Machine ain't cutting it

[Wulfman]

Thanks All;

My study was done with the FX nasal cushions and they determined that 7 was enough. I have a BIG problem with breathing through my mouth and even a chin strap won't keep it shut. I thought a little pressure relief with the nasal cushions might help with this. I am going to try the Quattro tonight with 0 EPR and then Sat and Sun with the FX and a setting of 0 EPR and then 1.

If you're not already........
Do nasal cleansing before bedtime.
Turn CPAP humidifier setting way down or Off.

You need to breathe through your nose as best you can.......if at all possible.


Den

[thegrons]

I downloaded the clinician manual to read the results; will reading these preclude the RT from reading my data this week or can I take a look and still download the memory stick?

Last night I tried the FX pillows and I am paying for it today, runny nosem sneezing...I don't know if I can take it. Will this go away? I think they stayed in most of the night and when I tried to open my mouth I heard a noise, and woke up and shut it. So I think the leakage will be minimal, but again if this nasal irritation is not temporary I don't think I can do the FX and have to go back to the full mask.

[Wulfman]

I downloaded the clinician manual to read the results; will reading these preclude the RT from reading my data this week or can I take a look and still download the memory stick?

Last night I tried the FX pillows and I am paying for it today, runny nosem sneezing...I don't know if I can take it. Will this go away? I think they stayed in most of the night and when I tried to open my mouth I heard a noise, and woke up and shut it. So I think the leakage will be minimal, but again if this nasal irritation is not temporary I don't think I can do the FX and have to go back to the full mask.

Reading the data from the screen has no effect on the data stored on the memory stick/card.

I've never used nasal pillows or anything other than a full face mask, so I can't help you much on the nasal irritation.....but, there have been many threads dealing with various products to use to relieve it or toughen up that area. I'm sure someone else will be along to give their recommendations.


Den

[Wulfman]

I did a little searching and the two most recommended ointments are "Lansinoh purified lanolin cream" and "Ayr gel" for nasal irritation.


Den

[woodg]

Thanks All;

My study was done with the FX nasal cushions and they determined that 7 was enough. I have a BIG problem with breathing through my mouth and even a chin strap won't keep it shut. I thought a little pressure relief with the nasal cushions might help with this. I am going to try the Quattro tonight with 0 EPR and then Sat and Sun with the FX and a setting of 0 EPR and then 1.

My personal belief is that the titration study is only 1 night. And on top of that, you're in a strange environment and I think in most, if not all cases, it's the first time that you have slept with a Xpap.

I was given an escape II by my DME (yes I know, If I had it to do over again, I wouldn't have accepted it) after about 3 or 4 weeks, I bought an Elite II on CPAPauction.com. That way I was able to actually see what was going on. After playing with my pressures for about 2 more months and not getting any real improvement, I bought an Autoset II, again from Cpapauction. The difference was amazing. I can show you the results and you can see exactly what day I started using the Autoset. Starting on that day and over the past 5 months, the 95% pressure on the Autoset at 10.2 was 2.2 higher than my titrated prescribed pressure.

In short I don't think that one night in the laboratory setting is really enough to get an accurate pressure.

If you can afford it, I would absolutely go for one of the Autoset machines. If you look around a bit and have a little patience, I believe you can find one at a pretty good price.

Sorry for being a little long winded, but it's been one of those kind of days.

Good luck.

[nobody]

Thanks All;

My study was done with the FX nasal cushions and they determined that 7 was enough. I have a BIG problem with breathing through my mouth and even a chin strap won't keep it shut. I thought a little pressure relief with the nasal cushions might help with this. I am going to try the Quattro tonight with 0 EPR and then Sat and Sun with the FX and a setting of 0 EPR and then 1.

I also got a pressure of 7 from the titration study and it definitely was not enough for me. My pressure now is 9 - 11 range and that is working very well. I think you need to raise your pressure. Personally I can't stand nasal prongs or pillows and won't use them. They might not be for you either.

[thegrons]

Thanks for your input; I am going back to the RT and he will re-read my stuff after a few more nights of changes and might suggest an increase in pressure. I doubt I will be able to handle the nasal pillows and will stay with the mask. I sneezed all day today and nose is bleeding. Don't think I will get used to this.

[ChrisC]

John,

Do you have your humidifier on at night and set high enough? Are you putting enough water in the chamber? (Is it dry in the morning?) If you're getting that much nasal irritation inside your nasal passages (not a peripheral irration around your nostrils), I have a strong suspicion that the air going in is far too dry and that you need your humidifier cranked up a bit. Use distilled water. Do be mindful of rainout (search for it here on the forum). If you find water getting into the house (rainout), make sure your machine is below your head (I keep mine in the bottom dresser drawer) and think about investing in a hose wrap (I use the snugglehose).

