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#1
I was diagnosed with OSA via a hospital outpatient sleep study, met with the Dr afterwards and sent back to get titration data in another study. After that, the Dr submitted a Rx for a bilevel capable unit; he selected and prescribed the ResMed Aircurve 10S with humidifier and (probably automatic with the humidifier) heated air.

I'm concerned that Archangel's machine choice doesn't wiki consider this bilevel capable, and wonder if a mistake was made

In the lab, a Mirage Quattro FFM was used; the DME therapist couldn't get one to seal, and switched to the Mirage Activa LT nasal mask. She had a hard time with it too, and blamed that mostly on the high pressures prescribed, 25/22. The lab tech also had trouble with keeping a seal for long enough for him to do his job, but finally did.

I'm here because after just 3 nights so far, I have numerous issues; perhaps they have to be lived with, but perhaps others here can guide me in minimizing or solving them.

I have no known allergies. I've developed pimple like pustules on my nose, and the pressure actually hurts a little. I understand that the silicone blows out and that I shouldn't have any "squeeze" on my nose without airflow. Do I understand correctly?

I was given a chinstrap which I wore the 1st 2 nights; my chin bone was bruised, and I tried without it the 3rd night, but the machine reported unsatisfactory seal; my wife said my lips were fluttering too; so I guess the chinstrap is necessary, but are there other options?

There is airflow from my nasal passages out my tear duct in one eye; I actually feel my eyelid lifting and dropping; is there a way to eliminate this?

I have both ResScan and the open-source package, but have not installed either (I don't have an SD reader for my PC, but my wife's does). At this point, time is not critical.

This is a miserable existence; all I hope to accomplish is for my snoring to stop so my wife can sleep comfortably, and will suffer if needed, but how much can be overcome?

Thanks!
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#2
The ResMed Aircurve 10S is a bilevel; but not an auto machine. It runs at two set pressures called IPAP and EPAP.
Your Rx is for 25 IPAP and 22 EPAP. Only a few machines are capable of pressures above 20 cm-H2O.

It's going to be difficult to adjust to that high pressure.

The tear ducts next tot eh nose are actually drains to the sinuses. There is a small flap that operates as a check valve in the duct; but sometimes they blow air with CPAP therapy.
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#3
Hi gbynum,
WELCOME! to the forum.!
Hang in there for more answers to your questions and much success to you with your CPAP therapy.
trish6hundred
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#4
You've been prescribed very high pressure with very little EPAP relief. I think you might have to find a compromise between a pressure that stops all obstructive apnea and something you can live with. Did you get the details of your titration study? What was the result of your diagnostic study?

Since the therapy is disrupting your sleep and you have physical symptoms like leakage from the tear duct, you might need to discuss a lower pressure with your doctor. I would recommend picking up Sleepyhead software and starting to get a better handle on what is going on in terms of events and leaks. http://www.sleepfiles.com/SH2/ Once you can get a baseline, you can determine what you are giving up if you choose lower pressures, particularly EPAP.
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#5
That pressure needs dropped right away. With the pressure you're on, there is only one possible result, and that is failure to adapt to the needed therapy.

So, that being the case, and I really feel it is, then what I would do if it were my body is to set the IPAP to 14 and the EPAP to 10. Then I'd run with it one or two nights and see if I were able to get the mask to seal properly, and get a decent nights sleep. I would download, install and review my results with Sleepyhead.

Once you are able to get some valid results, then you can make decisions as to where to go with the pressure settings. But simply allowing the unit to blow you up is not going to provide any benefit whatsoever. I'm surprised Doc is doing this, even if he does believe you will ultimately need this high a pressure.

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#6
I'm surprised the OP wasn't prescribed a bilevel auto.
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#7
(04-06-2015, 08:10 PM)justMongo Wrote: It's going to be difficult to adjust to that high pressure.

The tear ducts next to the nose are actually drains to the sinuses. There is a small flap that operates as a check valve in the duct; but sometimes they blow air with CPAP therapy.

I am going to try to make do for a few weeks; strangely, the pressure display when I awake is significantly lower. I've not looked at it at bedtime. I __THINK__ it cycles between 10 and 16 when I looked at it. I've the files on my PC now, and ResSoft will be loaded "really soon now"

I've had trouble (as in being aware, not a medical issue) with that eye to sinus check valve "forever"; air when blowing my nose passes through, as likely "snot". I had a noes bleed which worked its way out, too ... ugly! My optometrist says not to worry unless I have other problems.

THANKS!
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#8
(04-06-2015, 08:24 PM)Sleeprider Wrote: Did you get the details of your titration study? What was the result of your diagnostic study?
No. My PLAN is to wait for the 30+ day Dr appt to ask for it.
(04-06-2015, 08:24 PM)Sleeprider Wrote: Since the therapy is disrupting your sleep and you have physical symptoms like leakage from the tear duct, you might need to discuss a lower pressure with your doctor. I would recommend picking up Sleepyhead software and starting to get a better handle on what is going on in terms of events and leaks. Once you can get a baseline, you can determine what you are giving up if you choose lower pressures, particularly EPAP.
I understand. AS OF NOW, I still plan to wait for the Dr appt unless things get worse; sleep is no worse than w/o machine, and my wife can sleep w/o earplugs.

I downloaded ResScan and sleepyhead; is one better than the other? What are relative advantages?

THANKS!
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#9
(04-06-2015, 08:47 PM)retired_guy Wrote: That pressure needs dropped right away. With the pressure you're on, there is only one possible result, and that is failure to adapt to the needed therapy.

So, that being the case, and I really feel it is, then what I would do if it were my body is to set the IPAP to 14 and the EPAP to 10. Then I'd run with it one or two nights and see if I were able to get the mask to seal properly, and get a decent nights sleep. I would download, install and review my results with Sleepyhead.

Once you are able to get some valid results, then you can make decisions as to where to go with the pressure settings. But simply allowing the unit to blow you up is not going to provide any benefit whatsoever. I'm surprised Doc is doing this, even if he does believe you will ultimately need this high a pressure.

Dr is one of few in Greenville SC specializing in Sleep Medicine, and my primary care doc thinks highly of him ... I'll wait for my 30+ day appointment as long as it doesn't get worse; as I replied to another, it is no worse than without, and my wife doesn't need earplugs, a VERY GOOD thing.
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#10
(04-07-2015, 12:04 PM)gbynum Wrote: I downloaded ResScan and sleepyhead; is one better than the other? What are relative advantages?

THANKS!

You will be able to tell pretty quickly that Sleepyhead has much more detail, almost diagnostic level. While ResScan is a good summary, the Sleepyhead software lets you zoom in on any events and see the waveform (respiration) correlated with pressure and other data to see why it might have occurred. It is a much better tool for making decision about therapy and relating issues to your doctor.
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