Newbie

Greetings. I am new to CPAP and this forum. I am in my late 40's, 6' tall and weigh 220lbs. Neck size of 17". Despite having UPPP surgery a few years ago, a recent sleep study indicated severe OSA with an AHI of 84. O2 levls dropped as low as 68%. I was prescribed an APAP 6-16cmH20. Resmed Resmed Quattro FX Full Face Mask. Being fairly claustrophic, I am having a difficult time adjusting and have yet to make it through the night. I am finishing out my first week with the machine and last night was my best compliance yet at 3 hours of uninterrupted sleep. I believe leakage and air in the eye woke me up so I finshed the night without CPAP.

In reading statistics off the machine, I am a bit concerned - of those 3 hours I slept, my AHI was 22 and average pressure 10cm. Clearly there is some improvement but I am still concerned about long term benefits. I had expected the AHI to be <5.

Is this a gradual process or should I be getting more relief? While I am drowzy most days, I am functional and it is my long term health (risk of hypertension and stroke) that has me (and my wife) concerned.

I apprecaite your advice and comments.

- Flappy

Please register and add your equipment to your profile.
Depending on what brand of machine there may be some software available so you can see just what event category makes up that AHI.
How to address that AHI, which is a little too high, depends on the event category make up of that AHI. The prior UPPP kinda muddies up the waters a little.
Also need to check leaks to see if they are big enough to allow some events to slip past the defenses.

How to register your equipment once you have created a log in ID and are logged in.
wiki/index.php/Registering_Equipment_in_User_Profile

Profile updated, thanks!

Your machine choice isn't showing up. Links to any discontinued machines are broken...could you please add it to the comments section of your equipment profile...see how I have listed my spare machine in my comments section.

Click on the link to your humidifier that you have chosen...is that what your humidifier looks like? If so you then have a M series blower unit. Tell us all the words you see on both the blower and humidifier and we will figure out which machine exactly you have...or turn over the blower unit and look for a 3 digit model number...be sure to remove water tank if it has water in it before turning it over.

The M series machines were discontinued in 2010 so it would be unusual for a supplier to dispense that model machine but maybe you made a mistake on choice or you got your machine somewhere else.

If it is a M series machine I can get you the software but you will need a special card reader but maybe you have a PR System One machine (click on the link to my machine to see if yours looks like mine) and if you do then you can use SleepyHead or I will get you Encore and you won't need any special card reader unless your computer doesn't have a SD slot.
See my signature line for links explaining SleepyHead and other software options.

It was a process for me. I started using the machine for about 2 or 3 hours the first couple of nights, then 4 hours for a few nights, now usually between 5 and 8 hours. 8 hours if I get a really good night's sleep *smile*, I seldom get 8 hours of sleep any more. I actually used Ambien after the first night or so, for about a week, that was very helpful for me in getting used to sleeping with all the gear.

As far as claustrophobia goes, there are other kinds of masks that are much less closed-in, like nasal and nasal pillow, or even hybrid. Do you know yet if you breathe through your mouth when you're on cpap? I used to snore, so I'm guess that means that I breathed through my mouth at least some. Now, on cpap, I don't snore and use a nasal pillow mask without showing mouth breathing in my sleep data. So you might consider changing masks to something like a Wisp or Nano (nasal masks), or a Swift FX or Tap pap (nasal pillow masks). You can use the nasal masks with a chinstrap if you find you're breathing through your mouth, but trying a few things different, smaller impact masks would be good for you, sounds like.

Thanks to all for the replies. I am using an older machine inherited when my father passed. The RT said this machine was compatible thus I was able to save a few hundred.

I was originally diagnosed with OSA 5 years ago. I elected surgery for a deviated septum and the UPPP. It cured my snoring for a year but in hindsight that was probably due to the weight loss during the painful recovery. I still have partial nasal blockage and seasonal allergies so it was my choice for the full face mask.

Software would be great. I have been doing machine resets every night since the LCD display only shows weekly and monthly averages. I am new to this and would like daily logs. I think I saw card readers reasonably priced on eBay. I have a old data card - not sure if it works but those too are online.

Thanks again.

