new to Cpap

[IrisofNY]

Hi All,
I am new to CPAP and am so grateful to have found this group. My Dad died from severe sleep apnea and I think I've had it my whole life. My sleep study AHI was 58 and the last 3 nights were bet 5-6. My 3 nights with the machine (PR system one autopap with heated humidifier series 60) weren't as tough as I expected - actually used it for over 9 hrs each night. I have been somewhat of a mouth breather but wanted to avoid a FFM because of claustrophobia and sensitive skin. The DME gave me a nasal wisp mask, the only mask without forehead straps that she had.
I have a few questions I hope people can help me with.
1. The first is that I am so much more exhausted since Cpap, having trouble getting out of bed and falling asleep during the day which I've never done before. Any predictions when this exhaustion might stop?
2. I'm having trouble falling asleep: feel like I'm not getting enough air, getting stuffy, hate the smell of the mask and need to yawn which causes the air leaking out of my mouth.
3. Also having trouble falling back to sleep with surge of cold air into my nose and then mouth. I set the humidifier to 3 last night (from 2) and a lot of moisture was in the mask but not the hose. My bedroom is cool at night - 64 degrees and I was wondering if I should get the heated tube instead of what I have.
4. I downloaded sleepyhead but there isn't any data on the SD card other than hours used, 90% pressure and AHI. I'd really like to see what is going on during the night to maximize treatment and comfort.
I would appreciate any help or suggestions from you guys. I need this to be successful and get my energy back.
Thanks!

[Krelvin]

Welcome to the forum!

When you register on the forum, you will need to add what type of equipment you are using. You are asking lots of questions which other than the mask we don't know specifically what you are using. The name of the machine you mentioned is kind of a generic name which may match many different machines, some of which are not full data machines which might indicate why you are not seeing detail in your sleepyhead reports.

Most of the machines in PR current family typically will have a model number like DS220, DS450 etc... most machines that are less and equal to the number DS450 are not data capable. You would normally find that info by checking the bottom of the cpap itself (not the humidifier). make sure you remove the humidity tank before looking so you don't spill water.

Look for a tag on the bottom of the blower unit. There should be a model number on it. The model number will most likely start with a DS followed by a three digit number of the form *60 where * will be a 2, 4, 5, 6, or 7. The three digit number maybe followed by another letter or two. The "DS" may or may not be written on the machine itself, and there are reports that the third digit of the model number may be a 1 or a 2 instead of a 0.

[Sleeprider]

Hi All,
PR system one autopap with heated humidifier series 60
1. The first is that I am so much more exhausted since Cpap, having trouble getting out of bed and falling asleep during the day which I've never done before. Any predictions when this exhaustion might stop?
2. I'm having trouble falling asleep: feel like I'm not getting enough air, getting stuffy, hate the smell of the mask and need to yawn which causes the air leaking out of my mouth.
3. Also having trouble falling back to sleep with surge of cold air into my nose and then mouth. I set the humidifier to 3 last night (from 2) and a lot of moisture was in the mask but not the hose. My bedroom is cool at night - 64 degrees and I was wondering if I should get the heated tube instead of what I have.
4. I downloaded sleepyhead but there isn't any data on the SD card other than hours used, 90% pressure and AHI. I'd really like to see what is going on during the night to maximize treatment and comfort.
I would appreciate any help or suggestions from you guys. I need this to be successful and get my energy back.
Thanks!

The PR System One Auto is Model #560P and is noted on the bottom of the blower unit. Please confirm this. If this is correct, it is a fully data capable machine. Use the link in my signature to download a more updated version of Sleepyhead and try to get the data with that.

1. Getting accustomed to XPAP therapy can be exhausting at first. It is caused by arousals from having apnea events and other respiratory events that keep you from achieving deep sleep. You may feel like you spent the whole night partially awake. Assuming you have the 560P, it may be the machine is set for pressure from 4 to 20 cm and the pressure is not giving you the right treatment. The second link in my signature will take you to directions on downloading the clinical manual that will show you how to access the clinical settings where you can find the settings. We need to know what those are, although they will also show up in Sleepyhead data once you get it.

2. Same comment as 1. Your machine is probably set wrong. If it starts at 4.0 cmH20 pressure, you cannot get enough air and will feel suffocated. You must turn the minimum pressure up to at least 6.0. To do this turn the dial to light Setup, then press the main dial and ramp button (wedge) at the same time until the machine beeps. You will then be able to go through the REAL setup menu and change the minimum pressure, or ask your equipment provider to do this.

