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New to this all..
#1
Sad 
Hi to all, and greetings from the UK.

I found this forum via a US forum while looking for the manual for my newly prescribed machine, so here we go..... Sorry it it's a bit long.

It's now day 4 after getting my machine, after a full nights sleep study in the hospital, and I'm having 'issues'.

Since a teenager I've had sore/dry throat at all times and poor speaking voice and I'm just about to hit fifty.

Anyhow, during the sleep study I was forced to sleep on my back, something I never do, and they ended up with a pressure setting upto 18 at one point, but I soon woke unable to breath out because the pressure was too high (full face mask so couldn't exhale through my mouth), and my throat despite the humidifier being on max was sorely dry. This happened twice during the night. They reset the machine so the pressure was dropped and we started again.

So, I left after the study new machine etc, and it had the settings of 10 - 18 on the pressure front.

First night at home, exactly a repeat of the night in the sleep study except I was on my side for sleeping. I woke about 2 hours in unable to exhale and with a dry throat. Gave up with the machine at this point for the night.

Second night, after some reading I found the CPAP machine, has an environment setting for Temperature so I adjusted this to the current temp. also I found how to adjust the pressure. I turned it down a bit - when I woke the previous night it read 17.1 so I figured since that was too high, lets try 17. About 2.5 hours later I awoke same issues - throat too dry and can't exhale. Left machine off for rest of the night.

Night three (last night). Turned the machine down a bit more, just over three hours sleep before waking, only this time it was due to being tangled up in the hose and the mask being dislodged. Tried again, got another couple of hours before mask so too uncomfortable as I tried sleeping on my side and my mask then 'leaked' blowing air into my eyes.

Just ordered a CPAP friendly pillow, which should help as previously been using a wheat-husk based pillow which is too solid to allow any 'give' with the mask - which created the 'leak'.

So, should I be adjusting the max pressure down, to allow me to exhale, or should I just be going straight back to the clinic?

Please folks a little guidance here please.
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#2
Your machine has an EPR feature, (exhale relief). You can set it to 1,2 or 3, with each number giving you relief when you exhale. So if you are at your minimum pressure of 10, then when you exhale, it will drop to 7 if set at 3. If you are at your highest pressure, it will drop 1,2 or 3cm pressure on exhale, depending on the setting. This is a comfort feature. Try it.

As far as waking up with dry mouth, that's an indication you are mouth breathing. You may need a chin strap.

Download SleepyHead software and let us know your leak rates, AHI numbers, and 90% pressure reading.
http://sleepyhead.jedimark.net/

When you get a couple more posts, you can upload us a screenshot, and someone will advise on your settings.

In the meantime, try an EPR setting of 2, and see how it goes.

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#3
G'day Ncudmore, welcome to Apnea Board.

First off, it's not unusual to have issues at first, so don't feel you're on your own. Your max pressure of 18 is pretty high, so it makes sense to start at a lower pressure and build up to it. I agree with OpalRose's suggestion to use the EPR to lower the exhalation pressure.

The Simplus mask is very popular but it is known for leaking into your eyes. I find that placing a couple of layers of fabric (eg flanelette) over the bridge of my nose helps overcome this. On the other hand, your sore throat might be improved if you can avoid breathing through your mouth. Using a nasal mask or nasal pillows means that all the air goes via your nose, which is a lot easier on the mouth. As mentioned above a chin strap can help keeping the mouth closed.

DeepBreathing
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#4
Welcome to the forum, ncudmore.

Rose and DeepBreathing have given you good advice. Finding the right mask for you and getting it adjusted are two of the hardest things related to cpap. They just take time and experimentation.

The issues you are having with dry mouth may be caused by mouth breathing. I found I had dry mouth from mouth breathing even with a full face mask. I used Biotene gel, a gel formulated to help with dry mouth, until I finally solved the problem. A chin strap took care of the mouth leaks for me. I was even able to change over to a nasal pillow mask after I started using the chin strap. The nasal pillows helped a great deal with leaks and comfort.

There are several hose management solutions to help keep you from getting entangled with your hose while you sleep. I chose the HoseBuddy and highly recommend it.

Getting used to cpap therapy is mostly a matter of persistence, determination and trial and error until you find what works for you.

Good luck with your new journey.

"....respiration,—a troublesome practice, but one which custom has rendered necessary to our easy existence...." Oliver Twist, Charles Dickens- 1837

I use FlashPAP to load data from a FlashAir III wifi sd card in my machine to my computer and display it with SleepyHead .
robysue's Beginner's Guide to SleepyHead
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#5
Hi ncudmore,
WELCOME! to the forum.!
I know CPAP can take some getting used to, but just stick with it, it does get better over time.
Hang in there for more responses to your post and I wish you good luck on your CPAP journey.
trish6hundred
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#6
Keep adjusting the simplus. It will handle 20 cm without leaking.

