Pokey49 - Therapy Thread

[Pokey49]

I'm 75 and a greenhorn to this CPAP stuff. I have tested as having low moderate OSA with an AHI of 16.5. I am getting fitted next week for the first time for CPAP. Ive been advised here to go with a ResMed Airsense 10 or 11 which is is an autopap machine if I understand correctly. I have some questions. 
1) does the cpap machine determine the needed inhalation/exhalation pressures based on my respiratory physiology or does it require a tech or me experimenting with pressure settings?
2) I don't think I can tolerate a full face mask, but I am a mouth breather, especially at night. Can I use a chin strap to effectively accommodate a nasal pillow or partial face mask?
3) I am almost a 100% side sleeper. Is this of benefit or hinderance one way or another? or it doesnt matter? 
4) how long does it take to acclimate  to and or benefit from cpap. It seems a fair number of people here have their share of intolerance to it??
5) Will cpap help alleviate the whole body pain I wake up with most mornings?
Thanks
Pokey

[FLcracker]

I'm 75 and a greenhorn to this CPAP stuff. I have tested as having low moderate OSA with an AHI of 16.5. I am getting fitted next week for the first time for CPAP. Ive been advised here to go with a ResMed Airsense 10 or 11 which is is an autopap machine if I understand correctly. I have some questions. 

1) does the cpap machine determine the needed inhalation/exhalation pressures based on my respiratory physiology or does it require a tech or me experimenting with pressure settings?

If you wish, there's all the knowledge you need to answer your questions is right here in this forum....We have been using CPAP for over 10 years and have never been to a tech or sleep doc...All the fine folks on this forum are very willing to help...and many are well capable of doing so.

2) I don't think I can tolerate a full face mask, but I am a mouth breather, especially at night. Can I use a chin strap to effectively accommodate a nasal pillow or partial face mask?

My Mizz Cracker, the patient, tried several different facemasks, and settled finally on nasel pillows. She mostly sleeps (L)side but will occasionally roll onto her back. She has some ongoing 'mouth breathing problems' that we are working on controlling. 

3) I am almost a 100% side sleeper. Is this of benefit or hinderance one way or another? or it doesnt matter? 

No matter..As long as you have a good seal, no major air leaks, and can stop the mouth breathing.  Chin straps and cervical collars work well for that.

4) how long does it take to acclimate  to and or benefit from cpap. It seems a fair number of people here have their share of intolerance to it??

Some never achieve the comfort level they want and quit....Make adjustment settings that are necessary from folks on here that KNOW... Small increments up or down...Then give the machine time to adjust to the changes...Don't rush it.  Her severe OSA was around 60-70 events a night...With her 'nosey' she seldom goes above 3, and she has excelled real well in her daily life since she started CPAP.

5) Will cpap help alleviate the whole body pain I wake up with most mornings?

I have no knowledge of any CPAP therapy relieving pain....That's a whole 'nother subject....there's some real good pain relievers out there....some are even legal....most of the ones that are legal however are a crapshoot at best.  Probably need to consult with your PCP for that info.

Thanks
Pokey

Good Luck Pokey...Hang in there and in due time you will see major changes and improvements.   FLc

[saltydawg2]

I'm 75 and a greenhorn to this CPAP stuff. I have tested as having low moderate OSA with an AHI of 16.5. I am getting fitted next week for the first time for CPAP. I've been advised here to go with a ResMed Airsense 10 or 11 which is an autopap machine if I understand correctly. I have some questions. 
1) does the cpap machine determine the needed inhalation/exhalation pressures based on my respiratory physiology or does it require a tech or me experimenting with pressure settings?
2) I don't think I can tolerate a full face mask, but I am a mouth breather, especially at night. Can I use a chin strap to effectively accommodate a nasal pillow or partial face mask?
3) I am almost a 100% side sleeper. Is this of benefit or hinderance one way or another? or it doesnt matter? 
4) how long does it take to acclimate  to and or benefit from cpap. It seems a fair number of people here have their share of intolerance to it??
5) Will cpap help alleviate the whole body pain I wake up with most mornings?
Thanks
Pokey

(2)Around the same age as you, and I initially started CPAP in 2014. I went through a lot of masks. I'm STILL trying masks. Lately, because of leaks and dry mouth with Using a F30. The F30, in my opinion is a very good full face mask. It seals well, and is comfortable. But a chinstrap causes some problems because of leaks where it hits the lower edge of the mask. That seams true with ALL FFM. They are seldom "Large Leaks". I'm thinking along the same lines. I think I'm going to try the F&P Brevida nasal mask with the strap, hoping to close the mouth. If it DOES open, there will be a burst of air like you wouldn't believe! All you can do is try, but I would recommend the F30 as a first mask. 
(1) The Sleep Doc will set the machine based on findings during the study. They will monitor your use for 30 days at that setting. I personally wouldn't change anything the first 30 days, as it's  usually a 30 day compliance requirement for your insurer. There is an app for them to monitor you called MyAir. It's very limited in scope. You can get it too. I would, however, install the "Oscar" software to get an idea how it's working at that setting. Then, if needed, you can post those results here, and there are some very knowledgeable folks here to help you tweak it if needed.
(3). Sleeping on your side is best. I wish I could sleep that long on my side, but my shoulders won't tolerate it. That can also bring what mask comes into play. The back allows the airway to close some, and more pressure will be required to keep it open.
(5) Lord, I don't think so....If you wake up and your legs feel like they have been going for walks without the rest of you, "Restless Leg Syndrome" could be the culprit. You need to get a complete copy of the sleep study. It's yours, so don't take no for an answer. It will likely come in handy later and also tell you about leg movement. I think we are stuck with Tylenol at nighttime.