3. Your 560P has a heated hose option that costs $75 online, or you can ask your doctor to add this to your prescription. It is a comfort feature that warms the air and prevents condensation. Get it.

4. Get the testing version software and everything will work fine. http://sleepfiles.com/SH/index.html?TestingVersions

good luck! We're pulling for you.

Edited to remove a link to heated hose.

[Macpage]

1. The first is that I am so much more exhausted since Cpap, having trouble getting out of bed and falling asleep during the day which I've never done before. Any predictions when this exhaustion might stop?

Not uncommon at all. I felt like I only got the common symptoms of OSA after I started therapy. There are many thoughts as to why this is the case, yet a few lucky people seem to skip this all together. I simply think of it as an adjustment phase which is different for all of us depending on where we're at with all the different variables of treatment. For me, it got a little better each month and after about 4 months I rarily felt like falling asleep during the day.

2. I'm having trouble falling asleep: feel like I'm not getting enough air, getting stuffy, hate the smell of the mask and need to yawn which causes the air leaking out of my mouth.

As Sleeprider mentions this is most often caused by the Ramp feature of the machine starting at a pressure which is too low to breathe comfortably. I felt just like you described until making sure that the machine statred at a pressure that was "breathing friendly".

3. Also having trouble falling back to sleep with surge of cold air into my nose and then mouth. I set the humidifier to 3 last night (from 2) and a lot of moisture was in the mask but not the hose. My bedroom is cool at night - 64 degrees and I was wondering if I should get the heated tube instead of what I have

Agree with the others. Heated hose solves all you mention. The hose allows you set the temp you like, and it mostly allows you to use the humidity setting without getting condensation in the hose (rain out). Some here also keep the hose warm with cover and/or keeping it under a blanket close to the body when sleeping if not or in addition to using heated hose.

4. I downloaded sleepyhead but there isn't any data on the SD card other than hours used, 90% pressure and AHI. I'd really like to see what is going on during the night to maximize treatment and comfort.

Sleeprider & Krelvin are giving you great advice about getting set-up to work with sleepyhead to maximize your therapy. This is the absolute key to making all of this work, and you are in the right place for all the help. These guys have seen everything and in no time at all they will have you lined out on the software and learning to monitor and adjust. I only really turned the first corner with my therapy when the posters here looked at my data and guided me through the adjustments to eliminate my events. They've also helped with so much more of this therapy, but first thing is first and that's the data. Of course, getting the mask right is a big starting factor as well, and the Wisp is a great little interface for those of us starting out. You'll quickly find out about the mouth breathing. The data will show if you're leaking out of your mouth and losing therapy. Of course you might find out the old fashioned way.... you'll wake-up with a wicked dry mouth! Don't worry if this is the case. There are newer full face masks that are really light with comfortable headgear and designs that allow reading, etc. You will also find many posters who are willing to help with measures to prevent opening the mouth if you wwant to stick with nasal interfaces.

Prepare for a long introduction with a lot of patience required and lots of time, work, and experimenting invested. At the rate your going, that long period may end up not really being that long at all! Good luck!

Best,

Mike

[IrisofNY]

Thanks so much for your replies.
Confirming that I have the PR System one Auto 560P with range of 4-20, initial setting on 5.
I was able to change that to 6 last night (it had been set only for 4, 4.5 or 5) and also read the manual and preheated the humidifier. Initial breathing was so much easier. I had the humidifier set at 3 but changed to 2 because of moisture in the mask. Sounds like I should get the heated tube to prevent this.
A few more questions:
1. I am not stuffy now but very stuffy during the night and hard to breathe with the wisp nasal mask. It seems to hug my nose and go in and out with each inhalation and exhalation and didn't do that the 1st 3 nights. Any ways to prevent this?
2. Uncomfortable cold air blows from the wisp /hose swivel connection. Any recommendations for fixes?

[grayghost4]

Quote: Confirming that I have the PR System one Auto 560P DS450 with range of 4-20,

They are two different machines .... DS450 is the older 50 series (not auto)

The 560P is a newer 60 series Auto cpap.

The REF number is on the lable on the bottom of the cpap blower (not the humidifier)

[Julie]

Hi - turn down (or even off) the humidifier... if your local climate and indoor environment are already humidified enough, adding more will certainly congest you and you don't need the thing at all for 'therapy', just to facilitate things when air is too dry.

