doing fine until I awake with the machine roaring

No mask should ever cause pain, abrasions or open wounds/sores.
If they do then either
the mask is not fitted properly
the mask is not the correct size
the mask simply isn't a good mask for your particular facial structure

Do you absolutely have to use a full face mask because the nose is so congested you simply cannot breathe only through your nose?
If so...take a look at the Respironics Amara View full face mask. It doesn't have anything that goes over the nasal bridge area and thus would let your nose heal.
https://www.cpap.com/productpage/respir ... -mask.html

If your nose is only partially and sometimes congested then you might be able to use one of the nasal pillow masks that don't touch the nose except at the nostrils. Have you tried one?

I deleted the old ones and reposted on Friday and Saturday. Can you see them?

I can see the Friday report now.

The bulk of your AHI appears to be Clear Airway and very close to known awake times so I suspect that these were just awake/semi awake junk getting flagged.

So I don't think your asleep AHI is all that remarkable.
More remarkable might be the awakenings which mess with sleep architecture and that could maybe be a factor in your not feeling so great.
And of course if you really did take the mask off and sleep for a couple of hours without the mask then that for sure will impact how a person feels the next day.
Now why you are having the awakenings...sometimes that's real hard to figure out.

Pugsy wrote:
Do you absolutely have to use a full face mask because the nose is so congested you simply cannot breathe only through your nose?
If so...take a look at the Respironics Amara View full face mask. It doesn't have anything that goes over the nasal bridge area and thus would let your nose heal.
https://www.cpap.com/productpage/respir ... -mask.html
If your nose is only partially and sometimes congested then you might be able to use one of the nasal pillow masks that don't touch the nose except at the nostrils. Have you tried one?

I usually breathe through my nose when I sleep. The only reason i quit the nasal mask was the "burping" mentioned in the first post. The full face masks hide or eliminate the burping I guess. The amara view looks interesting for sure. I'll call my supplier tomorrow and see if I can get one.It seems as though my sleep problem may be related mostly to a poor fitting mask on the bridge of the nose. As I mentioned previously, I see my new MD in 3 days. I am going to see if I might be a candidate for a dental apnea device. I have a friend with severe apnea who swears by his dental device.

Upon looking into the Amara View mask I notice that it may not be recommended for people with glaucoma. I have glaucoma. Is that warning due to air being released towards the eyes and consequently drying them out? Started last night with my nasal mask. It sure is comfortable but the burping thing started again so I took it off and slept without any mask. Not feeling too good this morning. The more I look into dental devices the more conflicting info I find. Seems like the only way to find out is to try one and that is an expensive proposition with a good deal of time commitment. I'm sticking with looking for a mask fit that works. Seems from your input that I'm doing ok...the CPAP is working...just need to be comfortable with it. That would be the combination of a good mask fit and time using it. Looking and trying. Looking and trying.

Used the nasal mask last night with a custom bandage on my nose. Bandage worked. I reduced the pressure settings way down to avoid the "burping" thing. That worked too. However the lower settings apparently prevented a control of the apnea as the graph show. A lesson. I could tell immediately upon a wakening that it wasn't good. Lack of energy, bad attitude. A lesson. Back to higher pressures: 9 min/ 20 max and get the mask to fit. So it goes.

Roughly half of your AHI last night was clear airway/central and flagged mostly around the time of known awake times so I don't know I would worry about those and even if they weren't related to known awake time or SWJ...sleep/wake/junk....pressure changes won't fix centrals.

The other half of your AHI is mostly hyponea spread out throughout the night as we would expect.
If the higher pressures and the "burping...which is probably aerophagia" comes with the higher pressures then maybe try a compromise between last night's settings and the max 9/20 settings.
How about 8 minimum and 12 maximum and see what happens in terms of the hyponeas and the "burping"?

Thanks Pugsy. Will do. Just set the pressures as you suggest: 8/12. The journey continues.

Saw my new MD yesterday. Really like her. She thinks I need a bi-level machine or the next one above that (due to most of my apnea being caused by by CAs) however medicare says I need a sleep study first. They are backed up on those so it's 6 weeks out. The delay on all this seems to be to medicare requirements. What would it cost to buy a machine on my own? She also said a dental apnea device would be a good idea for me as a backup for travel, camping and so forth. It might not be as effective as a CPAP machine but would be better than nothing and I'd be more likely to take it along. It also might be as good as a CPAP machine. Only another sleep test would show that. I'm showing last night's graph. I'm learning to read these thanks to you all so I now see the CAs. I've gotten the FFM with a fabric cover to be very comfortable so that is no longer an issue. The fact that I have been learning a great deal about apnea on this forum was very helpful during the MD visit. I was able to converse intelligently about the issues. She appreciated that and thought the forum was a good thing for many reasons, one being that it keeps the newbie from feeling they're going crazy by themselves.

