Another NewB getting frustrated

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
wallanbrewer
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Another NewB getting frustrated

Post by wallanbrewer » Sun Apr 15, 2018 3:19 pm

Started PAP therapy 14 days ago. Use ResMed Airsense 10 with humidifier. SlimLine Non-Heated hose. Phillips Armara View full facemask.
I am an extreamly active sleeper is why I choose Full FaceMask. Really felt early on as tho I was having success and on my way to better things to come.
Felt more rested in morning even tho I was only sleeping 6 -7 hrs. But since those early nights, things seem to be getting more frustrating.
I am finding myself waking more frequently fighting the mask due to leaks around the corners of my mouth. It seems to happen when pressure builds up
or I have moved in my sleep knocking the mask out of optimal position. Did have one night where AHI was 3.2 and many nights averaging around 8 - 12 events.
Just tired of fighting to get a solid nights sleep. Called supplier of equipment to work on solution - not quick enough for my liking, but that is a different issue.
Have been lots of reading on this forum for answers, but thought it be benificial if posted my problem directly.
I have started importing nightly statistics into SleepyHead but do not really understand what it is telling me.
I really want this therapy to work. So any and all advice and suggestions are welcom

download/file.php?mode=view&id=532

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Pugsy
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Re: Another NewB getting frustrated

Post by Pugsy » Sun Apr 15, 2018 3:52 pm

Welcome to the forum.

Do you spend much time on your back?

I think you need to fit your mask at the beginning of the night at a higher pressure because where it's going it doesn't work so great.
What works fine for seal at 4 to 6 cm doesn't work so great when you get in the teens. No wonder it is leaking.

Also...I think if your minimum pressure was higher it would help that leak issue later in the night along with better prevent your airway from closing and might even prevent the pressure from needing to go higher and causing leaks and/or being so annoying.
These machines work best when in prevention workload instead of fix it after it happens mode.

Something maybe around 8 to 10 minimum if you can handle it. If you can't...go up slowly and watch the data as you go up.
Might get lucky and not need as much as I initially might think.

You need to ignore the CAs/Centrals for now...I suspect they are more along the lines of sleep/wake/junk from the awakenings than they are real. Besides...we can't fix them using this machine anyway. Fix the obstructive stuff that needs to be fixed and then we see if there is enough centrals to worry about.

The clusters late in the night...probably REM or on your back or both. You just need even more pressure at that time.
I may have to RISE but I refuse to SHINE.

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LSAT
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Re: Another NewB getting frustrated

Post by LSAT » Sun Apr 15, 2018 3:53 pm

Right off the bat I can see that your minimum pressure of 4 is way too low....I would gradually raise it to at least 8. It's possible that the 4 was depriving you of air and that's why you are waking up frequently. Leaks really look good so even though you are fighting with the mask, they're not affecting your AHI.

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Pugsy
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Re: Another NewB getting frustrated

Post by Pugsy » Sun Apr 15, 2018 4:12 pm

Do you have this clinical/provider manual?
If not get it and read it.
It's different than the user manual that comes with the machine.
https://sleep.tnet.com/home/files/resme ... -guide.pdf
I may have to RISE but I refuse to SHINE.

wallanbrewer
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Re: Another NewB getting frustrated

Post by wallanbrewer » Sun Apr 15, 2018 6:33 pm

I like to sleep on my side - more on my right side than on my left.
But since starting PAP Therapy and struggling with mask, I have migrated to my Back
thinking that would help with mask issues.

I have downloaded the Clinical manual and have read it. It looks like the
only thing the equipment supplier did was set time and date. Left everything
else default settings. I do seem to like and handle the higher - actually 10 -12 pressure sooner
in ramp than Auto Ramp so am thinking to lower Ramp to 5 or 10 minutes. Good idea?

Do you believe changing to a Nasal would help with mask issues?
My only concern there would be when I have congestion due
to cold causeing breathing through mouth.
Another reason I went with Full FaceMask. I have read here where some
have two seperate mask. But not crazy over that idea.

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Okie bipap
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Re: Another NewB getting frustrated

Post by Okie bipap » Sun Apr 15, 2018 6:46 pm

Many people do not use any ramp at all. I have used ramp of and on since I started treatment. I have pretty much settled on a five minute ramp time. That gives me time to get into bed and get settled before my full treatment pressure starts. If you use the mask fit function, it will put your pressure at your highest setting which gives you the opportunity to check for leaks at a higher pressure. I use the mask check every night before starting my ramp time. That way, I can check for leaks at the highest my machine can go during the night.

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Pugsy
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Re: Another NewB getting frustrated

Post by Pugsy » Sun Apr 15, 2018 6:53 pm

Nasal interface masks have less real estate touching your skin and needing to stay sealed...so yeah in that regard they make controlling the leaks easier.

My suggestion...
Get a nasal mask unless you have chronic nasal congestion issues where you just can't breathe through your mouth.
Worry about what happen if you get a cold later...you may not need a full face mask for months and months.
This stuff is already hard enough without adding more difficulties when there is an option that might be easier.

Many forum members who use a nasal mask as the primary mask have a full face mask in the back drawer just for IF they need it IF they get a cold or allergy flare up.

I have yet to have a cold bad enough that I just couldn't use my nasal pillow mask...and it will be 9 years next month that I have been on cpap and I have had more than my share of colds, upper respiratory infections and even a couple of cases of the plain old flu.
I find that the humidified air going up my nose actually helps if I have a cold and often I wake up breathing better than when I went to bed in terms of nasal congestion if I have a cold.

