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Hello to all,

I have been diagnosed with a moderate case of sleep apnea 3 years ago (AHI was 15 at initial study), and have started my treatment at that time. Prescribed pressure was 9 cm H2O.

I purchased a ResMed S9 Elite unit and ResMed P10 nose pillows. Also a heated hose. After struggling with it for about a month (just couldn't get used to it), I simply gave up and placed my equipment in a closet.

3 years later, after experiencing some real poor sleep quality lately (tired all the time, waking up numerous times throughout the night), I decided to go for another sleep study. I've done the first study (without the CPAP), which I believe was a success (about 4-5 hours of sleep), and than the second (titration) study, which was a disaster (I did not sleep at all, even though they gave a sleeping pill). Still waiting for the results of these studies (it takes forever). Even though I know the result of the titration study (no result), I am still interested in getting the first study results.

In the meantime, I pulled out my old equipment and tried it last night. I've set my pressure to 6 (original prescription was 9), just because I wanted to give it a slow start. Ramp up from 4 to 6 in 30 minutes.

SleepyHead recorded 3 hours and 43 minutes of sleep time. I could not fall asleep for about an hour, maybe even hour and a half, then I slept for some time, and finally I turned it off early in the morning and got another 3 hours of sleep without CPAP. I estimate that the real sleep time hooked up to the machine was about 2 hours, 30 minutes, after deducting the initial no sleep time.

Anyway, here are my SleepyHead results:

Sleep time: 3:43
AHI: 1.88
Average Leak Rate: 1.81
90% Leak Rate: 7.20
Average pressure: 5.87

I am glad that I managed to get some sleep. The biggest issue was the fact that the hose was a big problem. Whenever I turned, it would pull back. Even though my mask (pillows) stayed in place, it was a big nuisance, waking me up. I am working on my hose management, using my bed headboard to guide the hose down vertically. Hopefully that will help.

Another thing worth mentioning is that I have a problem breathing through my left nostril, which doesn't make things any easier. It may be a case of deviated septum, but it certainly is a case of "flimsy nostrils", as what I've learned from another excellent post here on the forum. As I use my finger tip, place by the nostril, and push slightly out and up, my nostril opens up and breathing is much easier (almost normal, I'd say). I have used those nose cones that you place inside your nostrils, and they definitely help, but it is almost impossible to use nose pillows with those. Thinking of a full face mask, where I might be able to use the nose cones as well, but I am really very hesitant, after reading about so many leak problems with full face masks. Irritation of the skin with those could be another issue. Pillows are so much easier to wear, I suppose.

Sorry about this rather long post. I just wanted to say everything that came to my mind, trying to get back into the CPAP world and hopefully improve the quality of sleep.

Please feel free to post any helpful hints.

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May we know which S9 you have -- look just above the start button.

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JustMongo passed away in August 2017
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There are different hose lengths, and there are also hooks or arms to hold the hose up.
Please organize your SleeyHead screenshots like this.
I'm an epidemiologist, not a medical provider. 
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(01-15-2017, 05:33 PM)justMongo Wrote: May we know which S9 you have -- look just above the start button.

It is ResMed S9 Elite with an added humidifier.
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Hi ppca,
WELCOME! to the forum!
Better luck to you the second time around with your CPAP therapy, hang in there for more responses to your post.
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A quick follow-up, after my second night:

I increased my starting pressure from 4 to 4.6, and the maximum (constant) pressure from 6 to 7.

I tested this new setting, wanting to get used to it, in the evening, while watching TV. It lasted for about an hour. This still goes into SleepyHead's report, increasing my total sleep time, which wouldn't be quite accurate.

So this is what SleepyHead reported, for my second day of usage:

Sleep time: 7:22 (it was really more like 5:00, if testing and trying to fall asleep were to be deducted)
AHI: 0.14
Average Leak Rate: 1.65
90% Leak Rate: 0
Average pressure: 6.88

As for AHI section, the only thing showing is Clear Airway Index, with the value of 0.14. I am also pretty sure that it happened while I was still trying to fall asleep.

Anyway, while I assume that AHI of 0.14 is very good, I wonder if this makes any sense, after only 2 nights. As I mentioned in my original post, AHI at my initial sleep study, 3 years ago, was 15. I hope I'm not doing anything wrong.

As for the real quality of sleep, regardless of the very low AHI, I can't really say that I woke up refreshed. Still feeling pretty tired, a little bit of headache too (very common in the past). I wonder if I need more "good" nights, to feel some real improvement.
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ppca, sounds like you're on the right track. Everybody responds differently to CPAP therapy. It took me about 1 1/2 months to really start to feel better during the day. It's great when you can notice a difference immediately but most people do take time to adjust and make up for all the years of sleep and oxygen deprivation.

Keep up the good work!
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It's normal to ease into the therapy a few hours every night. As long as you don't give up you'll notice the usage times getting longer eventually. Your AHI is really good (I wish mine was this low), you're not doing anything wrong. My guess is that the machine doesn't record many events because you are not actually sleeping much while hooked to the machine. Two nights is not enough for real conclusions.
It helped me to sling the hose over the headboard, and also added a homemade hose cover to it so it doesn't make noise when it moves. This way I wake up fewer times on account of the hose.
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Thank you all for your inputs.

(01-16-2017, 08:25 PM)Russatrice Wrote: My guess is that the machine doesn't record many events because you are not actually sleeping much while hooked to the machine.

That makes a lot of sense. While such a low AHI would be great, I just can't believe it is that good already. It would also explain why I still feel tired after waking up (not enough sleep yet).

As for the hose, I improvised a bit, also guiding it over the headboard. It's not too bad the way it is now. I may try to improve it further in the future.
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