MarkWill wrote:
. If I am wearing my mask correctly under what circumstances would I experience an event (apnea)? As I say, I had 27 per hour during my sleep study. On my first night with the device 14 per hour were reported and last night it was 2.5. If I am wearing my mask correctly, would I eventually expect to see zero per night i.e. it's keeping my airway open and therefore there are no events?
As others have pointed out, a few apneas here and there in a person with NORMAL sleep is
normal. The APAP makes it
harder for your airway collapse, but it does not make it impossible for your airway to collapse.
While it's great if you can get the AHI to consistently be very low, chasing an ultra-low AHI just to have an ultra-low AHI can be counter-productive. In general, once the AHI is well below 5.0, the focus should be on the overall quality of your sleep: Are you sleeping enough to feel rested? Are you getting to sleep easily and close enough to your desired bedtime? Are you staying asleep all night or only having a few very minor wakes that do not feel disruptive to your sleep? Are you waking up feeling rested at a time you want to wake up? And do you have enough energy to get through the day? These things all take time for most people so it's important to not expect that you should be feeling GREAT after only a few days of PAPing. If you're lucky, you should start to feel better within the first week or two. If you're like most people, it may take a month or two to really learn how to sleep well with the machine.
On both nights I have used it I have woken up very early (about 5:30am yesterday and 4:15am this morning). I do find it pretty difficult to get back to sleep but I am curious as to what expectations I should have about how deep my sleep is.
It could be that your body simply thinks it's "done" with sleeping since it has gotten a lot more restful sleep by 5:00ish than it used to get when you slept longer.
My guess is that some aspect of using the device (pulling the tube, etc) is waking me up but if the device is doing it's job it should be helping me reach a deeper sleep, yes?
It could be that you're noticing the mask or the tube when you finish a REM cycle. After a REM cycle you naturally return to a very light sleep stage, and it's not uncommon to actually wake up post-REM. Even people with normal sleep will often have a post REM wake or two during the night. Most of the time these post-REM wakes are so short that people don't remember them. But you are sleeping with this new
thing strapped onto your face, and so when your brain naturally arouses in that post-REM wake, it wakes up more than is should and so you are much more aware of the wake. Combine that with the fact that your body has gotten about as much time in bed as usual along with a higher quality of sleep than usual, and the body and brain may very well have trouble getting back to sleep because they feel like they've gotten enough rest.
No real question here - just trying to understand how long it should be before I start seeing results. It's just ironic that with this machine I have had two very early mornings, waking up much earlier than normal. I normally wake up around 6:30am naturally (no alarm).
In a later post you also said you went to bed earlier. Same amount of "Time in Bed" with higher quality sleep would explain why you are waking up much earlier than normal.
When I go to bed I use the ramp thing and all seems well. But when I wake up (and it's fully ramped up, which generally means a pressure of 11-12 for me), there's a fair amount of air coming out the mask at the front. A rel rush. The fitting seem really quite good, even if I hold it tighter to my face. I am unclear if this is by design. Although it feels like a constant rush, not aligned with my breathing, I am wondering whether this is something to do with exhaling CO2 perhaps? By the way, for what it's worth the MyAir site reports a very good mask seal (virtually no leakage). No idea if that is meaningful/accurate,
The vents on the P10 mask that you are using are the two mesh panels on each side of the base where the pillows clip onto the mask. If the air is coming from those vents, it's perfectly normal to have air rushing out of them. And the exhaust venting will be much more noticeable at 11-12cm of pressure than it is at 4-5cm of pressure, which is probably where your ramp starts off at. The reason is simple: There's a lot more air being pumped into the system at 11cm than there is at 4cm.
As others have pointed out the venting is indeed to prevent rebreathing your CO2.
. What is the process when I get up in terms of turning it off? If I press the On / Off button, it does seem to close down - somewhat. But there's still a light pressure coming out the mask, even though I am not wearing it. It's not "on" per se, because if I press the On / Off button again it starts blowing more air and the ramp starts. So, when it's blowing this "gentle" flow, what is the intent of that mode? It doesn't seem to timeout - stayed that way for at least 15 minutes. If I "long press" the On / Off button then the whole things shuts down.
The AirSense machines like you are using blow air at a very low rate for up to 30 minutes before turning itself completely off. The idea is that blowing the air through the tube will dry the tube out at the end of the night. The "long press" is a way to override this "feature" of the AirSense machines.
. Bit of a whine nit, but just wanted to say that I like the AutoSense (thought it's all I know!), but the sound made when pressing the button to navigate the menu is far louder than anything else about the machine - to the extent that it wakes the wife. That's pretty frustrating. It's whisper quiet and no issue at all, but if I want to check a setting the silly button wakes my wife up. Daft design.
Yes, you'd think there'd be a way to turn that off. When my hubby got his PR System One Series 60 machine I was pleased to see that PR had added a "turn off the annoying beep" setting---my System One Series 50 machine had no way to turn off the annoying beeps, and I wake up a lot during the night. Fortunately for me, my hubby is not a light sleeper.
Your wife may eventually get used to the beeping. Or you may wind up needing to do a lot less "fiddling" in the future. If your wife is very sensitive, she may find sleeping with a pair of earplugs may help.
. Frustrating financial issue. For all sort of other reasons, I am through my deductible on my health insurance for the year. So, this would be a great time to buy my CPAP device. However, my insurance company requires a three month period - which means I can't buy/claim it till next year, when I will be right back into a new deductible. That's pretty frustrating and means I pay 100% instead of 10% (coinsurance). Are there any suggestions for how to work with the insurance company to work around this? I'm guessing not but open to any ideas.
If you demonstrate excellent compliance during the first month, you might be able to get your insurance company to cough up the money before the end of the year. If not, then you know what will pay a good chunk of the deductible. So your insurance company will be picking up the bulk of the cost of a everything else much earlier in the year next year. Not great, but it is what it is. If your employer offers a Medical Flex account, make sure you sign up NOW for next year. That way the machine is paid for with tax-free dollars.
