New CPAP user

Hi, I just got my CPAP machine last Thursday. To say it's been rough adjusting to it is an understatement.

I was given a Resmed Airsense 10 Elite. My pressure is 9.

At the sleep study I tried a nasal mask and a full face mask. The nasal mask was the lesser of 2 evils. When I got my machine, they let me try different masks. I tried 2 nasal pillows and 2 nasal masks. Didn't even try the full face ones since I hated it so much at the lab. The one I chose was a Philips Respironics Nuance Pro. Using the medium pillows. I tried each one with the machine on for about 2 minutes each.

I've tried using it every night with varying degrees of success. The most I wore it one night was like 7.78 hours. Most of the time it's 5 or less.
My main issue is that I wake up in the middle of the night feeling like I can't breathe right. I take off the mask and try to readjust it but I can never get it on comfortably again. It seems I feel like I am fighting the pressure and I can't exhale properly. Trying to adjust and fight that while I am super tired is not fun so i end up turning off the machine and not using it the rest of the night. I have tried to turn it off/on to make the ramp feature start over but that doesn't seem to help either.

Another big issue is trying to find the right mask. I get 1 free mask "exchange" within 30 days. I have to wait 90 days from the start for insurance to pay for another mask.
My mask has silicone straps at the pillow area and those have been hurting my face. The company I am going through is sending me one with cloth straps but that counts as my "exchange".

I am finding that I tend to breathe through my mouth more so maybe the nasal pillows aren't such a good choice? I mean, how can I find right mask if I can only get a new one every 90 days? Testing for a few minutes at the therapist office is totally different than sleeping with it. I'm supposed to suffer until then?

I'm not sure the humidifier really helps. it goes up to 8 and it was on 4 at first. I tried it with 5 and 6 so far with no noticeable difference to me. I did try 8 one time and I woke up with water in my mask and in the hose. The air sometimes feels really cold as well, so they are trying to get me a heated hose, which they say my insurance will pay for. I guess they have to get doctor approval first.

I also frequently have nasal congestion. a weird thing that is happening right now is that mt left nostril seems to get stuffy with the mask on for some reason.

So far lots of annoyances and complaints and I have NOT felt any better in the mornings yet. Maybe I have not worn it long enough or for a long enough time?

Patience is the key. My first month was HELL!

Just remember that you are dramatically changing something you've been doing since birth. In my case I had to rethink and redo over 50 years of sleep.

It's different for everyone. It will get better.

Your machine has an EPR feature that lowers the set pressure to make it easier to exhale. If your pressure is set at 9 you can set the EPR (Pressure Relief) to 1-2 or 3. If you set it to 3 your pressure will be 9 on inhale and 6 on exhale. Make sure your EPR is being used. Sounds like you definitely need a FF mask or a good chinstrap....not too many are successful with the chinstrap. Keep after your DME and pester them so they allow you to test more masks. They get reimbursed for demo masks.

LSAT wrote:Your machine has an EPR feature that lowers the set pressure to make it easier to exhale. If your pressure is set at 9 you can set the EPR (Pressure Relief) to 1-2 or 3. If you set it to 3 your pressure will be 9 on inhale and 6 on exhale. Make sure your EPR is being used. Sounds like you definitely need a FF mask or a good chinstrap....not too many are successful with the chinstrap. Keep after your DME and pester them so they allow you to test more masks. They get reimbursed for demo masks.

How do I access this setting? I don't see that at all. Only thing I can change myself is humdity level and mask type and do a leak/fit test.

This manual explains how to enable EPR so that it is accessible to you.
https://sleep.tnet.com/home/files/resme ... -guide.pdf

Pugsy wrote:This manual explains how to enable EPR so that it is accessible to you.
https://sleep.tnet.com/home/files/resme ... -guide.pdf

nope, all i have is my options and sleep report. they must have locked it down somehow?

pontifex wrote:

Pugsy wrote:This manual explains how to enable EPR so that it is accessible to you.
https://sleep.tnet.com/home/files/resme ... -guide.pdf

nope, all i have is my options and sleep report. they must have locked it down somehow?

They CAN'T. You can access everything that they can.


Den

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Wulfman... wrote:

pontifex wrote:

Pugsy wrote:This manual explains how to enable EPR so that it is accessible to you.
https://sleep.tnet.com/home/files/resme ... -guide.pdf

nope, all i have is my options and sleep report. they must have locked it down somehow?

They CAN'T. You can access everything that they can.


Den

.

oh, i missed the directions on how to get to it.

EPR was at 2. I set it to 3.

If the straps bother you strap covers are available online; go to http://www.padacheek.com. You can also get mask liners there, many of our forum users use them. Mouth breathers generally need to use FF masks, because your open mouth causes the air to go out your mouth instead of down your throat where it is needed to keep your throat open. If you didn't like the FF mask you tried, maybe using a mask liner will make it more comfortable for you. Liners are also available from the link above, but they will have to know which mask you use as each mask fits differently as well as its headgear. I'd suggest trying a FF again; the F10, which I use, has minimal headgear (no forehead strap) and you might like that one better - unless that is the one you tried.

