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[CPAP] New to OSA/CPAP's lots of Questions!!
#1
New to OSA/CPAP's lots of Questions!!
I'm actually posting this for my husband, he was just recently dx'd with Severe OSA from an at-home Sleep Study (thru NovaSom).  His doc wrote up an RX for Auto CPAP 4-20cmH2o and told us to go to a DME store and pick one up.  We didn't go thru insurance as they would not cover anything until we hit our Out-of-Network deductible ($6000!!) so just decided to pay out of pocket.  We ended up getting the Phillips Respironics DreamStation Auto w/humidifier and an Amara view face mask.  The first night was a no-go as he "couldn't breathe" and we didn't know how to adjust settings yet. The next night I set it to A-Flex with Flex 3 and it was easier for him to tolerate, but he only got around an hour of use before the pressure ramped up too much and he couldn't tolerate it again, so off goes the mask.  The following nights I lowered the max pressure (I believe we now have it set to Min=5 Max=9) and last night shut off OptiStart and Smart Ramp but he just can't tolerate the higher pressures. I was worried about this happening, as he is fairly claustrophobic and I'm wondering if he would tolerate the increased pressures if we switched to another type of mask?  We downloaded SleepyHead and last night it said his AHI was 49.71 and he only wore the mask for over 2h35m.  I'm just confused as to what our next step should be...  Thanks in advance for any help you can give us!! Big Grin
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#2
RE: New to OSA/CPAP's lots of Questions!!
Ok. You have found the right forum so here is your first welcome.

For someone who is claustrophobic the Amara View is an excellent full face mask. For a different mask try nasal pillows with the ResMed P10 highly recommended by many here as a minimalist design. Get the fit kit as it contains am med and large pillows for your first time. Masks are typically an issue so I put together a Mask Primer to help. See my signature and please read that.

To really help you we need to see your SleepyHead charts. Could you please post them. Again see my signature.
This will tell us what is going on and allow us to really help you.

Thanks

Fred
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#3
RE: New to OSA/CPAP's lots of Questions!!
To help with adjustment to therapy. Watch TV or read while Using the cpap machine.
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#4
RE: New to OSA/CPAP's lots of Questions!!
G'day Darren (or is it Mrs Darren?). Welcome to Apnea Board.

It's very common for people to have trouble adjusting to a new way of breathing with a plastic alien strapped to your face blowing air up your nose from a compressor!!!
Shock

I remember when I started I averaged about an hour before the mask came off. I had trouble exhaling against the pressure and felt like I was drowning in air. It seems you are having the exact same problem.  The first thing to know is that it does get better with practice.  The second thing is that Philips machines have a ramp button - hit that at any time and the pressure will be reset and start building up slowly to the set pressure. It's not something to use habitually, but I found it helpful occasionally when the pressure seemed like it was too much. After a while you won't need to use it any more - in fact you can reduce the ramp time to zero.

The next thing is that masks are very individual, and many people need to try several before they find one which suits them. Fred's mask primer is an excellent introduction to researching and selecting a suitable mask.

And finally, I concur with Fred's advice to install #SleepyHead software and post some screen shots. That will definitely help us to help you.

Again, welcome to the forum, and good luck in your quest!
Paul
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#5
RE: New to OSA/CPAP's lots of Questions!!
Night 1: https://imgur.com/plclhMI
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#6
RE: New to OSA/CPAP's lots of Questions!!
Night 2: https://imgur.com/iyG44g9
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#7
RE: New to OSA/CPAP's lots of Questions!!
Night 3: https://imgur.com/aFPJd3n
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#8
RE: New to OSA/CPAP's lots of Questions!!
Night 4: https://imgur.com/jtIwyGH


Sorry for all the posts, but I can't post screen caps yet... Thanks to everyone for their replies!!
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#9
RE: New to OSA/CPAP's lots of Questions!!
Darren, the thing which really stands out in all your charts is the number of central apneas you experience. Did these show up in the initial sleep study? This is important, as you may need a completely different (and expensive) machine.

There are two basic types of apnea:

Obstructive which occur when your tongue, soft palate and other tissues in the throat collapse during sleep, blocking (obstructing) your airway. These are the most common type.

Central which are a totally different animal. Central apneas occur when the signal from your brain to your lungs to "breathe now" doesn't go through. It may not be generated by the brain, or it may be interrupted and not received / acted on by the lungs. Central apnea may be idiopathic (ie it's an existing condition) or it may be caused as a reaction to the CPAP treatment (pressure induced).

If the central apneas showed up in the original test then they are idiopathic and the appropriate machine is an adaptive servo ventilator (ASV). These are wonderfully effective in most cases but will cost several times as much as your auto machine. On the other hand, if the centrals are pressure-induced it may be possible to eliminate them by careful attention to the pressure and flex settings on your machine.

Please let us know about the original test results.
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#10
RE: New to OSA/CPAP's lots of Questions!!
I don't see it mention Central Apneas but maybe I'm reading wrong? Here's a pic of first night results: https://i.imgur.com/82vOnJx.jpg
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