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New to CPAP - Help needed
#1
New to CPAP - Help needed
Hi -

I've been suffering from significant fatigue and constant brain fog for the last four years and my wife says she regularly observes me holding my breath for 30+ seconds while sleeping. Based on recommendations here, I purchased a used AirSense 10 Autoset and used initial settings of min of 6 and a max of 14. Last night was my first night using the CPAP with the Dreamwear nasal pillows (which I switched to the nasal cushion at around 2:30 AM due to discomfort). Also worth mentioning that we have a 4 month old at home so I was up a few times with him.

I am apparently more of a mouth breather than anticipated so I ordered a chin strap which should be here in a few days. Any suggestions on adjustments to current settings?

Thanks in advance.

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#2
RE: New to CPAP - Help needed
I'm not one of the pros here, however, I'm sure you should raise the Min number to 6 leave the top number alone. The mask leaks are a concern. A chin strap is normally not successful. A full Face mask might work or a cervical collar is used by a lot of people with success. I would try the collar first they are cheap and can be purchased locally. Search on this site about Collars and look at Wiki at the top of the site. The Flat top of your Leak rate chart shows how bad your mouth breathing is.
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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#3
RE: New to CPAP - Help needed
You are leaking a lot, probably because your mouth keeps opening. This is not good because the CPAP machine can't maintain the air splint needed to keep your airway clear when your mouth is open and allowing air to escape. A chin strap may work. A soft cervical collar may work. Also, for a lot of people the problem tends to subside as we adapt.

But if none of the above works you will need a full face mask. Supplier#1 has a good website for looking at different masks and chin straps. You can order a soft cervical collar from Amazon.

For me personally, switching to a full face mask worked wonders. Just hang in there and allow your body and mind to adapt to these new circumstances. You will eventually feel a lot better than you have in years.
Sleepster

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#4
RE: New to CPAP - Help needed
Thank you both for the input. I'll explore the collar and/or full face mask to address the leaking issue and post back when I've got it figured out.
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#5
RE: New to CPAP - Help needed
stacey, it's not my intention to put you in particular on the spot; this is directed to the broader community.

I keep reading that flat topped leak rate indicates mouth breathing & I just don't get it. I'm hoping someone will explain.

the x axis indicates time. the length of flat tops indicate duration of leak episodes, so there must be an assumption that mask leaks are momentary & mouth leaks last a while? that makes no sense to me. please help me understand.

it's been my understanding that we look to the flow rate to identify mouth vs mask leaks.

the question is tangential but not entirely off topic. hoping for a quick answer but if a discussion is in order mods feel free to split this into a new thread (or direct me to). i might should've taken the hint when I asked this in another fairly recent thread and didn't get an answer.
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#6
RE: New to CPAP - Help needed
I copied and retained an image showing typical breathing waves with CPAP posted hear a year or more back.  It doesn't show flat-topped breathing as being due to mouth breathing but due to flow limitations or snoring during inspiration

 When one mouth breathes during exhalation, there's a steeper decline in pressure, but the decline continues past the 'zero' mark to a sharp pointed nadir, and then there's a sharp rise in the line to zero again.

In my particular case, mouth breathing is a problem during either action.  My lips part and there's a constant gale emitting from them.  So, I have to tape...nothing else works.
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#7
RE: New to CPAP - Help needed
thanks mesenteria. I agree that that flat topped flow rate curves indicate flow limitations. and again, my understanding is we look to the flow rate to distinguish between mask & mouth leaks. however, my question is why / how does a flat topped leak rate indicate mouth breathing?
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#8
RE: New to CPAP - Help needed
Sleepless I thought one of the experts would answer your question. I don’t have an answer all I know is what I have read here. I also know when I had that type of leak patterns I was told that is what it was and when I used tape it did not show up any more. So I assumed it was correct. Maybe someone who can explain WHY will post.
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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#9
RE: New to CPAP - Help needed
thanks stacey. I've been reading it quite a bit lately too which is why I'm asking. it might in fact be correct but the logic escapes me.
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#10
RE: New to CPAP - Help needed
The spikey leaks are usually Mask leaks are usually caused by mask movement, tossing & turning and such
Mouth Leaks tend to be longer and as such form the plateaus that we look for.  Mouth leaks are not the only cause but are the common cause.  A user with an FFM can generate this pattern and that is obviously not what we are calling a mouth leak.

Read this, it was written for Sleepyhead but is in general sound advice. http://www.apneaboard.com/wiki/index.php...s_of_Leaks
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