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Newbie with (lots of!) questions
#11
RE: Newbie with (lots of!) questions
Hi super10,
WELCOME! to the forum.!
Good luck to you as you start your CPAP therapy, hang in there for more answers to your questions.
trish6hundred
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#12
RE: Newbie with (lots of!) questions
Thanks everyone for your replies!

And, well, things are moving forward! I am now the proud owner of a ResMed S10 Autoset machine! I found an amazing deal on Craigslist, used in a smoke free house with only about 200 hours use. I won't mention the price, but it's low enough that I could make my money back if I do need to sell it.

I also have a Mirage Quattro full face mask on order, which should arrive tomorrow. I used the sizing template for it, and I think I'm a large, so fingers crossed that it fits. I also have some Remzzzs liners on order, that I hear help with leaking for bearded guys using full face masks. As Katmanndoo says, the biggest worry now is that masks don't fit with my beard, because I can't easily try lots of different masks without a prescription. So I'm just hoping that I get lucky and can at least get the Mirage Quattro to fit well enough for me to figure out whether I do have sleep apnea or not.

As BHappy says, there could be a number of causes for my daily headaches. My doctor thought sleep apnea sounded most plausible, and the more I've read about the condition and its other symptoms, the more I'm inclined to agree that it's worth me checking for it. Hopefully, by spending so little on the machine, I won't lose too much money if it turns out not to be sleep apnea after all.

I'm guessing that seeing as I haven't had the sleep study to know what pressure to use, I should just set the pressure range on the machine to as wide as possible and let the machine figure out what pressure to use for itself? Then if I wake up in the morning and it says it stayed at low pressure with no/few episodes that this suggests I don't have sleep apnea?
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#13
RE: Newbie with (lots of!) questions
The machine range is 4-20. I would suggest 6-20 for most normal adults. The settings also include a comfort feature called EPR (Exhale Pressure Relief) that can be set from 1-3. That corresponds to cm-H2O pressure, so a higher number is more pressure relief.
Sleeprider
Apnea Board Moderator
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#14
RE: Newbie with (lots of!) questions
Well the Mirage Quattro and the Remzzzs arrived, so I may give this a try tonight. I'm anticipating that it will be hard to sleep while I get used to it, so was going to wait until tomorrow night (when I don't have to be up for work the next day) for my first night, but I'm too curious to wait. If I'm still not sleeping after a couple of hours I can always give up for tonight and take the mask off.

I did the fit test thing on the S10 with the mask, and after a lot of playing around with the straps, got it so that I had the smiley face the whole time. I didn't use the Remzzzs when I did that, because they're single use and I didn't want to waste one, but hopefully that'll make it even better when I include those. The only concern I have is that I had to do the straps up pretty tight to get it to not leak, and all the guidance I've read says that overtightening is the worst thing to do. But I guess we'll see tonight...

I set the machine from 6-20 as Sleeprider suggests.
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#15
RE: Newbie with (lots of!) questions
Ok people, first night's data is below. Please can someone help me interpret what it means? First thing to say is, it looks like the times are wrong, so I'll have to double check that on the machine (I went to bed a couple of hours later than it says). Getting used to the mask was difficult, and I feel like I didn't sleep much at all, but perhaps these results indicate that I slept more than I thought I did? I certainly woke up with a huge headache, as I usually have done lately, so the CPAP therapy certainly didn't help that for the first night, though maybe that will take time.

The main question is - do I have sleep apnea? Again, I haven't had a sleep study and am self-diagnosing here, so the first thing I need to know is whether I do have sleep apnea at all?

Then, beyond that, what do these results tell me? Is the Apnoea Hypopnea index good/bad/ok? If it's bad, how do I get it lower? Is the leak index ok or too high? Anything else of note to people who understand these sorts of results?


[Image: 33621529695_b38be0aa87_k.jpg]
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#16
RE: Newbie with (lots of!) questions
You clearly have several periods of obstructive apnea. The cluster at 22:45 is associated with a large leak, and may be a sleep disruption or arousal. At 22:30 there is a cluster of mixed apnea, and you then have a pretty quiet night until 03:15 when you have some more events, and presumably stop therapy.

