Newish User / Questions / Problems / Thoughts

[UglyBob]

maybe I can call the number and the supplier can adjust that

Use OSCAR and learn how to adjust the machine yourself to achieve optimal therapy. The DME will just consider you an aggravation if you ask them to change the pressure.

I don't want to say my nose hurt, but it was a little sore or something.

Have you watched a few videos to learn how to fit and adjust the mask? https://www.youtube.com/results?search_ ... +CPAP+Mask

Humidity Level: 4

This setting might be too high. A high humidity setting causes nasal congestion in some people. It's OK to experiment with different settings.

I consider the DME an aggravation for all the stuff they put me through!

I'll check out the videos. Thanks!

I still have to play with the humidity. Low humidity causes a lot of problems for me, so I assumed it was too low. I'll figure that out eventually.

[Pugsy]

Yes...the SD card has to be in the machine when it is in use to get the detailed data files for you to see.
They aren't stored on the machine's internal memory. Only the smaller summary files get stored on the machine.
The larger detailed data files go directly to a SD card or they don't go anywhere.

[ChicagoGranny]

Low humidity causes a lot of problems for me, so I assumed it was too low.

The main symptom of humidity set too low is usually dry nasal passages upon awakening.

[Pugsy]

For me the main symptoms of not enough humidity/moisture in the air from cpap is a lot of sneezing or itchy nose or nasal congestion.
Pretty typical allergy like symptoms.
I just recently noticed a lot of sneezing only in the mornings and decided maybe I should increase the humidity setting which I did and since I did...no more sneezing.
Things have been a bit extra dry in the house recently what with the cold weather and running the furnace a lot more and no chance to open the windows and let outside humidity come inside.

[EK3377]

Let me qualify by first saying I don’t have the experience of many who are already advising you on this thread, however I have had my own challenges with my nasal passages and sinus irritation, and can pass along what I learned and seems to be working for me. I talked with my primary care, my sleep doctor, an allergy doctor, and most recently an ENT doctor about having symptoms that mimic a sinus infection, i.e. congestion and some sinus pain.

What I learned collectively, is that I am very sensitive to humidity level. For me too much humidity causes congestion and sinus pain, and too little causes dryness and irritation. Many others seem to do well with high humidity settings, but that didn’t work for me.

What has finally seemed to work through advice from the various doctors I mentioned and a lot of trial an error is:
1) Humidity setting right in the middle (3 on dreamstation)
2) Two sprays in each nostril of Nasacort or Rhinocort before bed (specifically advised against Flonase because contains alcohol, so added to airflow of therapy, has a drying effect)
3) Two sprays in each nostril of Ayr saline mist before bed and when you get up in the morning

One side note, I did ask the doctor about long term use of Nasacort or Rhinocort, as it is an anti-inflammatory that contains steroid. The doctor explained that there is no harm in long term use, and generally no side effects, as it contains a very low dose of steroid (it is over the counter), with only the exception of a person with glaucoma, they would need routine check ups if using a nasosteroid long term.

I have been using the saline mist and a middle humidity setting for the last three or four months. I added the nasosteroid a month ago, and that seems to have done the trick, and I haven’t had sinus symptoms or nasal congestion really since.

This won’t necessarily be the right combination for you, however having some understanding of how you are affected by increases and decreases in humidity, and what you can do to address those, you may find really helpful. And having talked to four different doctors about it, perhaps someone else can also benefit from that research.

[ChicagoGranny]

2) Two sprays in each nostril of Nasacort or Rhinocort before bed (specifically advised against Flonase because contains alcohol, so added to airflow of therapy, has a drying effect)

Use what you want, but Flonase contains 0.0000025 grams of phenylethyl alcohol per spray - not enough to irritate a pissant.

Nasacort and Rhinocort each contain hydrochloric acid.
.

hydrochloric acid.JPG

[UglyBob]

Last night seemed a little easier than the first two. Well, the breathing while still awake seemed easier. It still took forever to fall asleep and I woke up several times. (It always has taken me forever to fall asleep and I always wake up a lot).

I turned the ramp time to 30 then 45 minutes since it would go from 4.0 to 7 to 9 etc while I was still awake. I thought the auto ramp was supposed to keep it low until I fall asleep then go higher. I also turned the humidity to 3, thinking maybe there was too much since it got warm and somewhat humid around here yesterday. One of the times I woke up (thanks to the screaming cat at 4:30 this morning), everything felt too dry so I turned it back to 4.

