Newbie, trying to start with Sleepyhead

[Sleeprider]

So I tried the ResMed N20 nasal mask last night. Disaster! I stuck it out for almost 4 hours, but was absolutely miserable. It was fine as long I was reading on my back. And the nasal mask portion itself was comfortable. But the headgear was like a hard cage sticking out around my face when I tried to lie on my side. I finally gave up and switched to the Nuance Pro I have as back up. Problem is, with the Nuance Pro I still wake up about a half dozen times (at least) per night. Also, I tend to swallow a lot of air, leading to stomach discomfort/bloating and burping and (really weird) my teeth hurt. I must clench particularly hard to keep my mouth closed. Both those "symptoms" had gotten much better with the soft cloth mask.

Eileen

Booksfan, I agree with others that a larger pillow size on the P10 for Her will be ideal.  I want to make some suggestions on settings and your Sleepyhead chart.   Your chart is great, but you are getting very poor definition on the Flow Rate due to the scale being too large. You can right-click on the left margin of that chart where it says Flow Rate to make some changes.  Right-click on Flow Rate and select Y-axis, and over-ride the scale. Set the minimum at -80 and the maximum at +80 and you will see useful definition in the wave form.  Secondly, right-click again and select dotted lines and check the box next to Zero.  That will give you a line at the zero flow where inhale and exhale intersect. 

For settings, your minimum pressure is set to 5.0 cmH2O, but your median pressure through the night is 11.44, and the pressure never goes above 14.  I think you need to increase the minimum pressure to 9.0 so you get a bit more consistency. The machine is doing a good job of stopping events, but your minimum pressure is just nowhere near what you apparently need.  If you want to set a top limit for pressure the maximum would be 15.0.

Now let's talk about comfort.  You are not using one of the most important comfort features that your machine offers, EPR: Exhale Pressure Relief. You can use EPR to reduce pressure from 1 to 3 cm during the exhale portion of the respiratory cycle, and most people find this very nice.  Please feel free to experiment with an EPR setting that works for you.  You may need to enter clinical settings (control knob + home button) and scroll down to Comfort settings and Select EPR.  Select FULL TIME and choose a setting of 1, 2 or 3. You're going to like it.  While in clinical settings you can also select ESSENTIALS and change from ON to PLUS.  This will provide a more detailed on-screen sleep report. 

[kiwii]

One more thing, if you are swallowing air, then you are mouth breathing.

Not true in my case. Lots of aerophagia (initially), no mouth breathing. With Swift FX, there is still aerophagia, and still no mouth breathing.

I also suffered from Aerophagia and Gerd early in my treatment. It’s very painful.  There may be other reasons for experiencing this...

Yes, that is true. I also swallow air when chewing gum or eating dry toast.

But with xPAP, I can actually feel the air going down my throat when using the Swift FX. That was also the mask I started with, so I don't know how much of the excessive aerophagia I initially had was due to the Swift FX, or how much due to the higher pressures, or maybe even just getting used to using the machine. It literally felt like air was flowing down my throat and out the other end (I know that couldn't have really been the case, but it sure felt like it).

Anyway, all of that to say that none of that occurred while mouth breathing. The last time I tried the Swift FX was a few weeks ago. It still causes air to flow down my throat (not as bad though).

edit: oops... and that last test with the Swift FX was while I was awake. Maybe I have some anatomical abnormality, I don't know.

[booksfan]

So since I've last posted I have tried the Swift FX and the P10 (regular headgear and both small and medium pillows). Both were failures.

I went back to the Nuance Pro last night (my fall back mask). I have clipped and pinned the strap on the back so it fits my head a little better as I am using my husband's old headgear with new pillows. The back strap seems to ride up the back of my head a little less now. But I still had a miserable night, up at least half the night and my AHI was terrible!

[attachment=4419]

[booksfan]

I did have a much better night last night than the night before, but AHI still seems a little high and I still woke up several times during the night and had trouble getting back to sleep. Also, I'm still not sure how the Flow Limitation should look--is it OK? If not, what should I do?

Thanks!