Well, mom (age 83) is 14 days into her APAP therapy. She had a terrible time at first. Her GP just took the home Sleep Study (one night, no titration)company's suggestion of setting the pressure at 4 to 20.
The first night when the pressure ramped up to 16 or so, mom threw the mask across the room and went back to sleep. Can't say as I blame her. I had tried to explain everything to her but, with nightly oxygen deprivation, it wasn't getting thru to her. At this point, the APAP machine frightened her and she refused to use it. So, she skipped a night. Then, we had an appointment with her cardiologist who explained (again) that mom's CHF and AFIB were most likely CAUSED by the sleep apnea.
But, that night, she still wouldn't sleep with the APAP. I turned the pressure down to 4 to 8. She still wasn't interested. She was positive such a thing was impossible AND dangerous, even tho I had turned down the pressure. We had a big argument about it. She said, "YOU TRY SLEEPING WITH THAT DAMN MASK ON YOUR FACE!" So, I said, OK I WILL and, I did.
I was so exhausted from the events of the day and all the emotion and I slept like a baby. I LOVED it! I woke up once or twice to go to the bathroom, but put the mask back on when I got back into bed. Mom was astounded and agreed to try it for a nap.
The nap went well, so she used it that night. Since then, she has been very compliant. However, we are fighting the Big Leak Bear. We have tried all sorts of ideas that I have picked up from the forum. The only thing that worked was cutting the leg off of a pantyhose and putting it over her head and mask (cutting holes for eyes and hose and vents). That worked fabulously. But, she said it was such torture that she'd just as soon die and get it over with.
Because it was Thanksgiving, we didn't call the DME until the next Monday. He came by and tried to adjust her mask better and finally said, "I don't know why ResMed packs a standard size headgear with a SMALL mask. I'll have to order her a size small."
Geeze, I knew that the mask was small but the headgear isn't labeled, and I'm such a newbie at this, it didn't dawn on me. I thought WE were doing something wrong. So, he expects the new "small" headgear to be here this week. In the meantime, I started sewing on the current headgear. Mom is really small (about 5 feet and trying to keep 108 lbs on her). Reducing the size of the strap that goes over the head has helped considerably.
Last night she had a good night for about 6 hours, few events and no leaks. Unfortunately, she woke up at 3:00 a.m to go to the bathroom. When she put the mask back on, it leaked and the remaining hours were not too good.
In spite of all the problems, I think it is helping her tremendously. On her sleep study, her AHI was 44.8. ResScan says the last two days the AHI was around 9 to 10. AND...the lights are back on! She was so confused and out of it before. She is getting back to her usual intelligent self!
I have been slowly increasing the pressure that I had turned down to 8. I increase it by 0.2 to 0.4 about every 4 days. It's now up to 12. I can see that the OAs have decreased and, when she DOES have events, they are about half as long (on 11/27 she had a cluster of both central and obstructive events as long as 60 seconds EACH. Now, the events are no more than 26 seconds each). Also, when the pressure was 4 to 20, she had Centrals of about 10 per hour. Reducing the pressure and increasing slowly has reduced the centrals to about 4 to 5 per hour. The slow increase in pressure is not increasing the centrals and is bringing the OAs down and the hypopnea index, that was 17 on the sleep test, is down to 0.4.
Sorry for the long story.
I wanted to update everyone that helped me and thank all for this forum. It is a pearl beyond price!