New Member, finally compliant.

[702 Sleeper]

Hello everyone, my name is Randall. This is a little long but wanted to share my story in hopes that it might help someone. I've been browsing about on this forum for a while now and just wanted to share about finally complying with CPAP therapy. Ten years ago I was diagnosed with OSA. I did the sleep study, was setup with a RemStar Auto M Series with C-Flex. My pressure was 14cm on the straight CPAP setting and I just couldn't get used to it. I couldn't get any proper assistance and had many nights of throwing the mask off across the room in anger and frustration. My insurance company battled with me over whether I could have the humidifier and I live in the Nevada desert. I tried several masks, two different nasals, a full face and a pillow type, the Swift. The doctor told me either I would comply with it or not, it was my choice.

So I gave it up, put it in the closet, and forgot about it. Needless to say I've had ten years of rough nights. Sometimes I'd get what I would call a good nights rest, but always was up at least 4 to 6 times a night to use the bathroom. Over the years I'd pull out the CPAP and give it another try from time to time but it was always the same, I couldn't fall asleep under that much pressure. Plus my mouth would pop open from such high pressure and cause my sinuses to dry out. I'd go around sneezing all the next day.

In recent months my sleeping was so bad, that I couldn't find a position that would get me through the night. I'd wake up with screaming headaches at the top of my head. I was certain that one of these days I wasn't going to wake up. I went to the doctor and told him I was at my wits end. My blood pressure on that visit was 194/112. When he walked in he asked me if I was going to explode. He gave me new blood pressure meds and put in for a sleep study referral. I wasn't going to wait that long, I really thought I would die in my sleep.

So, I took matters into my own hands and start researching. Why was I having such a problem complying? I have a few friends that swear by the CPAP and they have no problem in complying. So I pulled out my machine from its carrying case and looked at it. I actually said to the machine, "we are going to work this out".

My first step was the mask. The Swift was probably my most successful one. So I focused on that mask. I went to the CPAP store here in Las Vegas and bought new head gear for that mask. The old head gear had deteriorated over the years and there was no resilience to the stretch of it. My logic for using the Swift nasal pillow mask, the less surface area that meets the face, the lower the chance for leaks. While I was at that store they directed me to a small full face that covered my mouth and had the nose pillows for against the nostrils. Still, as I moved I could feel leakage. I decided to stick to the Swift.

Secondly I researched my machine and after reading several different opinions and facts, I found out it had an auto mode. Duh! It says Auto right on the top. I also figured out how to put it into programming mode and I set the auto range between 8cm and 20 cm. I found out eventually that this was the key. With my room humidifier, humidifier on the CPAP machine, properly fit mask, automatic appropriate pressure, auto-ramp, and C-flex, I was determined this would work.

The first night was rough getting to sleep. I lay awake for about two hours trying to drift off. Finally, I slept for 4 hours and had to get up to go to the bathroom. Came back to bed and fought to get back to sleep but wasn't so successful. The second night I slept 5 hours, bathroom break, and back to sleep for 3 hours. Third night was fairly similar to the second night and on the fourth night I slept 7.5 hours without having to get up. Success!

My machine says I've averaged 7.59 hours per night sleep, 90% pressure of 12.1 cm, average system leak less than 9.2 L/min (which is dropping daily), and my AHI average is 5.1. From what I've read these are good numbers. I'm convinced that the auto-CPAP made the difference. There's no need to have the maximum pressure all the time. I'm convinced my pressure needs change throughout the night based on my sleeping position. Plus I sleep mostly on my back with my shoulders and head elevated with my chin pointed slightly down towards my chest. It helps me to keep my mouth closed.

So it's been a week now and I'm all in. Infact I actually look forward to putting that mask on and getting some peaceful rest. What a difference in the way I feel and my energy level. I'm not depressed all the time, I actually want to be active, and I don't dread going to bed. I'll be upgrading to the Swift ll since they are saying it is 86% quieter. The Swift just fits me well, I can wear my glasses and read while wearing it. The Swift just never seems to leak.

I'll blame myself for not being proactive ten years ago but I'm sharing the blame with my healthcare plan that made me feel like I was a bother and an insurance company that was cheap and greedy, without care for my health.

So thanks for reading and hope this helps someone find what works for them.

[Julie]

Hi, and congrats on having persevered. Would like to stop there, but... your AHI is actually higher than it 'should' be, or than most would like it, and while it may continue to come down, you could help it along better by doing a couple of things. We generally aim to keep it under 2 or 3 and find we feel better then.

Back-sleeping provokes many more apneas and we generally encourage people to side sleep if at all possible, sometimes wearing a backpack with a towel in there to keep you from flipping in your sleep - until you get used to the change (not forever).

A second tip that seems made for you would be to wear a soft cervical collar - it keeps your head off your chest, which then lets your airway open up better (important) and helps keep your jaw (if not lips) closed, eliminating potential leaks. I also suggest you use (free) Sleepyhead software to actually see what's really going on overnight and where you might be able to tweak things. The info you get from the machine's screen is generally not anywhere close to what the software gives, in detail.

[D.H.]

I'm glad you found the right mask and settings. It's outrageous that they would say that you don't need a humidifier in Nevada! Remember that you need an Auto CPAP for your new one. As far as I know, all the Auto-CPAPs come with data reporting.

