get everything working right and still have high AHI then futher investigation will be warranted. I don't want to try to tell you what to try, but I can relay my experiences and maybe you can get some ideas of what to try from them.

My pressures get up close to 20 at night and I have had no luck with anything but a full face mask. I bought nasal pillows because I thought it would be more comfortable, but I couldn't keep my mouth closed at high pressure. Even with a chin strap on it just blew my lips open when it got up around 20. Until I read on this site how to set my own pressures the low was set at 5, which meant that I would get the full face mask adjusted just right before falling asleep and then would wake up with a small hovercraft on my face. To fix this problem I would put the mask on then fake snore (deep in the throat) until the pressure shot up to 18 or so, then adjust my mask (at the time I had a Resmed S9 Escape Auto without a mask fit feature). The problem was that when the pressure came back down as I was falling asleep the mask pillow would deflate and the mask would be uncomfortably tight and leak because it was too tight against my face. My solution was to use the instructions available on this site to adjust my minimum pressure up to just below the low pressure my machine registered while I was sleeping so my starting presure wouldn't be that much lower than the pressures reached while sleeping. It was a process that took several nights because I had to slowly target in to the right settings. Remember that the pressure readings are not reliable if you have leaks and you may get leaks until you get the low pressure set right...but you don't what the low pressure set any higher than what you need to prevent leaks and eliminate an unnecessary amount of build up time. I got used to the high pressure very quickly - humidification really helps get used to the high pressure.

Also keep in mind that there is a compounding effect if your face mask starts leaking as the pressures go high. The machine tries to compensate for the leaks by raising the pressure, which then causes the leak to get worse...on and on.

Best of luck to you and whatever you do, don't get frustrated and give up.
11-25-2012 11:10 AM
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Sleepster Offline
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Posts: 4,993
Joined: Feb 2012

Machine: ResMed AirCurve10 VAuto
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: HumidAir and SlimLine Hose
CPAP Pressure: MaxI 13.6 | MinE 5.2 | PS 4.4
CPAP Software: ResScan SleepyHead

Other Comments: Diagnosed Nov 2011. Conquered aerophagia.

Sex: Male
Location: Houston, Texas

Post: #4
RE: First few nights not looking so good?
(11-25-2012 10:14 AM)ImReallyTired Wrote:  I'm thinking of trying a chin strap along with the nasal as my mouth keeps opening as soon as I fall asleep, does anyone know if that would help overall?

Hello and welcome. Yes, the chinstrap is made for exactly the problem you're having. You have to get the leaks under control before your APAP will be able to adjust the pressure properly. If the chinstrap doesn't work you'll have to try a different full face mask. It's normal to have to try different masks at first until you can find one that works for you. Your insurance company and your equipment provider will make allowances for this.

Call your doctor and your equipment provider and let them know what's going on. Communication is the key to success. Above all, stick with it.

Sleepster
Apnea Board Moderator
www.ApneaBoard.com


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.
11-25-2012 01:14 PM
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ImReallyTired Offline

Preferred Members

Posts: 32
Joined: Nov 2012

Machine: BiPap AutoSV Advanced
Mask Type: Nasal mask
Mask Make & Model: Quattro FX
Humidifier: System One Heated
CPAP Pressure: EPAP =14, PS= 3-10, BPM =Auto
CPAP Software: SleepyHead EncoreBasic

Other Comments:

Sex: Male
Location: Connecticut

Post: #5
RE: First few nights not looking so good?
Thanks guys.

I've just ordered a chin strap, and I also just spent about 20 minutes readjusting my full face, so, we'll see what tonight brings.

Got my fingers crossed.
11-25-2012 07:51 PM
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archangle Offline
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Posts: 3,159
Joined: Feb 2012

Machine: ResMed S9 AutoSet
Mask Type: Nasal pillows
Mask Make & Model: ResMed Swift FX
Humidifier: ResMed S9 H5i
CPAP Pressure: 16-20
CPAP Software: ResScan SleepyHead EncoreBasic

Other Comments: Happy PAPper

Sex: Undisclosed
Location: USA

Post: #6
RE: First few nights not looking so good?
The Quattro is sometimes difficult to tame. One thing to remember is that tighter is not necessarily better. The clear flap needs to inflate to hold itself against your face.

Your pressure range probably needs to be reduced. First off, it's difficult to make the mask not leak if the pressure range is too high.

Once you find what pressure works, it's good to eliminate the pressures that are too low because you have to work your way up through the low pressure before you get the right pressure.

Also realize the APAP will not always find the "right" pressure. Sometimes, after looking at the data the machines records, you may want to set it in a narrow pressure range.

Get the free SleepyHead software here.
Useful links.
Click here for information on the main alternative to CPAP.
If it's midnight and a DME tells you it's dark outside, go and check it yourself.
11-25-2012 09:44 PM
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Ugly Offline

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Posts: 568
Joined: Oct 2012

Machine: ResMed S9 AutoSet
Mask Type: Nasal mask
Mask Make & Model: ResMed Mirage Micro
Humidifier: ResMed H5i
CPAP Pressure: 7-14
CPAP Software: ResScan SleepyHead

Other Comments: Hydrocephalus, myopia, depression, chronic ugliness, stupidity, tinnitus, mixed sleep apnea.

Sex: Male
Location: Barrie Ontario Canada

Post: #7
RE: First few nights not looking so good?
(11-25-2012 10:14 AM)ImReallyTired Wrote:  Hello everyone. New forum user and new CPAP user. I've been diagnosed with moderate to severe obstructive sleep apnea and got prescribed a CPAP machine.

