Newbie just had my CPAP Titration done, need insight/advice!

[Pugsy]

Yes...EPR is available no matter which mode and functions the same in both modes.
If you are wanting to use EPR and at a pressure of 13 I think it will be more comfortable for you...we might have to adjust the pressure upwards just a little to compensate for the drop during exhale but cross that bridge if you come to it. Not everyone has to make that upwards adjustment.

For sure though...if you want to try APAP mode and use EPR...set that minimum to at least 11...I don't think 9 minimum with EPR in the mix will do quite what is likely needed.

[BullsFan91]

Yes...EPR is available no matter which mode and functions the same in both modes.
If you are wanting to use EPR and at a pressure of 13 I think it will be more comfortable for you...we might have to adjust the pressure upwards just a little to compensate for the drop during exhale but cross that bridge if you come to it. Not everyone has to make that upwards adjustment.

For sure though...if you want to try APAP mode and use EPR...set that minimum to at least 11...I don't think 9 minimum with EPR in the mix will do quite what is likely needed.

Thank you so much for your help, Pugsy! The machine i'm buying today comes with an RT040M mask. The machine was said to have been used for less than 2 months, so i assume the same goes for the mask. Can I just soak the mask in warm soapy water to clean it, and then use it? Or should i buy a new mask? I found a listing for the Airfit F10 mask in a large size, new and sealed for $50 locally. Not sure if large will be too big for me or not.

[Pugsy]

Here's the information about the F & P RT040
https://www.fphcare.com/products/freemo ... face-mask/
Yes...you can wash these masks and actually use hot water if you wish. I wouldn't boil them but I would use hot water from the tap. Hot soapy water will kill the bulk of any germs that might want to hitch a ride on the silicone.
If it was used every night for 2 months...the cushion might be getting a little tired but most likely it wasn't used every night if someone is giving up and selling the machine. When the cushions start getting tired they tend to start being difficult to get and keep a good seal. YMMV though and lot depends on whatever care the used mask had done to it in the past and how long it has been out in the open exposed to the air.
It will get you started and also give you an idea as to what size you might be needing.

For the AirFit F10...there is a sizing guide available that will also get you in the ball park in terms of sizing.
https://5faacd0c97cf0d23c6dc-064f3cd61b ... -guide.pdf
Please note that the sizing guides for each mask and brand will vary so don't assume that if you are a medium in one mask that the are a medium in all masks...check the sizing guides available (most full face masks have them) when you are looking at something from another brand or style FFM.

[BullsFan91]

Here's the information about the F & P RT040
https://www.fphcare.com/products/freemo ... face-mask/
Yes...you can wash these masks and actually use hot water if you wish. I wouldn't boil them but I would use hot water from the tap. Hot soapy water will kill the bulk of any germs that might want to hitch a ride on the silicone.
If it was used every night for 2 months...the cushion might be getting a little tired but most likely it wasn't used every night if someone is giving up and selling the machine. When the cushions start getting tired they tend to start being difficult to get and keep a good seal. YMMV though and lot depends on whatever care the used mask had done to it in the past and how long it has been out in the open exposed to the air.
It will get you started and also give you an idea as to what size you might be needing.

For the AirFit F10...there is a sizing guide available that will also get you in the ball park in terms of sizing.
https://5faacd0c97cf0d23c6dc-064f3cd61b ... -guide.pdf
Please note that the sizing guides for each mask and brand will vary so don't assume that if you are a medium in one mask that the are a medium in all masks...check the sizing guides available (most full face masks have them) when you are looking at something from another brand or style FFM.

I found the sizing guide for the Airfit F10 from Resmed and it looks like i fall within the guidelines for the large mask! I will be meeting with the seller to purchase the new sealed AirFit F10 mask a little later today. I'm so excited to start my home cpap therapy! I now have the ResMed S9 Autoset + H5I Humidifier in my hands, all in working condition!