[Macpage]

Thanks so much for your replies.
Confirming that I have the PR System one Auto 560P DS450 with range of 4-20, initial setting on 5.
I was able to change that to 6 last night (it had been set only for 4, 4.5 or 5) and also read the manual and preheated the humidifier. Initial breathing was so much easier. I had the humidifier set at 3 but changed to 2 because of moisture in the mask. Sounds like I should get the heated tube to prevent this.
A few more questions:
1. I am not stuffy now but very stuffy during the night and hard to breathe with the wisp nasal mask. It seems to hug my nose and go in and out with each inhalation and exhalation and didn't do that the 1st 3 nights. Any ways to prevent this?
2. Uncomfortable cold air blows from the wisp /hose swivel connection. Any recommendations for fixes?

I'm glad you found starting last night was better. 6 is a much easier starting pressure and some even prefer 7 or 8.

Yes, the heated tube will solve the moisture issue in most cases. Until then, you can try to keep the hose warmer by getting it close to your body or under your bed linens. You can also raise the teperature in the room if this is feasible or comfortable. Also, making sure that the hose has downhill slope away from your head may help any moisture that you are getting stay out of your mask. I would guess that the moisture was the cause of the congestion. If I get too wet, I am well stopped up by morning. However, this is the exact opposite of others. They get congested from not having high humidity. You will only know by trying it both ways. Yet, you're going to have hard time trying more humidity until you get the hose moisture (rain out) addressed. As we mentioned, with Pap therapy there is hardly ever a one way answer. It's always personal preference hence all the experimenting.

The Wisp is a good mask for new users that can use nasal interfaces effectively because it is very minimal and user friendly. However, mask fit is very individual and no mask/mask type no matter what the features will be "great" for everyone. There will always be those that love a type or model, and those that loathe it! There are plenty of users who can't stand how some small nasal masks fit on the nose. Many experience that with the fit too confining or on the wrong nose area that congestion or suffocation feeling is intolerable. Only you can decide after trying a certain interface. If the Wisp was comfortable to you before, it might just be congestion related to the moisture, or you might just be finding that it isn't for you. It usually takes some time to figure out a mask when starting. This period will shorten as you gain experience trying different ones.

All interfaces vent the air (CO2). The direction, sound, and force vary with each. Again, its all about personal preference and finding the one that is acceptable to you or that the venting can be addressed. F & P makes the Eson nasl mask which is a newer model that has a diffuser for the vent. There is little air felt from the vent. However, its probably early for you to be changing masks unless you have an issue with pain/sores/skin sensitivity, or you are able to still swap out for free with your DME. If these are the cases, you might go ahead and try something new. I note about waiting because until you get the data, you won't know if a nasal interface is effective for you. No sense in wasting time or money on nasal masks if you might need a full face mask or accessories to keep your mouth closed with nasal masks.

Best,

Mike

(Edited to correct)

[Julie]

"All interfaces vent the air" said macpage... but the 'air' that's vented is CO2, and it's important that you don't cover the vent with bedding, etc. because you don't want to rebreathe it.

[IrisofNY]

Thanks again. Will implement the hose suggestions tonight to see if it helps with mask moisture till I can get the heated tube.
Hopefully, will post SH data today and would appreciate input. Noticed that the data file dates are incorrect time zone and wrong date. Is there a way to reset that?

[Macpage]

"All interfaces vent the air" said macpage... but the 'air' that's vented is CO2, and it's important that you don't cover the vent with bedding, etc. because you don't want to rebreathe it.

Good note. Very important point.

I'm getting so used to therapy that I overlook or take for granted some of the important notes. We don't want anyone trying homemade diffusers without ample warnings!

Listen to Julie and keep the mask vent clear.

Best,

Mike

[IrisofNY]

Can someone tell me the simplest way to post my SH data to this thread. I'm not
as tech savvy as I'd like.
Thanks,
Iris

[IrisofNY]

Hi All,
It would be really helpful if I could get input on my SH data.
Thanks,
Iris

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https://lh5.googleusercontent.com/-efoA ... 5-0118.jpg[/img]

[Julie]

Love to help, but it's much too small to read... can you enlarge it?

[IrisofNY]

Thanks for everyone's help. Julie, I'm not sure how to post the data or enlarge it. Would appreciate any suggestions. My husband downloaded it for me. Can you see the data if you press "command and +" to enlarge on your imac?