Best way is set machine to your max setting and adjust the mask at that pressure.

Turn on your EPR to 3.
The dry mouth is likely do to mask leakage causing a fast air flow.
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#7
Welcome ncudmore..

I too am one who was found to have sleep apnoea following tests where I was forced to sleep on my back while being tested.... I think every person on the planet has apnoea if tested in that position... like you, I am a side sleeper only, and have been all my life.

I will leave it to others more versed in machine settings to give suggestions on the pressure settings.

As for the mask issues, it is a bit of an experimental thing.
I had a loan machine for my CPAP testing once I was diagnosed, the clinic also let me try a couple of different masks.
I have now purchased the identical set up to what I found worked best with the loan equipment.
I use a Philips Dreamstation coupled to a Fisher & Paykel Eson nose mask, I don't generally sleep with my mouth open, so the nose mask works fine for me.

Within this forum you will find posts and photos of various ways to position your machine and hose to overcome different problems related to sleeping while wearing CPAP head gear.

In a nutshell..
1. Place the actual machine lower than where your head lays on the pillow, on a low dresser/table/floor. [helps prevent 'rainout'.. excess condensation build up in your mask]

2. Run the hose so it hangs in an arc above your head, again to reduce 'rainout', you can run it over the bedhead, or through some form of loop/tie attached to the bedhead [as I have done], or use one of those self adhesive/removable plastic picture hooks to hang a loop from if you have a low/no bedhead.

3. A normal pillow that is relatively flat, and reasonably firm, would most likely be ok for you as a side sleeper.
I use a contoured one for head/neck/spine alignment, but from side to side it is flat, the contour is higher under my neck and lower where my head lies.. when I lay on my side there is no upward curve to the pillow pushing against my mask.

This is how I have my machine and hose set up. [if you choose to sit the machine on a carpeted floor use one of the small nylon/plastic kitchen chopping boards to sit it on, as I have done, CPAP machines with heated humidifiers can generate some substantial heat, there is a slight risk of setting carpet on fire according to some].
I can reach under and disconnect the hose, then simply slide the machine out on the chopping board to access the filters/SD card/water chamber.
[Image: 20160709_165618_zpsnlovtu9e.jpg]

Hang in there, it takes time to get things sorted out as to what works best for you.

It took me an extra month longer to reach compliance for getting my driving licence reinstated because I had difficulty coping with using a CPAP machine.
Now, after 6 months without my licence [the automatic minimum suspension period for an accident caused by an undiagnosed medical condition] I finally got my licence reinstated last week with full HC-semi trailer endorsement back.

But most importantly of all.... I can now ride my motorbikes again. Thumbs-up-2

You will get it all resolved too.
Sleep-well
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#8
Smile 
Many, many thanks to all those who replied.

So, progress.... last night.

Changed the RHI setting to 3, increased pressure from 14 to 15 back towards the 18 setting the hospital gave me, and didn't have a problem with exhaling. So more progress required here.

Tried the new 'cpap friendly pillow' - not so good, basically too high and woke with sore neck in middle of the night. Slept rest of the night with wheat husk pillow, so will get new softer pillow asap. So work in progress here.

Relocated machine, now 'level' with bed and not above - now maybe it's because of the UK climate, but I was issued the machine with a heated air hose which I'm guessing should avoid condensation in the hose; but because it's heated it's also not that long to start hanging it from the bed post....

In short only woke once, sore throat wasn't the reason Smile , and neither was the problem with exhaling - it was the sore neck. Still 7.5 hrs sleep with machine which was best so far, but the AHI was also the highest at 9.0.

However, I think this is a bit misleading... I took a while to get to sleep both times, and was very aware of my breathing, several times I actually paused/stopped my breathing as I drifted between 'consciously controlling' my breathing and going back to 'just letting it happen' as normal, and then found myself 'gasping' for air!

So still a work in progress but moving in the right direction thanks to those who posted....
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#9
Great, thanks for letting us know!

Give it some time. When I make changes, it sometimes takes a few days for everything to settle.

I also had problems finding the right bed pillow. I think I tried at least 3 or 4 different ones. It's almost as bad as finding the right mask....well, not quite. Smile
But neck pain isn't fun.

After trial and error, I ended up with the same pillow I used before Cpap, the My Pillow.

Good Luck!
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