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Therapy is not working!!!
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erossco Offline

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Posts: 6
Joined: Feb 2015

Machine: resmed airsense 10
Mask Type: Full face mask
Mask Make & Model: unsure
Humidifier: unsurr
CPAP Pressure: 5 to 20
CPAP Software: Other Software

Other Comments:

Sex: Male
Location:

Post: #1
Therapy is not working!!!
Hello. I am hoping someone can help me to understand something. I have been on CPAP therapy since February of this year. It has not gone well at all. I started out with a full face mask with a Resmed AirSense 10 machine. I could not get used to the air flooding my face after the ramp time ended. My doctor suggested I get the nasal pillows. I am a nose breather and I have no problem keeping my mouth closed. Everything I have read indicates the pillows work well for someone who has no problem breathing through their nose. I honestly have no clue how to breath when using the pillows. I am a nose breather and I find it impossible to exhale using them. I can't wear them more than 5 minutes. With air going into your nose, how do you overcome it when you need to exhale? Any help will be greatly appreciated. I have not used the machine in over a month because I need more than 2 hours of sleep.[/font]
09-22-2015 08:34 PM
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OpalRose Offline

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Posts: 3,181
Joined: Nov 2014

Machine: PR System One REMstar Auto 560 with A Flex
Mask Type: Nasal pillows
Mask Make & Model: AirFit P10 For Her
Humidifier: REMStar heated humidifier with heated hose
CPAP Pressure: Auto Cpap 10-13 AFLEX 1
CPAP Software: SleepyHead EncoreBasic

Other Comments: Started CPAP Therapy October 23, 2014

Sex: Female
Location: Northeast Ohio, USA

Post: #2
RE: Therapy is not working!!!
Welcome erossco,
Breathing should feel natural with nasal pillows. Are you using the EPR feature on your machine?
EPR drops the pressure when you exhale. There are 3 settings, 1,2 or 3.

Your pressure setting of 5-20 could also be part of the problem. Do you know where your medium and 95% pressure is? Has your AHI reading been under 5.

You could try moving your minimum pressure up a bit. A starting pressure on 5 is too low for most people. We could zero in on a better setting for you if you could give us a bit more information to go on.

OpalRose
09-22-2015 08:51 PM
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DeepBreathing Offline
Wiki Editor
Moderators

Posts: 2,296
Joined: Sep 2013

Machine: Resmed S9 VPAP Adapt
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: Resmed H5i
CPAP Pressure: EPAP: 9 - 15 PS: 3 - 10
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Male
Location: Perth, Western Australia

Post: #3
RE: Therapy is not working!!!
Hi Erossco, welcome to Apnea Board

To help us help you, we really need some more details...

Edit: Just noticed your setting is 5 - 20. This indicates an Autoset machine, which is a great choice. As OpalRose said, 5 - 20 is too wide a range and may be contributing to your problem.

First, which machine do you have? There are several different types of Airsense 10s, including CPAP, Elite, Autoset and "Autoset for her". The name will be printed somewhere on the front of the machine. This is important, as the different models have different capabilities.

Second, what is your pressure setting? This should be on your prescription, assuming you haven't changed it. If you don't have your prescription, ask for it! Otherwise you will can follow the instructions here: http://www.apneaboard.com/resmed-airsense-10-aircurve-10-setup-info

Third, are you using pressure relief? This drops the pressure by 1,2 or 3 units on exhalation, making it much easier to breathe out.

Fourth, do you have the correct mask type set on your machine? There are different settings for full face masks, nasal mask and nasal pillows.

And lastly (phew!) are you using software to monitor your progress? The MyAir system will give you a general indication, but you really need SleepyHead to look at the intimate details. SleepyHead is available here: http://www.sleepfiles.com/SH2/ It's a free download, but I know that Mark (who wrote the software) would really appreciate a donation to help him continue development.

Read the setup guide I mentioned above, read all the documentation which came with your machine, and read this user guide: http://www.resmed.com/au/dam/documents/p...ac_eng.pdf

The machine will be a big part of your life from now on. It can make life so much better for you, but only if you put in some effort to understand the machine and its settings. Once it's all tuned in, you should find breathing a lot easier and your sleep will be refreshing.

DeepBreathing
Apnea Board Moderator
www.ApneaBoard.com


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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.
09-22-2015 08:56 PM
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MobileBasset Offline

Advisory Members

Posts: 198
Joined: May 2015

Machine: ResMed AIRCURVE 10 V Auto
Mask Type: Nasal mask
Mask Make & Model: Fisher Paykel Zest
Humidifier: Integrated
CPAP Pressure: 10 (minE 6,maxI 12, PS 3)
CPAP Software: ResScan SleepyHead Other Software

Other Comments:

Sex: Female
Location: Florida

Post: #4
RE: Therapy is not working!!!
I never tried a FFM but have been using a nasal mask successfully for years. Because of all the hype I decided to give the nasal pillows a try and I had the same exhale problem you are describing plus some others. So I returned to the nasal mask with which I have no problems. I do use a lesser pressure on exhale because I am on bilevel but an EPR setting on your machine will do the same thing.

Others who have been successful with the pillows will give you the list of things to adjust. I'm just saying there is still another type of mask to try.