As you know with the M series machine you must use the Infineer DT 3500 smart card reader. Nothing else will do.
Yes, I saw some on EBay recently and in fact bought one and sent it to Mark in Australia so that he could see if he can make it so SleepyHead will work. But it hasn't got there yet and will take some time to see if it is even possible to make SleepyHead compatible with the M Series machines.

I will send you a private message containing information on the Encore software that will work with your machine.
It will also work with the newer PR S1 50 and 60 series machines should you ever upgrade.

This thread has a couple of examples of what you will be able to see on your reports. There are other summary reports but the detailed nightly reports are the main ones we like to look at.
viewtopic.php?f=1&t=39869&st=0&sk=t&sd=a
If you happen to have the M Series Pro CPAP with CFlex you won't have Flow Limitation data available. That data point is only available in auto adjusting mode APAP. The Pro model just reports 0.0 FLs...doesn't mean there weren't any though. It just won't flag them.

My first machine 4 plus years ago was a M series APAP machine. So if you run into trouble with it I might still remember some tricks.
Using the software there is a way to erase the Smart card. The smart card only holds 7 nights of detailed graphs then the oldest gets written over.
On the LCD screen you get average AHI for 7 and 30 days. Also you get average total leaks for same 7/30 days.
Total leak being the mask's expected vent rate plus any excess leaks.

The EBay seller...$25 plus 4 s/h...is probably the best price I have seen and he ships promptly. The smart cards are still available at various places...we can see if yours works before buying a new one if you want to.

What size Quattro do you have (sm, med, lg)?
Was it fitted by a clinician?
Was it previously owned?
Did you check the condition of the silicon frame cushion?
Do you clean the mask in warm soapy water on a daily basis?
Are you wearing it low enough for an unobstructed field of vision?
Have you read the fitting guide? http://www.resmed.com/us/assets/documen ... lo_eng.pdf

Johann wrote:What size Quattro do you have (sm, med, lg)?

Medium

Was it fitted by a clinician?

Yes

Was it previously owned?

No

Did you check the condition of the silicon frame cushion?

Yes

Do you clean the mask in warm soapy water on a daily basis?

No - will start

Are you wearing it low enough for an unobstructed field of vision?

Yes except for reading

Have you read the fitting guide? http://www.resmed.com/us/assets/documen ... lo_eng.pdf

Not yet.

I don't have a problem while on my back; however, I am a side sleeper and that is when I get air in the eye. I'll keep working at it.

Since you say you don't have a problem on your back, only your side, I would ask what type of pillow do you use? If you're using a regular pillow when you sleep on your side you could be levering/moving your mask enough to cause leaking.

There are specially made CPAP pillows that have cutouts where your mask goes, so when you're on your side, the mask fits into the cutout without touching the pillow. Another type you could try is a small throw pillow (square ones that fit on a couch) instead of a full size pillow. That way, when you roll over your mask is not touching the pillow. Personally I use a buckwheat pillow which is pretty small, and filled with buckwheat hulls. You can fill it as full or as soft as you prefer. It provides good support, and will form a depression where you lay your head so your entire head is supported.

Hope this helps!

-Bill

When I first started, I had air blowing in my eye as well (same mask). Somebody here suggested that I place it a tad lower, and that worked for me. Anytime I get air ni my eye, I just refit it a little lower, and the leak is gone.

I apprecaite all the suggestions and it is possible that mask placement is the issue since I am still learning the ropes. Leakage was so bad on a traditional pillow that I invested in one of these. It helped a little but not much; however, I am only on day three with it so perhaps more tweaking is necessary.

Uncle Flapp wrote:I am only on day three with it so perhaps more tweaking is necessary.

Hi,

This early in, I'd worry less about data and more about trying to get as much sleep as possible. Getting the mask to fit comfortably and getting leaks knocked down is the key right now. Once you get about 2 weeks in, then start watching the AHI numbers. I am a little concerned that you are set for 6 to 16. That is a really wide range, and wide ranges can lead to poor treatment. The reason is that if you start having an event, it can take so long for the machine to ramp that far up that it cannot treat the event. The lower number is the key. If your sleep study didn't come up with better numbers than that, then you are probably going to have to self-titrate, but that requires being able to see the detail level data. That will take one of those odd card readers. Another option would be to rent or borrow a more modern machine with an SD card for a few weeks.

