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Starting Treatment
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Geniale Offline

Preferred Members

Posts: 48
Joined: Jan 2016

Machine: PR System One Auto 60 Series
Mask Type: Nasal pillows
Mask Make & Model: AirFit P10 for Her
Humidifier: PR System One Heated Humidifier
CPAP Pressure: 7-7 cm H2O
CPAP Software: SleepyHead

Other Comments: UARS

Sex: Female
Location: Canada

Post: #11
RE: Starting Treatment
So... first night went quite well actually! The mask is my biggest annoyance. Can't say I slept better than usual, but I think I didn't have too much trouble getting used to the machine, although my pressures are quite low, so that probably helps. I felt kind of weird (light-headed, slightly dizzy and nauseous) this morning and throughout the day. Headaches were worst than usual as well. I don't know if those are normal side-effects or not, we'll see if it persists.

My SleepyHead results seemed really promising! I attached a screenshot (keep in mind I have UARS, so in my sleep study, my AHI was only 0.4 but my RDI was 18.6).

[attachment=2113]

Maybe you guys can help me understand if my leak rates are normal (I had major leaks a few times because my nose would get itchy from the humidity and I had to lift the mask to scratch). I think I also had a small leak going into my right eye, but I couldn't feel it if I put my hand in front of it, just a cold feeling in my eye, adjusting the mask didn't do anything, so maybe I was just imagining it!

Another thing I'm wondering is why the machine keeps lowering and raising the pressure every few minutes, even if I'm not having any events... I know that woke me up a couple of times because I could feel it ramping up.

Oh, and also, the writing on SleepyHead on the daily sidebar (left hand side) is really small, and I can't seem to change that... is there a way to make it more legible? I changed the sizing of the writing in the other areas so that it was easier to decipher, but couldn't figure out that one (which IMO is the one you most want to be able to read).

Thanks!
(This post was last modified: 02-03-2016 11:47 PM by Geniale.)
02-03-2016 11:44 PM
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GPSMapNut Offline

Advisory Members

Posts: 175
Joined: Nov 2015

Machine: DreamStation Auto
Mask Type: Nasal pillows
Mask Make & Model: Resmed AirFit P10 and PR DreamWear
Humidifier: DreamStation + heated hose
CPAP Pressure: 9-16
CPAP Software: SleepyHead EncorePro Other Software

Other Comments: Used Respironics REMstar Pro with C-Flex for 11 years and ResMed S9 Elite loaner for 3 months

Sex: Male
Location: Mississauga, ON, Canada

Post: #12
RE: Starting Treatment
Leak rate is very good - remember that what you see in SH for PR machines is the total leak which includes intentional (venting) and unintentional. In Encore, you could view unintentional. In any case, IMHO, the rates I see in your graph are very good.

Itchy nose? I'd expect it from lack of humidity. I sometimes get it before water in humidifier warms up and than it goes away.

AFAIK, Jumping pressure as shown in SleepyHead is not jumping. These are test pressure pulses that machine sends when it senses an event or an imminent event. These pulses are just that - pulses. They are not nearly as long as you would think looking at the graph. In my opinion, it's a bug in sleepy head that shows them as a line steeply raising to a pick and than falling. In reality they are so short that normally not even perceivable. Maybe they show in SH as spikes because of low resolution of pressure data from PR machines. In Encore, they are marked as a pressure pulses and don't even show on the pressure graph.

Everything I post on this board is nothing more than an opinion expressed by an apneak. Normally, it's based on facts and experience but sometimes, I may get things wrong or not have all the facts.
I reserve the right to change my mind. Why? Because tomorrow I may know better.
02-04-2016 09:17 AM
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Geniale Offline

Preferred Members

Posts: 48
Joined: Jan 2016

Machine: PR System One Auto 60 Series
Mask Type: Nasal pillows
Mask Make & Model: AirFit P10 for Her
Humidifier: PR System One Heated Humidifier
CPAP Pressure: 7-7 cm H2O
CPAP Software: SleepyHead

Other Comments: UARS

Sex: Female
Location: Canada

Post: #13
RE: Starting Treatment
As well, thank you for taking the time to respond!

I had a even better night yesterday, will post about it shortly.

(02-04-2016 09:17 AM)GPSMapNut Wrote:  Itchy nose? I'd expect it from lack of humidity. I sometimes get it before water in humidifier warms up and than it goes away.

I preheat my humidifier while I brush my teeth and get ready to go to bed, so the water's warm by the time I put on the mask. The itchy nose (which I had again last night) is more towards the end of the night than the beginning - around 4 or 5 AM.

(02-04-2016 09:17 AM)GPSMapNut Wrote:  In Encore, they are marked as a pressure pulses and don't even show on the pressure graph.

