Therapy Questions for me as a newbie

[MistRiver]

I just picked up my machine. I ended up with a dreamwear nasal (I think it's called cushions. The ones that don't go inside your nose but sit under), and a resmed autosense 10 for her. My prescription from the titration had me at 5cm but that setting felt very much like I wasn’t getting any air when I breathed in. I think it's called feeling air starved? As a separate point, I found it hard to breathe without EPR during my titration study. My understanding is if I want to keep to the five my doctor prescribed but set it on auto in case I have more need for pressure than the sleep study picked I’d set it to 7-20 with en EPR of 2 so that in never drops below the 5cm prescribed. Is that right? Setting to it 7 with EPR 2 definitely felt way more tolerable to me. Also, will I get in trouble with the doctor for changing my setting? Do they tend to even notice? My doc is a ridiculous one that thinks the machine type doesn’t even matter at all and patients don’t even need basic information about their therapy. He just said I had apnea and needed a machine, and gave me no more info at all. He says the only thing that makes any difference at all is the mask. So I doubt he’ll cooperate with me being in on my own therapy. I have medicaid if that matters.

As an aside: while I initially thought I would go for a full face mask I love the dreamwear, at least as far as sitting here with it on for an hour while I play video games trying to get used to it. We shall see tonight but it's SO much less claustrophobic making. At least with the higher than 5 setting.

[Julie]

The question is... will my MD get in trouble with me (as a customer) if he dares try to tell me what to do with my therapy (that he didn't obviously bother much about - or maybe didn't know much)? We all change our pressures routinely with no trouble and can help you if necessary.

[MistRiver]

Thank you Julie. I was able to figure it out how to change it fairly quick. This machine seems super easy to use. Do you think 7-20 is a good starting pressure range? Just to kind of see? They prescribed me a set 5. I really really hate the feeling trying to breathe at a 5.

[Julie]

Definitely fine... too low to do any remotely potential damage, but should be high enough for you to breathe at unless you have other problems going on.

[LSAT]

I agree

[Pugsy]

Starting minimum of 7 with ability to go to 20 is a good starting point and you never know...might be all you need.
That's my minimum...the 7 cm except I use 3 EPR just because I like it and I have the 20 cm max. Sometimes I might see the mid teens pressure for a short period of time but for the most part it averages around 9 or 10.

[MistRiver]

Thank you. I will try these settings. One thing though. I've been sitting here just trying to adapt before I try to sleep. I've had it on for an hour and my nose and mouth have super dried out. I tried it on humidity 3, 4, and auto. Should I just turn the humidity way up?

[Julie]

Do you mouth breathe even when awake (sounds like it)?

[Pugsy]

Did you use all those setting trials within the hour or so while awake?
Did you like use 3 for a little bit of that hour and feel the nose was too dry....then try 4 for a little while and then try auto for a little while? All these within an hour or so?

What is the humidity level inside your house?

You might end up like me in another area too. Your nose might just need more water for whatever reason.
Get some Simply Saline or similar product and use it right before bedtime.

[MistRiver]

Julie, I'm not exactly sure but it was extremely strange keeping my mouth closed the whole time.

Pugsy, I tried it for about 2 1/2 hours throughout the evening trying to adapt so I could try it well at bedtime. I left one humidifier setting on until I just couldn't stand the dryness. For auto that was an hour just with that. Also about 40 minutes on 3. I took breaks in the middle until the dryness didn't feel as bad. Then I would try another setting.

Now for how it went last night. I was able to wear the mask all night. After the initial feeling of claustrophobia I adapted fine and didn't have any problem through the night. Even when I was woken up through the night I didn't feel even a tiny bit of claustrophobia. I can't really say if I feel better because 3 of 5 smaller children woke me up several times and kept me up half the night. I also have the start of a cold. I tried a humidity of 5. I didn't feel dried out at all, though I had a small bit of condensation around my nose when I got up. I'm a little congested but that might be just the cold. I did have a minor problem keeping it from leaking towards the end when I was laying down again and again after helping children. My pillow kept dislodging it slightly. Is there a trick to that?

