Trying CPAP one last time... AHI looks really bad

[Sleeprider]

I gave you the default starting pressures, and the machine may elevate EPAP to a higher level if obstruction is detected. PS minimum of 3 is the Resmed recommendation and it works well for most people. The machine will deliver up to 15 cm of pressure support if you have a central or hypopnea where your normal minute vent rate is not maintained. I have coached a few people to try different starting pressure where we have an awareness of problems with pressure support, but my strong preference is to go "by the book" for the first night and then make adjustments from there.

[gsilver]

Alright. I'll try it tonight and see how it goes.

//Realizes that it'll probably be rough at first... Good thing that the machine showed up today instead of Monday like the tracking information originally said

[Sleeprider]

Good luck! I am actually pretty confident you will be fine based on what I have seen of your centrals and past treatment. Just blow if it feels like the machine is taking you for a ride.

[gsilver]

Alright... first night with the new machine. It was really hard to sleep on it since it felt like every breath had a different pressure (the only time where I was solidly asleep was about 2:30 - 5:00), and I experienced a number of small leaks, so I had to adjust the mask straps a number of times. On the plus side, AHI was 0.15 with only 1 hypopnea in the entire night, and I actually felt like getting up this morning before 7:30! Still kind of tired, but being able to get up that early is certainly an improvement. 

Attached the graphs.

[Sleeprider]

Congrats on making it through your first night.  To help us all out, please minimize the monthly calendar by clicking the trangle in the date line and turn off the pie chart in File/Preferences/Appearance.

You basically had no apnea events all night, but your sleep was disrupted. Your EPAP stayed in the 4.0-5.0 range most of the time, so a starting pressure of 4.0 works.  If you find the minimum PS 3 is disruptive, you can cut that back or not. This is going to be a matter of adapting and becoming comfortable with a therapy that is going to take some time to get used to.  As best I can tell, your PS was in the range of 3 to 10 through the night, so you did not require anywhere near the maximum range of 15 cm PS.  The machine is working completely as expected and you are doing a great job with it to put together a stretch of good sleep...this will get better with time.  I think in time, the default settings can be narrowed, and you can experiment with lower minimum PS and see if that helps.  Otherwise, this is a very promising start.

You've come a long way!

[trailrider]

Congrats of your progress! It's a journey. At least you are in the right direction with your new ASV!

[Gideon]

[jaswilliams]

Well done with your first night, as you get used to the way an ASV works your sleep will get better great effort

[Marillion]

As others have said, given time you will get used to the new machine and will sleep easier. What a difference! I'm really glad you came here to ask for help. If you would have stayed on your previous machine (as many do) you would have become another one of those that have given up on CPAP with the resulting very bad consequences to your health. Well done and keep up the good work! Keep us posted as to how things go.

[gsilver]

Yeah. I figure that I'll probably be able to get used to it. It's annoying, but I'm already noticing a few ways that I feel better than before (though I'm still a ways from being able to get by without napping).
I also figured out that if I strongly inhale when the machine raises pressure on me when I'm still awake, it'll back off a little. That helped last night.

And, similar to the first night, I was awake (or sleeping very lightly) for most of the first part of the night, but after getting up for a bit, re-adjusting the mask, and then trying to get back to sleep, I got more sleep during the second half.

Though one thing that was odd was that the mask felt very damp the first night, yet I woke up with my mouth feeling completely dried out the second. On both nights, the humidifier chamber was down to about 50% by morning. I might have opened my mouth for a while while asleep (though being a full face mask, it didn't leak that much)