[Pugsy]

Do you also have the clinical/provider manual for the S9?
If not you can find it here.
http://www.apneuvereniging.nl/forum/pdf ... manual.pdf

The S9 AutoSet is a great little machine. I am pretty sure that you will be happy with it no matter which mode of operation you end up using.
You may or may not even like or need apap mode but it is there available in case you do.
I happen to be someone who benefits greatly from auto adjusting pressure modes because my REM OSA is much worse and sometimes I need a LOT more pressure during REM than I need at other parts of the night. With auto adjusting pressures I can use lower pressures for most of the night and let the machine increase the pressure as it sees fit during REM. I am fortunate in that varying pressures don't create a problem for me. I sleep right through them and don't have any issues that would make me have to make compromises.
You might be like me and be able to sleep through wide pressure changes and never know it until you see the reports or you may be like someone else who finds that even the tiniest pressure change causes sleep disruptions or problems.

You won't ever know until you try though. I hit the road a running with apap mode and never looked back.
I have played with cpap mode a little but not extensively because it would mean I would have to use substantially more pressure all night long just to take care of 20 % of the sleep time that we normally have REM sleep.
It's just not something I want to do all the time when auto adjusting works just fine for me.

[BullsFan91]

Great input Pugsy! I just started reading your sticky on sleepyhead. I'm definitely going to need some help interpreting my first sleep report, which i will post first thing tomorrow morning once I wake up and import it into sleepyhead!

I think i may start with apap mode actually, with the minimum of 11 and max of 15 (2 above my prescribed pressure). I was actually wrong, the machine i got came with the Resmed Quatro full face mask, which i washed in warm tap water with mild detergent, and now am letting dry in the garage. But i will still go and get the AirFit F10, and use that tonight after i make sure i have it fit snug with minimal leaking.

I tend to sleep on my side, not my back. At least when i am trying to sleep, I start on my side and also sometimes facedown, which may be an issue with a full face mask and regular old pillows. I guess i'll adjust my mask for sleeping on my side, and it should still be a good fit when i eventually get on my back, if that ever happens.

[Pugsy]

Do you have chronic nasal issues that mandate that you mouth breathe? If not, you might want to investigate a nasal interface mask at some time in the future...like the nasal pillow mask that I use.
A lot less "stuff" on the face and so much easier to side sleep or even sleep on my stomach. Just a thought for down the road...maybe use the DME and mask swapping capabilities for various mask trials while you can.

[RustyShackleford]

I've been using the Airfit F10 for over a month now. I sleep on both sides and my back. It leaks occasionally when I'm on my side but it's usually a quick fix. Very little leaking when I'm on my back. It's been great so far.

[BullsFan91]

Do you have chronic nasal issues that mandate that you mouth breathe? If not, you might want to investigate a nasal interface mask at some time in the future...like the nasal pillow mask that I use.
A lot less "stuff" on the face and so much easier to side sleep or even sleep on my stomach. Just a thought for down the road...maybe use the DME and mask swapping capabilities for various mask trials while you can.

During my cpap titration they started me out on the regular nasal mask. I tend to be a mouth breather, i guess the resistance through my nasal pathway leads me to breath through my mouth. I try to force myself to be a nose breather but it feels like i'm not getting enough air sometimes. I requested the full face mask during the study after i couldn't fall asleep with the nasal mask (kept having to open my mouth to inhale and exhale). Maybe down the road I may try the pillows combined with a chinstrap , if this F10 mask doesn't do the trick.

[BullsFan91]

I've been using the Airfit F10 for over a month now. I sleep on both sides and my back. It leaks occasionally when I'm on my side but it's usually a quick fix. Very little leaking when I'm on my back. It's been great so far.

That's good to hear! Thanks!

[BullsFan91]

Okay so I just had my first night's sleep at home on cpap/apap. I'm definitely feeling much much better than before, but I did wake up several times throughout the night either because of an apnea event or because the mask was leaking and caused me to have a very dry mouth, therefore having to adjust the mask.