I have several suggestions to quiet this down. First, lets turn EPR down to 1. Minimum pressure to 7. Everything else looks okay for a first night. I think a lot of events are due to arousal and sleep disruption, and you will see a significant reduction of events moving forward. Nothing unusual about this as you adjust to this new experience.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#17
RE: Newbie with (lots of!) questions
Thanks again Sleeprider! You're a lot less expensive than a sleep study, and just as useful  Grin

I've made the changes you suggest to the machine's settings. I'm also going to try a different mask tonight, the Resmed P10 nasal pillow. I'm skeptical about this, because I'm a mouth breather, but it would be wonderful if I could get a lightweight mask like that to work for me, so thought I'd give it a go. I got a chin strap, but I'm not convinced that's going to work by itself... even just testing it earlier awake, I still wanted to exhale through my mouth. But reading online, some people suggest also sticking your lips together with denture strips. I'm going to try that tonight with the chin strap and see what happens... if it still doesn't stop me breathing through my mouth, it'll be back to the full face mask tomorrow.
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#18
RE: Newbie with (lots of!) questions
Hi Super10.

The Centrals seem to start when the pressure goes up. Hopefully with the higher minimum floor the machine won't need to react and kick up the pressure higher than 10 or 11 cmH2O. You will probably feel your ribs aching, tired and quite unrested in the mornings initially. Will probably take a couple weeks or so for the body to get used to breathing under pressure. The ribs/lungs are "exercising" to exhale under pressure even with EPR 1. Just persevere and it will get better.

edit: I too had morning headaches before becoming a hosehead - that was what triggered me to embark on a sleep study and this journey. I rarely wake up with headaches now, unless it was a previous night of strange beers, strange red wine or food triggers. Note you mentioned earlier about difficulty doing a sleep study. Not sure if you meant doing one at a clinic or that even covers doing one at home. There are home kits you can use to do a sleep study, an e.g. is Supplier #10 in the supplier lists above, which offers rental kits for such purposes. That way you would also be able to get a reading on your SPO2 levels during the night if the headaches persist, in addition to other information.
lots-o-coffee
The doctor says coffee does not affect my tinnitus and it's got lots of antioxidants....however, the after dinner drinks are a different matter altogether. 
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#19
RE: Newbie with (lots of!) questions
Well now I'm really confused! I feel like I just had a really good night's sleep, and if these results are to believed I didn't have too many sleep apnea episodes. But I also had some large leaks, so maybe that affected the accuracy of the results? Also, as you can see from the graphs, I gave up on the nasal pillows really quickly and switched back to the full face mask. I don't think nasal pillows are for me.

On the headaches, part of me thinks that sleep apnea isn't the cause of them, or is only a partial cause, but time will tell. I woke up at around 6:30ish to use the bathroom and had a seriously banging headache, but then went back to sleep for a couple of hours and now only have a very slight headache, which is unusual for me without taking painkillers. So we'll see... I guess I need to continue the treatment for longer to see what happens with the headaches.

Newbee2016 - thanks for the advice! The issue with the sleep study is basically that I'm a Brit working in America. My British employer won't pay for me to have a sleep study done in America, and has instead booked me to have one done under the British National Health Service next time I'm back in the UK. I'm not going back on a trip for a few months, and due to how fed up I was getting with the headaches decided I would take matters into my own hands and just buy the machine in advance of this. I might still have the sleep study done when I do go back on the trip, but I haven't decided yet. I guess it depends whether I feel 'cured' just by using the machine by that point or not.


[Image: 32827894003_26f314796f_k.jpg]
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#20
RE: Newbie with (lots of!) questions
super10, congratulations on your encouraging progress. The duration of your large leaks was short enough that the apnea readings are still good. An AHI of 2.42 is impressive at this stage, and you will probably improve on that number soon.

I wish you would tell us more about your brief experience with the P10 mask. There are some tricks to using nasal pillows successfully, but we can't help you if you don't tell us what the problem is. You mentioned before that you are a mouth breather. I was too when I was using a full face mask, but I learned to use the P10 in just a few minutes of practice while wide awake. I quickly realized that there is a huge advantage in having the CPAP pressure applied specifically to your nostrils, because the nasal and sinus passages open faster and wider than they do with a full face mask and so breathing through your nose becomes considerably easier. You then don't feel that urgent need to open your mouth to breathe - at least that was my experience. I am not sure that you experimented long enough with the P10 to really notice the difference and relax into it.

Perhaps you also find the P10 headgear (straps) too tight. You can reduce the pull considerably if you separate the straps extremely widely, with one strap pulled down almost to the nape of your neck and the other one pushed forward on top of your head. It seems weird at first but I know it works well because I do it every night!
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