Starting [CPAP] Tonight

[Sleeprider]

First of all, look at those great respiratory statistics.  Great tidal volume, good respiration rate and nothing but good health there.  A bit of leakage in teh nasal mask, but nothing out of control.  Your Philips unit does not graph flow limitation but charts it as an event, and just a couple events showing in the FL line.  Events are entirely hypopnea which suggests  you could benefit from increasing your minimum pressure (5), by at least .5 cm and possibly 1.0 cm to 6.0.   I think I'd try 6.0 unless the pressure bothers you and give that a try.  

Good results to start!

[RustySocket]

First of all, look at those great respiratory statistics.  Great tidal volume, good respiration rate and nothing but good health there.  A bit of leakage in teh nasal mask, but nothing out of control.  Your Philips unit does not graph flow limitation but charts it as an event, and just a couple events showing in the FL line.  Events are entirely hypopnea which suggests  you could benefit from increasing your minimum pressure (5), by at least .5 cm and possibly 1.0 cm to 6.0.   I think I'd try 6.0 unless the pressure bothers you and give that a try.  

Good results to start!

I have studied the charts and am trying to understand your comments.  While I can make some educated guesses about them,  I really don't have any understanding about what they mean at this point and I have no frame of reference regarding good or bad data.

I am a firm believer that I am my best advocate for my own healthcare, and I routinely discuss things with my primary care physician so that I can make informed decisions.  I have researched how to get into the clinician setup for my machine,  and have reviewed all the settings.  Not because I intend to change them, but because I simply want to know what the device can do and try to understand why it is set up the way it is.  

If you will,  could you help me understand ( or point me in the right direction to read ) what your looking at when you suggest increasing the minimum pressure and how I can learn to evaluate my data.  I'm not opposed to making the change at some point on my own, however we are only looking at a single nights worth of data and I guess I feel like I should give my provider the courtesy of allowing her to do her job without me making changes unknown to her.  

Regarding leaks,  with my very limited experience I don't see how a mask can be 100% leak free 100% of the time.  I sleep on my sides due to a back injury,  I am overweight and toss and turn a lot during my sleep just trying to stay comfortable.  When you are looking at leak data,  what or when does a leak become significant and when is the fit good enough.  I currently am using a cushion, as it was comfortable but I also felt that the pillow was comfortable (but maybe a little more intrusive).  My provider gave me an appropriate size pillow to exchange if I wanted to try it.  She didn't really want to, stating that my insurance would only pay for one, but that they did have a 30 day fit guarantee.  When I asked about the cost of the extra pillow it was insignificant with respect to just what it costs me in fuel to drive the roundtrip to exchange it,  so I said I would just pay for it myself as I would rather have an option at home to try.   The problem I see with this approach of "try it and see"  is again that I have no frame of reference and I could easily see someone getting into a "chasing the rainbow" situation trying every mask available.  I hope that makes some sort of sense.  

I like to read,  point me in the right direction  and Thank you for taking the time to share your knowledge.

[Sleeprider]

Start with Robisue's Begginer's guide to Sleepyhead, and we can talk in the morning.
http://www.apneaboard.com/wiki/index.php...SleepyHead My minor change is based on many years of looking at this, and you certainly do not "need" to do anything. 5 is a very low pressure, and your machine tends to be behind the curve in getting to, and staying at an effective pressure. If you see continuing hypopnea, that would be the reason why.

[RustySocket]

Thanks for the reply and the links to read.

I have a tendency to over-analyze things. It's just my nature.

[RustySocket]

Here are my most recent charts: On 9-10 I changed from a cushion to the pillows to see if that would be more comfortable.  I had a real hard time falling asleep and felt like I was not getting enough air/struggling to breath.  As you can see I layed awake for a while, removed the mask and hit the ramp button.  I feel like the air is too humid and warm.  I dont notice this sensation when I put the mask back on in the middle of the night after a restroom break.  It's just when I first lay down to sleep that I feel like I'm not getting enough air.  I either open my mouth and let air flow out or lift the mask a bit to vent it.  It's like I'm breathing air out of a baloon that doesn't have enough Oxygen in it or something.  However again, I don't notice that in the middle of the night.  I am resisting the anxiety and trying to just calm myself through it as I know I'm not really suffocating but that what it feels like at first.  

Also,  with respect to this thread.  Should I continue to post charts here or start a more proper titled thread?  What is the convention followed with respect to the trend on this board?

Thanks again for all the comments and suggestions.



Switched to Pillows for the next chart.  First two short sessions I was awake and struggling to get my breath.  

[Gideon]

What size pillow are you using?  Try the next size up.  A lot of users try/are given too small of a pillow.

[mogulman]

I had a CPAP a few years ago and couldn't get used to it. Started back on it about a month ago.

I was using Nasal Pillows back a few years ago, and I had to use a Large, where I use Medium for a mask or nasal mask. Not so much for the size, but because the nasal openings were bigger on the large.

That being said.... I really like the Nasal Mask a lot more than Nasal Pillows. Pillows felt better on my face. I felt a little constricted even with the Large pillows though. I feel less constricted with the nasal mask that I have now.

Also...I toss and turn a lot and notice that my leak rate is much lower than you. I also had 3 back surgeries from 2010-2013. I mostly sleep on my side but occasionally on my back. Prior to back surgery I was a stomach sleeper.

[RustySocket]

I should have clarified. The sensation of not getting enough air is the same with the cushion and the pillows. I switched from the cushion to the pillows to see if I could get more comfortable and less leakage when I sleep on my side. I have attempted to sleep on my back but that is just not going to work for me.

The mask frame I was supplied is a large. The cushions and pillows are both smalls. I will speak with my provider and see what other options I can come up with to try.

From what I read the sensations I am experiencing are common. I have a positive attitude and believe most of this is psychological and that I will overcome it with time.

I'm also trying to understand what my machine is trying to do in Auto mode. I notice from my graphs that in the middle of the night after I have been asleep for a while it raises the pressure a bit and then drops it back down. This seems to be cyclical and repetitive. Then at other times it does different things that seem random. Does anyone have any insite on this and what events or patterns it looks at to make these changes?

[Gideon]

Read http://www.apneaboard.com/wiki/index.php...SleepyHead
There is much interpretive data in this article.

Flow Limit (FL in the events chart). Snore, are frequently precursors to Obstructive events.  OA (Obstructive Apnea) and H (Hypopnea) are obstructive events.  After they occur your machine will increase pressure to prevent future events.  If none occur pressure is reduced after a period of time.  For CA (Central Apnea/Clear Airway) events nothing is done.  Your machine sends short pressure pulses to check what is happening.  That is the nutshell version.

[mogulman]

You may want to try a Nasal Mask instead of the Cushion/Pillows. Or if you think the leakage is coming from your mouth opening during sleep, maybe switch to a full face mask?

I found my leakage is a lot less and I could breath better with Nasal mask rather than cushion/pillow type.