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[Pressure] 2nd time user
#1
Gross 
2nd time user
Hi, I was diagnosed with OSA in 2017 and used a Resmed S9 with a humidifier. This lasted about 3 months after using a Quattro mask, after this I stopped using the machine because of a change in medications which opened my throat more and I felt better and had greater nights of sleep, this was a reduction in Gabapentin which had a rare side effect in causing a swelling in my throat and enlarging my tongue. Unfortunately because of a historical spinal bleed, I had to start raising the Gabapentin again and on top of that, I was starting to get testosterone injections because mine was very low. Along with the morphine tablets, I have slipped right back to 2017.

Now my main problem is the sleep medicine dept at the hospital have given me a machine to set my pressure again but unlike the S9 I cannot get comfortable with the pressures in this machine which is the Airsense 10 autoset. So far in the weeks that I have had it, I've managed 2 hours which shows an AHI of 20. I'm worried now because I go back to the hospital on the 9th of December with a shockingly low level of readings. 

I was directed here by veteran users who were on Facebook and now I feel I need help in using this new machine but the downside is I'm NOT allowed to adjust the settings without a nurse approving it. My only communication is with their answering machine and they get back to me the next again day.
Anything that people could recommend including setting changes I could pass onto the nurses.

One further thing is there such a thing as wide fitting full face masks that don't squeeze your nostrils together.  Thanks
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#2
RE: 2nd time user
Hi Chutchy50. Welcome to Apnea Board. You will have to post your OSCAR charts before we can see if changes need to be made to your settings.

There are lots of different full face masks, and you will need to contact your equipment providers about getting a different one that fits you better. They are usually required to help in this regard, so don't hesitate to ask them.
Sleepster
Apnea Board Moderator
www.ApneaBoard.com


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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#3
RE: 2nd time user
Sorry about that, first-time nerves lol

As I said my attempt is dire.


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#4
RE: 2nd time user
Welcome to the forum.
A few questions

Do you have a history of Central apnea?
Can you post a full copy of your diagnostic study, not just the summary, the charts and tables too. ?
What were your settings on the S9? Including EPR?
What is your current EPR?

I would love to know all of the above but you need to get the centrals under control. The quickest way to do that is to
1. Set EPR =0. This has the highest probability of a rapid improvement.

2. Set min pressure to 6 strictly for comfort

IF these centrals are caused by low CO2 in your blood this will work.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
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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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#5
RE: 2nd time user
[attachment=17663]


My ERF on the S9  was set at 0 and the pressure I was comfortable at was 10, I have since found out after having a search on some UK medical sights that I'm basically in a catch 22 position with OSA and my low testosterone and my replacement therapy. Low testosterone is bad for sleep apnea and the therapy aggravates OSA. Claustrophobia has a big part to do with mask-wearing and breathing through it, the feeling of suffocating causes mild panic.


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#6
RE: 2nd time user
Testosterone actually made me gain weight while I was on it, about 3 months. I had to stop because I thought it increased my BP. looking back at those 3 months I now think not taking anastrozole made me gain 25lbs due to increased estradiol. the extra 25lbs made my sleep disordered breathing way worse, enough that it finally stood out (glaringly). my worsened sleep disordered breathing was probably the cause for my high blood pressure. I'm also hoping that sleep disordered breathing was the cause for my low T to begin with and that it self corrects while on CPAP.

are you awake a long time while wearing the mask? I have a lot of central apneas even while awake if I don't concentrate on taking slow, comfortable breaths while wearing the mask. at times I've forgotten to do this while awake, instead I inhale and exhale deeply, it carries into my sleep and centrals become my main problem.

have you tried masks that don't sit on the bridge of your nose(full face, nasal pillow, nasal cushion) ? a different mask that doesn't rest on your nose may help with feelings of claustrophobia.
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#7
RE: 2nd time user
The feeling of suffocation is likely due to the low pressure of 4. You probably would be better off at 6 as an absolute minimum like most adults.
Dave Sparky DukeNukem

I'm not a doctor in real or fictional life. My posts include opinions based upon user experience and researched info regarding CPAP therapy and should not be considered medically professional directions or advice.


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#8
RE: 2nd time user
I have adjusted the machine to 0 EFR and set the pressure to 6. But it’s still the pressure breathing out that is still the issue. I have even reduced my morphine intake from 75 to 40mg. At this moment in time I haven’t been to sleep from 6.30am Monday morning till now Tuesday afternoon 4pm. Now I don’t feel tired at all, I’m now thinking of stopping my testosterone injections. After trying out 2 masks I have realised straps on both masks sit where I had my spinal bleed. I’m lost.
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#9
RE: 2nd time user
Please post your sleep study results as requested by @bonjour.
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#10
RE: 2nd time user
The charts that will help people help you are the Daily charts. Before posting them, please turn off the pie chart (File - Preferences - Appearance) and the calendar (small triangle to the left of the date. Please stack your graphs this way:

Events
Flow rate
Pressure
Leaks
Snores
Flow limitations.

You can squeeze the graphs by grabbing the horizontal gray line that separates them.

If possible, please also post your sleep study, blanking out any personal information.
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