Furthermore, remember to keep your old one on hand as a spare! Like a spare refrigerator or a dishwasher, run it as least one a month for several hours.

[Soothest Sleep]

Congratulations on persevering! Well done, you!

Jean

[702 Sleeper]

Thanks for the responses. I just woke up and checking my machine I see that my AHI is down to 4.9. It's an average and moving lower after every night. I've read that 4 to 5 AHI is normal for everyone including those who aren't diagnosed with sleep apnea and that range is the goal. As far as sleeping on my back, I find it to be the most comfortable. I've ordered a wedge cushion to elevate my torso and head. The flatter I lay seems to promote my mouth opening more. I'm not sure why I should replace my machine already since it has less than 1000 hours on it. It seems to work fine.

[D.H.]

Thanks for the responses. I just woke up and checking my machine I see that my AHI is down to 4.9. It's an average and moving lower after every night. I've read that 4 to 5 AHI is normal for everyone including those who aren't diagnosed with sleep apnea and that range is the goal. As far as sleeping on my back, I find it to be the most comfortable. I've ordered a wedge cushion to elevate my torso and head. The flatter I lay seems to promote my mouth opening more. I'm not sure why I should replace my machine already since it has less than 1000 hours on it. It seems to work fine.

Below five is considered "treated." Even lower is even better. If you use it every night your body gets used to it and the residual throat irritation subsides. Use it even for naps!

[Pugsy]

What pressure minimum are you starting the night with? The default settings are for 4 cm minimum and 20 maximum.
The maximum isn't nearly as important as the minimum.

I think we could reduce the AHI a bit with a little change in the minimum pressure setting if you are using the default 4 cm and not cause a lot of problems reducing the AHI with a little pressure change.

So what is the minimum pressure setting?

Also...your machine is a full data machine (yours is like my first machine back in 2009) but you need a Smart Card and a very special and pricey card reader to use the Encore software to see what is going on.
I don't know how important it is for you to see more data (there's more available by using the software) but just wanted to offer that as an option.
If you want more information on the software and the card reader...tell me what operating system is on your computer and do you have a Smart Card already in the machine.

[palerider]

Thanks for the responses. I just woke up and checking my machine I see that my AHI is down to 4.9. It's an average and moving lower after every night. I've read that 4 to 5 AHI is normal for everyone including those who aren't diagnosed with sleep apnea and that range is the goal. As far as sleeping on my back, I find it to be the most comfortable. I've ordered a wedge cushion to elevate my torso and head. The flatter I lay seems to promote my mouth opening more. I'm not sure why I should replace my machine already since it has less than 1000 hours on it. It seems to work fine.

4 to 5 is a pretty crap AHI, think about it, an AHI of 5 is like being poked with a stick every 12 minutes, all night long.

I'm with pugsy, raise that minimum, your machine is slow to respond, so getting the minimum right is very important.

[D.H.]

To 702Sleeper. Please all your equipment to the profile. I see that you have an auto CPAP, but I had to read through the posting to find that. Better if you put it in the profile!

[Pugsy]

To 702Sleeper. Please all your equipment to the profile. I see that you have an auto CPAP, but I had to read through the posting to find that. Better if you put it in the profile!

It won't show up in the equipment profile because he is using an old discontinued machine. Any links chosen will be broken.
Optimal advice in this situation is to simply add it manually to the comments section of the equipment profile.
"Respironics M series Auto with humidifier" is sufficient.

[D.H.]

To 702Sleeper. Please all your equipment to the profile. I see that you have an auto CPAP, but I had to read through the posting to find that. Better if you put it in the profile!

It won't show up in the equipment profile because he is using an old discontinued machine. Any links chosen will be broken.
Optimal advice in this situation is to simply add it manually to the comments section of the equipment profile.
"Respironics M series Auto with humidifier" is sufficient.

OK, then (s)he can put is in as comments for now. When the new one comes, (s)he can add it to the profile directly.

[Pugsy]

OK, then (s)he can put is in as comments for now. When the new one comes, (s)he can add it to the profile directly.

You are assuming that another machine is coming and that it won't be a broken link machine.
I saw no mention in what was said about getting a different machine.
Though it was going to something I was going to bring up if he/she is wanting more data than the M series machine offers on the LCD screen.
I think the money might better be spent towards a newer machine but that's for discussion later.

[702 Sleeper]

I listed the machine in the equipment section of my profile but it doesn't show. I have my minimum pressure set at 8cm. My machine is older but hardly used. I received it in 2007 and it does have a smart card in it. It's a RemStar Auto M-Series with C-Flex with about 1000 therapy hours use.

[palerider]

I listed the machine in the equipment section of my profile but it doesn't show. I have my minimum pressure set at 8cm. My machine is older but hardly used. I received it in 2007 and it does have a smart card in it. It's a RemStar Auto M-Series with C-Flex with about 1000 therapy hours use.

put it in the comments, or signature.

[D.H.]

Here's another tip for 702Sleeper. She what your pressure is when the majority of incidents occur. If they occur mostly below x, then raise the minimum above x. If you don't have any "Clear Airway" or "Central" events, then you probably don't have to worry about too much pressure.