first night results: not too bad, not perfect

[Shnoozer]

First night done!

Airsense 11 and n30i mask. I left all the settings where intact, did the 'test flight' and the mask sealed nicely. The little nasal pillow have to be just right but then the pressure seems to hold them in place, so very little tightness needed in the mask.

First few minutes were hard. I couldn't get enough air, it was too strange, etc. I had a panicky feeling. But I tried to 'relax into it' and pretty quickly settled down.

I had stayed up late intentionally so that I was tired and ready to sleep. Sure enough I fell asleep. During the night, I turned from side to side a few times and it was easy to adjust the pillows/straps very slightly to keep them in place. No worries.

At one point, I got up to use the bathroom. When I got back, I reconnected but I couldn't settle into it again. I wanted to take a nice big breath but if I opened my mouth, the air shooting out made that 'big breath' super weird and unsatisfying. Then I started to realize I was getting congested, which I had noticed before I went to bed. I had blow my nose and felt a little stuffed up but just a little, and it was a bit worse.

So, I bailed out. I thought it had been about 2 hours. In the morning, I checked the app and saw the below data, which I think isn't bad for first night!



I am thinking to try a full mask, the kind that has nasal cushions on top, just to see how it would feel. Still, encouraging start. I did 5 hours first night.

[Miss Emerita]

It's great that you've now actually slept with the mask and machine, with excellent AHI results. What are your pressure settings? You describe twice feeling air-starved at the start of a session, and that makes me wonder whether your minimum pressure (either regular or for a ramp period) is quite low.

Could you let us know what machine you have and what your settings are?

[Shnoozer]

It's great that you've now actually slept with the mask and machine, with excellent AHI results. What are your pressure settings? You describe twice feeling air-starved at the start of a session, and that makes me wonder whether your minimum pressure (either regular or for a ramp period) is quite low.

Could you let us know what machine you have and what your settings are?

I put the equipment into my signature - Airsense 11 and n30i mask.

I'm not sure how to see the actual data yet, but I did load an SDcard into the machine cause I like to geek out on this stuff and will definitely try OSCAR.

In the prescription (from Lofta) it said the pressure was 4 to 20 - so I assume that was what it was set to. But, with an auto CPAP doesn't it try to titrate up to a therapeutic level, so it' not a set pressure?

But yea at the start, it doesn't feel like much air. At 6 it feels great, at least from using the 'test flight' feature. Could I adjust it to start at 6? I am 100% comfortable tweaking the settings on my own as long as I understand it pretty well.

[Pugsy]

I put the equipment into my signature - Airsense 11 and n30i mask.

Which AirSense 11 model machine? There's more than one and exactly which machine model is real important to know.
It does sound like you probably have the AirSense 11 AutoSet machine and if that's the case please edit your profile comments to reflect the exact model.
Thank you.

[Miss Emerita]

To avoid that air-starved feeling at the start of a session, I'd recommend a minimum pressure of 6 or 7. Do you have EPR on? (It drops your pressure by 1, 2, or 3 when you exhale.)

You might also consider signing up for a free account at Sleep HQ. Then you can share a link here.

[Shnoozer]

Which AirSense 11 model machine? There's more than one and exactly which machine model is real important to know.
It does sound like you probably have the AirSense 11 AutoSet machine and if that's the case please edit your profile comments to reflect the exact model.
Thank you.

Done! I think, I just updated the sig info to what's on the exact page where I ordered the machine.

[Shnoozer]

To avoid that air-starved feeling at the start of a session, I'd recommend a minimum pressure of 6 or 7. Do you have EPR on? (It drops your pressure by 1, 2, or 3 when you exhale.)

You might also consider signing up for a free account at Sleep HQ. Then you can share a link here.

EPR is on, yea. I did feel that thing where the exhalation is a bit labored, but it was so slight and I forgot about it right away.

I can't export my data yet because I don't have an adapter for the SDcard to get to my laptop and don't feel like fussing with it on the phone. Should have the adapter within a day or two.

[Miss Emerita]

If your EPR is 3, I'd suggest a minimum of 7; if it's 2, a minimum of 6. This will let you have the same EPR "feel" all the time. (The machine can't go lower than 4.) Be sure to check whether you have separate settings for ramp. Or just turn ramp off, if it's on.

[Shnoozer]

Ok, I got the little adapter and got OSCAR going.
I dont really understand it yet but its kind of fun learning about how this works.

[Shnoozer]

To avoid that air-starved feeling at the start of a session, I'd recommend a minimum pressure of 6 or 7. Do you have EPR on? (It drops your pressure by 1, 2, or 3 when you exhale.)

You might also consider signing up for a free account at Sleep HQ. Then you can share a link here.

Thanks for this tip. I am trying to make small adjustments so I just I upped the min pressure from 4 to 5, and upped the EPR from 1 to 2. Even that made a huge difference so I'll probably bring the min pressure to 6 tonight. I had basically zero feeling of resistance exhaling so maybe that's settled, too.

