Brand new to board... a few questions before I get my CPAP

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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Pugsy
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Re: Brand new to board... a few questions before I get my CPAP

Post by Pugsy » Wed Apr 15, 2015 12:04 pm

A setting of 2 on the PR S1 machine without the heated hose being attached (if unsure if yours is heated or not the heated hose has a black coupling on the end where it attaches to the humidifier) so I am going to assume no heated hose...that setting of 2 is low..with 1 being the lowest except for 0 which turns it off. Depending on the ambient humidity in the bedroom...that setting of 2 being so low the machine probably just doesn't need to add much water to the air it delivers. If you want to check to see if it gets warm it's best to do the warm up thing at the beginning of the night and not try to catch it during the middle of the night or the end of the night when it simply might not be cycling.

Do you know how to do the pre warm up thing and then just pull out the water chamber after about 15 minutes to see if it is warm on the bottom?

When my ambient humidity is high...like now it has been raining and I have the windows open....I barely use any water and I have my humidifier set to maximum delivery (that's what my nose likes).

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hifiaudio
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Re: Brand new to board... a few questions before I get my CPAP

Post by hifiaudio » Wed Apr 15, 2015 3:29 pm

Ok good to know. I must just not be using much humidity. That part has not bothered me much.. dryness, etc. Are there some people that just dont need the humidity to be on very high, even on higher pressures like 13?

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Pugsy
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Re: Brand new to board... a few questions before I get my CPAP

Post by Pugsy » Wed Apr 15, 2015 3:38 pm

There are people who prefer a higher humidity at very low pressures (I think RobySue is one of those people) and there are people who use higher pressures with zero added humidity (I cringe when I read it) so there is a very wide range of what is "normal" out there.
There are people in the tropics who want higher humidity delivery to their nose and there are people in the high desert who don't even use a humidifier.
When I say that there is a wide range of normal...it's really wide.
Can't base needs on pressure needs or even where we live. It's all about what the nasal mucosa feel best with.

Heck, I lived in Las Vegas for 5 years...all pre cpap need and my nasal mucosa never did adjust to the dry air there.
My nose just wants a lot of water so I use maximum setting and even supplement with Simply saline almost at least once every day.

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hifiaudio
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Re: Brand new to board... a few questions before I get my CPAP

Post by hifiaudio » Thu Apr 16, 2015 8:17 am

So another night down, I will upload the data if anyone wants but it may not be that useful until I get the mask / sleep issues under control. I had AHI of 27 but I think its again going to have a lot to do with my mouth being open.

I started the night this time trying out the older full face mask that my office gave me for free since I kept talking about a full face mask. It is the Fisher and Paykel "Forma" Full Face mask. It did not fit or feel very good. It had a medium and large fit and neither seemed to stay on my chin very well. I kept it up with this one until around 1am I think and switched back to the Swift FX and chin strap.

Man.... if it werent for my stupid mouth opening I think I would be sleeping like a baby with the Swift FX. I am liking it a lot. Many times I wake up or lay there feeling like almost nothing is on my nose or not feeling any pressure, even though its on 13. The chin strap is more bothersome than the mask. But my stupid mouth is still coming open and waking my back up. Plus I am getting CRAZY gas. REALLY REALLY bad. Once I get about halfway through the night I am passing gas constantly! If it weren't so uncomfortable and a bit of a pain feeling from the bloating it would be funny.

I said yesterday that I was going to research taping so I guess I will do that in earnest today and find the best technique to use. I should also be able to get that hybrid mask tomorrow so maybe it will also solve my problems.

I did sleep more last night, even had a dream or two, so things are improving. I just wish I could make that Swift mask work for me 100% since it has become so comfortable for me.

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Re: Brand new to board... a few questions before I get my CPAP

Post by yaconsult » Thu Apr 16, 2015 9:31 am

Many people use a chinstrap to encourage them to keep their mouths closed. The Ruby Red chinstrap seems to be a popular choice - I would recommend the adjustable model rather than one of the fixed sizes. Some people have also recommended a soft cervical collar to do the same thing. Good luck with your taping experiments - maybe it will be all you need. Your machine will tell you how successful you are.

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Re: Brand new to board... a few questions before I get my CPAP

Post by hifiaudio » Thu Apr 16, 2015 7:52 pm

Gonna try mouth taping tonight. I think I have duct tape and packing tape on hand. Suggestions of one over the other?

