Newby Question - Titration test last night, Sucked!

[SW 2.0]

At my sleep study 2 weeks ago, I was diagnosed with 22.5 events per hour and a low of 77 for SPO2. So last night, I had my titration study. Given that I'm a little bit claustrophobic, I told them I did not want a full mask. I tried a NASAL pillow from RESMED first, and couldn't stand that, and I ended up going with a ResMed AirFit N10 which was not great but "ok". The pressure was very low to start, and she had a humidifier running. The room temperature was somewhat cool, which I prefer, and I was able to finally fall asleep. I got up at 12:20 and used the bathroom, and then was able to get back to sleep. However, I woke up at 3am and the temperature was very warm, and the mask was blowing like crazy.

I waved for the assistant and asked if she could fix the room temperature, and adjust how hard that mask was blowing. She told me she had to really increase the pressure, and would decrease it until I fell back asleep, which didn't happen until at least an hour later. I meet with the doctor this Friday.

I just don't know about getting used to this, especially if it's going to take a lot of pressure (I asked her if she got up to 18, and she said "around there"). How do you deal with this?

Do the self adjusting machines fix this problem? What do I ask for on Friday when I meet with the doctor? Does the AirFit P10 perform better than the N10? Their website says "Patients using the AirFit P10 sleep more than 40 minutes longer per night" - can anyone vouch for that?

Greatly appreciate any insight. Horrible thought to have to deal with this for the rest of my life, so I'm hopeful it will improve.

[Julie]

When you are tested, they take things to extremes to see how your system reacts to them, so they can get a 'baseline' picture of all features that can influence your OSA and Cpap. If they didn't do that, they couldn't really know where limits were to how much or little you need pressures to be, or what happens when they are raised, lowered, etc.

[LSAT]

Sounds like a pretty typical titration session. If your pressure needs to be at about 18, it wouldn't matter if it was a CPAP or APAP...the pressure would still be 18 max. The difference is that with an APAP the pressure would flucuate. Some people can't handle the changing pressures. It's something to discuss with your doctor when you review your sleep study with him.

[SW 2.0]

Thanks, appreciate the insight and feedback. For me, this is like venturing into unknown woods in the dark, except when forum members like you come along and shed some light.

[kteague]

Titration nights are notorious for being difficult. My long term experience is nothing like that first night. It has become routine. When you see the doctor, be sure to get a copy of the detailed report (not just a summary). Should be a few pages with info about sleep stages, sleep positions, etc. It is too early to offer much meaningful advice. Just do your homework on machines before accepting one. That's the first really big deal, not getting pressured into and stuck with a machine that doesn't best meet your needs. The similarity in the names makes it easy to think you're getting something you're not. Better to delay and come back here and ask if there's any doubt. After that it's one step at a time. Good luck going forward.

[SW 2.0]

That's really good to hear. Thank you.

When I did the first sleep study, I did get a report and then also asked for a copy of the graph, which I have since annotated with what I have learned. It looked like there is a pattern - the hypopneas and apneas all seemed to happen the most during REM sleep, which could not have been seen without the graph and was not in the report. Maybe that's not important, but I did find it very interesting.

I would attached a copy but I don't see a means to add a pdf attachment.

[CaptainRaven40]

I have not heard anyone say they went in for there titration test and just love the night I for sure didn't. I was given the Optilife nasal pillow mask and it was horrible and asked for something else, but was told that was the best on the market and would work best for me. I now know that was a complete lie especially for me. I like my Airfit P10 so far. It is a great little mask. I have only used it for 2 nights. I went from the Pilairo Q which I loved to begin with and began to hate very soon after causing sores and them bleeding in the middle of the night onto my pillow. I then moved to the Wisp and slept ok with it, but it leaked right into my eyes and there was nothing I could do to keep it from doing so except sleep on my back and that kills me after a while. So that was not the mask for me. I went back to my DME and was told that I could not get another mask without paying 100% out of pocket for another one. They didn't tell me this up front and that was sneaky of them, but isn't unheard of for a DME it seems. The therapist there though is super nice and I wanted to try the P10 and all she had was a for her version and she let me try it on and the medium fit great and she said that is all I have and it is a for her. I asked the difference and she said that the pink band and that the largest pillow it can hold is the medium. I said that I didn't care about the color because my wife and I would be the only ones seeing it and I just wanted my therapy to work. So she told me to take it and that she wasn't putting it in to the system and just to let them know when it was time for new parts if that was the mask I was using. So keep at it and don't let the study scare you too bad. They are all bad if you ask me. It isn't a great place to sleep. Just hang in there!

