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First night behind me - 2nd night update - mostly Centrals?
#1
First night behind me - 2nd night update - mostly Centrals?
Got my A10 Autoset delivered via UPS yesterday and used it last night for the first time.

I did a mask fit test, and adjusted it to not leak while lying down.
(while lying flat on my back, and perfectly still, which I later found out is not a real world scenario...)

I had read somewhere about making it looser than you think you need it to be. I think the elastic bands must have broken in some after the first hour or so, and loosened up even more. Plus I realized when your head rolls over a little, the whole mask/harness shifts pressure on the seal, and opens up leaks.

Woke up pretty much every hour:
Oh is it morning yet - no it's 12-something.
What's all the air noise - wow it's just 1-something.
Why is my heart pounding - ah just 2-something in the morning.
How is it blowing on my eyes and my neck both at the same time?
etc...

Around 4am I realized I was going to have to tighten it up. Not wanting to wake up my wife with all the Velcro on and off sounds, I took the mask with me to the bathroom and torqued it down some more. No more leaks, even when moving my head to the side. Feels a little too tight though. Not sure if there is going to be a happy medium, or just leave it as is.

Turned off the ramp this morning (for tonight). It started at 4 (machine is set for 6-12) with a 20 minute ramp. Every time I paused the machine (go to the bathroom, check/reset the seal, etc.) it started the ramp again. Then I ended up laying there for 20 minutes waiting for it to get up to 6. Figured I might as well just start right at 6 from now on.

It's weird how you can realize there's air coming from somewhere (noisy) but not be able to figure out where it's getting out. Thinking-about Pressing different points on the mask, feeling all around it for air coming out, but still not pinning it down.

At one point it felt like the seal had flopped outwards, sort of inverted from how it's supposed to be. With the machine cranking up the volume of air to compensate, I couldn't just push the seal back in because it would blow back out again, I had to take the mask off completely and start over.

Haven't run the data through Sleepyhead yet, plus with all the leaks it probably doesn't mean a lot for this first night anyway. Here's the summary data from the machine display for now:
8.1 hours
Pressure 11.9
Leak 6L/min
AHI 13.2
Total AI 11.6
Central AI 11.0

Humidifier set to auto, climateline tubing. After I got it to quit leaking I definitely wasn't feeling dry anymore, but before that I got dry mouth at least a couple of times.

One weird thing, sometimes when my mouth would open, my cheeks would balloon out, chipmunk style. I had to make a conscious effort (which kind of interferes with sleeping...) to get my mouth closed, and then to get my cheeks to squeeze back in again, making that extra air go somewhere. That kept changing how the mask was sealing too, with my cheeks swelling up and going back down.

Even with waking up multiple times, I still feel the same this morning, or maybe a little better, than without the CPAP at all.

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#2
RE: First night behind me - lotsa leaks and waking up
(03-17-2015, 09:42 AM)worn_out_in_lebanon Wrote: Got my A10 Autoset delivered via UPS yesterday and used it last night for the first time.

I did a mask fit test, and adjusted it to not leak while lying down.
(while lying flat on my back, and perfectly still, which I later found out is not a real world scenario...)

I had read somewhere about making it looser than you think you need it to be. I think the elastic bands must have broken in some after the first hour or so, and loosened up even more. Plus I realized when your head rolls over a little, the whole mask/harness shifts pressure on the seal, and opens up leaks.

Woke up pretty much every hour:
Oh is it morning yet - no it's 12-something.
What's all the air noise - wow it's just 1-something.
Why is my heart pounding - ah just 2-something in the morning.
How is it blowing on my eyes and my neck both at the same time?
etc...

Around 4am I realized I was going to have to tighten it up. Not wanting to wake up my wife with all the Velcro on and off sounds, I took the mask with me to the bathroom and torqued it down some more. No more leaks, even when moving my head to the side. Feels a little too tight though. Not sure if there is going to be a happy medium, or just leave it as is.

Turned off the ramp this morning (for tonight). It started at 4 (machine is set for 6-12) with a 20 minute ramp. Every time I paused the machine (go to the bathroom, check/reset the seal, etc.) it started the ramp again. Then I ended up laying there for 20 minutes waiting for it to get up to 6. Figured I might as well just start right at 6 from now on.

It's weird how you can realize there's air coming from somewhere (noisy) but not be able to figure out where it's getting out. Thinking-about Pressing different points on the mask, feeling all around it for air coming out, but still not pinning it down.

At one point it felt like the seal had flopped outwards, sort of inverted from how it's supposed to be. With the machine cranking up the volume of air to compensate, I couldn't just push the seal back in because it would blow back out again, I had to take the mask off completely and start over.

