New driver needs help

[ThermalChaser]

Hi All,

I just started a new job as a truck driver. I've never had trouble sleeping but my BMI is 44 so the doc that gave me my DOT physical recommended a sleep study. I met with a woman from the company for 5 minutes. She gave me a home sleep test and had me meet her the next day to evaluate the results. We met the next day for about 10 minutes and she downloaded the results to her laptop. She informed me my AHI was 80 and gave me a machine (Resmed AirSense 11 with full-face mask).

She didn't make any adjustments to the machine. It was new in the box. There was never any mention of a prescription. I'm fairly sure she isn't a doctor but I don't recall her title. She seems pretty knowledgeable and she does use a machine herself which is reassuring since she has first-hand experience with it. So I assume I'm on default settings of 4-20" auto. The only adjustment I made was to disable ramp per her recommendation.

I did the initial test run with the pressure at 4, then 10, and during the test I went ahead and napped for about an hour. No problems.

I started the machine up last night for the first time. Fell asleep just fine but woke up 45 minutes in with my cheeks blown up like a balloon and air escaping from the sides. The pressure was at 18". I turned the machine off, reset and tightened the mask as much as I could stand. I slept for 2 hours to awake with the same problem. Machine was blowing full tilt (19") I was swallowing air and it was blowing out the sides with the mask on super tight. Reset again and slept another 4 hours. Woke up again with the same problem.

I feel like the max pressure is just way too high.

The machine shows usage of 6:45 but the MyAir app only shows 3:25. The company rep told me I'd need at least 4 hours to be compliant but I'm wondering whether she will be reading that from the app or directly from the machine? Why does the app have a different reading? (Time zone settings are correct and this was all before noon)

The only good news is my AHI on the app is 0.8 though I don't know if that's to be trusted since the usage results aren't the same. I downloaded the data to Oscar but aside from the statistics noting usage everything is blank. I suppose that's because I only inserted an SD card after using the machine and it will write all the data next time I use it?

I can't start work until I get this sorted so it's my 1 and only priority right now. I figured this is the best place to begin my crash course.

Thanks in advance for any help/pointers/answers!

[zonker]

Hi All,

I downloaded the data to Oscar but aside from the statistics noting usage everything is blank. I suppose that's because I only inserted an SD card after using the machine and it will write all the data next time I use it?

yes, pop the sd card in now so that it will write tonight's data. then, of course, post it right here so you can get some advice.

btw, thanks very much for taking the time to read the newbie post before making your own post. it's very helpful!

[palerider]

I feel like the max pressure is just way too high.

The machine won't go that high unless you're having breathing problems that cause it to go that high.

I downloaded the data to Oscar but aside from the statistics noting usage everything is blank. I suppose that's because I only inserted an SD card after using the machine and it will write all the data next time I use it?

Yes.
Upload an OSCAR graph tomorrow, after you've used the machine.

Be sure to read the first post on the forum about how to format the graphs.

[ThermalChaser]

I spent most of the day waiting on a return call from my employer's sleep person (I have no idea what her credentials are). I have very little time to get acclimated to the machine before jumping behind the wheel of an 80,000lb killing machine so I spent the entire day reading and watching youtube videos. This is my one and only priority right now so let the crash course begin.

With no data to go off of I decided to start with comfort settings. I enabled EPR at 3 and disabled Ramp. I reduced max pressure to 14. I took a nap for an hour and half. AHI 0.9 and I felt ok. I got the phone call from the employer and told her what I'd changed and reported the improvement. I was a bit worried she'd be upset with me for fiddling with it but she wasn't at all. She said most people need to make some changes in the beginning and she was happy that I'm taking an active role in learning about and managing my condition.

So last night I popped in an SD card and slept for half the night with those settings (4-14" Autoset, EPR 3, No Ramp). Getting to sleep was still troublesome and I woke up a few times. I didn't feel great at the end of the session. Much better than the first night though as I didn't wake up with chipmunk cheeks and a flatulent mask.

I'm still not sure whether I like EPR on or off better and I wanted to try fixed pressure so I switched EPR off and set the pressure to 10 which seemed to be the median value of the previous session. I slept a couple more hours. Initially fixed pressure felt more cumbersome but it was easier to acclimate to and I fell asleep much faster. At the end of this session I felt the best I have since I started this journey.

