New CPAP user having many Centrals

[LSAT]

Melatonin...Most stores sell 3mg and higher...1mg and lower are available on line.......1mg = 1000mcg

Low Dose Melatonin..... .3mg = 300mcg
http://www.amazon.com/Sundown-Naturals- ... _it&sr=8-1

[Pugsy]

Condensation in the tube was causing the gurgles, and i was getting drips on my upper lip in the supine position.

Check out posts here in this thread....posts # 2 and 3 I think.
viewtopic/t94035/Pugsys-Pointers-3Deali ... -road.html

Pretty easy to fix with a heated hose.

Gotta keep the air in the hose warmer so it doesn't cool and release the moisture in the mask and hose.
Several ways to help reduce rain out (condensation in mask or hose) explained in the above thread.
Since you already discovered that reducing the humidity causes nasal congestion then you won't want to try that remedy and it doesn't always work anyway if the problem in the mask is the moisture in your exhaled breath.

Do you have or know about the heated hose for the PR S1 machines?
Some of the 60 series machines may already have the special lid and 80 watt power supply and all you would need is the heated hose but if your machine isn't heated hose capable it's easy to convert it.
I did it myself...super easy.
Your DME should be aware of the upgrade kit
https://www.cpap.com/productpage/pr-hea ... e-kit.html
and it should be covered by most insurance.

If you are getting rain out now...just wait until winter when it can really be worse.
The heated hose also allows for better more constant humidity control in addition to more control over the hose air temp.

https://www.cpap.com/productpage/pr-sys ... ifier.html

This humidifier offers three levels of humidification (70, 80 or 90 percent) and the heated tube has five levels of temperature available, ranging from 4 to 16 degrees above the room temperature. These two features work together to deliver the optimum humidification level at the mask.

[schn00gins]

Just wanted to thank you all for your help.

Looking into buying either a sleeve for my hose or a heated one (currently using sweat pants, haha).


My next step is not getting my nostril used to the nasal pillows. compared to the comfortgel I had before, these are a much better fit, but after a night of wearing them, my septum and nostril gets really sore and erythematous--I actually thought I coincidentally was getting a zit because of how tender it was, but that doesnt seem to be the case.

Recommendations i found include actually sizing UP (which is counter-intuitive) and adding some sort of emollient like Ary gel or Vaseline.

[yaconsult]

Please do NOT use any petroleum based products like vaseline on your nasal pillows. What is recommended here is Lansinoh HPA Lanolin for Breastfeeding Mothers: http://www.amazon.com/Lansinoh-Lanolin- ... B005MI648C This will not damage your nasal pillows. You can probably find it at local drug stores, walmart, etc.

[Pugsy]

Try loosening the head strap just a little bit.
And yes I know it seems counterproductive to suggest the next size larger but it will sometimes work.
Here's why...if the nasal pillows are a tad too small they sort of get scrunched up inside the nostrils (usually also associated with the top strap being too tight) and they shouldn't ever touch the inside of the nostril at all.
When properly fitted the nasal pillow rim rests against the outer nostril skin and the inner cone is just barely inside the nostril but not touching anything inside.
Going up a size lessens the chance that the nasal pillow will get "sucked" up into the nostril. I learned this lesson with my current P10 nasal pillow mask. I have always used the XSmall nasal pillow size no matter what brand or type of nasal pillow mask I have ever used but with the P10 I had to go to the Small size because the XSmall was trying to climb up inside my nostril and I don't wear my mask tight at all...it was the pillow size doing the climbing just from my inhaling.

Nasal pillow masks should never cause significant pain or abrasions or bruising or blisters. If they do then it's either too tight or the wrong size nasal pillow. Or maybe a little of both.
At most...a very minor tenderness only at the outside skin area of the nostrils could be expected...anything worse then something is wrong.

[schn00gins]

Update:

Congestion issues have been resolved. I'm in a humid climate, was running between 3-5 on my humidifier based on what I quickly read and left it at that. Since then I've been around 0-2, using a second gen antihistamine daily, and afrin in one nostril just at night while I wait for some intranasal antihistamines from my pDoc (already using flonase). I'm fully aware of the concerns with afrin--last night was the first time I needed it.

I'm now comfortable with my nasal pillows and have few leaks.

I messed around with pressures just to see my response, not to try to improve my sleep. Some things I found:

1) Like it was thought, setting my APAP to auto was correlated with many arousals
2) CPAP pressures >7 are enough to open up my mouth and cause me to lose seal also causing many arousals
3) I looked back on my data i've collected over the last ~2wks, and I see that my AHI and specifically my CAs often shoot up when I was above pressures of 7 or using APAP--and some of my best nights were with a pressure of 6.5(although I've never tried below 6.5).


So with this information, I've set my machine to APAP of 6min 6max, Aflex 3. I'm still having CAs(or arousals) that tend to start about 1.5-2.25 hours after I fall asleep. They cluster a little afterwards, especially within the last 1.5hrs of sleep. I do recall waking up often in the night and rolling over or adjusting something, but in all honesty, I don't really feel uncomfortable--I don't know what's causing me to toss and turn. Like previously, still having vivid dreams and remembering them the next morning.

Any suggestions for my CAs/arousals? LET ME KNOW IF THERE ARE ANY SPECIFIC AREAS YOU'D LIKE ME TO ZOOM IN ON

[Julie]

Hi, haven't read thru whole story, but is there a reason you're not wearing a full face mask vs the nasal one?

[LSAT]

Stop worrying about the CAs...They are insignificant. Changing pressures every day will not prove anything. Stick with one pressure for several days before making changes.

[schn00gins]

Hi, haven't read thru whole story, but is there a reason you're not wearing a full face mask vs the nasal one?

Not specifically.I didn't find out I was have these mouth issues until I was using higher pressures for a few days. I did forget to mention that I created a chin strap that I used last night for the first time. It worked really well based on not waking up with my seal lost (although I was at a lower pressure than what normally causes me to lose my mouth seal).

[schn00gins]

Stop worrying about the CAs...They are insignificant. Changing pressures every day will not prove anything. Stick with one pressure for several days before making changes.

I hear what you're saying, but I just want to clarify that I was fiddling with my pressures not to try to find a therapeutic pressure, but mainly to see how I would respond.

That being said, given that a large portion of my AHI is due to arousals, I'm trying to reason through what is going on.

[Julie]

You may also be sleeping in such a way that your head falls forward, closing your airway and flow of Cpap air, and many people wear soft cervical collars to counter that... plus it keeps your jaw closed (if not lips) so leaks may not be as much of a problem either.