I downloaded Encore, mainly because I wanted to compare how it flagged events (I find on SleepyHead that some of the events that are flagged aren't really anything while there are other moments in the flow rate that even my un-expert eyes can tell are events) but the display settings make it really wacky. I posted a thread on the Software Support Forum, but until I'm able to resolve this issue, there's nothing I can do with it.
02-04-2016 11:09 AM
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GPSMapNut Offline

Advisory Members

Posts: 175
Joined: Nov 2015

Machine: DreamStation Auto
Mask Type: Nasal pillows
Mask Make & Model: Resmed AirFit P10 and PR DreamWear
Humidifier: DreamStation + heated hose
CPAP Pressure: 9-16
CPAP Software: SleepyHead EncorePro Other Software

Other Comments: Used Respironics REMstar Pro with C-Flex for 11 years and ResMed S9 Elite loaner for 3 months

Sex: Male
Location: Mississauga, ON, Canada

Post: #14
RE: Starting Treatment
(02-04-2016 11:09 AM)Geniale Wrote:  >>>>>
I preheat my humidifier while I brush my teeth and get ready to go to bed, so the water's warm by the time I put on the mask. The itchy nose (which I had again last night) is more towards the end of the night than the beginning - around 4 or 5 AM.

For that, I'd increase the humidification setting.

Everything I post on this board is nothing more than an opinion expressed by an apneak. Normally, it's based on facts and experience but sometimes, I may get things wrong or not have all the facts.
I reserve the right to change my mind. Why? Because tomorrow I may know better.
02-04-2016 03:29 PM
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Geniale Offline

Preferred Members

Posts: 48
Joined: Jan 2016

Machine: PR System One Auto 60 Series
Mask Type: Nasal pillows
Mask Make & Model: AirFit P10 for Her
Humidifier: PR System One Heated Humidifier
CPAP Pressure: 7-7 cm H2O
CPAP Software: SleepyHead

Other Comments: UARS

Sex: Female
Location: Canada

Post: #15
RE: Starting Treatment
(02-04-2016 03:29 PM)GPSMapNut Wrote:  For that, I'd increase the humidification setting.

Thanks, I've been using the humidifier and heated tube on max settings for the past couple of nights. It's a little better, but my nose still gets itchy.
02-06-2016 10:57 AM
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Geniale Offline

Preferred Members

Posts: 48
Joined: Jan 2016

Machine: PR System One Auto 60 Series
Mask Type: Nasal pillows
Mask Make & Model: AirFit P10 for Her
Humidifier: PR System One Heated Humidifier
CPAP Pressure: 7-7 cm H2O
CPAP Software: SleepyHead

Other Comments: UARS

Sex: Female
Location: Canada

Post: #16
RE: Starting Treatment
So, I've been using the machine for four nights now.... still feeling very light-headed all day since then (is this normal? low blood pressure?) and headaches are worst. On the plus side, I don't feel like I've been run over by a truck (only a car) when I wake up in the morning)!

Day 3 I increased my minimum pressure to 6cmH2O, to see if I would feel better, but no. Plus, I realized it was probably too early in treatment to start toying with pressures, so I put it back down to 5.

Days 3 and 4 I couldn't even feel the pressure anymore, sometimes I wondered if the machine was still on, so I'd make a small leak to check and sure enough, it was working. So I guess I'm getting used to it.

Day 4 I switched to a softer pillow to see if I would notice leaks less and sure enough, whilst my leak rate is not any better, I woke up less often (but my husband was also away, so that could have played a role).

However, my RDI has gotten worse in the past couple of nights...

Here are my charts:

[Image: screenshot-2016-02-02.png?dl=0]

   
   
   

Any comments, advice, recommendations are appreciated! Thanks!
(This post was last modified: 02-06-2016 12:01 PM by Geniale.)
02-06-2016 11:15 AM
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vsheline Offline

Advisory Members

Posts: 1,907
Joined: Jul 2012

Machine: S9 VPAP Adapt (USA Model# 36007, not better 36037 or 36067)
Mask Type: Full face mask
Mask Make & Model: F10 or SimPlus w/ 2Liners. MirageQuatro & Gecko gel pad
Humidifier: H5i
CPAP Pressure: 15 EPAP, PS 5-10
CPAP Software: ResScan

Other Comments: Marfan Syndrome, chronic bradycardia, occasional Cheyne-Stokes Respiration

Sex: Male
Location: California, USA

Post: #17
RE: Starting Treatment
Hi Geniale,

It would be fine to increase the Min Pressure setting to 6 or higher, especially if this is more comfortable for you.

The saw tooth increases in pressure are not a SleepyHead bug; these are normal. The machine raises the pressure 1.5 cmH2O occasionally to see if this reduces Flow Limitation and stays at a higher pressure if improvement is observed.

I think using A-Flex setting of 1 (not 0, 2 or 3) is best for lowering Flow Limitation.

Raising the Min Pressure should also help avoid Flow Limitation and UARS.