I do have one question. My front teeth hurt a little. I assume that's from the nasal mask pushing on it. Will I get used to it and it won't keep causing that?

Oh and my machine says AHI of .6 or something like that. It says it used 8.5 as the pressure. I'm downloading sleepyhead now but that sounds pretty good to me.

Thank you.

[Julie]

Your very high humidity setting could in fact be causing your 'cold' if local conditions are already damp, rainy, whatever (vs dry). Turn it down to e.g. 1-2 and see if it helps. You may want more after that, but you also may not need any (I use it only rarely where I live).

[MistRiver]

Thank you Julie. I started the cold symptoms yesterday morning. I will keep on eye on the congestion from the machine though. I may try 4 through the night tonight and see how it goes just in case.

[Pugsy]

I use a setting of 6 for my humidity and I have to set the temperature manually now that cooler household temps are here so that I don't have copious amounts of water in the mask or hose.
A little water in the mask (we call it rain out) isn't a big deal as long as it doesn't disturb your sleep. When you get too much water in the mask or hose it makes an awful racket and will wake the dead...so not a good thing in terms of sleep but the water won't hurt you.

Some people live near the ocean where the humidity is already relatively high so their machines actually don't put out much extra moisture and their noses are quite happy under those conditions.
Not everyone lives under the same conditions and not everyone's nose likes drier air either.

You have to decide what your nose needs and wants...
If you are really catching a cold (and with all those kids I wouldn't doubt it one bit) then most likely more moisture is going to help.
I usually tell people if a hot steamy shower seems to make the nose happy then increase the humidity setting.
Humidity preferences or needs is highly individualized. I know couples where both use cpap and one will use maximum humidity setting and the other not use any at all. Go figure but that's just the way it is.
You have to figure out what your nose wants and needs yourself....trial and error.
If you didn't like 3 and it felt too dry for you....I sure wouldn't go lower.

If you really are catching a cold...it's going to be a rough few days anyway...even if you weren't new to therapy.
Just being ill messes with our sleep and our breathing and all that stuff. We take the data with a grain of salt when ill.

[MistRiver]

So I've been doing trial and error like Pugsy suggested. The night before last I had it at humidity 4 temp 75. I woke up with my nose fine but my mouth feeling a little dry. Since I did well with humidity 5 I decided to try that again last night. Pressure was at 6.4-20 like I've had it for the last several days. I had a hard time because of feeling like there was slight resistance to breathing in but I forced myself to ignore it and go to sleep. Generally if I ignored the not being able to feel like I'm breathing okay I wake up and it feels natural and actually kind of nice with the reassuring feel of slight air pressure when I breathe in. Last night when one of my sons woke me up in the middle of the night I had water on the exhale hole on top of my head(dreamwear nasal mask) it was making a loud noise so I took it off and tried to blow the water off and set it back to humidity 4 and turned the hose temperature up a little. My room was colder than normal so I'm not sure if that's what happened as last time I had it on humidity 5 I didn't have a problem. I got most of the water blown out and tried to go back to sleep. For the life of me (and I tried for 2 hours) I could not put my mask back on and feel like I could breathe in well. It was like trying to breathe against resistance. At first I thought maybe I had the nose holes in the wrong place so I kept trying to take it off and back on to re position. I could not get it to feel any better. I even tried turning it up to a minimum of 7 and I tried keeping it on for a bit to force myself to adapt. I just could not get rid of the slight feeling of breathing against something. I do think my nasal passages might have closed up a little but not closed off or anything.

Any thoughts on what might have happened and what I could do differently? I tried really hard to just put it back on but it was awful.

Thank you.

P.S. The cold seems to have pretty much cleared up so I don't think it's from that.

[MistRiver]

Bumping this up in hope I get help before I go to bed tonight. I hope this isn't against the rules.