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How am I doing?
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tunibell Offline

New Members

Posts: 1
Joined: Apr 2014

Machine: System One RemStar Auto with A-Flex (560P)
Mask Type: Full face mask
Mask Make & Model: ResMed Quattro Air
Humidifier: Unsure
CPAP Pressure: 10-13
CPAP Software: SleepyHead

Other Comments:

Sex: Female
Location:

Post: #1
How am I doing?
I was diagnosed with OSA in January with an AHI of 13.4. During my titration study (easily one of the worst night sleeps of my life), it was estimated that my pressure would need to be set at 15-17.

I received my CPAP machine (System One RemStar Auto with A-Flex (560P)) on Friday. I initially went with a nasal mask, but two days ago switched to a full-face mask since I was opening my mouth at night and constantly breaking the seal.

My first few nights with the full-face mask have been characterized by very painful gas. I spoke with my doctor yesterday, who advised that I change the pressure settings to 13-15. Since I was suspicious of the initial high setting, I went ahead and changed it to 10-13.

Here's last night's data:
AHI: .36
Hypopnea: .24
Clear airway: .12
Flow limit: .97
Leak Rate: W-Avg of 1.57
Total Leak Rate: W-Avg of 34.16

I still woke up this morning with a bloated belly and gas, but at least I didn't wake up in the middle of the night because of it!

Because my AHI is so low, could I conceivably lower the pressure even farther?
04-03-2014 11:27 AM
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retired_guy Offline

Preferred Members-2

Posts: 2,744
Joined: Jan 2014

Machine: ResMed S9 Autoset
Mask Type: Nasal pillows
Mask Make & Model: Resmed Airfit P10
Humidifier: ResMed
CPAP Pressure: 10.6/14, EPR 3
CPAP Software: ResScan SleepyHead

Other Comments: Is it bedtime yet?

Sex: Male
Location: Beautiful, albeit very wet Oregon Coast

Post: #2
RE: How am I doing?
You shouldn't drop your pressure all that much for awhile. You dropped it from a minimum of 15 to 10 already. Now, you will want to give it awhile so your body can stabilize to the new settings. As far as the bloated belly is concerned, you're probably swallowing too much air in the night. So the key to that is to do more breathing through your nose and less through the mouth. A chinstrap might solve the issue for you whether you go back to the nasal mask, or continue with the full-face mask. A suggestion that was made to me once was to get one of those sweat bands that people wear when they go running around in circles and try that as a chinstrap. I haven't done it, but it sounds like a good idea. Certainly better than running around in circles.
04-03-2014 11:44 AM
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trish6hundred Offline

Advisory Members

Posts: 6,430
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: #3
RE: How am I doing?
Hi tunibell,
WELCOME! to the forum.!
CPAP therapy can take some time to get use to but it does get better. There is a thread here on this board called "Aerophagia," (swallowing air,)that has some helpful information in it, you might want to take a look at it..
Hang in there for more suggestions and best of luck to you with your CPAP therapy.

trish6hundred
04-03-2014 12:29 PM
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herbm Offline

Preferred Members-2

Posts: 852
Joined: Jan 2014

Machine: ResMed AutoSet S9
Mask Type: Oral
Mask Make & Model: ResMed Airfit P10 Nasal Pillow
Humidifier: ResMed H5i
CPAP Pressure: 11-16
CPAP Software: ResScan SleepyHead

Other Comments: Backup Mask: Innomed Hybrid FFM -- Oral+Nasal Pillows

Sex: Male
Location: Austin, TX

Post: #4
RE: How am I doing?
The swallowing air part "retired_guy" said:

When our cheeks fill up with air we have a strong tendency to SWALLOW. Swallowing is a very complex chain of events that initiates move whatever is in our mouths into our esophagus and thus to our stomach (see Wikipedia for a surprisingly involved description.)

If your mouth can stay closed, and you can breath through your nose then you can use a nasal pillow mask.

Even if you have to use a strap, this is likely FAR LESS intrusive than a mask that covers your nose and mouth and the straps that go with those.



AND YOU ARE DOING GREAT, except for the gas bloating which you will figure out how to deal with.

Sweet Dreams,

HerbM
Sleep study AHI: 49 RDI: 60 -- APAP 10-11 w/AHI: 1.5 avg for 7-days (up due likely to hip replacement recovery)

"We can all breathe together or we will all suffocate alone."
(This post was last modified: 04-03-2014 03:48 PM by herbm.)
04-03-2014 03:47 PM
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Tez62 Offline

Monitors

Posts: 837
Joined: Feb 2013

Machine: Resmed S9 Autoset
Mask Type: Full face mask
Mask Make & Model: Resmed Mirage Quattro
Humidifier: Resmed
CPAP Pressure: 5-15
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Melbourne, Australia

Post: #5
RE: How am I doing?
tunibell, welcome, your AHI at your sleep study was low and you have mild sleep apnea, severities are measured 0-5 normal, 5-15 mild, 15-30 moderate and 30+ severe. Your original pressure does seem high, I would query why your doctor set it so high at the start, there may be some reason. With an auto CPAP where you can set a low and high pressure, your pressures don't need to be so close. My sleep specialist suggest a difference of around 10. You really should also start close to the minimum pressure setting available on your CPAP which is 4. Without knowing why your doctor set it so high my suggestion would be around 4-14 and leave it for a few weeks to see how it goes. You need to download free software from here called Sleepyhead to monitor your data. We can help you with that if you need help. Remember this is just our advice from afar and would speak to your doctor before you change it again.
On the mask, if you are comfortable with the full face mask, stick with it, it takes time for our bodies to adjust and sucking in air which causes the bloating is one of the adjustments that takes time.
Hope this helps and good luck and please ask any questions.
04-03-2014 03:53 PM
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JimZZZ Offline

Advisory Members

Posts: 370
Joined: Dec 2013

Machine: ResMed S9 AutoSet
Mask Type: Full face mask
Mask Make & Model: Fisher & Paykel Simplus
Humidifier: ResMed H5i (not using)
CPAP Pressure: 9 - 14
CPAP Software: ResScan SleepyHead

Other Comments: CareFusion PureSom Ultra Chinstrap

Sex: Male
Location: Western North Carolina

Post: #6
RE: How am I doing?
(04-03-2014 03:53 PM)Tez62 Wrote:  With an auto CPAP where you can set a low and high pressure, your pressures don't need to be so close.
Like Tez62, I would question the narrow range between the max and min pressures prescribed. IMHO, an autoset device will give you more information if you set a wider range and then observe the resulting average and 95% pressures over a few weeks. After all, the purpose of autoset is to determine what pressure is needed. After it is apparent that a given pressure is needed, you can begin to narrow the range to eliminate disturbing pressure changes and aerophagia.

I only have four month's experience so am still in the process of using the method I have described. I would welcome any opposing opinions or corrections to my idea.
04-04-2014 05:53 AM
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