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Survived my first night with CPAP, but just barely
#1
Ohmy 
Well, night one down. Very restless night, much like in the sleep study. Going by the Respiratory Rate in SleepyHead, I slept maybe 2 1/2 hours tops. Hoping for a better night tonight. A few observations:

1) Still trying to get the CLA temp and humidity right. Setting Climate Control to Auto made it too humid, playing around with it set on manual at 1 or 2. Hose temp was 64, but might bring that up a tick. With warm humid air for some reason I feel like I'm not getting enough air, like the feeling you get when you pull a blanket over your head. Cool air is more refreshing, so I'm trying to set the humidifier at the minimum it would take not to dry me out.

2) Related to the point above, one creeping thought I keep having was that the mask wasn't exhaling right and that I was inhaling my own CO2 right back in. I have a P10, and when I exhale I didn't feel it flowing out of the mask vents in the front. It was a steady whisp of air the whole time. Is that how it's supposed to feel? How do you tell if the vent is blocked?

3) Set the EPR from 2 to 3. EPR is good. Made breathing feel more natural.

4) I found that with the mask off I was prone to taking medium low-effort shallow breaths (1sec inhale, 1sec exhale), and with the mask on I couldn't help but take long deep breaths (3 sec inhale, 3 sec exhale) and that, more than anything else, is what I think kept me up all night. I was way too conscious of my breathing. Couldn't go into auto-pilot and not think about it. Hearing the sound of my mask on inhale/exhale contributed to that as well.

5) It know it's a contradictory thought, but I keep wondering how I'd do with either the pressure turned up or down. One one hand my current setting of 8 makes it hard to breath in a shallower and more relaxed fashion, and on the other it sometimes feels like I'm fighting against resistance when inhaling. The mask seems to fit fine, though, so I'm not sure it has to do with the size of the nasal openings.

6) Good news is that I kept my mouth shut all night without a chin strap. Yay for that. Only time I was tempted to open my mouth was for a big inhale of refreshing cool air, related to points above.

7) On account of the previous points, I'm tempted to switch the machine into APAP mode with a tight range, perhaps 7-9. I might play around tonight setting the CPAP to different pressures to see how it feels to breath with it. Not sure yet.

8) I don't know if it's because the treatment is working super-well or that I never feel in deep enough sleep, but apart from one hypopnea that looks caused by a mask leak (which, thankfully, there were very few of compared to my FFM at the SS), I had ZERO events (apart from some snoring averaging around level 1 on SH)! Hard to believe right out of the gate. For reference, my home study said I had just a few OAs but a hypopnea every 2 minutes correlated with a drop in blood oxygenation. There's the tiny nagging feeling that the home study was mistaken and they never monitored that in the SS (went straight for titration), but the fact that I'm so tired mid-day seems to back up that the home study was onto something. I'm overweight too, but I don't think that's just it.

9) Not sure if this is any known side effect, but I felt hot all night. Maybe because the air was too humid and I was exhaling hot humid air with it being diffused all around my face. I dunno. I was thinking the room was too hot, but when I took the mask off at about 6AM I felt cooler. Ugh.

10) Had to get up to pee twice last night, which is unusual. There's a 33-50% chance of me doing that once around 5AM, so I consider this an anomaly. Another side effect?

11) Am I supposed to hang up my hose to air out after each night or is that only after a weekly washing? Can I just store it in a bin or something during the week?

So yeah, really confused and concerned. Hoping to push through past the weekend but if I keep getting 2 hours of sleep at night I may have to give up during the week as I have a 45 minute highway drive to work and I -cannot- nod off doing 75MPH. Any advice is much appreciated.

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#2
Most of your points sound like what I went through. I had to force myself to trust the equipment. I adjusted the settings while awake and once they felt right just crossed my fingers and slept.

The air out the vents is not very strong, if it's there then they are not plugged.
I try to avoid standing water in the hose.
APAP mode sounds like a good idea.

