Nasal Mask vs Face Mask (Newbie)

[RaydeeohMan]

The only settings I have are the humidity level and ramp time. It will let me do a Mask Fit test, and run warmup but I can't set the pressure myself. That can only be set by my doctor. It was originally set on Auto (4-20) but he changed it a week ago to a fixed setting of 7.That made a big difference. Before that it seemed to be really blowing too hard.
I have the humidity level set at 4. I did feel a bit of dry mouth this morning, so may change it to 5.
Last night went much better; I kept the mask on for around 5 hours. I'm hoping that this CPAP machine makes a real difference for me, like people say it does. The way I sleep now I feel like a zombie with a bad hangover!
I wonder how often should I import data into Oscar? Once a week, maybe? It's easy to dock I just have to remember to lock the card so Oscar won't write any files to it. I read that when that happens, the CPAP machine won't write more data to the card.

[Jas_williams]

No need to lock the card with an AutoSet 10 that was only for the older S9 range of machines

[RaydeeohMan]

No need to lock the card with an AutoSet 10 that was only for the older S9 range of machines

Thanks, Jas. One less thing to worry about.

[RaydeeohMan]

Just commentary: I have read here that CPAP machines come from the factory with the pressure set at min 4 and max 20 (Thanks, LSAT). When your doctor orders a machine for you s/he specifies the pressure that is appropriate for you. EXCEPT that the pressure often remains at the same range of 4-20. That is exactly what happened to me. I struggled adapting to my machine like everyone else, but I think it was even harder because the pressure was too high. I called Apria 3 times but they were no help. They did say that only my doctor can change the prescribed pressure. They never said that he didn’t order a specific pressure at all!
I finally called my doctor, who had to put me on hold while he called Apria to get access to my machine. That told me that he was not monitoring my results or paying any attention at all to how I was doing. After he got my report he changed the pressure from 4-20 to 7. That is what he told me anyhow. I have no way to check the pressure setting on my machine. I assume that is blocked, as Apria said that only my doctor can change the setting.
I know that the coronavirus has changed how things are done now, and that is why I never was brought in to be trained on using my CPAP machine. I am still shocked though that my doctor wouldn’t pay any attention at all to how I was doing. Maybe I’m just naive, but given that pretty much everyone struggles to adapt to using a CPAP, why would a doctor just completely ignore a patient? I can’t go to his office in person, but he can download my data, and talk to me on the phone. That finally did happen, but only after I initiated it. I had so little information I didn’t even know that normally the patient is brought in to be trained and fitted in the use of the CPAP. The only thing I was ever told by my doctor was that he was ordering the machine for me and that it would be shipped to me soon. And, actually it was the receptionist who told me that.
I’m just venting here, and maybe I’ve been spoiled by having doctors that actually care about their patients. Part of the problem is the epidemic, but that doesn’t explain all of it. I’m glad at least that I found this CPAPTalk board. I might even eventually see some improvement in my sleep!

[Pugsy]

I have read here that CPAP machines come from the factory with the pressure set at min 4 and max 20

That range is only applicable to the machines that will do an auto adjusting mode with a minimum and maximum pressure. Those are the factory defaults for auto adjusting/apap machines in auto mode.

Your equipment profile shows the AirSense 10 CPAP machine. It is NOT a machine that has an auto adjusting/apap mode available.
The default pressure setting from the factory for that machine is simply 4 cm fixed all not. It can't auto adjust at all.

Can you confirm if you have the AirSense 10 CPAP machine or if you have the AirSense 10 AutoSet machine?
If it is the AutoSet and you couldn't find it....look down in the R section of the machines in the equipment menu.

You aren't locked out of the clinical menu setup area....all you need to know is the secret handshake or combination of button pushing to get into it.
You might want to download and read the manual...it explains all that.
https://www.respshop.com/manuals/ResMed ... %20her.pdf

[DreamDiver]