I'll leave the interpretation of the two sessions to those of you that know better what you're looking at. I was more comfortable during and felt better after the 2nd session but I did notice on the graph I was snoring throughout it whereas the first session it appears I didn't snore at all. I didn't mention the AHI for the two sessions because I feel it's unreliable as I only had 2-3 flagged events which IMO seems to be far too small a data set to be of any use. (ie one false flag or missed flag could double or half my overall score)

Any tips/info/observations would be welcome. I hope I formatted the report correctly.

[Pugsy]

Try the minimum of 10 but turn on EPR and set it to 3.
Change back to auto mode instead of fixed cpap mode set to 10.
In auto mode again...set the max to 15. So minimum of 10, max of 15 and EPR to 3 full time.

See how you do.

[ThermalChaser]

Try the minimum of 10 but turn on EPR and set it to 3.
Change back to auto mode instead of fixed cpap mode set to 10.
In auto mode again...set the max to 15. So minimum of 10, max of 15 and EPR to 3 full time.

See how you do.

OK. I dialed it in. I'll try to run it this afternoon if I can get a nap in. Thanks for the suggestions.

[ThermalChaser]

I'm feeling much better today. I forgot to reinsert my SD card so I'll have to wait until tomorrow for detailed data but I fell asleep fairly easily and got 7 hours. I only woke up once. My reported AHI was 0.0. Leak rate is down to 20 which is much better but still some room for improvement there.

I spoke with my company and informed them I'm ready to hit the road. I head out Sunday. Thanks for the help. I'll post another report tomorrow morning.

[Pugsy]

Leak rate is down to 20 which is much better but still some room for improvement there.

Understand that the leak number reported on the LCD screen is what we call a 95% number and all that means is the leak was AT OR BELOW that number. In this case 20 L/min....so for 95% if the time you were at OR BELOW that number.
Most likely if you could see the leak details you would see that you spent very little time up in the 20 L/min neighborhood.
As long as the leaks didn't wake you up they weren't bad enough to negatively impact therapy itself or the recorded results and I would shrug my shoulders and move on.

I have a good example here in this thread so you can see that the times in really large leak (and a corresponding high 95% number) don't really tell the entire true story. Yeah, the leaks were bad but it wasn't like it was going on all night.
The bulk of the night my leaks were well managed.

viewtopic.php?f=1&t=108724&p=1036669&hi ... t#p1036669

[loggerhead12]

Are you a glider pilot?

[ThermalChaser]

Are you a glider pilot?

I'm working on it. I've been flying contests on Condor since 2018 and finally last year I decided it's time to start losing the weight so I can do it for real. I was 345 lbs at the time. I'm down to 270. The max pilot weight seems to be 110kg. It's my goal to get there by June.

[loggerhead12]

I'm working on it. I've been flying contests on Condor since 2018 and finally last year I decided it's time to start losing the weight so I can do it for real. I was 345 lbs at the time. I'm down to 270. The max pilot weight seems to be 110kg. It's my goal to get there by June.

Nice! Driving down the BMI will, in all likelihood, reduce the pressures necessary for your CPAP therapy as well.

[ThermalChaser]

Nice! Driving down the BMI will, in all likelihood, reduce the pressures necessary for your CPAP therapy as well.

Yeah I hope to come off the machine in time but right now I'm kinda digging the fighter pilot look with the mask and all.

[chunkyfrog]

You may be disappointed.
Many things contribute to apnea, but the most common are tenacious.
CPAP is like glasses--it only works when you use it.
I remove my glasses--I bump into things.
Fighter pilots RULE!

[zonker]

Nice! Driving down the BMI will, in all likelihood, reduce the pressures necessary for your CPAP therapy as well.

Yeah I hope to come off the machine in time but right now I'm kinda digging the fighter pilot look with the mask and all.

unfortunately, it's not a "cure". it's a life condition which cpap helps to control.

[SDBud]

The only adjustment I made was to disable ramp per her recommendation.

Did she say WHY you should disable that?

It's helpful for new users, as it builds up pressure slowly at first (adjustable from 2 to 4 or 5 minutes, as I recall),
and it's often more comfortable until you get used to using the machine.

I used ramp for a few months, then turned it off.