Yes...if you need Ramp...that is fine but I think the "Auto" part of it means until it thinks you are asleep or 30 minutes whichever comes first. If you want to reduce the ramp time...go over to regular ramp...and start it at maybe 5 or 6 if that is comfortable and limit it to 5 or 10 minutes if you are thinking you will be asleep by then.

And sometimes when a nasal interface mask is used a person doesn't need as much pressure as a full face mask...so your pressure needs might reduce a bit. Doesn't happen for everyone but it happens enough that we mention it.
Plus it's a bit easier to sleep in those other positions without the mask getting in the way or bugging you or the bed pillow causing it to leak.
I may have to RISE but I refuse to SHINE.

wallanbrewer
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Re: Another NewB getting frustrated

Post by wallanbrewer » Sun Apr 15, 2018 7:01 pm

Thanks much!! I will make changes you suggest and see where it takes me. And thanks for this forum. You have been SOOO much more help than the equipment provider who thus far has been of no help what so ever.

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Rstasik
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Re: Another NewB getting frustrated

Post by Rstasik » Mon Apr 16, 2018 9:32 am

I am newb, old cpaper. I can't find my posts after I installed tapatalk.
I don't think my sleepyhead data got uploaded.
Please advise, thank you.


Sent from my SM-G950U using Tapatalk


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kteague
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Re: Another NewB getting frustrated

Post by kteague » Mon Apr 16, 2018 9:46 am

wallanbrewer wrote:
Sun Apr 15, 2018 6:33 pm
I like to sleep on my side - more on my right side than on my left. But since starting PAP Therapy and struggling with mask, I have migrated to my Back
thinking that would help with mask issues.
If side sleeping feels more natural to you and might help with your sleep, you might find a firm flat sleeping pillow works best. Pillows that allow one to sink in tend to put pressure on the mask leading to leaks. Sleeping with your face at the edge of the pillow with the mask hanging off might help. Some on here have said they carved a cutout in the side of a cheap foam pillow to accomodate their mask, in the manner of the cpap pillows out there for sale.

TedVPAP
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Re: Another NewB getting frustrated

Post by TedVPAP » Mon Apr 16, 2018 7:17 pm

Rstasik wrote:
Mon Apr 16, 2018 9:32 am
I am newb, old cpaper. I can't find my posts after I installed tapatalk.
I don't think my sleepyhead data got uploaded.
Please advise, thank you.


Sent from my SM-G950U using Tapatalk
You should start your own thread so the forum can try to help you.

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Dog Slobber
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Re: Another NewB getting frustrated

Post by Dog Slobber » Thu Apr 19, 2018 10:23 pm

Pugsy wrote:
Sun Apr 15, 2018 6:53 pm
Many forum members who use a nasal mask as the primary mask have a full face mask in the back drawer just for IF they need it IF they get a cold or allergy flare up.
Pugsy wrote:
Sun Apr 15, 2018 6:53 pm
I have yet to have a cold bad enough that I just couldn't use my nasal pillow mask...and it will be 9 years next month that I have been on cpap and I have had more than my share of colds, upper respiratory infections and even a couple of cases of the plain old flu.
I find that the humidified air going up my nose actually helps if I have a cold and often I wake up breathing better than when I went to bed in terms of nasal congestion if I have a cold.
Hi Pugsy,

The above two paragraphs from one of your posts intrigued me.

It seems to suggest that Nasal Pillows have an inherent advantage over Nasal Masks.

I'm wondering if I should consider switching to Pillows over my ResMed n20.

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Re: Another NewB getting frustrated

Post by palerider » Thu Apr 19, 2018 11:42 pm

Dog Slobber wrote:
Thu Apr 19, 2018 10:23 pm
It seems to suggest that Nasal Pillows have an inherent advantage over Nasal Masks.

I'm wondering if I should consider switching to Pillows over my ResMed n20.
There's no implication there... She just happens to prefer pillow masks over the 'over the nose' nasal mask.

All she's saying is that people with nasal/pillow masks keep a full face for times when they may be too congested to breath through their nose.

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wallanbrewer
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Re: Another NewB getting frustrated

Post by wallanbrewer » Sat Apr 21, 2018 3:15 pm

Per suggestion of Pubsy, I have changed from the Resperonics Armara View FFM to ResMed N20 nasal mask. With Armara, when leaks occured it took pressure to high teens. Right off the bat the N20 has brought pressure down to comfortable pressure of 12 - 14. Still wakeing up multiple times during night and AHI increases in early sessions - 4am and beyond, But see better things to come as I aclimate my body to new mask going into the future. Numbers are not where we would like to see them, but only three weeks into therapy. Posted screen shot of first night with N20 to get feedback. Thanks Pugsy and to all who have responded to this feed.

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Pugsy
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Re: Another NewB getting frustrated

Post by Pugsy » Sat Apr 21, 2018 3:29 pm

You need more minimum pressure at some times during the night and not others.
The 2 usual culprits when we see clusters like you are having are REM stage sleep or sleeping on your back or maybe a combination of both.

The timing of the clusters doesn't really point to REM stage sleep especially when the cluster happens so soon after sleep onset..
Do you spend much time sleeping on your back?
The clusters around 00:40 and 2:00...might be REM or at least one of them might be REM.

It's common to have our OSA worsen and/or need more pressure in REM or when sleeping on our backs.

If it is supine sleeping that is the culprit and you can figure out some way to stay off your back (easier said than done sometimes) then you may be able to get by without increasing the minimum pressure.
If not you may need to increase that minimum pressure from 8 to around 10 if you wish to keep EPR at 3...or if you wish to turn EPR down or off then the 8 minimum might get the job done.
I may have to RISE but I refuse to SHINE.