This report you just posted is the same one from Monday night with settings 7 min and 9 max.
Did you make the change to 8 min and 12 max yet? If so, what does that report look like?

There are 2 main types of bilevel machines...regular bilevel which is pretty much cpap/apap with greater variability in the difference between inhale and exhale....and the ASV type of bilevel which has special functions where it can actually breathe for you when a central happens.
When centrals are numerous enough that they need treatment then the usual progression in machine is to try the regular bilevel first and then if that doesn't work then move on up to the ASV type. Insurance companies want to provide the least expensive option that gets the job done and ASV is real pricey so they want documentation of need before they pay...hence the additional sleep studies.

You could probably find a bilevel machine on the secondary market but they aren't cheap and at this point we don't know which bilevel you need.

Do you have any known heart issues...like congestive heart failure?

Your images continue to disappear. Are you possibly deleting them by mistake?

Sonnyboy wrote:Your images continue to disappear. Are you possibly deleting them by mistake?

Don't think so. That's a puzzle. I can always see them on the forum. I'm going to put the correct graph from last night up now....I hope.

Just tried IMGUR...can't get it to even come up properly on my screen. Something is very wrong there. And Pugsy, yes I did change my settings to 8/12 for the last 2 nights. Sorry about the wrong graph. I felt the last 2 nights were my best sleep with the CPAP.
Just got word that I can take my sleep test this coming Sunday. GOOD NEWS.
My MD mentioned that the ASV would most likely be the best thing for me but we have to play the insurance game.
I'm working on getting IMGUR to work.

bluetrout wrote:

Sonnyboy wrote:Your images continue to disappear. Are you possibly deleting them by mistake?

Don't think so. That's a puzzle. I can always see them on the forum. I'm going to put the correct graph from last night up now....I hope.

Just tried IMGUR...can't get it to even come up properly on my screen. Something is very wrong there. And Pugsy, yes I did change my settings to 8/12 for the last 2 nights. Sorry about the wrong graph. I felt the last 2 nights were my best sleep with the CPAP.
Just got word that I can take my sleep test this coming Sunday. GOOD NEWS.
My MD mentioned that the ASV would most likely be the best thing for me but we have to play the insurance game.
I'm working on getting IMGUR to work.

This image is great. Pugsy and the rest of the experts will be back to help you. I'm reading along and learning.

I would just continue with these settings since you feel that you have have had better results in terms of how you feel these last 2 nights. We can't do anything about the centrals and the hyponeas are borderline needing anything done about them at this time. A little more minimum would likely help reduce the hyponeas but you need more than 2 nights on these settings anyway. Plus you have the upcoming in lab sleep study so I wouldn't be in a big hurry to change anything at this time. Let's see what comes of the sleep study.

Hey bluetrout
I know it's been almost a year since your posting, but I'm wondering how you're doing and if you've tried the Amara View Full Face Mask?
It doesn't go up over the nose and I find it generally very comfortable. I was getting some irritation on the tip of my generously-sized nose , but for now, I've solved that problem by wearing a bandaid on it when I go to sleep. I have a very high-bridged and narrow nose, so I had doubts that the over-the-nose types of FFMs would even seal correctly for me, let alone be comfortable enough to tolerate.

Also, even though this is definitely the FFM that works best for me, I think I may have to switch back to nasal (I started with the Philps Dream Wear) but couldn't seem to relax because I had to keep my mouth closed which was really difficult even with the use of a chip strap, and made me feel like I couldn't get enough air.
However, my problem with the FFM is that I now wake up BURPING Ugh!!!! And like you mentioned, once it starts, it seems to continue every time I fall asleep and my mouth relaxes. It's as if the back of my throat "rejects" the air being forced into it, instead of staying splinted open, and burps in response. Now I'm going to look into a more substantial chip strap to use with the Dream Wear. I'm also thinking of falling asleep with the Amara View, and then switching to my Dream Wear once I start getting the burps (usually early morning).