Just Diagnosed, New CPap User

[mummmz]

Hello,

So glad I found this group. I hope you can help me. I was recently diagnosed with obstructive and central sleep apnea. I tend to over-inhale quite a few times during the day but the doctor only addressed the night time breathing at this point. I picked up my machine yesterday and had a horrible night trying to use it. When I tried it on in the office it seemed fine.

1. The mask and tubing stink! It's hard to wear something on your face that smells so bad. I got up and washed both again in the middle of the night trying to get rid of the smell. Today I soaked the mask and tubing in soapy water for a couple of hours, rinsed it well, and let it air dry. I could still smell that plastic smell. I put them in a ziplok bag for several hours with some baking soda. I guess it is a little better. Any helpful hints to get rid of the smell?

2. I tried using the ramp setting and that was fine. I dozed off and was sleeping until it went above 10-11. At that point, I felt like I was smothering. Also, the seal on the mask kept blowing out. I kept adjusting it but the air flow was just too strong. It got up to 15 and that was all I could take and removed it. By that time it was dawn. Needless to say, I hardly got any sleep. I tried sitting up in bed reading but I can't wear my glasses because of the mask.

3. If I opened my mouth to try to mouth breath so much air blew in that my cheeks and lips puffed out. Isn't the whole reason for a full face mask so I could also breathe through my mouth?

4. I don't think the humidifier worked at all. The metal plate did not get warm. I tried using it without the humidifier but that was worse because I could feel the wind from the air pressure. I guess the water buffered the wind if that makes sense.

If you can offer any tips on how I can get some sleep using my machine tonight I would appreciate it so much. I want to make this work. I tried to sleep from 11pm-6am. I downloaded the program so I could see my information on the SD card. Here it is:

AHI 19.6
Usage 5:09hrs
Mask Fit 100%
Total Clear Airway Apneas 37
Total Obstructive Apneas 41
Total Hypopneas 23
Best Night June 17, 2016
14-Day Average 19.6
Min Pressure 8.0cm H2O
Max Pressure 20.0cm H2O
Device Mode AutoCPAPwithAFlex
Ramp On
Ramp Time 30min
Ramp Start Pressure 4.0cmH2O
Best Usage June 17, 2016
14-Day Average 5:09 hours
Total Disconnects 12
Large Leak Time 0:00hrs
% of Night in Large Leak -%
Best Mask Fit June 17, 2016
14-Day Average 100% fit

_________________
Machine:Philips Respironics DreamStation Auto CPAP
Mask: ResMed Quattro FX Full Face CPAP Mask and Airfit-F10 Headgear
Humidifier: DreamStation Heated Humidifier
Additional Comments: Rx Autopap min 8, max 20, with medium Resmed F10 full face mask, and heated humidity.

[zoocrewphoto]

Hello,

1. The mask and tubing stink! It's hard to wear something on your face that smells so bad. I got up and washed both again in the middle of the night trying to get rid of the smell. Today I soaked the mask and tubing in soapy water for a couple of hours, rinsed it well, and let it air dry. I could still smell that plastic smell. I put them in a ziplok bag for several hours with some baking soda. I guess it is a little better. Any helpful hints to get rid of the smell?

Welcome to the forum. I haven't had a problem with the smell, so I don't have much advice. You might try rinsing with vinegar and see if that helps.

2. I tried using the ramp setting and that was fine. I dozed off and was sleeping until it went above 10-11. At that point, I felt like I was smothering. Also, the seal on the mask kept blowing out. I kept adjusting it but the air flow was just too strong. It got up to 15 and that was all I could take and removed it. By that time it was dawn. Needless to say, I hardly got any sleep. I tried sitting up in bed reading but I can't wear my glasses because of the mask.

Your settings aren't quite wide open, but they really are too wide. DO you have a clincian's manual for your machine? You can get it free from apneaboard.com

You may or may not need pressure that high for therapy, but you can reduce the maximum a bit while you are getting used to it so that it doesn't go that high. If your pressure tops out and you need the higher pressures, you can add it back in once you are acclimated a bit. Also, if the range is more narrow, it may need to go as high. your minimum may need to go up, but we won't mess with that until we can see some actual graphs from sleepyhead. We need to know if the events are obstructive or clear airway, or a mix.

3. If I opened my mouth to try to mouth breath so much air blew in that my cheeks and lips puffed out. Isn't the whole reason for a full face mask so I could also breathe through my mouth?