Just commentary: I have read here that CPAP machines come from the factory with the pressure set at min 4 and max 20 (Thanks, LSAT). When your doctor orders a machine for you s/he specifies the pressure that is appropriate for you. EXCEPT that the pressure often remains at the same range of 4-20. That is exactly what happened to me. I struggled adapting to my machine like everyone else, but I think it was even harder because the pressure was too high. I called Apria 3 times but they were no help. They did say that only my doctor can change the prescribed pressure. They never said that he didn’t order a specific pressure at all!
I finally called my doctor, who had to put me on hold while he called Apria to get access to my machine. That told me that he was not monitoring my results or paying any attention at all to how I was doing. After he got my report he changed the pressure from 4-20 to 7. That is what he told me anyhow. I have no way to check the pressure setting on my machine. I assume that is blocked, as Apria said that only my doctor can change the setting.
I know that the coronavirus has changed how things are done now, and that is why I never was brought in to be trained on using my CPAP machine. I am still shocked though that my doctor wouldn’t pay any attention at all to how I was doing. Maybe I’m just naive, but given that pretty much everyone struggles to adapt to using a CPAP, why would a doctor just completely ignore a patient? I can’t go to his office in person, but he can download my data, and talk to me on the phone. That finally did happen, but only after I initiated it. I had so little information I didn’t even know that normally the patient is brought in to be trained and fitted in the use of the CPAP. The only thing I was ever told by my doctor was that he was ordering the machine for me and that it would be shipped to me soon. And, actually it was the receptionist who told me that.
I’m just venting here, and maybe I’ve been spoiled by having doctors that actually care about their patients. Part of the problem is the epidemic, but that doesn’t explain all of it. I’m glad at least that I found this CPAPTalk board. I might even eventually see some improvement in my sleep!

Some hopeful feedback...

1. Your machine profile shows the Airsense 10 CPAP. You actually have an Airsense 10 Autoset set in CPAP mode according to your recent OSCAR post. (This is a more flexible machine than a straight CPAP-only machine.) If you fix that in your profile, we'll be better able to help you.
2. It's your machine, and your therapy. If your doctor is too busy or Covid-19 is hamerping your therapy, you can take control of your own therapy. People on this forum can help you find the clinician's menu so you can set your own pressures. The Respiratory Therapist (RT) at your DME (Apria) is required to wait for a prescription to make changes to your therapy. You are not bound by that policy. It's your therapy. You can make changes to your machine's pressures as you please.
3. From your previous OSCAR chart, it looks like straight CPAP therapy at 6cm is actually a pretty good starting place for you!
4. I'm curious if you could post a couple more days of charts so we can see your progress.
5. If it looks like some settings changes might help, we can tell you how to make those settings changes for yourself. You can try them on for size and see how you're adapting.
6. If your RT gets upset and tries to change your settings without your permission, you can put your machine into airplane mode so they can't change your therapy. If they squawk, you can tell them you'll be making the pressure changes from now on, and that if they want to read your data for compliance, they're no longer allowed to change your settings without your permission. Tell the doc you're taking control. Then, put it back off airplane mode so they can review your data via 4G.
7. It's good to vent, and your therapy thread is the right place to do it, so vent away!
8. Keep letting us know how it's going for you.

[dvejr]

Getting a mask fit that is comfortable and effective is very difficult and takes a lot of experimentation. I am so used to my mask, it is so comfortable, that I sometimes reach up to touch my face in bed to make sure I remembered to put it on.

[RaydeeohMan]

I have read here that CPAP machines come from the factory with the pressure set at min 4 and max 20

That range is only applicable to the machines that will do an auto adjusting mode with a minimum and maximum pressure. Those are the factory defaults for auto adjusting/apap machines in auto mode.

Your equipment profile shows the AirSense 10 CPAP machine. It is NOT a machine that has an auto adjusting/apap mode available.
The default pressure setting from the factory for that machine is simply 4 cm fixed all not. It can't auto adjust at all.

Can you confirm if you have the AirSense 10 CPAP machine or if you have the AirSense 10 AutoSet machine?
If it is the AutoSet and you couldn't find it....look down in the R section of the machines in the equipment menu.

You aren't locked out of the clinical menu setup area....all you need to know is the secret handshake or combination of button pushing to get into it.
You might want to download and read the manual...it explains all that.
https://www.respshop.com/manuals/ResMed ... %20her.pdf

It IS the Autoset machine, as DreamDiver noted. I was told that only my doctor could adjust the pressure and I had no reason to doubt that, but that obviously is wrong. It may be true for Apria personnel, but clearly I can change it myself if I decide to do so. I think for now though I will leave it at 6.I will study that manual though, there may be other little tricks in there I should know about.

Thanks!