I looked at the sleepy head data and tried to discern all that i could from it, but i'm posting the graphs from the "Daily tab" as well as a screen shot from the statistics screen so that some of the experts can help me interpret and evaluate what I should try to fix for my 2nd night. I have a feeling it will mostly be the mask leaks, as i spent nearly 25% of the time above the leak threshold. Pugsy i read some of your helpful sticky regarding SH, but i was hoping you'd still help me interpret my data from last night. I'd really appreciate it!

Let me know if you'd like to see screen shots of the other tabs or graphs.

[Pugsy]

First of all you can turn off the AHI and Mask pressure graphs...they are just showing redundant information and not really needed at this time. To turn off just go to preferences/Graphs tab and remove check mark.

You can get pretty much all the graphs of main importance on one screen shot.
On the left...turn off the pie chart (again in Preferences/appearance tab I think).
On the right side...main graphs are
Events
Flow rate
Pressure
Leak
Flow limitation
You can resize these graphs so that they will all fit one image by hovering the mouse on the bottom of each graph until you see a little short double line...then click and drag to resize and SH will remember the change.

Also a little hint about using imgur so that the entire report can be seen and to let us click on the image if we need to see it larger do this...
With the image in front of you look below the little box of all the addresses and click on Large Thumbnail...this will change the addresses in the boxes...after clicking on large thumbnail copy the last line in the box of addresses and paste it into the text you are composing here. The image will be shown in its entirety instead of being cut off on the right side and if we need so see the larger image we can do it easily just by clicking on the image.
So you will get something like this...mine you can't click on ...I can't get my imgur to load right now and had to use an old copy from a prior post and I can't get the link to activate but I think this will give you an idea what we like to see.
My machine doesn't give me Flow limitation graph...so that's why it is absent.

[Pugsy]

Now about last night...don't change anything...just work on the leaks and mask fitting.

Read this
https://maskarrayed.wordpress.com/tamin ... e-quattro/
While it may not be specifically for your mask..the general principle is the same.

Also...go here and find your mask in the product section ...there's usually a video available to help with fitting
https://www.cpap.com/cpap-masks/full-face-cpap-mask.php

[BullsFan91]

Thanks for all the advice Pugsy! I will make the changes to sleepyhead and definitely just work on eliminating the leaks!

[BullsFan91]

Hey so I have an update. I was experiencing mask fit issues with the large airfit f10, so went with the used medium quattro fx full face mask that i bought with the machine. I bought a new cushion, but i experienced irritation with the cushion and also had to tighten the mask too much in order to eliminate leaks. I also could not fall asleep with the mask on. I then ordered the Airfit P10 Nasal Pillows and to my surprise I am able to actually use them. I thought that maybe nose breathing was not possible for me because of the congestion/resistance, but turning the humidity to 4 or 5 out of 6 really helps.

The thing is, i've been having issues keeping the mask on all night long. The pasts few nights i would have the mask on, sleep for an hour or two, then wake up and take it off for a bit (then i would have to warm up the humidifier again, which takes 20 minutes), and during this period of waiting for the humidifier to be ready, I would fall asleep with the mask off and have terrible sleep for 3 or so hours without cpap therapy. Then I would wake up and have to warm up the humidifier on, and make sure i'm awake when it is ready so that i can put the mask back on and then start the machine.

The issue above I can correct mentally, by not taking the mask off when i wake up in the middle of the night, or setting a timer for 20 or so minutes so that i can wake up when the humidifer is warmed up, in case I doze off while waiting.

The other issue that I am having is that since using the nasal pillows mask, I have been having a lot more central apneas/clear airway apneas than with the full face mask, while having less obstructive apneas. My AHI has ranged from around 1.68 to 6.1 (last night). My pressure settings are a min of 11cm and max of 15cm with EPR of 3cm. I noticed that last night i had a cluster of lark leak periods (I usually dont have any large leaks with the nasal pillows mask, i guess turning my head or something caused the pillows to change position). There were a cluster of CAs during this large leak cluster, but also when there were no large leaks. I will post the data momentarily.