This is probably because of the higher pressure and possibly body position as well. i sleep with my mouth open all night. I don't even like the feel of air going through my nose at night. But mouth is barely open. Except when I sleep on my back, my mouth opens wider, and my cheeks flap. But as I sleep on my back, my pressure goes up, so it is a combo effect for me. If I stay on my side, the pressure stays lower, and my mouth stays barely open and comfortable.

4. I don't think the humidifier worked at all. The metal plate did not get warm. I tried using it without the humidifier but that was worse because I could feel the wind from the air pressure. I guess the water buffered the wind if that makes sense.

Settings will vary by person. You have the heated hose,so you should have some options. Somebody with your machine will be able to help you more. I have a Resmed.

AHI 19.6

What was your untreated ahi at the sleep study. This may be an improvement,, but will not help you feel much better until it is much lower. Doctors look for less than 5, and most of us feel better at less than 2.

Min Pressure 8.0cm H2O
Max Pressure 20.0cm H2O
Device Mode AutoCPAPwithAFlex

You have a pressure range of 12, which is pretty huge. Some people use a straight pressure. Many with a range have a narrow range of only 4 (ie, 8-12). Mine is 11-17, but it only has 3-4 spikes a night above 14.

Ramp On
Ramp Time 30min
Ramp Start Pressure 4.0cmH2O

Most people find that the ramp bothers them within a few days. If you feel like you aren't getting enough air, just turn it off, or reduce the time. Once you are used to the pressure, you probably won't mind going straight to 8. I start at 11, and it feels refreshing to me, and I fall asleep faster.

Machine:Philips Respironics DreamStation Auto CPAP
Mask: ResMed Quattro FX Full Face CPAP Mask and Airfit-F10 Headgear
Humidifier: DreamStation Heated Humidifier
Additional Comments: Rx Autopap min 8, max 20, with medium Resmed F10 full face mask, and heated humidity.

[mummmz]

1. Thanks. I'll try to use vinegar to clean it again.

2. I only have the User manual. I'll look for the clinician's guide on the website. The medical supply store set it up for me and I think they locked in some of the settings. When I try to overexpand my lungs to take a deep breath would it cause the machine to think it needs to increase the setting? I didn't use sleepyhead, I used the Respironics DreamMapper app on my computer. Isn't this the information? Total Clear Airway Apneas 37, Total Obstructive Apneas 41

3. So the solution is less pressure. I'm wearing it right now and the pressure is 9.4. That feels OK but somewhat stuffy.

4. I have it set on 5 right now. The humidifier wavy lines are there but the thermometer is not. I'm not sure this is the correct hose. It looks like a heated hose would have pins on the end that plugs in the machine and this one doesn't. How can I tell if this is the correct hose and if I am getting humidity?

I have the first sleep study report but I don't see the AHI. I'm continuing to look for it.

If I can't change the setting myself I will bring it to the store tell them to change it. The doctor will just have to understand I have to get used to it.

I didn't use the ramp feature every time I restarted the machine.

Thank you so much for your help.

[mummmz]

I still don't see the AHI but my May sleep study included 29 central apneas, 5 obstructive apneas, 24 hypopneas, 34 total apneas, 58 apnea+ hypopneas,. All Resp. Events = 58.

I'll add that I was taking Invokana for diabetes which I believe cause acute shortness of breath and I went to the ER. A few days later my doctor added Metformin because the steroids given in the ER cause my blood sugar to rise to almost 400. I started on a LCHF diet and normalized my blood sugar then took myself off the Invokana. I told the doctor when I had my next visit.

[Pugsy]

Go here and request the clinical/provider manual. Instructions about 2/3 down the page.
http://www.apneaboard.com/adjust-cpap-p ... tup-manual

The heated hose is considered optional and you may just be using a regular hose.
You are correct in that for a heated hose to work it needs a power source and that power source is right at the humidifier hose junction.
See this
https://www.cpap.com/productpage/pr-dre ... ifier.html

The fact that you only have a humidity choice and not humidity and hose air temp does point to probably they have given you a regular hose.

I downloaded the program so I could see my information on the SD card. Here it is:

What program? DreamMapper? It doesn't offer much detail. The AHI....you didn't sleep well so I bet a lot of awake breathing irregularities got flagged. You need to see if all those events are associated with known awake times on the machine.
You need to get SleepyHead for much better detailed information
http://www.apneaboard.com/forums/Thread ... workaround

and see here for additional information about SleepyHead..the download link for SH is broken right now here at this website but the other information about SH is good
https://sleep.tnet.com/reference
https://sleep.tnet.com/equipment

[mummmz]

I think I will be making a trip to the medical supply store monday. My prescription said heated humidity so a mistake was made. I can get her to lower the max setting if I don't get it done before then. I think I will be getting a different mask too. This one is once again leaking air by my eyes.

