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Need some help/advice - here's my symptoms and machine settings
#11
RE: Need some help/advice - here's my symptoms and machine settings
The local place I'm using that has my prescription and using my insurance says they will allow me to swap all types of masks for free for 30 days. I started with the F20, used it for 2 nights,  and it left a really bad mark at the top of my nose that a week later is now finally almost gone. The hose in my face was annoying but I could probably get used to it.  The mark it left was the main deal breaker.  I called them and they swapped the f20 and it's 2 replacement cushions for the F30i and 2 replacement cushions that goes with it and it didn't cost me anything additional. I think I can keep swapping if I want to until I find something. I did have to pay ridiculous IMO prices for them. Just the cushions was like $100 because my insurance is covering nothing other than applying it to my deductible so I spent around $500 for the machine, 2 cushions, mask and headgear, hose humidifier etc. Then have $38 or something payments for 9 more payments. I think I'm forced to do a 10 month thing to verify that im using it etc, supposedly that's common.

Just stressful for me because I'm sleeping the exact same way I was before I even did the machine and just don't want to be throwing the money away if it isn't helping.

I am considering trying a different mask. The Dreamwear full face for example has replacement cushions for $12 on Amazon and supposedly if I'm supposed to replace the cushions every month $100 is a lot to fork up.  Thought about seeing if it would seal better and then I know cushions are cheap. Could buy 10 for what one of the f30i's would cost

I guess it's just about trying to find the best mask for me at this point.  Do you have any other full face recommendations.
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#12
RE: Need some help/advice - here's my symptoms and machine settings
Here is my chart from last night.

I pretty much slept terrible last night. Toss and turned most of the night...prior to cpap it was typical that I would periodically have those nights. After I put the mask on I spent a bit readjusting again and it seems like the pressure leak looks a lot better. Didn't notice any leaking.

The Clear Airway's jumped up again even with the EPR off. As far as the EPR setting, it feels the same as it did as far as my breathing before or after turning it on....so at this point it doesn't matter too much rather I have the setting on or off as far as my actual sleep. I notice the Clear Airway's jump up at the end of my sleep. I will say around that 5 am time is when I know I was tossing and turning a lot as well.

Any thoughts on the chart today? Thanks


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#13
RE: Need some help/advice - here's my symptoms and machine settings
As far as stats, the CA moved up a bit but are in an acceptable number range. CA have this trait we call consistently inconsistent meaning they're variable per night.

How did you feel, rested or not? I'm wanting to have you build a trend, so we can see what the CA do over a period of several days. It's not highly detailed, in the trend making, just a notation of they've gone up to x and down to x.

As for leaks, if they go worse than this, they'll negatively impact therapy. How about looking up the Fisher & Paykel Vitera full face? It's light enough despite the forehead bar. It doesn't touch if adjusted correctly. It has one quirk, it must sit lower on your face than ResMed's. But you gain very light strap adjustment with no leaks. The vent is a bit robust and some will call it a bit noisy.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#14
RE: Need some help/advice - here's my symptoms and machine settings
Keep trying masks! The contours of people's faces are so different, what works for one person may not work for another. When you try a new mask, take a look at a couple of mask-fitting videos to make sure you're doing your best at adjusting it. But as you note, those leak stats are better and are not bad -- again if you're pretty sure leaks are not waking you up.

Sleep patterns will vary from one night to another on PAP, same as without it, so you'll have better nights and worse nights. This chart looks pretty good to me. Those CAs toward the end of the night may well be coming after some arousal breathing, given your report of choppy sleep. The arousal breathing is deeper; that washes out more CO2; that reduces the "breathe now" messages going to your brain; and you pause your breath. The real problem isn't the CAs so much as the arousals.

Do have patience; this *will* get better. Your (frustrating) experience is the most common kind there is, but if you stick with it, you'll find yourself sleeping better and feeling more rested. The improvement may not be dramatic, from one night to the next, but there will come a point when you think back and realize things are going a lot better for you.

Keep us posted, would you?
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#15
RE: Need some help/advice - here's my symptoms and machine settings
Good morning,

Here's my chart from last night. It's basically more of the same as far as those Clear Airway Events. I tried bumping pressure up to 7 with the thought that if it pumped more air through that it would stop the clear airway deal. Looks like pressures remained 7-9 throughout the night. Guess I could try bumping it up to 10 one night and seeing what happens.

Definitely getting frustrating. I've also noticed that my left eye has felt dry for a bit and that sort of coincides with when I switched to this F30i. As I was feeling this morning I think the air blowing out the front holes may be reflecting from the pillow back into my eye area or perhaps a leak around where my nose is blowing up there. Otherwise it's definitely a comfortable mask and doable but just worried about that and leaks and I know with you recommending I switch masks I feel like I should try another.