Also, for some stupid reason I kept the SD card in the computer when I thought I had put it back in the machine. I'm so mad about that! It's in the machine now so I guess tomorrow I can see what Oscar says.

[Pugsy]

Auto ramp still ramps up to the minimum setting and it takes 30 minutes to get there....the only thing different is that if you fall asleep before the 30 minutes is up it will suspend ramp and go directly to the minimum pressure sooner than waiting until the end of the 30 minutes.

So it doesn't stay at the lowest setting the entire 30 minutes...it's still ramping up even in auto ramp.
I think you thought it stayed lower the whole time it was in ramp if you weren't asleep and that's not how it works.

[UglyBob]

Auto ramp still ramps up to the minimum setting and it takes 30 minutes to get there....the only thing different is that if you fall asleep before the 30 minutes is up it will suspend ramp and go directly to the minimum pressure sooner than waiting until the end of the 30 minutes.

So it doesn't stay at the lowest setting the entire 30 minutes...it's still ramping up even in auto ramp.
I think you thought it stayed lower the whole time it was in ramp if you weren't asleep and that's not how it works.

Yes, that is what I thought. I wonder if I should go back to auto ramp.

It takes me a long time to fall asleep, sometimes over three hours, and that's before the machine. The first two days the airflow from the very beginning was too much. Last night that was a lot better but as I lay there longer and the pressure gets higher it's hard to deal with, then I end up pressing stop and start. I guess I'll continue getting more used to that. The hardest part is it feels like I forget how to breathe and then I'm trying to figure out how to breathe normally and I end up having to gasp several times through my mouth to catch up or something. Hopefully that makes sense. I'm wondering if a full face mask might be worth trying while I still have time to switch masks, or if that would even help.

I'd also like to thank everyone again! Everyone here has been very helpful and I really appreciate it!

[Pugsy]

What are your current settings? All of them?
The minimum and maximum?
Where the ramp starts?
How long for the ramp?
Using EPR or not...if using it at what setting?

Maybe we can compromise a bit to allow you to take the prolonged time it takes you to get to sleep with some little tweaks.

In the meantime....use the machine while awake and under no pressure to fall asleep .....like while reading or watching TV so that you can get more adjusted to the overall pressures and way of breathing and not be focusing so much on it while trying to fall asleep.
All that focusing is just making the insomnia worse.

With some time....the body will adjust to the pressure and it won't seem nearly as strong as it seems right now.

[Miss Emerita]

The recommendations for sleep "hygiene" include one that says if you can't fall asleep (or back asleep) in around 20 minutes, get up until you feel ready to sleep. I think the reason is to help you strengthen the mental association between going to bed and going to sleep. Maybe worth a try? Here are all the recommendations:

• Keep a consistent sleep schedule. Get up at the same time every day, even on weekends or during vacations.
• Set a bedtime that is early enough for you to get at least 7 hours of sleep.
• Don’t go to bed unless you are sleepy.
• If you don’t fall asleep after 20 minutes, get out of bed.
• Establish a relaxing bedtime routine.
• Use your bed only for sleep and sex.
• Make your bedroom quiet and relaxing. Keep the room at a comfortable, cool temperature.
• Limit exposure to bright light in the evenings.
• Turn off electronic devices at least 30 minutes before bedtime.
• Don’t eat a large meal before bedtime. If you are hungry at night, eat a light, healthy snack.

[UglyBob]

What are your current settings? All of them?
The minimum and maximum?
Where the ramp starts?
How long for the ramp?
Using EPR or not...if using it at what setting?

Maybe we can compromise a bit to allow you to take the prolonged time it takes you to get to sleep with some little tweaks.

In the meantime....use the machine while awake and under no pressure to fall asleep .....like while reading or watching TV so that you can get more adjusted to the overall pressures and way of breathing and not be focusing so much on it while trying to fall asleep.
All that focusing is just making the insomnia worse.

With some time....the body will adjust to the pressure and it won't seem nearly as strong as it seems right now.

I don't have a lot of options available to me, at least that I know of. The supplier made someone bring it to me and program some things.

It starts at 4.0 when I first turn it on. Above that it says pressure 8.0 - 13.0. So I guess those are where the ramp starts and the min and max. I can choose a ramp time in 5 minute increments from 5 - 45 minutes.

