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New to PAP, F&P user, few questions
#1
New to PAP, F&P user, few questions
Hi everybody!

First of all I've been reading this forum a lot in the past few days and it's been helpful so thanks for that.

I've had obvious sleep apnea for many years but was unable to afford treatment, which was extremely
discouraging. I had a tonsillectomy two years ago which did significantly reduce the severity on an at-home PSG test,
but still suffer considerably.
Which makes it really awesome that I finally got a machine through a special program 3 days ago, yay!
I'm soooo optimistic about how much this thing might help me, so right now I'm totally open to it being difficult to 
adjust. But I do have quite a few questions. Overall it's been more comfortable/tolerable than I feared, and I got
a few hours of actual sleep with the mask on every night, but there's a lot to optimize.

- Is there a way to power off the machine without pulling the power cord? The manual keeps saying there's a switch at the
power supply but I don't see it.
- SleepyHead doesn't work with this model, are there other alternatives? The data on F&P website is sparse, to say the least.
- I use a full face mask because of breathing difficulties through my nose. The one I was given has that forehead support
which is a bit overwhelming and the part of the mask that sits on my nose bridge is starting to hurt, how are masks without
the forehead or without the nose part? (Already trying to get a pad)
- On night 2 I developed a canker sore on my gum. I believe this was from the pressure of the mask and definitely not dry
mouth. Is this common?
- Does anyone know the delay on the Sleepstyle before therapy 'resumes' after SensAwake kicks in? I'd rather keep it on
but it's been really annoying having to pause for a sip of water and then start all over again at 4 cm.


Here is some of the info I have on my events:
My last PSG: 6.5 AHI, 13.4 RERAs, lowest O2 85% (0.3% of the time), AHI breakdown: OA 1.9, OHA 4.3, central 0.3

The F&P website tells me I'm getting a lot of central apnea events, but that my OSA is down. I've read about treatment emergent CSA 
but I figure it should resolve within a few days/weeks/months? And if it really were emergent CSA, I suppose discontinuing treatment
would return everyone to normal? Is it possible that an ill-fitting mask (squeezes my mouth) would be reflected by CSA detections?
How would RERAs show up, if at all?

Info from first three nights: 
AHI/OA/OHA/CA/CHA per hour
14.6/3.7/2.47/3.97/4.38
8.8/1.8/1.2/3.6/2.2
12.5/3.3/1.1/3.7/4.4

I figured out how to change the pressure settings but a clause I had to sign to get the machine says I can't deviate from
the prescription. So I have to wait to ask my GP for permission, urgh.

Thank you very much in advance for your valuable advice!
Sporky
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#2
RE: New to PAP, F&P user, few questions
It helps us to have the all the settings. It appears you are using Auto CPAP 5-13. Your machine offers an exhale relief "Sensawake", and ramp, and we don't know your settings for those features, but from your results, I suspect you are using them. From your results you still need a bit more minimum pressure, and I encourage you to use your exhale relief setting at 1 until the CA is much lower. CA is fairly common in new users, especially if you are arousing due to the new use of CPAP, and is not something we specifically treat, or even worry about. In addition to your AHI statistics, your machine may also provide data on the pressure used.

Go to the CPAP Setup Manuals link at the top of this page and request the clinician manual for your machine. That will give you a lot more insight on the controls and features. I would suggest a minimum pressure of 7. SensAwake drives your pressure to the minimum when it detects you are awake, and having a low pressure like 5 can result in inadequate support during sleep transition. Hopefully someone more familiar with the F&P machine will chime in with suggestions.
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#3
RE: New to PAP, F&P user, few questions
Hello, good evening, and welcome.

I have only two minor contributions; don't know the F&P machines, and I hope some users of the Sleepstyle and/or Icon will answer your other F&P-specific questions.

Sensawake and/or ramp: In your case those seems to be useless if not counterproductive, so IIWY I would switch them off. With those off, the machine should increase the pressure to whatever is necessary fairly quickly. It seems to me that 5 to 15 is too wide a range (very likely the minimum should be higher), but if you're stuck with that during the compliance period for contractual reasons, then oh well. Sad

After switching off that stuff, don't be concerned about the lack of pressure ramp; it's really no big deal. If you'll pardon my being brutally honest, that's only a mickey-mouse feature for wussies, having nothing to do with the actual therapy.

Software: For your machine there's only the "Infosmart" PC software from F&P. It's closed-source payware and is, or has been, supposedly available only to medical professionals, but at least Supplier #26 from the list here has sold it to individuals in the past. I don't know whether it's still available there. Because it is the only software to interpret the data from your machine, it's probably worth some digging to find a retailer that will sell it to you, including trying most of the entries on that list of known-good suppliers. In the past it has also been available via Bittorrent, so if you're a p2p file-sharing aficionado, that is one possible alternative.