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Re: Brand new to board... a few questions before I get my CPAP

Post by Sonnyboy » Thu Apr 16, 2015 8:12 pm

Hi,

I would suggest avoiding duck tape or packing tape -- too hard on your skin.

You might try micropore tape which you can purchase at the drug store with the other bandage supplies or search "taping" on this forum for other suggestions.

Fold over the ends of the tape so it is easier to remove.

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Re: Brand new to board... a few questions before I get my CPAP

Post by tedburnsIII » Thu Apr 16, 2015 8:57 pm

hifiaudio wrote:Gonna try mouth taping tonight. I think I have duct tape and packing tape on hand. Suggestions of one over the other?
Can't say.

I've been using a blue-colored type of painter's tape. Remove the soft plastic layer of blue and both sides are adhesive- but I don't remove the blue layer. It seems to work pretty well. It doesn't seem to be bothering my skin and ripping it off isn't that bad.
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Pugsy
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Re: Brand new to board... a few questions before I get my CPAP

Post by Pugsy » Fri Apr 17, 2015 3:20 am

I would be afraid of duct tape because it sticks too well and is likely to take off several layers of skin when you remove it and still leave a yucky residue on your face.

The packing tape...I don't know what kind you have or what you call packing tape. My packing tape is really nothing more than extra wide Scotch tape and it probably wouldn't be bad to use but if your packing tape is that tape with reinforced stuff in it (don't know what they are called) then that might be too much like duct tape.

You want a tape that will come off with minimal effort and not tear your skin up. You don't want to cement your lips shut.

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hifiaudio
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Re: Brand new to board... a few questions before I get my CPAP

Post by hifiaudio » Fri Apr 17, 2015 6:33 am

Ok so a kind of odd and disappointing night last night. I went to Walgreens and got the Nexcare micropore tape and used that. Night started off fine... a bit of a weird sensation since swallowing and clearing my throat from time to time had to be done without being able to open my mouth at all, but I managed. I got to sleep within 20-30 minutes of going to bed I believe. But while I was trying to go to sleep I realized that while my mouth was closed, when I slightly dozed I would get chipmunk cheeks, and I just knew that once this happened while I was fully asleep it would put enough pressure on the tape with constantly puffed cheeks and some air trying to push through that it would spring a leak. I woke up a couple of hours later in some sort of mild panic and ripped the tape off my mouth. It is kind of hazy as to what actually was going on. Maybe a bad dream or something? But after I did that my mouth hurt and I didnt want to put anything back on, and in a bit of a daze I just went back to sleep with no CPAP and woke up this morning.

But I did have some time on the CPAP and asleep, so I was looking forward to today's AHI score... but it is not good. It looks like much of the sleep, even though I had the nasal pillows in and my mouth covered, still had a lot of OSA and a few centrals. Now, for the last 30 minutes before I woke up, everything all of a sudden got basically perfect.... so I wonder what was going on.

I hope to be able to pick up my hybrid mask today. If not, I will try taping again but go a little further to the sides of my head with the tape so air cannot leak so easily out of the sides when I get the chipmunk cheeks.

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Pugsy
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Re: Brand new to board... a few questions before I get my CPAP

Post by Pugsy » Fri Apr 17, 2015 7:57 am

Do you sleep on your back or your side or both?
The pressure of 13 isn't getting the job done for preventing the OA events.
The blank in the first part of the night you probably weren't asleep since you know you didn't go to sleep right away.
I don't know why the blank at the end of the session unless you weren't asleep or as deep of sleep as you thought you were.

Supine sleeping can make the OSA worse and/or need higher pressures when on our backs.
Same thing with REM stage sleep but I don't think that you had REM from 11:30 to 1:00

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hifiaudio
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Re: Brand new to board... a few questions before I get my CPAP

Post by hifiaudio » Fri Apr 17, 2015 8:05 am

Yeah I do sleep on my back. I know I dreamed some last night. I feel reasonably certain that I was completely asleep for that last bit before I woke up suddenly.

Hopefully the hybrid mask may improve something. Do I have the ability as an end user to put my CPAP into auto mode maybe on a pressure range of 12-16 or something like that to see if it works better? Or does the Dr. have to change that setting?

