First night with Cpap

hello,

I am a brand spanking new CPAP user.
had both my studies done and picked up my machine yesterday.
Resmed S9 Elite with Mirage FX mask.

I used it last night with little success but thats ok, its only the first night.

The pressure was set to 8.
Humidifier set to 3.0

Here is what I noticed.
I was thirsty during the night.
I did not notice any warm most air.
The water tank was full this morning. I am pretty sure it did not use any water.

I downloaded sleepytime and this is what it shows me.
Mode: CPAP 8cmH2O
Date Sleep Wake Hours
2/20/2012 1 4:58 03:45 04:36:04
AHI 5.22
Hypopnea 0.43
Unspecified Apnea 0.00
Obstructive 3.69
Clear Airway 1.09


Min Avg 90% Max
Pressure 4.30 7.85 7.38 8.00
EPAP 4.00 4.94 4.96 5.00
Minute Vent. 0.62 9.06 12.00 22.88
AHI/Hr 0.00 1.93 8.00 14.00
Resp. Rate 2.00 13.35 15.60 31.60
Flow Limit 0.00 0.02 0.19 0.42
Leaks 0.00 0.40 4.80 45.60
Snore 0.00 0.14 1.34 3.54
Tidal Volume 180.00 709.45 1140.00 2460.00

I did not sleep much at all.
I felt like when I was about to fall a sleep I woke up catching my breath.

Any suggestions or inputs?
I know I dont have much time with this yet.

Did you use ramp last night? Looks like you might be using ramp starting at 4 maybe.
Pressure of 4 cm isn't very much and many people find that low of a pressure to be rather stifling and hard to be comfortable with. Maybe try not using ramp?

Are you using EPR? If so at what setting?

The air won't seem warm and moist like you probably imagine it would even at the highest setting. I use a heated hose and the air is not like a sauna which we might think it should feel like.
Dry mouth ? Might be some mouth breathing going on.

You might also increase the humidifier setting a bit. If you don't notice much water use then it likely didn't use much and you may be more comfortable with a bit more moisture.
May not help dry mouth from mouth breathing but it may help the other.

First few nights can be a bit of a challenge. It is hard to get used to all this "stuff" attached to our faces.
For a first night report....yours is really quite decent. Leak rate is good...I see the max was 45 L/min but I expect that was probably a spike from fiddling with the mask. The other leak numbers are quite low.

It will get easier and it will get better. Congrats on getting through the first night.

Welcome, glad you found the forum and are reaching out for support. You have a good attitude, like you said it's only one night. Besides time, for those not opposed to medicine, one thing I recommend is one of the night time pain relievers with benadryl. The pain reliever helps with little aches and pains we usually do not even notice and the benadryl helps you sleep.
Please keep us posted as we are interested in following your progress.

BigTex: howdy from down heeer... please place your equipment in your profile section of the control panel. This may not be much comfort, but your first night seems rather normal. Your mask leak rate seems high, so try and make sure the mask is adjusted right. Remember, an over-tightened mask will leak as bad as an under-tightened mask. It's hard to help you without knowing what type of mask you have. Keep up the good work!! Use this forum to solve each step that gives you problems. Educate yourself. When you get the hang of having that dang thang' on your face, you'll thank your lucky stars. Keep us posted!

Sheriff

Hi BigTex - I am new here too. Just finished night 5 with my first CPAP. Fun, isn't it?? I expected to feel the humidifier more too but I suspect we would feel it a lot more if we didn't use it (really dry irritated nasal passages). I fill my tank to the top fill line and it is only a little (maybe 20%) below that in the morning even though I have it set on 3. I wonder if the amount of water it uses is related to the relative humidity or temperature in the room.

Congrats on having your first night under your belt! I love the SleepyHead program to see how I did each morning. It's like getting a report card with all As instead of Ds anf Fs for a change!

ohwhatanight wrote:I wonder if the amount of water it uses is related to the relative humidity or temperature in the room.

Yep. Amount of water used is related to ambient room humidity, temp and even the pressure that a person uses.

ERP?
Not sure what that is..

The machine is set to ramp from 4 to 8 in 10 minutes.
I will increase the humidifier to 4 and see how that goes.
I am pretty sure it did not use a drop of water.

I appreciate the help.

Thanks to everybody who responded.

EPR Exhale Pressure Relief
3 available settings...1, 2 and 3
each will reduce the pressure during exhale to make it easier to exhale against....a per cm reduction with each setting choice...1 is 1 cm...2 is 2 cm and 3 is 3 cm reduction.

Do you have the clinical/provider manual for your machine? If not, you should have it because it explains a lot of these features. Let me know if you don't have the manual and I will send you a link for it.

If the machine didn't use much (or any water) and you feel like things were a bit dry..go ahead and increase your humidifier setting from 3 to maybe 4 or 4.5 and see how things go. Humidifier setting is strictly a comfort feature and there is no reason why you can't adjust it to suit your needs.
Some people like and need more moisture and some people refer less so you will just need to experiment to find out which setting you like the best.

There is a video explaining some of your machines features. Have you seen it?
http://www.cpaplibrary.com/machines.html

BigTex wrote:The machine is set to ramp from 4 to 8 in 10 minutes.
I will increase the humidifier to 4 and see how that goes.
I am pretty sure it did not use a drop of water.

Welcome to the forum BigTex.

I currently have my humidifier set to 2 when in Houston, and while it might not seem like you use much in one night, you'll notice a significant drop over a week. That's because Houston is usually pretty close to 100% humidity at night anyway.

Don't worry about your machine not working. Go to somewhere dry, like Colorado, and you'll notice you use a lot more water.

You don't need to use lots of water. The humidification is purely for comfort, and many people have issues if it's either too low or too high. Personally, my nose will run all day long and I'll have sneezing fits all day long if my humidification is too low for a few days, and I get sinus headaches in the mornings if it's too high. The correct setting for me also seems to fluctuate with the seasons or something and with location. When I'm in Colorado I have to increase the setting to something that would give me headaches for sure in Houston.

There's something strange with your pressure numbers: your 90% level is less than your average.

Dry mouth could be mouth breathing. This would be the case even with high humidity. If your mouth is closed, no air is passing that way and the humidity is irrelevant. If you're mouth breathing all the therapy is going straight out your mouth. Keep an eye on it and it's a problem we'll have plenty of suggestions.

For many people, an initial ramp setting of 4 is uncomfortable. It feels like you can't breathe. If so, you might want to (ask your DME to) increase the initial pressure to something like 6. After they've been using CPAP for a while, many people get sick of the ramp altogether and disable it.

Get http://www.inspiresleep.com. and get rid of the machine.