[Pokey49]

Thanks FLcracker. I guess all I can do is work with the situation and tweak as needed until I find a sweet spot. I hve 2 friends on cpap and they report sleeping well and waking rested each morning. I will believe when I feel it as Ive had sleep issues for some time due to a combo of pain, anxiety and apparently my breath. Im working on all 3 at this point with my PCP, psych doc and I think my DBE supplier will be monitoring how I am doing and help me make adjustments

[Pokey49]

Im going to ask to try something other than a FFM the first time. I can anticipate Im not going to much like feeling like Im a fighter pilot when I go to bed. I do sleep on my sides for most of the night and yes my shoulders hurt in the morning, but my back hurts too when I lie on it in bed for to long. Old bones I guess and to many heavy backpacks in my younger days.
I think I am going to have to depend on the techs at the DBE supplier to help me with pressures. I do know that where I am getting a cpap machine that they are able to monitor things remotely. The doc who read my home sleep study is in California and I live in Missouri. His recommendation was auto pap @ 4-20cm. As I understand those are the minimum/maximum pressures of the machine ??? that it needs fine tuning somewhere within that range.
Saltydawg you suggested to leave whatever its first set on alone for the first month since Medicare might require that. What happens if those setting are obviously not working well? I am curious how it is determined that the inhalation/exhalation pressures need adjusting? Will I be able to note that pressures are to high or to low?

[Dormeo]

Medicare is interested only in seeing that you use the machine for at least 4 hours a day for most of the days during the 30-day period. They don't care at all about your settings. From trusted web site::

As far as Medicare is concerned, you are not compliant unless you are using your machine at least 4 hours each night for 70% of the nights during a 30-day period in your first three months. So, if you use your machine 22 days out of 30 for at least 4 hours a night you are compliant. If you use your machine for 3 hours, 59 minutes, and 59 seconds, you did not use it enough so you were noncompliant.

A range of 4 to 20 is a lazy sleep doctor's go-to recommendation. I strongly recommend that you start with a minimum pressure of 7. Pressures of 4, 5, or even 6 leave many adults feeling air-starved. I also recommend that you turn the ramp off and set your EPR to 3. That will make it easier for your to exhale, as your pressure will smoothly drop by 3 whenever you start to breathe out.

It's fine to leave the maximum pressure at 20 to start with, just to see how the machine responds to you. The pressure will go up when the machine sense you have had an obstructive apnea, a hypopnea, or a flow limitation. The rise in pressure doesn't "fix" the event in progress; it's intended to head off additional obstructive problems. The pressure then will go back down after you've had some time without obstruction.

I think for many people, side-sleeping works better for apnea than back-sleeping, and it works better with a mask than stomach-sleeping.

One thing you can do for mouth-breathing is to try taping your mouth. I do this using Somnifix tape, but there are cheaper options out there if tape works for you.

Here is probably the single best thing you can do to get used to PAP therapy when you get your machine. Set it up outside your bedroom during the day or evening, put your mask on, and use the machine for several hours while you watch TV, read, or use your devices. You want something that will slightly distract your brain from the new sensations and teach it that these sensations are safe and fine. If you have the latitude vis-a-vis usage requirements, I'd actually do this for a couple of days before trying to use the machine at night.

[Pokey49]

After numerous challenges that I won’t bore anyone with I finally got set up with cpap. I had my first experience last night. It didn’t go well but everyone I know or spoken to about getting started with it they all have claimed it was a hard adjustment 
My machine is a ResMed Airsense 11 with a nasal pillow & chin strap as I am normally a mouth breather at night. I couldn’t see me accommodating to a full face mask. I sleep on a semi firm orthopedic pillow for my neck. I don’t think the two would work well together. And I think it would be claustrophobic. 
While using the nasal pillow/chin strap combination last night I felt like I wasn’t getting enough air and caught myself overriding the chin strap to get a bigger breath.  So don’t know if this combo is going to work. I’m wondering about the mask type that sits under your nose and over your mouth??

Also realized I didn’t have the type of airline that is heated. The machine blowing cold air up my nose was not at all comfortable. I see ResMed offers a heated line. I assume that will work on my machine?? 

Anyway after two attempts last night to use the machine I gave up and took off the mask. Will try again tonight but thinking I need to modify my setup to be successful. Any advice would be appreciated 
Thanks
Paul aka Pokey

[SarcasticDave94]

You'll want to do a few things to succeed. First, update your user profile for the Apnea Board, so we know what you have. This info will be readily seen on every post.

Next, you need to download OSCAR charts for free in the link above. It goes onto your computer, and will get data through the standard format SD card you'll need to put in the slot on the left side panel of your CPAP before you sleep.

From there, you can post comments about the Apnea, CPAP, etc. and can attach OSCAR screenshots. Data drives informed answers, this helps us help you with accurate suggestions.

As they say, pictures are worth a thousand words.

[Pokey49]

ok I will update my profile. I downloaded Oscar the other day except the DBE provider did not give me a SD card. Also what do I need so my computer can read the SD card , a SD reader that plugs into an USB port??

[SarcasticDave94]

The SD card will be a standard case, any decent brand, between 2-128 GB capacity. You don't need the largest, just whichever you can find inexpensive.

Yes you'll need an SD card reader which will plug into a USB.

Amazon will have some decent choices for both.