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Newbie w/issues!
#1
Newbie w/issues!
Good day! I've had 2 at home sleep study tests: #1 showed apneas at 6.8 (slept mainly on my back), but was deemed inconclusive b/c the canula slipped a bit.  #2 showed apneas at 5.7 - but I had slept only on my sides and had taped my mouth to see if positional treatment would work.  I was given the option of CPAP therapy or continuing to try positional therapy.  In the end, chose the machine which I've had since - late April.  

I had a terrible time for the first month trying to maintain my 4 hours (for compliance) b/c the nasal pillows hurt so much. I tried all sorts of recommended lotions and they helped a bit, but not enough.  Month #2: Left the States for the summer - and still struggled with the pillows.  Found a sleep specialist here who recommended a nasal mask - what an improvement in terms of comfort!  So, here are the issues: 1) I have slightly higher apneas with the mask and quite a bit higher leaks with it. With the pillows, apneas mainly <3.0 (w/ .01 to .06 CA) and leaks mainly <7 (w/ two at 19); with the mask, most apneas <3.0, but 2 at 3.5 (w/.04 to 1.0 CA, but last night's was 1.9) and leaks (over the 2 weeks since using the nasal mask) of 7 at <19 and 7 at 22 to 42 (1x).  I can't use SleepyHead yet b/c I need my IT Department in the States to make changes to my security options.   

I am now in my 2nd full month of using the machine for at least 6-7 hours per night whether or not I get that much sleep.  Since I'm such a newbie at all of this, I constantly question my results and wonder if I'm doing ok? W/in the last week, I've had 3 excellent nights, 2 okay nights, and 2 miserable nights - w/last night in the last category.  I had had 1.5 hours of amazing sleep, but awoke b/c of very clogged nasal passages - had a really hard time getting air! Insomnia kicked in for 4 hours - I read, tried new sleeping positions to "unclog" my passages, and finally got up (which meant turning off the machine, removing my mouth tape, unhooking myself from the hose, and removing the head gear) in order to use saline solution.  And, here's where my "newbie-ness" really kicks in: When I awoke after 1.5 hours of sleep, the clinical data recorded ZERO apneas and 2L/min leaks.  After 4 hours of insomnia, there were 2.0 apneas and 1.0 CA with 6L/min.  I fell asleep and was awakened by a bad dream complete with heart thumps - did not check the data. About 2.5 hours later, I got up and checked the data: 3.5 AHI w/ 1.9 CA and 24L/min! Huh? (FWIW: there were no central apneas during my sleep study tests.) 

If there are any insights into my 2 months, I'd appreciate it.  I'm especially interested in the pillows vs the mask results, the increased mask leaks, some CA, and if bad dreams/wearing the mask while awake can influence the results.  Thank you in advance!
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#2
RE: Newbie w/issues!
If the machine's own interpretation is that your AHI's total less than 6/hr, on average, and relatively consistently from night-to-night, you are 'mechanically' treated, and should probably let it go until you feel well enough about your circumstances to start tweaking the settings for an even better result.  Many of us routinely get AHI of about 2/hr and under regularly.

What counts mostly, if your treatment is 'mechanically' sound, is how you feel about it.  It's the mental and emotional state, including your confidence and the sensations that you are fairly rested, that counts now.  This is probably what you should be looking to spend your time and anxieties on fixing. So, getting more comfortable, maybe getting more actual sleep if that is possible, or even just accepting the sensation of 'fogginess' that so many of us live with under PAP therapies of all kinds.  I used to fairly bounce out of bed, feeling alert and rested, but now I find myself almost clawing my way up out of sleep, or certainly out of bed.  

Could you post some SleepyHead charts for us?  It's a freeware available at sourcforge.  Some others who are regulars here have the links and how-to's in their signatures.
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#3
RE: Newbie w/issues!
Mesenteria, Thank you for your reply! I'd like to show you my SleepyHead results, but my Mac won't "allow" the app.  I have to wait until I'm back in the States to have my IT Dept. change my security settings.  Until then, I have to rely on the ResMed Clinical Data info.  Best.
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#4
RE: Newbie w/issues!
a very small point but one that is often overlooked. it's my understanding the threshold for being 'treated' is ahi <5.

(mild: 5-14, moderate: 15-29, severe: 30+)
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#5
RE: Newbie w/issues!
Woops!  I was too fast there and must have hit the "6" key next to it.  Thanks for catching my error, and yes, below FIVE (5) AHI is the correct number of events per hours.

I regret my error, and for not catching it myself.
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#6
RE: Newbie w/issues!
no worries mesenteria. figured you know this and it was a typo but it's misstated often enough I took it upon myself to be the trivial detail police. besides, many of us are still fighting brain fog so we have to help each other out.
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#7
RE: Newbie w/issues!
Hi laprof. Welcome to Apnea Board.

One key point to consider is the choice of mask. You've found that pillows don't suit and the nasal mask isn't ideal either. The fact is that every face is different and a given mask is guaranteed not to suit everybody. You might need to try several different masks before you find the one that is right for you.Work with your DME and try to get a 30 day return agreement so that you can experiment a bit. My suggestion is that you go to a full face mask such as the F&P Simplus or Resmed F20. With a full face mask, you don't need to worry about mouth leaks (hence no need for taping your lips) and if your nose gets blocked you can breathe through your mouth for a while. Not too long as you'll get a very dry mouth.
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#8
RE: Newbie w/issues!
Dear Sheepless, Mesenteria, and DeepBreathing - Thank you ALL for your replies. I appreciate your willingness to help me get over this bump. I will bear in mind the <5 apneas and different masks. Of course, as I've read on this site, just when I'm ready to toss the machine through the window, I get an excellent night's sleep - last night! Had 7.5 hours of real sleep, 2.0 AHI (w/ only 0.2 CA), and a leak of 10L/min. One change that I made last night was how I put the liner on my nasal mask. I'm hoping that that small change is the start of many more good nights! Of course, I know that sleep apnea has a way of rearing its ugly head when it feels like it... Best.
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#9
RE: Newbie w/issues!
Those little victories, when they come, are so important for our morale.  I hope you continue to see them more often, LAProf.  "Perseverance" is the motto of my regiment, Lord Strathcona's Horse (Royal Canadians).  That, and an open mind, keep most of us on the climbing path.
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#10
RE: Newbie w/issues!
After years with a nasal mask, I switched to nasal pillows with mixed results. The first was a feeling of freedom. That said, I have found with the AirFit p10 was switching from medium to large pillows helped with the mask hurting from being too tight. And taking a break from the pillows by returning occasionally to a mask helped. And then mixing a Swift FX nasal pillow into the mix.
Finally, I found that sleeping on my back clears temporary congestion after a while. Also, congestion issues mostly eliminated with pillows vs masks.
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