I was able to do 7 hours in the mask last night. I feel a little odd this morning but possibly better rested.

The remaining issue seems to be congestion and the mask itself. It's OK, but I feel a bit more congested in the morning than when I go to bed. And, there is an annoyance emerging where my left nostril is a bit irritated by the nasal pillow. I will just keep going and see how it unfolds.

One question: last night i took of the mask to use the bathroom and full pressure air came shooting out for the entire time I was out of bed. I see it on the OSCAR chart, and somehow it's registering an apnea event right at that time. Shouldn't it stop blowing air while the mask is off, and automatically detect when it's back on? I thought it did so on the first night.

I got SleepHQ sorted so the data is now here: https://sleephq.com/public/teams/share_ ... 6914491875

[Miss Emerita]

Many thanks for the Sleep HQ charts. You had some very nice stretches of peaceful sleep last night -- good to see!

I recommend turning your ramp off. Your ramp pressure is 4, and if you're doing well with the small increases in your minimum, there's no reason you shouldn't have that same experience right from the start.

I'll be interested to hear how you like the minimum of 6. That will allow you to have a constant EPR of 2 throughout the night.

I have a 10-series machine, and the automatic off never worked for me, though auto on does. When I want the machine off, I hold my breath while I press the button, and then I disconnect my short hose from my long hose.

For the sore spot on your nose, you might try Lansinoh cream, which is made to help nursing mothers. A little dab'll do it.

For the stuffiness, try playing around with your humidity setting. For some people, relief comes with more humidity; for others, with less.

[Shnoozer]

Many thanks for the Sleep HQ charts. You had some very nice stretches of peaceful sleep last night -- good to see!

I recommend turning your ramp off. Your ramp pressure is 4, and if you're doing well with the small increases in your minimum, there's no reason you shouldn't have that same experience right from the start.

I'll be interested to hear how you like the minimum of 6. That will allow you to have a constant EPR of 2 throughout the night.

I have a 10-series machine, and the automatic off never worked for me, though auto on does. When I want the machine off, I hold my breath while I press the button, and then I disconnect my short hose from my long hose.

For the sore spot on your nose, you might try Lansinoh cream, which is made to help nursing mothers. A little dab'll do it.

For the stuffiness, try playing around with your humidity setting. For some people, relief comes with more humidity; for others, with less.

I tried these modifications for night 3 with pretty good success.

I turned up the min pressure to 6 and except for the for 30 seconds or so, it was very comfortable flow.
Turning off the ramp was definitely a good idea. It took me just a minute or so to settle into the CPAP, then breathing felt normal.

I didn't have any nursing cream but i used some saline nasal gel and it seems to help my nose. Also, I found that I could loosen the mask a bit and still keep a good seal, which I'm sure helped a lot.

No luck on the hose blowing air when I disconnect to use the bathroom. Maybe i just have to turn off the machine.

Here are the results: https://sleephq.com/public/teams/share_ ... /dashboard

thanks again!

[Miss Emerita]

Excellent news all around! (It's nice to see a 0.0, isn't it? But that's quite rare; don't be aiming for that.)

At this point, what matters are not the numbers but how soundly you sleep and how rested you feel. I suggest you continue with your current settings for at least a few more days. If all goes well, you may want to experiment with a minimum of 7 and EPR of 3.

Yes, I turn the machine off manually too.

[Shnoozer]

I am continuing to learn about how this all works, and slowly dial things in.
Another good nights sleep, feeing very rested.

But the data is interesting. I loosened a the mask a little more, for comfort, and wow a lot of leaking last night. Maybe too much?
Interestingly the night before I didn't use the mouth tape and amazingly my mouth stayed close. Last night I put it on, just to see, and there was a lot of leak. I suspect it was the mask, not leaking from the mouth, because with tape on it's very obvious if the mouth opens (but possibly it happened and I didn't wake up).

i am going to try cushions instead of pillows tonight or tomorrow as the next experiment. Ramp is definitely staying off, I don't love that feature. And min pressure of 5 is feeling pretty good right from the start.

Here's the data. My VERY newbie interpretation is that it worked well in terms of apnea, but with so much leaking I may have been stirring around more than is necessary. I remember having to adjust the mast during the night a couple of times.

https://sleephq.com/public/teams/share_ ... a178ccc261

[Miss Emerita]

As far as your therapy goes, your machine can compensate for leaks up to 24 and probably up to 30. So from that perspective, your leaks are OK. The question is whether the leaks are messing with your sleep.

It's clear you slept through some of the leaking, and it's equally clear that at several points during the night, leaks and wake-ups were correlated. It's hard to tell which caused which, though. So keep experimenting -- with different masks, different strap adjustments, different ways of keeping your mouth closed.

If you have a strong preference for a minimum pressure of 5, that's OK, but it does look like your flow limitations were better when your minimum was 6 and you could get the full benefit all night from your EPR of 2. I don't know whether any of the FLs disturb your sleep, but it's possible that they do.