Edited to add: Or if you're not but you know someone who is, then ask that person to look for a torrent of it for you.

If you're going to look for the software, it'd be good to do a search for "infosmart" here and probably also at the cpap-talk board, and/or a general web search, for sagas about installing, registering, and using that product. It seems that the registration has to be done via the F&P web site, and you have to pretend to be a company or organization rather than an individual. Apparently if you're merely a patient (a.k.a. peon) with no institutional affiliation, F&P's automated serial-sending server software will flush your application and won't send you the serial number to let the software continue to work beyond the 30-day trial period. So caveat emptor big-time when dealing with all F&P software and its bureaucratic operational requirements. Good luck.
"I wanted to be a Boy Scout, but I had all the wrong qualities.  They were looking for kids who were trustworthy, loyal, helpful, friendly, courteous, kind, obedient, cheerful, thrifty, brave, clean, and reverent.  Whereas I tended to be devious, fickle, obstructive, hostile, rude, mean, defiant, glum, extravagant, cowardly, dirty, and sacrilegious."  (George Carlin)
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#4
RE: New to PAP, F&P user, few questions
(05-27-2018, 10:37 AM)Sleeprider Wrote: Go to the CPAP Setup Manuals link at the top of this page and request the clinician manual for your machine.  That will give you a lot more insight on the controls and features.  I would suggest a minimum pressure of 7.

He said that for legal (contractual) reasons he's stuck at 5-15 without the permission of his doctor.
"I wanted to be a Boy Scout, but I had all the wrong qualities.  They were looking for kids who were trustworthy, loyal, helpful, friendly, courteous, kind, obedient, cheerful, thrifty, brave, clean, and reverent.  Whereas I tended to be devious, fickle, obstructive, hostile, rude, mean, defiant, glum, extravagant, cowardly, dirty, and sacrilegious."  (George Carlin)
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#5
RE: New to PAP, F&P user, few questions
A clarification about Sensawake, etc.: What I meant was based on that being distinct from what's generally called EPR, or exhalation (expiratory) pressure relief. I don't know what F&P calls that (and am too lazy to search). EPR is useful, but IMO Sensawake and ramp are mickey-mouse features. So if the Sleepstyle can be set to use a slightly lower pressure on exhalation and yours is set that way, that's fine. Or if F&P haven't provided an EPR feature separate from Sensawake, then foo to them and do whatever works.
"I wanted to be a Boy Scout, but I had all the wrong qualities.  They were looking for kids who were trustworthy, loyal, helpful, friendly, courteous, kind, obedient, cheerful, thrifty, brave, clean, and reverent.  Whereas I tended to be devious, fickle, obstructive, hostile, rude, mean, defiant, glum, extravagant, cowardly, dirty, and sacrilegious."  (George Carlin)
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#6
RE: New to PAP, F&P user, few questions
Hey, thanks for your replies!
I'm going to try my hand at InfoSmart, hopefully I can find a recent enough version that'll support the machine I have.
My exhale assist (F&P call it Expiratory Relief Technology) was set to 2 out of 3 so I'll try it at 1 only. I actually hadn't
considered that that might be problematic. It's separate from SensAwake which I'll try not using Smile
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#7
RE: New to PAP, F&P user, few questions
(05-27-2018, 01:26 PM)Sporky Wrote: My exhale assist (F&P call it Expiratory Relief Technology) was set to 2 out of 3 so I'll try it at 1 only. I actually hadn't
considered that that might be problematic. It's separate from SensAwake which I'll try not using Smile

Sorry for my confusing phrasing! When I said "slightly lower pressure on exhalation", I didn't mean that you should change the setting from what it's at now, although it is often useful to experiment with that and see what works best for you in that range of 1 to 3. What I meant by "lower" was lower than the pressure the machine puts out during inhalation, and that's usually considered a comfort feature although it does affect the therapy in a small way. As Sleeprider has pointed out a few times in various threads here, when EPR (or ERT as F&P calls it, thanks!) is enabled, the other pressure settings really should be increased by that same amount (1 through 3) so that you're still getting the proper EPAP pressure (on exhalation). However, when you're using a range of pressures to begin with, it's not so important because the machine should adjust automatically anyway.
"I wanted to be a Boy Scout, but I had all the wrong qualities.  They were looking for kids who were trustworthy, loyal, helpful, friendly, courteous, kind, obedient, cheerful, thrifty, brave, clean, and reverent.  Whereas I tended to be devious, fickle, obstructive, hostile, rude, mean, defiant, glum, extravagant, cowardly, dirty, and sacrilegious."  (George Carlin)
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#8
RE: New to PAP, F&P user, few questions
Got it!
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#9
RE: New to PAP, F&P user, few questions
Welcome  sporky
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