I think you are doing well, keep it up!
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#3
(11-21-2015, 12:37 PM)PoolQ Wrote: Most of your points sound like what I went through. I had to force myself to trust the equipment. I adjusted the settings while awake and once they felt right just crossed my fingers and slept.

The air out the vents is not very strong, if it's there then they are not plugged.
I try to avoid standing water in the hose.
APAP mode sounds like a good idea.

I think you are doing well, keep it up!

Thanks for the reply! I just spend 30 minutes tweaking the settings so I'm crossing my fingers they'll work better tonight. Now for APAP, do you find that it'll quickly go to the max pressure and stay there? I tried a very tight window of 7-8 and within a minute or to it ramped up to 8 and I was just breathing normally. Didn't come down until I restarted the machine. Also, one thing I'm going to try is a static setting of 7 since that felt more natural than the 8. Hopefully that'll let me fall asleep faster and if my AHI goes up then I'll know it's not enough.
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#4
Maybe the reason why you felt like you were not getting enough air, was because you weren't! Setting the machine on straight CPAP mode at 8cm of pressure might be a starvation setting for you. Since you have an APAP machine (everybody wants), I don't see any logic to putting it into CPAP mode. APAP is the way to go. But if you put it into a "tight window" you are not letting the APAP do its thing. Give it a big window (like a max of 12 or 14) and let it self-adjust your pressure through the night. Changing the EPR to 3 is also the way I'd go.

On #2, put the mask on, turn the machine off, then exhale. You should be able to tell if the vents are working. It's unlikely that you're exhaling down into the hose then inhaling the same air. Your machine is not gonna let you do that, I don't think. Possibly just your imagination because the 8cm was too low?

On #10, maybe that was because you were awake most of the night? Kidneys are more active awake than asleep.


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#5
Want to refer to your #8 question/statement and your last paragraph.

That 0.0 AHI is pretty much meaningless if you are not sleeping more than a couple hours.

I know that it was your first night, but try to wear the mask with machine on while reading or watching TV for an hour before bed. You will get used to it faster that way.

I'd rather see you on APAP with a range of 8-13, then watch for a week and then download some graphs from sleepyhead here. This way, we would know what your pressure needs are and be able to advise you better.
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#6
My concern with setting the APAP range that high is 1) my ENT might get pissed because he was reluctant to write me an APAP script even CPAP is what the sleep study physician recommended, and 2) I'm concerned that if the APAP jumps to the higher pressures it'll either keep me awake or wake me up. Falling asleep and staying that way is my goal for the next few days. I'll be keeping an eye on SleepyHead to make sure my hypopneas are under control.
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#7
(11-21-2015, 01:36 PM)Tacoma Droner Wrote: Maybe the reason why you felt like you were not getting enough air, was because you weren't! Setting the machine on straight CPAP mode at 8cm of pressure might be a starvation setting for you.

[Image: ax1BseG.png]

You nailed it! Even though it felt funny for a few minutes I initially upped the pressure from 8 to 8.6 and then 9 after a mid-sleep break. MUCH BETTER! Apart from a single bathroom break I slept through the whole night! I no longer had the restricted breathing sensation that in hindsight was the reason I couldn't fall asleep in the sleep study or last night. My body kept thinking it was going to suffocate. I think 8-9 was the highest the SS ever got and it took them a while to get there. I am so relieved right now! Feeling pretty good too after 8 hours of sleep, but still a little tired on account of the awful night I had before. Looking forward to tomorrow morning.

Also, I had an AHI of 0.26! Only one CA and one OA for the whole night, and no hypopneas! The CA reported a small mask leak of 2.4 after the event was entirely over followed by some erratic breathing so the event looks legit. Same with the OA. One thing I did notice was that when my respiratory rate was the lowest and most stable, I was snoring despite no events (though there was some "flow limit" activity). Does that mean I could use even more pressure?
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#8
It gets better - the more you use it.
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#9
Amazing
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#10
Thanks everybody! One more thing, am I supposed to empty out the humidifier every day or just keep topping it off & wash it out weekly?
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