Resumed OSA therapy on AutoPAP

Greetings, ladies and gentlemen

I was diagnosed with a mild OSA in 2008 and was put on CPAP therapy (AutoSet s7, full mask). I discontinued the therapy on my own chiefly because of disturbing rain-outs, particularly during colder periods of the year.

In 2014, finally tired of being tired all the time, I visited my sleep doctor once again. Despite having an AHI of just 4.5, I was yet prescribed with a newer device, Autoset s9. What a huge difference it made! My AHI dropped to 0-0.7 and started feeling much better immediately. However, there are a few issues that prevents my therapy from being a complete success:
1) Nasal congestion. I tried different settings: 4-6 humidity, 60-86F for the heating tube (by the way, with climate control turned on, water level doesn't seem to drop -- is this supposed to be like this?). Still, my nose tends to get congested, though less with lower temperatures. When I turn off the climate control, my nasal congestion appears to retreat, but then I experience rain-outs again ;

2) My mouth tends to open, due to #1 above, I think; having a chinstrap, however tight, doesn't help it;

has anyone else had similar issues and successfully overcome them?

What mask are you using?
Where is the rain out occurring...at the mask or the long hose?

My mask covered my nose only at first, then I switched to a full mask, Mirage Quattro fx. This year I have used Airfit f10. Rain-outs occur both in the tube and in the mask, if climate control is off. With climate control on, i have a nasal congestion

When you say Climateline is off....does that mean you have the humidifier setting turned off (set to 0) and the temperature control set to 0 also...or is it off as in off of automatic but you can still select temp and humidity settings independently?

The default for when the Climateline hose is plugged in is "automatic" and you can only select air temp.

Did you know you can set it so that the humidifier doesn't add moisture but you can still have a little warmth to the air in the hose?

Condensation occurs because of moisture in the air hose or mask (some in the mask may be from moisture in your exhaled breath) is released by the air as it cools.
Warm air hold more moisture than cool air.

You need to warm up the air in the hose and mask somehow....either a hose cozy, warmer bedroom temperatures...so that the air doesn't cool and release the moisture.

Do you have the manual that explains all the choices?
http://www.apneuvereniging.nl/forum/pdf ... manual.pdf

Placing the machine lower than the mattress will let gravity help you a bit as the water will run downhill but won't prevent the condensation from forming. Might be less annoying though.

If I use a humidifier in any but the coldest couple of months (when central heat is highest and driest) I definitely get congested, so why not try turning it right down?

Here is what I have done:
1) at first, I followed a recommendation to max out humidity level to 6 and gradually increase temperature. Reached a max of 86F, still nasal congestion, dry mouth; water in the humidifier does not go away

2) then, dropped to 72F, then to 64F, less of nasal congestion and month dryness; water in the humidifier does not go away visibly;

3) also, tried to incompletely engage the ClimateLine tube, effectively turning off heating (no electrical contact). As a result, even less nasal congestion, some dryness of the mouth, but there is rain-out, and water in the humidifier goes down considerably

I suggest you do try a FF mask because chin straps are ineffective at keeping your lips closed.

tan wrote:but there is rain-out, and water in the humidifier goes down considerably

So this happens when the ClimateLine isn't connected to electric. Is this correct? How did you accomplish this? Just not engage the plug in the back of the humidifier?
Did you also change the humidifier setting?
If you are using water from the chamber and getting rain out then heat is going to the water chamber and moisture will be added to the air and without the warming of the ClimateLine hose then rain out is going to occur.
If the water in the chamber goes down visibly....heat is being added to the chamber and depending on what that setting is...there's going to be rain out in the hose if the air isn't warm enough to retain the moisture.

What I would suggest is go into the clinical setup menu and take the setting off of "automatic" and change it to manual/patient and then you can set the humidity to a lower level and then you can also set hose temperature warm enough to prevent rain out.
Two separate settings that need to be done. One for humidity to be delivered and one for the hose air temperature.

Or increase the bedroom ambient air temp. You have to warm up the air in the hose in some way or you will get rain out...
or don't heat the water chamber.

Julie wrote:I suggest you do try a FF mask because chin straps are ineffective at keeping your lips closed.

I do use a full face mask. It helps but not as much as I wish it to. My mouth still tends to open, so air goes through both the channels

Pugsy wrote:

tan wrote:but there is rain-out, and water in the humidifier goes down considerably

What I would suggest is go into the clinical setup menu and take the setting off of "automatic" and change it to manual/patient...

Thanks, Pugsy! My settings was indeed "automatic". I feel like I need humidity somewhere in between the "optimal" and "rain-out", as I wake up with my nose clear when water starts dropping on my face

When set to "Automatic" the S9 will try to deliver 80% humidity all the time no matter what the air temp in the hose. Depending on the bedroom temperature if you opt for a cooler hose temp then rain out can happen but when you take it off of "automatic" you can decrease the humidity delivered and as long as your nose is happy that's fine. Not everyone needs or wants 80% humidity.

In the patient/manual mode you can fiddle with the humidity and temperature independently of each other till you find something that keeps the nasal mucosa happy and the air temp just warm enough to prevent condensation. Sometimes it just takes a couple of degrees warmer to prevent rain out.

What I also noticed is that my machine sometimes elevates pressure a bit (up to 10), when my breathing goes async with automatic air waves, which may puff my cheeks and eventually force my mouth open, so air escapes through my mouths. Should I bring down my upper limit ? The current settings are at 4/20. Here is my typical night:

You have to upload your images to some place like imgur or photobucket and link to the image.
Explained here
Screen shot thread viewtopic.php?f=1&t=81072&p=737779#p737779

Pugsy wrote:You have to upload your images to some place like imgur or photobucket and link to the image.
Explained here
Screen shot thread viewtopic.php?f=1&t=81072&p=737779#p737779

Thank you, Pugsy, updated my post above accordingly

and here is one of my worst nights, after which I felt really terrible: tired, sleepy during the day, racing heart, elevated blood pressure, etc.