Newbie CPAP user with a few questions...

[wardnine]

Hey, 46/m, was very recently diagnosed with moderate OSA (25.4 pAHI). Recently purchased a CPAP machine (Airsense 10 with ResMed Airfit F30i mask). Have had and have been getting used to the CPAP machine for the past 13 days (of which I've actually used the machine 9 days) and have the following comments/questions:

-Of the 9 days I've used the machine my "events/hour" were below 5 AHI for 8 days. I assume that's good?

-Roughly how long would it take someone diagnosed with moderate sleep apnea to notice benefits from it? I suppose I feel slightly less tired when I wake up in the morning (though not substantially so) though I also think I'm getting less sleep as it's been taking me longer to go to sleep with the mask on, including if I for some reason wake up in the middle of the night being harder to go back to sleep. But the getting to sleep issue does seem to be improving as I get more used to the mask. I still use coffee or 5 hour most mornings to supplement energy.

-The other noticeable effect of the mask is a dryer mouth most mornings when I wake up. It's not that big of a deal but my mouth is often noticeably dryer when I wake up. Are there known ways to manage this? I do breathe mostly through my mouth, which is part of why the F30i mask was recommended.

-How often in actual practice does maintenance need to be performed? I see the recommended maintenance intervals provided by my DME supplier but don't know if I trust those intervals given their monetary incentives. So for example does that mask cushion really need to be replaced once a month? Do the cushion and water chamber need to be cleaned daily with other portions (such as the tube and mask frame) cleaned weekly? I've had the CPAP machine for 13 days and haven't performed any maintenance yet, other than replacing the distilled water in the water chamber every other day.

Any feedback on the above or other best practices advice for a newbie still getting used to CPAP would be very much appreciated, thanks!

[Pugsy]

Roughly how long would it take someone diagnosed with moderate sleep apnea to notice benefits from it?

It takes as long as it takes. Some lucky people see marked improvement after the first night but others (most people) are going to take longer....and sometimes a lot longer.
Mostly it's a gradual change IMHO.

The other noticeable effect of the mask is a dryer mouth most mornings when I wake up. It's not that big of a deal but my mouth is often noticeably dryer when I wake up. Are there known ways to manage this? I do breathe mostly through my mouth, which is part of why the F30i mask was recommended.

Dry mouth is a common complaint even with a full face mask. If you have some room to increase the humidity setting you might try that but sometimes people just get a really dry mouth and nothing helps except adding one of those oral moisturizing products. A lot of people here use the Xylimelts with good success.

How often in actual practice does maintenance need to be performed? I see the recommended maintenance intervals provided by my DME supplier but don't know if I trust those intervals given their monetary incentives. So for example does that mask cushion really need to be replaced once a month? Do the cushion and water chamber need to be cleaned daily with other portions (such as the tube and mask frame) cleaned weekly? I've had the CPAP machine for 13 days and haven't performed any maintenance yet, other than replacing the distilled water in the water chamber every other day.

No....none of that maintenance needs to be done that often.
Same thing with replacement schedule....nothing has to be replaced that often.
My personal opinion....replacement parts are a cash cow for DMEs and it's profit driven.

Most of us long time cpap users have come up with our own schedules for cleaning and/or replacing anything and it's a far cry from what DMEs say. Funny how the DME suggest schedule happens to match how often insurance will replace something......

Most important thing I can tell you.....learn about patience pills and give yourself a full 3 months of regular cpap use and work mainly on sleeping more than anything else. It takes a while to get use to all this stuff and until you are sleeping well and long enough you won't really stand much chance of feeling improvement.
It takes a lot more than just slapping a mask on.

[Janknitz]

Dry mouth is also caused by mouth breathing, and increasing the humidity may not help, even in a full face mask.

You mention you often woke with a dry mouth before CPAP. It's worse with CPAP since air is flowing through your mouth at a higher volume.

With untreated apnea, mouth breathing can be caused by air hunger. If your apnea is not well-treated with CPAP, you may still be experiencing air hunger. Most of us with apnea well-treated by CPAP experience AHI's of less than 1.0. If the dry mouth persists, and your AHI is still well over 1.0, you may want to download open source software and see whether your treatment can be better optimized. With less air hunger, you may naturally stop mouth breathing.

Sometimes we mouth breathe due to nasal congestion. Is that an issue for you? If nasal congestion has always been an issue, consider seeking treatment with your primary care provider. If nasal congestion is new to you with CPAP, try adjusting the humidifier very slowly, incrementally up or down and give it a few nights to see if nasal congestion is better or worse. Too much humidity can cause nasal congestion as much as too little. It often takes a bit of time to find the "sweet spot" for humidity.

Sometimes it's habit, and we can learn to breathe through our noses by practicing all day long. What this means is that you put your tongue on the roof of your mouth on that ridge behind your top teeth and keeping it there all day with lips sealed when you are not talking or eating. Believe it or not, after a few days that becomes the natural resting place for your tongue, and the habit can carry over into sleep for most people. When that isn't working, some people here use a chin strap, or a soft cervical collar to support the chin.

If you can conquer mouth breathing, you may be able to use a nasal mask, a nasal pillow mask, or a variation of a nasal pillow mask that is lighter in weight, easier to seal, much more comfortable than a full face mask.

[mlmollenkamp]

I would add that if you are still experiencing daytime sleepiness and your AHI is over 5 even occasionally, especially if its just below that the rest of the time it would be worth while talking with your doctor. I've used a machine for almost 20 years. I wish I had been more insistent the beginning. It took a long time to get my machine set up right but it was much better once it was. Keep at it, the most important measure is how you feel.