I think I'm going to call my cpap supply people today and switch the mask up. I'm really nervous about the F&P Vitera because the Resmed F20 was such a disaster with the marks on the bridge of my nose. The only other thought is at least while I was awake and coherent which it felt like I tossed and turned from around 3 am until 6:30 am last night, it does feel like I am breathing through my nose always. While I'm sleeping it could be a different story. Maybe I try a nose one?

As far as last night, it felt like one of the worst nights of sleep which is disappointing because the previous night was also not good so I was extra tired even last night. Was hopeful I would of slept better. Guess I need to mix it up and try a different mask. Chart wise, its just the Clear Airway ones that really look problematic.


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#16
RE: Need some help/advice - here's my symptoms and machine settings
Different anatomy features is one of the reasons for all the different masks available.   Your reluctance to try the F&P is like saying that since you had a bad experience with a Chevy, you are nervous about trying a Ford.   Because of the Vitera's adaptability or forgiveness, I would say you have a better than 50-50 chance of it working for you.  Many members here have found the F&P to be more effective than the F20 as well.  If you are having to spend your own money, then this will be another plus as well.  The F&P masks are less expensive than the Resmed's.

Good luck!
Crimson Nape
Apnea Board Moderator
www.ApneaBoard.com
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Useful Links -or- When All Else Fails:
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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.
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#17
RE: Need some help/advice - here's my symptoms and machine settings
It appears that you turned on the EPR again?  Your centrals are much higher.  I believe you need to keep EPR off if it is on again.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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#18
RE: Need some help/advice - here's my symptoms and machine settings
Raising your minimum pressure won't help with the CAs. It's OK to leave it at 7, but don't raise it again. And do turn off the EPR again.

Your leaks really aren't bad at all. (Notice that the scale here only goes up to 11; on your previous chart it went up to 20.) The dry eye is worth dealing with, though, if you can. In general, I do think it's smart to go ahead and experiment to find the very most comfortable mask for your unique face.

As Dave notes, CAs are going to vary from night to night. I'll have .2 CA index one night and 1.2 the next. Go figure.

And the CAs in all likelihood are just a reflection of restless sleep, with a number of arousals. Have patience; the more comfortable you get with the new experience, the fewer arousals you'll experience.

You might try setting your machine up outside your bedroom during the day or evening and using it with your mask while you watch TV or read. This might help you adapt faster to the whole business.
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#19
RE: Need some help/advice - here's my symptoms and machine settings
I called my cpap people and tomorrow I'm going to go for the size fitting to try out the F&P Vitera. Hopefully I will have better success with that.

I did turn the EPR on last night to see if it would go back up because the previous night (with it still off) I slept bad and had 10 CA events even with the settings off. That obviously didn't work out well for me because I had 18 this morning so I already have it turned back off and will leave it off for the foreseeable future....dumb decision on my part.

I guess going forward, I will suffer through the mask again tonight (they couldn't get me in today), and then tomorrow I will swap for the F&P Vitera and go from there.

As far as rest of settings, you think we're good to leave pressure around the 7-20 range and no EPR?

Thanks. I'll plan to report back after my first night with the Vitera.
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#20
RE: Need some help/advice - here's my symptoms and machine settings
I also had one pricing question. You guys know a lot better than me. I'm going to attach my invoice for all my equipment. Does this invoice seem reasonable?

On the machine, my understanding was it has to be a Rental and I pay X amount per month for 10 total months and then I own it. $40ish x 10 is $400 so that seems reasonable enough considering I'm seeing $900-1000 online for the machine. Of course the Airsense 11 just came out and I barely missed out on that and got the 10....but no big deal there.

Where I feel like the high payments are is I paid $53.95 for the tube (~$10 on amazon), and what I gather a total of $258 for the mask and 2 more cushions....and then $166 for the humidifer that I thought came with the dang machine itself. I paid a total up front cost of $539 and they told me that would apply to my deductible. I have a middle of the road insurance plan with a $1250 deductible for myself and more for the whole family. I pretty much hadn't been to the Dr. in 5 years so I never see myself meeting that deductible. Had I met my deductible I would of just paid 20% of that or the $134.91.

I guess my question is 1 is this a reasonable insurance price and 2 going forward once I find the mask I actually want (hoping its that Vietra) I do see cushions are only $15 or so on Amazon vs $71 I would have to pay through insurance. They told me regardless of brand of mask I got, if its full face the insurance dictates that exact price. Just wanted to see what you guys thought. I will say so far my insurance hasn't processed the claim so its possible I get reimbursed for some of this but this is what the company was thinking price wise and what I had to pay the day I picked it up.

Does anything look off/weird with this invoice?


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