[RaydeeohMan]

Just commentary: I have read here that CPAP machines come from the factory with the pressure set at min 4 and max 20 (Thanks, LSAT). When your doctor orders a machine for you s/he specifies the pressure that is appropriate for you. EXCEPT that the pressure often remains at the same range of 4-20. That is exactly what happened to me. I struggled adapting to my machine like everyone else, but I think it was even harder because the pressure was too high. I called Apria 3 times but they were no help. They did say that only my doctor can change the prescribed pressure. They never said that he didn’t order a specific pressure at all!
I finally called my doctor, who had to put me on hold while he called Apria to get access to my machine. That told me that he was not monitoring my results or paying any attention at all to how I was doing. After he got my report he changed the pressure from 4-20 to 7. That is what he told me anyhow. I have no way to check the pressure setting on my machine. I assume that is blocked, as Apria said that only my doctor can change the setting.
I know that the coronavirus has changed how things are done now, and that is why I never was brought in to be trained on using my CPAP machine. I am still shocked though that my doctor wouldn’t pay any attention at all to how I was doing. Maybe I’m just naive, but given that pretty much everyone struggles to adapt to using a CPAP, why would a doctor just completely ignore a patient? I can’t go to his office in person, but he can download my data, and talk to me on the phone. That finally did happen, but only after I initiated it. I had so little information I didn’t even know that normally the patient is brought in to be trained and fitted in the use of the CPAP. The only thing I was ever told by my doctor was that he was ordering the machine for me and that it would be shipped to me soon. And, actually it was the receptionist who told me that.
I’m just venting here, and maybe I’ve been spoiled by having doctors that actually care about their patients. Part of the problem is the epidemic, but that doesn’t explain all of it. I’m glad at least that I found this CPAPTalk board. I might even eventually see some improvement in my sleep!

Some hopeful feedback...

1. Your machine profile shows the Airsense 10 CPAP. You actually have an Airsense 10 Autoset set in CPAP mode according to your recent OSCAR post. (This is a more flexible machine than a straight CPAP-only machine.) If you fix that in your profile, we'll be better able to help you.
2. It's your machine, and your therapy. If your doctor is too busy or Covid-19 is hamerping your therapy, you can take control of your own therapy. People on this forum can help you find the clinician's menu so you can set your own pressures. The Respiratory Therapist (RT) at your DME (Apria) is required to wait for a prescription to make changes to your therapy. You are not bound by that policy. It's your therapy. You can make changes to your machine's pressures as you please.
3. From your previous OSCAR chart, it looks like straight CPAP therapy at 6cm is actually a pretty good starting place for you!
4. I'm curious if you could post a couple more days of charts so we can see your progress.
5. If it looks like some settings changes might help, we can tell you how to make those settings changes for yourself. You can try them on for size and see how you're adapting.
6. If your RT gets upset and tries to change your settings without your permission, you can put your machine into airplane mode so they can't change your therapy. If they squawk, you can tell them you'll be making the pressure changes from now on, and that if they want to read your data for compliance, they're no longer allowed to change your settings without your permission. Tell the doc you're taking control. Then, put it back off airplane mode so they can review your data via 4G.
7. It's good to vent, and your therapy thread is the right place to do it, so vent away!
8. Keep letting us know how it's going for you.

Thanks DreamDiver, yeah it's definitely an Autoset machine. And I can get into the menu to change the settings if I ever decide to do so. Right now I am no where near being confident enough to do that. There is just so much I don't know yet. I still have to study how to interpret all that data that Oscar is providing. I'm definitely not worried about getting my RT upset, mostly because to my knowledge I don't have one. I doubt if I'll be hearing from my doctor's office unless I make contact first.

I'm not sure which type of chart is best but here is both a daily one from last night, and one that covers all time, which for me is April 8 - May 3, 2020.

Thanks for all your help!

[DreamDiver]

Thanks DreamDiver, yeah it's definitely an Autoset machine. And I can get into the menu to change the settings if I ever decide to do so. Right now I am no where near being confident enough to do that. There is just so much I don't know yet. I still have to study how to interpret all that data that Oscar is providing. I'm definitely not worried about getting my RT upset, mostly because to my knowledge I don't have one. I doubt if I'll be hearing from my doctor's office unless I make contact first.

I'm not sure which type of chart is best but here is both a daily one from last night, and one that covers all time, which for me is April 8 - May 3, 2020.

Thanks for all your help!

Some more feedback:

Still good on your current settings, so again you could probably keep it here for a bit just to see how things balance out.