I used DreamMapper. I'll download SleepyHead tonight or tomorrow.

I did wake up a lot of time during my sleep study.

Thank you,
Dani

[Pugsy]

Heated humidity.....that's the humidifier. You don't have to have a heated hose to get heated humidity.
The heated hose is for the air temperature in the hose...not for the humidity delivery. The humidity is delivered by heating up the water in that water chamber in the humidifier.

Now if that heating plate under the water chamber never heats up...something is wrong with the humidifier but while not impossible...it isn't very common.
The humidifier heating plate will cycle on and off. It isn't always warm.
You might try checking it about 15 minutes after starting the machine and see if that plate its warm...now it won't get blistering hot...just warm.

[mummmz]

I'll check the heating plate to see if it warms up. I really would like humid, cool air.

I went into clinician's mode and change the max pressure to 11. Once I get used to that I'll see if I can up it. I also turned on AHI. She said I would need to bring the machine in for her to change it. I love how doctors and medical personnel want to keep us in the dark.

May AHI for last night was 17 and the 7 day was 19.4. That would include yesterday and today.

Now if I can get the mask to fit I'll be set...I think.

Thanks,
Dani

__________
Machine:Philips Respironics DreamStation Auto CPAP
Mask: ResMed Quattro FX Full Face CPAP Mask and Airfit-F10 Headgear
Humidifier: DreamStation Heated Humidifier
Additional Comments: Rx Autopap min 8, max 20 (temporarily set at 11), with medium Resmed F10 full face mask, and heated humidity.

[zoocrewphoto]

One tip for the mask leaks.. If it is leaking by your eyes, it may help to try and start it a twink lower. I had this problem when I started.

[palerider]

I'll check the heating plate to see if it warms up. I really would like humid, cool air..

you can have humid air, or you can have cool air, physics doesn't want you to have both.

[Pugsy]

I have the heated hose Respironics machine model just prior to your DreamStation machine.
I need to look at the provider manual to see if the humidification with the heated hose attached works like my machine and if it does ...don't discount the heated hose being able to help you get the needed moisture without warming the air so much.
I can set mine so that I can get maximum moisture 90% at a setting of 1 for hose air temp and that setting of 1 means just 4 degrees above room air and it's feels "cool"..not warm by any means.
I use cooler setting of 1 in the summer and warmer setting of 4 or 5 in the winter and my humidity is always a constant 90% on my Respironics machine. You have more control of the hose air temperature with a heated hose than without.

I don't have that manual though...so I have requested it and once I look at how the heated hose works I will know if it works like my Respironics machine works with its heated hose and I will report back what I learn.

[mummmz]

That's interesting about the the heated hose. It sounds like it might work better for me. The air leaks don't start until the pressure gets higher. I have a small face, in fact I can wear kids glasses. I thought they gave me the same mask that I used at the sleep study but this one is bigger. It goes almost between my eyes all the way to the bottom of my chin. I wonder if I should try nasal pillows or just a nose mask.

I tried to use the machine for 3 hours last night. I was very sleepy since I had not slept the night before. I still couldn't fall asleep and gave up. My AHI was 21.84 for last night. How do I insert a picture of my SleepyHead report?

Thanks,
Dani

[Pugsy]

If you didn't sleep the AHI and SleepyHead report is pretty much useless because of the awake/semi awake breathing getting flagged by mistake.
Remember the machine doesn't know if you are awake or asleep. It can only measure air flow and our awake/semi awake breathing is very irregular when compared to asleep breathing and it's common for the machine to flag those irregular flow rates as some sort of apnea event.
So awake/semi awake breathing has to be mentally removed from any evaluations.

How to insert an image...you have to put it on some sort of photo hosting website and then link to it.
Imgur.com is fairly simple...instructions here
https://sleep.tnet.com/reference/tips/imgur

We don't need each and ever graph that SH produces...see here for examples of what we usually like to see and you can get them all in one image
viewtopic/t103468/Need-help-with-screen-shots.html

[mummmz]

I guess there's no point showing the report then. I'll try again tonight and post it tomorrow. This is all very new to me.


Thanks,
Dani

[Pugsy]

Yes...not much point if you didn't sleep at all and finally gave up and took the mask off to get to sleep.

Perhaps we can target why you can't seem to get to sleep...anything in particular seem to make sleeping difficult?
Did you get past the odor issue?