My first night

I received my IntelliPAP autoadjust with humidifier yesterday afternoon, and was incredibly eager to get some sleep. I'm using a full face mask, as I am a terrible mouth breather and thought I'd do much better with it. My sleep study showed 18 hypopnea events per hour, one apnea, and desaturation to 82%.

I slept maybe six hours total, with many awakenings; I think I'm just not used to the mask or airflow yet. Also, because I'm a mouth breather and my mouth got very dry, I kept increasing the humidity up to a final 10 until I got gurgling; then, reduced it back down to three and resigned myself to a dry mouth in the morning. Anyway, my AHI was 11.84 on pressures of 4-20. Based on my meager understanding, I kicked the base pressure up to 6 in hopes of reducing the AHI, and reduced the pressure relief from 3 to 2.

The thing is, even with the crappy scores and significantly less sleep than I normally get, I was more awake today than I have been in a long time. I hope it's not just placebo effect.

Do you think I made the right choices on my changes to the base pressure and pressure relief? Also, any suggestions on dry mouth prevention?

Yes, on the minimum pressure changes and you very well may need a bit more but go up slowly. Easier to adjust to and easier to monitor the results.

Dry mouth can happen even with full face masks. You can try adding humidity as best you can till you start getting the rain out (condensation in hose causing the gurgling) and it might help some. Dry mouth is from mouth breathing and sometimes the humidifier simply cannot add enough moisture if someone is a serious mouth breather. There are some products made by Biotene to help with dry mouth (mouth wash and some gel) that can be found in WalMart and some grocery stores. Otherwise, trying to limit the mouth breathing and staying well hydrated is about all there is to do. Some people who use full face masks also use a chin strap to help keep the mouth closed as much as possible.

Forum member Emilia uses the same machine as you do and she can offer more insight into settings that might help you be more comfortable and optimize your therapy. I imagine she will be around later to help you out.

18 hypopneas, 1 apnea and O2 desaturation to 82%? It's interesting that your doc prescribed an auto-CPAP machine since your primary problem appears to be hypopneas. Were you given a report that stated the recommended pressure that the lab found would allow you to breathe effectively? It seems you might be a candidate for either a BIPAP or an ASV if you're showing low SPO2 with no obstructive events to account for it.

More pressure is probably better than less, but I would definitely NOT decrease the EPR from 3 to 2. You need to get your air moving and that's what EPR does.

Any other health concerns? Congestive heart failure perhaps?

Regarding the dry mouth, you need humidity. But when you crank the temperature up so high that water condenses out in the tubing and mask making gurgling sounds that distrub your sleep, you've gone too far. Try routing the hose under the covers to keep the air in it warm. That should help. Anything you can do to train yourself to breathe through your nose will help.

I'm actually in relatively good health; 40, overweight but not obese, no CHF or other heart problems. I had a uvulopalatopharyngeoplasty (UP3) and inferior turbinate submucous resection (ITSMR) about seven years ago, and it helped with my snoring but didn't eliminate it (obviously).

They prescribed CPAP at 10; I bought an APAP because I knew I could use it as a CPAP if necessary, but wanted the flexibility of APAP if I could use it. Maybe I should just try setting the machine to CPAP mode at 10 and see how things go for a few nights.

Thanks for the tip on Biotene; I'll give it a try!

Well, second night sure FELT better; I slept in one position all night long, no waking up with dry mouth (I think partially because I used chapstick and made a conscious effort to keep my mouth shut). I had kicked it up to min 6/max 20, and my AHI was 8.59. Certainly better, but obviously not where I want it to be. Tonight, I'm trying full CPAP at 10 to see how it goes.

I'll keep you posted.