[SW 2.0]

Thanks CaptainRaven40! It was depressing to say the least - I had hoped that I might be one of the lucky ones and wake up nice and refreshed and without the usual headache and 3pm tiredness

You are the first person to answer my question about the Airfit P10, and I'm intrigued. I understand everyone's face is different and will have different results because of that, but the sales pitch on that one has me intrigued. I have no trouble keeping my mouth closed sleeping, and wanted the least intrusive mask, so I was trying to stay with a nasal mask in lieu of a full mask. However, the sleep technologist told me that with higher pressures some people do better with a full mask.

I guess it comes down to what happens with the DME during the first 30 days and what kind of exchanges they will allow? I didn't get to try but 3 different masks during the titration study.

[Pugsy]

There is an old wives tale told by DMEs and nasal pillows and higher pressures. That they don't go well together but it's not set in stone. Higher pressures can be a challenge for any mask and not just nasal pillow masks. I see pressures over 20 cm nearly every night and I have used nothing but a nasal pillow mask for well over 6 years now. As the new models come out try them and if I like them I keep using them.
So for now I am using the ResMed AirFit P10 nasal pillow and have been for a little over 1 1/2 years now.

We have lots of people using a nasal pillow mask with pressures in the upper teens and even in the 20s with great success. So it can be done.

If you want to try a nasal pillow mask like the P10 then by all means try it. You won't ever know how well you might do until you try it yourself.

Oh..regarding the titration study night...I refer to mine as the night from hell. Part of it was the idiot tech (long story there) and part was I simply didn't sleep well at all for various reasons. I woke up with massive headache and bloop pressure through the roof and went home to sleep.
I was hoping to be one of those miracles myself but it didn't happen. Luckily the titration was the worst of my nights.

If you want to use a nasal pillow mask...go to Walmart and in the baby aisle there is a product called Lansinoh lanolin ointment/cream. Get a tube and use it sparingly at night. It will help with any minor chafing and tenderness the nasal pillows might cause. After a bit of time and experience with fitting the nasal pillows you may not need it but it comes in handy at first.
Also...anything other than minor tenderness with any nasal pillow usually means either too tight or the wrong size nasal pillow.

[Janknitz]

IMHO, full face masks are VERY difficult to use for a newbie, and the higher the pressure to leakier and more difficult they are to seal. Sleep techs and DMEs who claim they are best for higher pressures obviously never tried themselves.

Nasal pillows, on the other hand, when fully inflated from higher pressure seal nicely against the nostrils and tge airflow is barely noticeable. I think they are the easiest to deal with at high pressure.

[yaconsult]

That's a very typical experience you had - don't worry! Titration needs to determine the appropriate pressure ranges for your body so will need to probe above and below the needed pressures to determine the best ranges. Your treatment after you get your machine will not be like your titration.

Believe it or not, your body quickly adjusts to the pressure and many people will tell you that after a short time they pull their mask off or pillows out because they're not even sure if the machine is on! I'm NOT kidding!

In a short time, most people welcome the feeling they get after putting their mask on because they know if means they are going to get some sleep.

[Madalot]

If it's any help, please know that you WILL get used to the pressure (hopefully). I started out at 11 and now am at a range of 18-23 and the 18 feels like nothing to me (now). I also use a FFM and have since day one. I'm lucky and don't have a lot of trouble with leaks.

Work with your doctor and keep at it. A few months from now, you'll be an expert.

[SW 2.0]

Thanks to all - you give me hope! It's a pretty bleak feeling right now.

Friday is when I meet with the Doctor to find out the results of the titration study and see technically how it went. I have read sleep apnea causes many health related problems, but has anyone experienced much reversal of those problems after being on CPAP for a length of time? Not the symptoms (headaches and tiredness), but actual weight loss, improvement in blood pressure, etc?

[knothead]

Thanks to all - you give me hope! It's a pretty bleak feeling right now.

Friday is when I meet with the Doctor to find out the results of the titration study and see technically how it went. I have read sleep apnea causes many health related problems, but has anyone experienced much reversal of those problems after being on CPAP for a length of time? Not the symptoms (headaches and tiredness), but actual weight loss, improvement in blood pressure, etc?

Guess I am a lucky one as my apnea, snoring AND hi BP got better. BP was up & down was on bp medicine. After about a year the doc took me off med and bp runs a steady pace now. So to answer your question, yes things can get better, just gotta stick with it, and listen to all the great advice on this board. Ask questions and get familiar with your equipment...

[SW 2.0]

Awesome thanks! Except I feel funny calling you knothead! Sounds like something I used to call my boys when they were younger