Also, with the EPR, I highly doubt it'll help relieve the nasal discomfort you're experiencing. EPR is most beneficial when people struggle to breathe out against the pressure being forced in by the machine. In your case, it also effectively drops your pressure to 4 when you're breathing out with EPR is set to 3. I had terrible numbers with my EPR on and my pressure @ 10cm.. turned off EPR, and they normalized.

I too am a horrible, horrible mouth breather sometimes. I know I'm mouth breathing because A) My mouth is dry like the Sahara during the night, B) I feel like ass in the morning, like I haven't sleep at all (because I haven't!) and C) My wife elbows me in the ribs over the wind-tunnel blasting out my mouth. I often use a chin strip and a strip of painter's tape over my mouth. It's very gentle tape and nice and thick. It doesn't create an impenetrable seal, so you don't have to worry about asphyxiation.. it just "encourages" your lips to stay together. I alternate between the Swift LT and the Swift FX nasal pillow masks.

Don't give up. Plenty of people that are/have been in the exact same situation as you and are more than happy to help you through it. I HATED the idea of getting a "stupid Darth Vader mask" and swore that I didn't need it (until my sleep study!). Fast forward a year and a half later, and I won't sleep without it. Actually, I forgot to pack it a few weekends ago and absolutely regretted it. I had the worst sleep of my life...

[thegrons]

Thanks for the encouragement; I did crank up the humidifier and it took care of much of the irritation; I bought a heavy fleece for the tubing that works very well and also keep the unit on the floor on two phone books... I am dropping off my data to the RT today to see the results. I have shut down the EPR and hopefully this will do the job. If not I don't think the RT will tell me to go up to 8 or 9 from 7 but I am guessing that at that low level, creeping up from 7 to 8 would be safe?

Do you know where I can get a card reader for the ResMed S8 Elite II? CPAP doesn't carry them anymore.

Thanks,

Grons,

PS I have notice that when my mouth opens with the fx pillows it makes a noise and wakes me and I am learning to keep it closed. The chin strap did nothing except make me sweat on my chin...

[Wulfman]

Thanks for the encouragement; I did crank up the humidifier and it took care of much of the irritation; I bought a heavy fleece for the tubing that works very well and also keep the unit on the floor on two phone books... I am dropping off my data to the RT today to see the results. I have shut down the EPR and hopefully this will do the job. If not I don't think the RT will tell me to go up to 8 or 9 from 7 but I am guessing that at that low level, creeping up from 7 to 8 would be safe?

Do you know where I can get a card reader for the ResMed S8 Elite II? CPAP doesn't carry them anymore.

Thanks,

Grons,

PS I have notice that when my mouth opens with the fx pillows it makes a noise and wakes me and I am learning to keep it closed. The chin strap did nothing except make me sweat on my chin...

Are you reading the nightly data from your LCD screen in the morning? You've got the instructions on how to do it.
In my opinion, your pressures are inadequate at the present time. If you increase your pressures and the numbers get better, you know you're going in the right direction.
It's only "air".
There have been two quotes reportedly made by ResMed's former CEO Peter C. Farrell, "The only way a CPAP machine could hurt you is if someone hit you on the head with it." and "The treatment is as harmless as a bowl of cereal."


Den

[thegrons]

Thanks, I'll make sure I don't get hit with mine or electricute myself. I am still working through the manual on the data...I have had a busy weekend and started to go through the menus but couldn't make heads or tails out of them because it doesn't show the night I used it it just seems to give me the option of day or week. I assume day means the preceding evening? But again knowing what the numbers represent is going to be a matter of study; I don't know what the demarcation is for any of the numbers that would tell me when I have arrived and frankly as I read the manual it doesn't seem to be too discriptive either.

When it discusses percentiles of this that and the other thing I don't know what any of it means or what combination of numbers are acceptable.

Den;

I will go in the menu and give you the daily numbers today and maybe you can tell me what they mean and if they are good or bad. I know the AHI as something to do with apnea episodes but it doesn't seem to tell me if the machine brought me through or did its job? I guess I will ask my RT after he reads the data stick.

Leaks .10 L/s
AHI 33.7
AI 26.6
HI 7.1

What this means??????

[ChrisC]

If I had to guess, I'd say your pressure is too low. That's not a good AHI at all: your AI should not be 26.6.

[jdm2857]

Your AHI (the total number of apneas and hypopneas per hour) is way too high. The guideline for good treatment is an AHI of 5 or less, but you should strive for as close to zero as you can get.

Your 95% leak rate of 0.1 l/s is pretty good. ResMed says as long as it is below 0.4 l/s the machine can compensate for the leak and provide good therapy. Again, your goal is as close to zero as you can get.

It sure seems like your pressure is too low. I would raise the pressure to 8 for a few nights and see what happens.