The "daily" chart is often most useful. Obviously, that's the first chart you shared below. It looks like you've set up the left side bar and graphs just right. If you could scrunch the graphs to fit your window or make the OSCAR window taller for your screen capture, we'll also see your flow limitation graph better. At times that can be useful.

Occasionally, it's nice to see your Statistics tab, but that's for long-term views, like 1-month, 6-month and 1-year comparison trends. For now, dailies are good.

Notice how one area in the Event Flags graph is lighter than the other. That's the bit that shows up magnified in the lower graphs. So it looks like you've been exploring the magnification feature for looking closer at specific flagged events in the flow rate graph. That's great! However, unless you've got a question about a specific event or cluster of events that you want someone to view closeup, it's best to show the full graphs. That way, you can better evaluate things like your pressure graph and flow limitations over the whole night or session.

The below image shows an example of how to get graphs back to full zoom: Right click in the area highlighted in red, pull down to "100% zoom level". The screencapture that for upload on the forum.

For now, just keep using the mask and machine, do the research you require to make yourself comfortable and let us know in a few more days how you're doing by posting some more daily graphs right in this thread so we can track your progress with you.

Sounds like you've got this!

Chris

[RaydeeohMan]

Getting a mask fit that is comfortable and effective is very difficult and takes a lot of experimentation. I am so used to my mask, it is so comfortable, that I sometimes reach up to touch my face in bed to make sure I remembered to put it on.

They sent me a nasal mask to start with, but I had no idea that I was supposed to sleep with my mouth closed so that didn't go very well. I called Apria and they sent me a full face max, which I tried a few times. While I was waiting for that I kept using the nasal mask, and gradually got used to it. So, for now I'm just using the nasal mask, but I'm not sure which I'll end up using. I did get a chin strap to help me keep my mouth closed and that helps too. I am getting used to the nasal mask, I definitely know it's there but I don't have any trouble falling asleep.

[dvejr]

I've long used nasal pillows and suffered mouth leaks. In my experience, it doesn't help much to clench (or cinch) my jaw. Air just flows past my teeth, flaps my lips, and emerges.
I live with it. Others apparently tape their lips together!

[zonker]

I've long used nasal pillows and suffered mouth leaks. In my experience, it doesn't help much to clench (or cinch) my jaw. Air just flows past my teeth, flaps my lips, and emerges.
I live with it. Others apparently tape their lips together!

i'm using what forum member jay aitchlee has advised-

viewtopic/p1089718/viewtopic.php?f=1&t= ... s#p1086296

this plus a firm foam cervical collar has done wonders for me.

[DreamDiver]

I've long used nasal pillows and suffered mouth leaks. In my experience, it doesn't help much to clench (or cinch) my jaw. Air just flows past my teeth, flaps my lips, and emerges.
I live with it. Others apparently tape their lips together!

i'm using what forum member jay aitchlee has advised-

viewtopic/p1089718/viewtopic.php?f=1&t= ... s#p1086296

this plus a firm foam cervical collar has done wonders for me.

We really are all so different. Even with jay's gear, I'd be in jvejr's camp. Air would just leak past my teeth and past my lips. Dry mouth in five minutes. No chipmunk cheeks though! So no nasal masks for me.

Chris

[zonker]

I've long used nasal pillows and suffered mouth leaks. In my experience, it doesn't help much to clench (or cinch) my jaw. Air just flows past my teeth, flaps my lips, and emerges.
I live with it. Others apparently tape their lips together!

i'm using what forum member jay aitchlee has advised-

viewtopic/p1089718/viewtopic.php?f=1&t= ... s#p1086296

this plus a firm foam cervical collar has done wonders for me.

We really are all so different. Even with jay's gear, I'd be in jvejr's camp. Air would just leak past my teeth and past my lips. Dry mouth in five minutes. No chipmunk cheeks though! So no nasal masks for me.

Chris

heh. true, what works for me doesn't necessarily work for thee.

also, i realize that i don't post this link with the same accompanying text each time.

i have modified jay's method to something that works more readily for me. i use two scunics instead of his suggested one. one goes around as jay indicates. up over the top of my head. but i add another that goes around and over the back of my neck. i also use wee elastic bands that help secure the rig in place.

what this does is, it takes my top lip and presses it against my top teeth. the other band presses my bottom lip and presses it against my bottom teeth. pushing them together in effect sealing them and no air escapes.

the cervical collar helps keep my jaw from dropping.

all of this allows a smooth path for air to come in through my nasal mask and lowers my ahi.