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New to CPAP - 3 months - advice?
New to CPAP - 3 months - advice?
I am totally new to CPAP.  My sleep study indicated I had severe OSA at 52.

Fortunately I was reviewing this board and was insistent on a new Resmed Airsense 11 Auto which I have had since mid June.
Due to two extended motorcycle trips both 12-14 days there were periods when I did not use a machine as with limited space
I could not take the AS 11 and the Mini has been all but impossible to source for purchase or rent here in Canada. I just got word
the one I ordered will be delivered this week.

I had horrible dry mouth during my sleep study and subsequently as well which I now of course know was my mouth opening.
I had been using an N30 mask. I then purchased an F30 which initially was horrific, my mouth no longer dry but AHI went up to 30
and I found I couldn't breath through my nose, my cheeks were bulging, a horrible experience.  Back to the N30 and AHI was 4-6 typically
with lots of leaks.    Someone suggested I had positional apnea as I had been exclusively back sleeping so I tried the F30 again on my side
and AHI went from 29 down to 0.8!!   If I sidesleep with either the F30 or the N30 and use mouth tape my AHI is 0.5-1.5 now.

Yet I still feel tired.  Maybe 90 days with two extended non use breaks due to the lack of a travel unit are not enough.
I attach an Oscar snap shot of last eve using the N30 with mouth tape for any suggestions.

During my sleep study I had no CA events, but that is all I have now for the most part.  I have turned off EPR as I found it annoying
and also ramp time if OFF.  

Any advice is much appreciated.

Bob H.

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RE: New to CPAP - 3 months - advice?
Bob - your numbers look great. Large leaks are not a problem. Flow limits and snores are not a problem. Only a few centrals, not a problem. Many people have a central here and there. They happen when you are awake too. Think about watching a suspenseful movie or reading a suspenseful book or concentrating on a project that requires high precision. Many folks stop beathing for 10+ seconds a few times during the day. No worries as long as centrals aren't long (say over 20 seconds) of very, very frequent (say 5+ per hour). You had less than 1 central per hour on September 11th. Chasing numbers is a losing game. Now you are at the point where the relevant question is "how do you feel?" 

Remember also that centrals/obstructives/hypopnea don't count if you KNOW for certain you were awake then. After all, the subject is SLEEP apnea.
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RE: New to CPAP - 3 months - advice?
I really appreciate the reply.  I kinda thought things were going well, yet I often feel quite tired some days.
I have had Apnea my entire life but only recently was guilted into doing something about it.

I have zero issues with the therapy itself, I just hope that at some point I'll feel more energized for the effort.  My wife no longer
wakes me up for "holding" my breath at least.  

I'd also like the option to back sleep again, but not sure that would be possible.
My sleep study recommended a fixed pressure of 13 and during the study I slept exclusively on my back as with so many wires
attached I didn't to disrupt things.  

But I was advised here that to use Oscar one needed an APAP machine so I contacted the clinic and they revised my prescription to
APAP with 9-16 pressure.   I have an Airsense 11 auto as a result and initially used an N30 mask but had lots of leaks from my mouth opening and typically my AHI was 4 to 6.
 When I tried a full face mask to eliminate the mouth leaks and back slept, I was all but choking, cheeks ballooning and my AHI went up to 30.  Yet when I side slept with the F30 it went down to 1.0 (+/- 0.5)  so I don't sleep on my back anymore.  I get similar results with the N30
side sleeping provided I tape my mouth closed.
I do wonder if I upped the start pressure to say 12 and kept the upper at 16 maybe it would allow me to back sleep?? 
I might experiment sometime soon to see if that helps, otherwise I'll just avoid my back as I am at present.

This board is a wealth of knowledge as it seems you are prescribed a machine and your left on your own to figure it out.

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RE: New to CPAP - 3 months - advice?
The consensus opinion here is that you are right on -- patients get a machine and then are mostly left to fend for themselves. That is why this board exists -- patient empowerment. The black band at the top of the page has an entry saying "wiki." There is a ton of information to be read in there.

The preferred method is to sleep on your right side. #2 choice is on your left side. #3 choice is on your back. I think one reason is that back sleeping encourages chin tucking (aka positional apnea) in which you cut off your own airway.

Be aware this is a journey. Some folks take up to 6 months before feeling really good. And then again, we all have occasional terrible nights -- sometimes because of other medical problems.
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RE: New to CPAP - 3 months - advice?
We sleep differently each night.
I've been CPAP since 2007 and have had undiagnosed sleep apnea, probably for 40+ years and I still do not always feel great each morning. This is a marathon, NOT a quick race.
It will take time; you have been deprived of good sleep for a very long time.
BE PATIENT and ask as many questions as you like.
I have always been told that the only stupid question is the question that you do not ask.
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RE: New to CPAP - 3 months - advice?
Thanks for the input, advice & support to both of you above.  Yes I have 50+ years of catch up to overcome.
Funny enough I used my N30 2 nights ago and tried it without mouth taping and then the F30 a night later and 
had the same results, 2.1 AHI.  I had been at 0.7 or so but obviously things fluctuate.
I am trying to educate myself on reading Oscar charts but clearly there are subtleties to that I have yet to figure out.
I may post a chart again in a couple months if I am still unsure about things.

I just obtained a new AirMini at my own expense so I am committed to keeping this up.

Bob H
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