If you try a nasal mask don't get a size that crowds your nose. You want a good amount of air space around the nose.

if you can't decide then you don't have enough data.
09-22-2015 09:01 PM
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zonk Offline

Advisory Members

Posts: 7,908
Joined: Feb 2012

Machine: A10 AutoSet
Mask Type: Nasal mask
Mask Make & Model: Activa LT
Humidifier: Integrated /ClimateLineAir
CPAP Pressure: 9/13
CPAP Software: ResScan

Other Comments: CPAP since Nov 2010

Sex: Male
Location: Australia

Post: #5
RE: Therapy is not working!!!
(09-22-2015 08:34 PM)erossco Wrote:  Everything I have read indicates the pillows work well for someone who has no problem breathing through their nose.
I cannot use nasal pillows either, prefer nasal mask ... don't believe everything you read to be true
What works for someone, not necessary going to work for someone else
Not using software, what the machine sleep report say ... hours, AHI, AI, central Ai, leak, pressure?
You'll need check "Essentials" set on "Plus" in the clinical menu so the data can be displayed on the sleep report
SleepyHead software download at the top of page, works with windows and Mac computers

Pressure range 5-20, so I assume you have AirSense 10 AutoSet, this is wide range for the machine to works within
You'll need look at the SD card download and see what is really going on
09-22-2015 09:14 PM
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Sleeprider Online
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Advisory Members

Posts: 3,385
Joined: Dec 2014

Machine: Resmed Aircurve 10 Vauto
Mask Type: Nasal pillows
Mask Make & Model: Resmed Airfit P10
Humidifier: Resmed Climateline
CPAP Pressure: Auto Bilevel 18/9, PS 3
CPAP Software: ResScan SleepyHead EncoreBasic

Other Comments:

Sex: Male
Location: Where they make Respironics

Post: #6
RE: Therapy is not working!!!
Therapy may or may not be working. How many hours per night do you use your CPAP? As far as exhale pressure, it takes time to get used to the pressure, but if you are above 14 cm H2O pressure, you might qualify for bilevel therapy that allows for lower exhale pressures. Meanwhile, the EPR (Exhale Pressure Relief) setting on your machine should help. It is important that you understand your therapy and take a look at its effectiveness using software. Sleepyhead software available from the forum is a great way to really quantify events and visualize your progress.

So looking at your machine, what are your average and 90% pressures? By all means, talk with your doctor and make this work. It's important for your long-term health.

______________________________________________
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09-22-2015 09:38 PM
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PaulaO2 Offline
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Moderators

Posts: 8,067
Joined: Feb 2012

Machine: S9 Autoset
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: H5i
CPAP Pressure: 14-20
CPAP Software: SleepyHead

Other Comments: Ehlers-Danlos Syndrome, Hypermobility Type; chronic sarcasm

Sex: Undisclosed
Location: western NC, USA

Post: #7
RE: Therapy is not working!!!
Each mask is different. I used one nasal pillow mask then switched to another nasal pillow mask. I could not breathe out well and had a hard time adjusting. I changed the EPR from 1 to 3 and that fixed it. Eventually I moved it to 2 once I got used to it.

So try raising the EPR to see if that helps. Sit up with the mask on and the machine on and wear it while watching television or reading. This will get you used to it faster.

PaulaO2
Apnea Board Moderator
www.ApneaBoard.com


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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.
09-22-2015 10:54 PM
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trish6hundred Offline

Advisory Members

Posts: 6,451
Joined: May 2012

Machine: Resmed S9 AutoSet for Her
Mask Type: Full face mask
Mask Make & Model: Fisher & Paykel Simplus
Humidifier: H5i Heated Humidifier
CPAP Pressure: 10 - 7-20 Cm H2O
CPAP Software: Not using software

Other Comments: I started CPAP in 2008. Totally blind since birth.

Sex: Female
Location: Missouri, USA

Post: #8
RE: Therapy is not working!!!
Hi erossco,
WELCOME! to the forum.!
I encourage you to stick with CPAP therapy. Once you get it fine tuned to your needs it will work well for you.
Much success.

trish6hundred
09-23-2015 03:05 PM
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PaytonA Online
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Monitors

Posts: 3,015
Joined: Dec 2013

Machine: ResMed S9 VPAP Auto
Mask Type: Full face mask
Mask Make & Model: Resmed Mirage Quattro
Humidifier: H5i(distilled-top up)
CPAP Pressure: VAuto MinE14.0 MaxI 20.6 PS4.0
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Male
Location: Orange County,California

Post: #9
RE: Therapy is not working!!!
It would be helpful to know what kind of nasal pillows mask erossco is using. Some of them seem to take a little different methods to get the pillows seated properly.
09-23-2015 06:50 PM
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justMongo Offline

Monitors

Posts: 3,853
Joined: Sep 2013

Machine: ResMed VPAP Auto (S9)
Mask Type: Full face mask
Mask Make & Model: ResMed Mirage Quattro
Humidifier: ResMed H5i
CPAP Pressure: 18 IPAPmax - 11 EPAPmin, PS=5
CPAP Software: Other Software

Other Comments: μολὼν λαβέ

Sex: Male
Location: Калифорния

Post: #10
RE: Therapy is not working!!!
(09-22-2015 09:38 PM)Sleeprider Wrote:  Therapy may or may not be working. How many hours per night do you use your CPAP? As far as exhale pressure, it takes time to get used to the pressure, but if you are above 14 cm H2O pressure, you might qualify for bilevel therapy that allows for lower exhale pressures. ...

A bilevel auto may be appropriate.

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.
09-23-2015 07:16 PM
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