Haven't run the data through Sleepyhead yet, plus with all the leaks it probably doesn't mean a lot for this first night anyway. Here's the summary data from the machine display for now:
8.1 hours
Pressure 11.9
Leak 6L/min
AHI 13.2
Total AI 11.6
Central AI 11.0

Humidifier set to auto, climateline tubing. After I got it to quit leaking I definitely wasn't feeling dry anymore, but before that I got dry mouth at least a couple of times.

One weird thing, sometimes when my mouth would open, my cheeks would balloon out, chipmunk style. I had to make a conscious effort (which kind of interferes with sleeping...) to get my mouth closed, and then to get my cheeks to squeeze back in again, making that extra air go somewhere. That kept changing how the mask was sealing too, with my cheeks swelling up and going back down.

Even with waking up multiple times, I still feel the same this morning, or maybe a little better, than without the CPAP at all.

I think the first couple of nights are difficult because it takes some adjustment to sleeping with something on our faces and having air forced onto us. What helped me was to turn the ramp feature off (with it on I felt I was not getting enough air) and turned EPR to 1 and then eventually to 2 so that I did not feel like I was breathing against pressure on exhale. Before using EPR, my cheeks would puff out and the pressure would open my mouth and woke me up. I am pretty new to the forum, but this is so far what has worked for me. Good luck to you!
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#3
RE: First night behind me - lotsa leaks and waking up
That's a good point about EPR. I may try that and see what happens.
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#4
RE: First night behind me - lotsa leaks and waking up
Sleep study results (available just now). This was from a 3 night in-home study:

Sleep time 350 minutes
Avg apnea 26 seconds
Avg hypopnea 24 seconds
RDI(AHI) 4%: 21.4
RDI(AHI): 38.6
Apnea max density 67.69
RDI(AHI) max density 73.85

11 centrals

Snoring index: 96.1

Lowest o2: 83%
102 desats

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#5
RE: First night behind me - lotsa leaks and waking up
One little hint for seal blowout correction. You did not say that you tried this but with some masks, when one gets a leak, one can revert the seal by pulling the whole mask slightly off your face and letting the air inflate the seal as you move it back against your face. Give it a try. You may not need to take the whole mask off.

One of the things that I needed to do while using my full face mask to prevent dry mouth is to seal my mouth off with my tongue. This is something that one must be able to do well in order to use nasal masks or nasal pillows. One needs to be able to do it but not as well to prevent dry mouth with many full face masks.

The way it works is to put the tongue against the roof of your mouth. Some say the tongue should be right behind your front teeth. Some say it should be further back. Whatever works best for you. Try sucking with your mouth open and stopping off that suction with your tongue. That is what you want only in reverse.

I practice this and keeping my mouth closed (my jaw tends to drop a little when I am relaxed in bed) at least every night in the time between going to bed and falling asleep. I have been able to make it work well enough to, in conjunction with humidification, avoid dry mouth although I can not do it well enough to use nasal pillows or mask.

Best Regards,

PaytonA

Admin Note:
PaytonA passed away in September 2017
Click HERE to read his Memorial Thread

~ Rest in Peace ~
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#6
RE: First night behind me - lotsa leaks and waking up
Thanks for those tips!

I've been practicing the tongue work some already. I wear an upper and lower dental retainer too. The bottom one is a C shape, and the top one is a model of the front half of the roof of my mouth. All that stuff in there at the same time as my tongue complicates it a little.

I'm also continuing to work on keeping my lower jaw pushed forward at the same time. When it gets pushed back I can feel the airway closing even while sitting. I can almost close it all the way off during the day just by pulling my jaw back as far as it will go.

It's a lot of stuff to be concentrating on when I'm supposed to be sleeping. :-)
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#7
RE: First night behind me - lotsa leaks and waking up
Sounds like a pretty typical first night. Worry not, it gets better! Good luck with your new machine!
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#8
RE: First night behind me - lotsa leaks and waking up
You might find the article Taming the Mirage Quattro Mask useful: https://maskarrayed.wordpress.com/taming...e-quattro/

I think the first night of use is often disrupted sleep until you get things sorted out. It gets better. Don't overthink the jaw position stuff. If you ever get to where you can avoid mouth breathing, the nasal masks and pillows are sure a lot nicer.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

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#9
RE: First night behind me - lotsa leaks and waking up
Hi worn_out_in_lebanon,
I know CPAP therapy can take some getting used to but, just hang in there, it will get better.
Good luck with your new mask and machine.
trish6hundred
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#10
RE: First night behind me - lotsa leaks and waking up
Thanks everyone. I've learned a ton on here over the past couple of months.

Sleepyhead told me something tonight, about my data last night, that I had heard of, but never really paid attention to before.

Right before one of my wake-ups last night, I was in Cheyne Stokes respiration for a little over 22 minutes.
Will be interesting to see if that continues.
AHI ramped up from nearly nothing to 40 in the hour leading up to it.

Clear airway - 89 events.

90% pressure 11.88

And a bunch of other stuff that doesn't make any sense to me just yet...


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