-john-

jweeks wrote: This early in, I'd worry less about data and more about trying to get as much sleep as possible. Getting the mask to fit comfortably and getting leaks knocked down is the key right now. Once you get about 2 weeks in, then start watching the AHI numbers. I am a little concerned that you are set for 6 to 16. That is a really wide range, and wide ranges can lead to poor treatment. The reason is that if you start having an event, it can take so long for the machine to ramp that far up that it cannot treat the event. The lower number is the key. If your sleep study didn't come up with better numbers than that, then you are probably going to have to self-titrate, but that requires being able to see the detail level data. That will take one of those odd card readers. Another option would be to rent or borrow a more modern machine with an SD card for a few weeks.
-john-

Hi John. Thanks for your reply. I am on day 3 with the pillow and on day 10 with the CPAP. I still don't have the mask down yet and get leaks whenever I roll on my side which is the only real way I can sleep. Longest stint with therapy is three hours and I am seeing an AHI of 22. My 90% is around 10. The good news is I now have the software and a card reader is on the way - I look forward to more detailed statistics. Maybe once I get used to this thing I can slowly ramp up the minimum, starting with 8, to see if it helps lower the AHI.

I apprecitate your feedback.

- Flappy

Uncle Flapp wrote:

jweeks wrote: This early in, I'd worry less about data and more about trying to get as much sleep as possible. Getting the mask to fit comfortably and getting leaks knocked down is the key right now. Once you get about 2 weeks in, then start watching the AHI numbers. I am a little concerned that you are set for 6 to 16. That is a really wide range, and wide ranges can lead to poor treatment. The reason is that if you start having an event, it can take so long for the machine to ramp that far up that it cannot treat the event. The lower number is the key. If your sleep study didn't come up with better numbers than that, then you are probably going to have to self-titrate, but that requires being able to see the detail level data. That will take one of those odd card readers. Another option would be to rent or borrow a more modern machine with an SD card for a few weeks.
-john-

Hi John. Thanks for your reply. I am on day 3 with the pillow and on day 10 with the CPAP. I still don't have the mask down yet and get leaks whenever I roll on my side which is the only real way I can sleep. Longest stint with therapy is three hours and I am seeing an AHI of 22. My 90% is around 10. The good news is I now have the software and a card reader is on the way - I look forward to more detailed statistics. Maybe once I get used to this thing I can slowly ramp up the minimum, starting with 8, to see if it helps lower the AHI.

I apprecitate your feedback.

- Flappy

It is a struggle to get it all figured out at the beginning. When I had my sleep study, the tech fitted me with the quattro fx, and it fit perfectly, no leaks. I rolled over and slept for 5 hours straight, first time in years. When I went to the dme, I asked for a quattro fx and got it. I struggle with leaks like crazy. It would take tries before I could get it started without leaks, then it would leak an hour in and start farting or bothering me. And I really picky about any little hiss. When I asked for advice, I did get the great help about positioning which really helped. But several people suggested that it was too big. I have the small, and there is no extra small. I would be the prefect candidate for one. It does mean that positioning is extra important as any extra bit up or down could cause a problem.

I was also having trouble with the velcro on the headgear as the headgear was too large for my head. I asked my dme for smaller headgear. They said it didn't exist. I emailed them a link on cpap.com as well as an email from Resmed. They told me they couldn't order it. I asked another dme and got it 3 days letter. Wow. What a difference. I have to use it at its largest setting, but it helps my mask fit so much better. Now, I usually get it correct on the first or second try, and it doesn't start leaking unless I drool or sweat. Even then, I can usually dry it with a kleenex without taking it off.

You may or may not need a different size, but it takes time to figure it out, find the right position, the right tension of the headgear, etc. I had the right mask from the first day, but it took me 6 weeks to master fitting the mask and avoiding most leaks.

As for pillows, I side sleep most of the time, and I use a regular pillow, but my face kinda hangs off the end of the pillow. That keeps the pillow from pushing on the mask.