You are very new to cpap; all of us struggled to use the mask all night and get comfortable with it. It is not uncommon to spend a month or so getting totally comfortable with the whole thing, which is a huge adjustment for you and your brain. It's a gradual process, so stick with it and come back here with your difficulties and we will help you.

pontifex wrote:

Wulfman... wrote:

pontifex wrote:

Pugsy wrote:This manual explains how to enable EPR so that it is accessible to you.
https://sleep.tnet.com/home/files/resme ... -guide.pdf

nope, all i have is my options and sleep report. they must have locked it down somehow?

They CAN'T. You can access everything that they can.


Den

.

oh, i missed the directions on how to get to it.

EPR was at 2. I set it to 3.

Based on the following information, your "effective" pressure at the end of your exhale cycle and beginning of your inhale cycle will only be 6 cm.

I was given a Resmed Airsense 10 Elite. My pressure is 9.

Just so you know........
ResMed's EPR exhale relief drops the pressure on exhale by one whole centimeter for each number of the setting.


Den

.

Wulfman... wrote:

pontifex wrote:

Wulfman... wrote:

pontifex wrote:

Pugsy wrote:This manual explains how to enable EPR so that it is accessible to you.
https://sleep.tnet.com/home/files/resme ... -guide.pdf

nope, all i have is my options and sleep report. they must have locked it down somehow?

They CAN'T. You can access everything that they can.


Den

.

oh, i missed the directions on how to get to it.

EPR was at 2. I set it to 3.

Based on the following information, your "effective" pressure at the end of your exhale cycle and beginning of your inhale cycle will only be 6 cm.

I was given a Resmed Airsense 10 Elite. My pressure is 9.

Just so you know........
ResMed's EPR exhale relief drops the pressure on exhale by one whole centimeter for each number of the setting.


Den

.

Is it bad that I increased it? It was originally set at 2.

Last night I wore the mask all night, other than waking up a few times to adjust the mask. Last night was also the 1st time I used my new hose holding pole (sort of like a hose buddy but lots cheaper) so it held the hose up above me more instead of it hanging down the side of the bed.

It's not bad that you increased the EPR to 2.
Some people will find that the additional drop in exhale might allow an apnea event of some sort to happen and if that happens we can adjust the pressure upwards just a little and still keep whatever EPR lets you get to sleep.
Doesn't happen to everyone though...it all depends on just how much baseline pressure is needed to keep the airway open.
You can evaluate the need by looking at the software reports....if you AHI doesn't increase remarkably then that 2 cm drop isn't hurting a thing.

Pugsy wrote:It's not bad that you increased the EPR to 2.
Some people will find that the additional drop in exhale might allow an apnea event of some sort to happen and if that happens we can adjust the pressure upwards just a little and still keep whatever EPR lets you get to sleep.
Doesn't happen to everyone though...it all depends on just how much baseline pressure is needed to keep the airway open.
You can evaluate the need by looking at the software reports....if you AHI doesn't increase remarkably then that 2 cm drop isn't hurting a thing.

My AHI last night was .5

pontifex wrote:My AHI last night was .5

Doesn't get much better than that. How was the sleep quality in general?

The possible issue when using EPR and that drop letting apnea events slip past the defenses is more evident when someone was already using maybe the bare minimum pressure needed to keep the airway open.
That doesn't appear to be the situation in your case based on such a nice low AHI when using EPR.

My thoughts on using EPR or any of the comfort features....whatever it takes to get good sleep is fair game to use. While some people may say "it's only a comfort feature and not part of therapy"...I think comfort is a huge part of therapy and if we aren't comfortable we simply don't sleep so great.
I think "comfort" is a critical part of good therapy. If I was miserable for some reason and not sleeping well...then that sort of defeats the whole purpose of this therapy which is to improve sleep quality and prevent sleep apnea from further destroying not only our sleep but causing all sorts of damage to our body.

Pugsy wrote:

pontifex wrote:My AHI last night was .5

Doesn't get much better than that. How was the sleep quality in general?

The possible issue when using EPR and that drop letting apnea events slip past the defenses is more evident when someone was already using maybe the bare minimum pressure needed to keep the airway open.
That doesn't appear to be the situation in your case based on such a nice low AHI when using EPR.

My thoughts on using EPR or any of the comfort features....whatever it takes to get good sleep is fair game to use. While some people may say "it's only a comfort feature and not part of therapy"...I think comfort is a huge part of therapy and if we aren't comfortable we simply don't sleep so great.
I think "comfort" is a critical part of good therapy. If I was miserable for some reason and not sleeping well...then that sort of defeats the whole purpose of this therapy which is to improve sleep quality and prevent sleep apnea from further destroying not only our sleep but causing all sorts of damage to our body.

How was sleep quality last night? I guess good, Other than waking up a few times to adjust the mask. I didn't feel any different than I do any other morning though. I keep seeing people say even ontheir 1st night with the machine they had awesome sleep or felt so much better in the morning. I'm not noticing any change yet.