I have no idea about EPR, I don't see any setting anywhere on the machine about that. I have a feeling that's controlled by the supplier, and I think they might have adjusted it some which is why last night seemed easier. The only sections on the screen are My Options, and Sleep Report. Under My Options I have:

Ramp Time - Auto - I switched it back after your earlier response about how it still ramps up even if I'm awake
Humidity Level - 4
Mask - Pillows
Run Mask Fit
Run Warmup
Airplane Mode - Off


I have worn it some during the day to get more used to it. I figure over time it will get easier. Like I said before, last night was much better than the first two.

The recommendations for sleep "hygiene" include one that says if you can't fall asleep (or back asleep) in around 20 minutes, get up until you feel ready to sleep. I think the reason is to help you strengthen the mental association between going to bed and going to sleep. Maybe worth a try? Here are all the recommendations:

• Keep a consistent sleep schedule. Get up at the same time every day, even on weekends or during vacations.
• Set a bedtime that is early enough for you to get at least 7 hours of sleep.
• Don’t go to bed unless you are sleepy.
• If you don’t fall asleep after 20 minutes, get out of bed.
• Establish a relaxing bedtime routine.
• Use your bed only for sleep and sex.
• Make your bedroom quiet and relaxing. Keep the room at a comfortable, cool temperature.
• Limit exposure to bright light in the evenings.
• Turn off electronic devices at least 30 minutes before bedtime.
• Don’t eat a large meal before bedtime. If you are hungry at night, eat a light, healthy snack.

That's something I usually do, but now this stupid machine gets mad and lowers my score if I take the mask off. I still have ended up getting up and moving around. I have definitely read those recommendations before since this has been a problem for most of my life. Thanks though, it's been a while since I looked at them.

[Pugsy]

Download the manual and read it.
There are more options available to you once you know how to get to them.
https://www.respshop.com/manuals/ResMed ... %20her.pdf
It also explains what EPR is and how it works.

I think turning it on and using it might make things a little more comfortable for you.
I know you think that 8 cm pressure minimum is awfully high but in the grand scheme of things it's really quite low.
I do think using EPR will make it more comfortable when you do reach it.

Now your insomnia issues and taking so long to fall asleep...you need to be talking to your doctor about that.

[UglyBob]

Download the manual and read it.
There are more options available to you once you know how to get to them.
https://www.respshop.com/manuals/ResMed ... %20her.pdf
It also explains what EPR is and how it works.

I think turning it on and using it might make things a little more comfortable for you.
I know you think that 8 cm pressure minimum is awfully high but in the grand scheme of things it's really quite low.
I do think using EPR will make it more comfortable when you do reach it.

Now your insomnia issues and taking so long to fall asleep...you need to be talking to your doctor about that.

Wow, there we go! Those things were not included in the manual that came with the machine. So here's the current settings:

Response - Standard
Ramp Time - Auto
Start Pressure - 4.0
EPR - On
EPR Type - Full Time
EPR Level - 1
Humidity Level - 4
Tube - SlimLine
AB Filter - No
Essentials - On
SmartStart - On
Reminders >
Language
Date
Time
Press. Units
Temp Units


The insomnia is something I've always dealt with since I was a child. I've talked to doctors. I'm used to it. I'm hoping this will help me sleep better once I get there then the insomnia won't be as big of a deal. And who knows, maybe it's harder falling asleep knowing that I'm not getting good sleep anyway.

[Pugsy]

And who knows, maybe it's harder falling asleep knowing that I'm not getting good sleep anyway.

Most definitely. The mind is a very powerful tool but it doesn't always work to our best advantage. Sometimes it works against us.

Essentials - On

Change essentials to "Plus"....then you can get some extra detailed data quickly on the LCD sleep report screen if you happen to want a quick glance.

EPR Level - 1

Play with changing the EPR settings but you need to turn off ramp while testing because ramp is starting at 4 and EPR can't be felt at all at 4 cm no matter what the setting. Test all the settings with your minimum pressure of 8 and see which one simply feels better to you.
But remember....ramp as to be off for you to really feel EPR in action. Since the machine uses 4 cm to start with in ramp and since the machine can't go below 4 cm...if you try to use EPR in this situation you can't do it because the machine has no where to go.

Once you are done testing ....you can turn ramp back on if you wish.