Because you are feeling dizzy/headachy, I suggest lowering the Max Pressure setting to 15 or lower for the first few weeks. Can always raise again later after you discover more about how you react to high pressures.

Take care,
--- Vaughn

Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
(This post was last modified: 02-06-2016 01:45 PM by vsheline.)
02-06-2016 01:16 PM
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GPSMapNut Offline

Advisory Members

Posts: 175
Joined: Nov 2015

Machine: DreamStation Auto
Mask Type: Nasal pillows
Mask Make & Model: Resmed AirFit P10 and PR DreamWear
Humidifier: DreamStation + heated hose
CPAP Pressure: 9-16
CPAP Software: SleepyHead EncorePro Other Software

Other Comments: Used Respironics REMstar Pro with C-Flex for 11 years and ResMed S9 Elite loaner for 3 months

Sex: Male
Location: Mississauga, ON, Canada

Post: #18
RE: Starting Treatment
(02-06-2016 01:16 PM)vsheline Wrote:  .......
The saw tooth increases in pressure are not a SleepyHead bug; these are normal. The machine raises the pressure 1.5 cmH2O occasionally to see if this reduces Flow Limitation and stays at a higher pressure if improvement is observed.
.....
Do you see the same increases in Encore?

Everything I post on this board is nothing more than an opinion expressed by an apneak. Normally, it's based on facts and experience but sometimes, I may get things wrong or not have all the facts.
I reserve the right to change my mind. Why? Because tomorrow I may know better.
02-07-2016 07:26 AM
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Geniale Offline

Preferred Members

Posts: 48
Joined: Jan 2016

Machine: PR System One Auto 60 Series
Mask Type: Nasal pillows
Mask Make & Model: AirFit P10 for Her
Humidifier: PR System One Heated Humidifier
CPAP Pressure: 7-7 cm H2O
CPAP Software: SleepyHead

Other Comments: UARS

Sex: Female
Location: Canada

Post: #19
RE: Starting Treatment
(02-06-2016 01:16 PM)vsheline Wrote:  Hi Geniale,

It would be fine to increase the Min Pressure setting to 6 or higher, especially if this is more comfortable for you.

I think using A-Flex setting of 1 (not 0, 2 or 3) is best for lowering Flow Limitation.

Raising the Min Pressure should also help avoid Flow Limitation and UARS.

Because you are feeling dizzy/headachy, I suggest lowering the Max Pressure setting to 15 or lower for the first few weeks. Can always raise again later after you discover more about how you react to high pressures.

Take care,
--- Vaughn

Thank you for the advice! I tried increasing the minimum pressure to 7 (and max pressure to 15) the night before last to 7 and felt less lightheaded in the morning. My RDI also went back down below 1. However, my mask leaks at anything higher than 6 and I woke up countless times trying to adjust it. I had one eye that was completely tomato red for the first hour after waking (it went away after a few applications of synthetic tears) but was still really dry all day.

Last night, I kept my settings to 7-15 with A-Flex 1 but couldn't tolerate it - all I could feel was the air leaking into my eyes and was making me really anxious and panicky. The skin outside my nose would get really itchy, I could hear/feel all the tiny leaks and pressure points, I kept making tiny adjustments and felt like everything was just getting worse, my head felt like it wanted to explose, I basically I just felt the need to rip the mask off my face. So, that's what I did, and I got up, read, to a bath, and stayed up until I knew I would fall asleep quickly. I went back to bed and set the pressure back down to 5, because I didn't want to feel that anxiety again. I want the use of CPAP to be as enjoyable as possible so that I'm able to use it - I don't want to associate it with feelings like last night's, so I figured using it at 5 was better than not using it at all. My RDI did go back up however.

Basically, I think it's time to change masks...

The good news it that I don't feel it difficult to breathe with the pressure (even at 7 it felt like the machine wasn't even on except for the noise).
02-08-2016 10:36 AM
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Geniale Offline

Preferred Members

Posts: 48
Joined: Jan 2016

Machine: PR System One Auto 60 Series
Mask Type: Nasal pillows
Mask Make & Model: AirFit P10 for Her
Humidifier: PR System One Heated Humidifier
CPAP Pressure: 7-7 cm H2O
CPAP Software: SleepyHead

Other Comments: UARS

Sex: Female
Location: Canada

Post: #20
RE: Starting Treatment
(02-07-2016 07:26 AM)GPSMapNut Wrote:  
(02-06-2016 01:16 PM)vsheline Wrote:  .......
The saw tooth increases in pressure are not a SleepyHead bug; these are normal. The machine raises the pressure 1.5 cmH2O occasionally to see if this reduces Flow Limitation and stays at a higher pressure if improvement is observed.
.....
Do you see the same increases in Encore?

[Image: Capture%20test.PNG?dl=0]
02-08-2016 10:41 AM
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