Oh hey, greetings and welcome. Isn't the modern era great? When I started in 1997 I knew nothing of an online forum like this and the only way to adjust my machine was with a screwdriver. I would have had to possess an expensive tool called a manometer to get any readings. Times have changed. You're among friends.

Quote:Actually what I have right now is an Auto CPAP. My second night at the sleep center, the one where they have you wear the mask so they watch throughout the night and adjust the levels, did not go so good. I finally fell asleep at around 4 am, they got me up at 5:30, so, not enough time to dial things in, hence the auto pap.

I don't think you are meant to be made comfortable during sleep studies. I'm new to this auto CPAP stuff myself and I regard it as quite amazing. It's regularly adjusting my pressure to a level higher than the "experts" had determined. No wonder it's been hell.

Quote:Anyway, I just installed Sleepyhead and I'm a little
confused/worried about what I think I'm seeing. For example, over
the 5 days I've been using the machine my AHI has gone from a
low of around 16 to a high of around 28!

And this is an "auto" machine? During the past week and a half when I acquired my loaner and started logging my AHI was never that high but the pressure has gone, without exception, higher than they dictated it should be at.

Quote:The pressure is also all over the place too, at times throughout the night it's all the way up 19, about to blow the mask right off my face.

I hope you're keeping a log somewhere, either separately (like I have to do) or on an SD card. Somewhere, someone will listen.

Quote:Sorry for the somewhat long post, I know I'm all over the place but I've been looking forward to getting my sleep apnea under control for a really really long time and now that I have the machine I'm really bummed out that it's not doing what I think it should be.

Someone once said asking stupid questions is easier than correcting dumb mistakes.
Someone else said, there really is no such thing as a stupid question.

Obviously I'm of no help but I hope you can discuss this with some so-called "professional" so they'll listen to you.
11-25-2012 11:22 PM
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ImReallyTired Offline

Preferred Members

Posts: 32
Joined: Nov 2012

Machine: BiPap AutoSV Advanced
Mask Type: Nasal mask
Mask Make & Model: Quattro FX
Humidifier: System One Heated
CPAP Pressure: EPAP =14, PS= 3-10, BPM =Auto
CPAP Software: SleepyHead EncoreBasic

Other Comments:

Sex: Male
Location: Connecticut

Post: #8
RE: First few nights not looking so good?
Figures, another suckish night.....

I think my leaks were a little better, but still woke up 2 or 3 times with that damn mask floating over my face. AHI was 21.89. The pressures are pretty consistently over 15, sometimes 19. (machine is set at a max of 20). Can that be right? I can't imagine how anyone can have that kind of pressure and not have alot of leaking.

I'm going to call the people who came out to put the machine in today and see if they can either back down the max, or help me fit the mask, or give me some sleeping pills, or something, anything.......

Thanks for all the encouragement, it does help.
11-26-2012 06:43 AM
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Sleepster Offline
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Moderators

Posts: 4,993
Joined: Feb 2012

Machine: ResMed AirCurve10 VAuto
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: HumidAir and SlimLine Hose
CPAP Pressure: MaxI 13.6 | MinE 5.2 | PS 4.4
CPAP Software: ResScan SleepyHead

Other Comments: Diagnosed Nov 2011. Conquered aerophagia.

Sex: Male
Location: Houston, Texas

Post: #9
RE: First few nights not looking so good?
(11-25-2012 11:22 PM)Ugly Wrote:  I'm new to this auto CPAP stuff myself and I regard it as quite amazing. It's regularly adjusting my pressure to a level higher than the "experts" had determined. No wonder it's been hell.

I hope you realize that auto CPAP's do not always set themselves to the correct pressure. They usually require manual adjustments.

Sleepster
Apnea Board Moderator
www.ApneaBoard.com


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.
(This post was last modified: 11-26-2012 08:55 AM by Sleepster.)
11-26-2012 08:55 AM
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Ugly Offline

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Posts: 568
Joined: Oct 2012

Machine: ResMed S9 AutoSet
Mask Type: Nasal mask
Mask Make & Model: ResMed Mirage Micro
Humidifier: ResMed H5i
CPAP Pressure: 7-14
CPAP Software: ResScan SleepyHead

Other Comments: Hydrocephalus, myopia, depression, chronic ugliness, stupidity, tinnitus, mixed sleep apnea.

Sex: Male
Location: Barrie Ontario Canada

Post: #10
RE: First few nights not looking so good?
(11-26-2012 08:55 AM)Sleepster Wrote:  
(11-25-2012 11:22 PM)Ugly Wrote:  I'm new to this auto CPAP stuff myself and I regard it as quite amazing. It's regularly adjusting my pressure to a level higher than the "experts" had determined. No wonder it's been hell.

I hope you realize that auto CPAP's do not always set themselves to the correct pressure. They usually require manual adjustments.

Yeah. If they did then it would be like artificial intelligence and they'd cost three times as much. Still I'm taking daily notes when I wake up and will try setting the S9 Escape to an arbitrary "average" number when I have to return the borrowed S8 AutoSet. That will be December 5 . The average as of today is 10.3, a bit of a jump from the assigned 8.0 - I haven't gotten a reading that low yet. And I am not told I stop breathing much. The AI has ranged from 0.0 (only once) to 0.8 - AHI ranges from 2.3 to 5.7 over a period of 12 nights.
Because of the funky data card that the S8 requires - and I wasn't given - I have to do all this stuff manually.
11-26-2012 10:20 PM
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