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Re: Brand new to board... a few questions before I get my CPAP

Post by Pugsy » Fri Apr 17, 2015 8:29 am

Changing the pressure is easy...anyone can do it but I have been hesitant to suggest it due to the centrals. Just because we can change things doesn't always mean we should.
More pressure could make them worse but the OA is bad as it is so maybe it wouldn't be that big of a deal to try a small range in apap mode.

If you primarily sleep on your back then it's possible that the blank spot at the end of the night you might have been on your side.

How to get to the clinical setup menu where we change the pressures.
http://www.apneaboard.com/pr-system-one ... structions
Please note that if it doesn't stick then the pressure settings are likely written on the SD card and we might need to erase the SD card and start over but don't worry about losing data if we have to do that...the machine stores all the important stuff on it's internal memory and the only thing that would be absent is the flow rate graphs.

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hifiaudio
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Re: Brand new to board... a few questions before I get my CPAP

Post by hifiaudio » Fri Apr 17, 2015 8:54 am

Does the machine think "he is at a 12 but all of a sudden I think he needs 16" and it just jumps up immediately? So from time to time you may get a blast of largely increased pressure?

Just picked up my Mirage Liberty hybrid... hopefully it is the answer!

sleepydc
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Re: Brand new to board... a few questions before I get my CPAP

Post by sleepydc » Fri Apr 17, 2015 10:58 am

hifiaudio wrote:Gonna try mouth taping tonight. I think I have duct tape and packing tape on hand. Suggestions of one over the other?

For my FFM (full face mask) use I found it started working a whole lot better when I started using tape. Some people end up using chin straps with FFM's. I tried and disliked chin straps. For me, the "partial tape method" solves most of the issues with "mouth breathing" and "draw drop," which interrrupts the seal of a FFM (full face mask) because my face changes shape when that occurs and the seal is broken. At this point, I hardly notice it's there -- and (in combination with some of the techniques described below) it promotes nasal breathing, which seems to be a pretty good thing while sleeping, helps prevent leaks that wake me up, helps prevent "chipmunk" cheeks, and helps prevent drymouth. It's not for everyone, but here's what I'd suggest:

I have now been using surgical tape for about a year now, and it has worked wonders and works very well for me. I use silk surgical type tape you can get off of Amazon, 2" wide. There's also a 1" wide version. If you gently pull it off in the morning, there's usually no problem. Just type something like "3M-Durapore-Silk-Tape 2 inches x 10 yards - box of 6" or the like on the Amazon site. For me, it works very well with a full face mask (FFM) -- the FFM helps prevent pressure problems if my jaw does open slightly, and the tape substantially prevents my jaw from dropping and also thereby keeps my face largely in the same "position" as I fall asleep (thereby avoiding the inevitable leaks that can occur when your facial shape changes from the point of initial placement/tightening of the mask). .

I was actually worried about not being able to breath with the tape if there was a shut-down. I've found that this set-up, however, offers very few worries:

For the silk tape, apply a 2inch wide strip vertically from a spot just above your upper lip (the indentation just below your nose) down to just under your chin (with your lips closed and your jaw in a comfortable place). As you bring the tape and press it underneath your chin, "fold" the edge back on itself (maybe a 1/2 inch or so) so that the edge hangs a bit from your chin -- makes for easier removal in case of emergency. Because it's only 2 inches wide and vertically placed, your entire mouth is actually not taped -- you can, in a pinch, breath around the edges -- and the silk tape itself I've found by accident (in opening my mouth with it being placed) will also let a little air in if you open your mouth forcefully. In short, it doesn't take too much force to maneuver or breath around the silk tape, but at the same time the tape seems to mostly keep my jaw from dropping when I relax and fall asleep, which is the whole point. [The setup also seems to work best when combined with the technique, described elsewhere on this site, of learning to relax with the tip of your tongue against the roof of your mouth as your mouth is closed, which "seals" the mouth from the nasal passage and helps prevent dry mouth]. (In placing the tape, I've also found it helpful to focus on firming the contact with the skin at the point below the nose and under the chin more than the lips, which seems to leave a little area of the lip region feeling less taped, if that makes sense). [To remove with less "tear", try pulling up vertically from underneath the chin till you reach your lip, then pull across "horizontally" for the remainder.]

The usual caveats about making up your own mind about this, considering safety issues, etc. apply, of course. But frankly, I'm surprised more people don't do this.

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