Noob Questions -Feeling Tired, Leaking, The S9 and ResMed

[canadrian]

First of, I have been lurking this forum for several days as a member, and many before that, and have already found out answers to many of my initial questions.

Apologies however, as my searching skills may not be up to snuff, and I am sure these questions have been answered before.

I finally got my follow-up visit with the doctor, and have been using the S9 AutoSet APAP since last Tuesday. I found that I got used to the mask a lot quicker than I thought (the sleep test was a nightmare).

I have noticed however, that while I wake up in the middle of the night far less than I did before, I feel * a lot* more tired. I never really did feel tired before (the APAP) when I woke up, or weak during the day. I don't know if my body is now getting used to REM sleep and decides it wants more than 6-7 hours or what. Has anyone else experienced this?

Also, I found that I wake up once or twice a night because the air is leaking around the sides of my nose, going in my eyes (I have a full face mask, if that makes a difference). I think the seal is tight enough initially, but after it ramps up to the 10-15 I have been prescribed, and with a little moving around, the mask starts to leak. I have adjusted it every night, but with no results. Are there any 'tricks' or such that people use to keep their mask sealed, even when they turn during the night?

I hear a lot of people talking about looking at their results through ResMed. When I asked the clinic, they mentioned the software to get the results was only for clinics and not the public, but it appears this is incorrect (or, they use different software). I would like to be able to see my own data more than once a month, etc. Do people on this forum generally recommend/find it's worth it to buy the software?

Lastly, does anyone know if the S9 should keep any sort of accurate data on the info screen? I seem to only get 'last night's' data, and sometimes that is incorrect (Saturday night it said I slept 0.2 hours with the device, rather than the 5 or 6 I did).


Sorry for the lengthy post and the amount of questions. Any answers would be greatly appreciated!

[kteague]

Hi. I'll leave the data questions to those with your type machine. Just mentioning my personal theory on time spent sleeping after starting CPAP. Having untreated sleep apnea for who knows how long, the body has endured a prolonged assault. Once one can, with treatment, get restorative sleep, seems reasonable the body would crave some extra time sleeping as it recovers. At some point that should naturally resolve, but even then, CPAP cannot compensate for short sleep. That said, non resolving issues are best investigated to be sure something about the treatment isn't in need of adjusting or that other medical issues aren't in need of attention.

[dtsm]

Couple of comments:

You need to resolve your leaks first - this might mean trying other masks if your FFM continues to leak.
It would help to monitor data, including leaks, events, etc. Check your pm box on this.

Give it time..even after you resolve leaks, sleep better, it might take as long as 6-12 weeks before you feel the difference. Everyone is different, don't give up.

It's a marathon!

[robysue]

I have noticed however, that while I wake up in the middle of the night far less than I did before, I feel * a lot* more tired. I never really did feel tired before (the APAP) when I woke up, or weak during the day. I don't know if my body is now getting used to REM sleep and decides it wants more than 6-7 hours or what. Has anyone else experienced this?

Yes, some of us have experienced this. I'm 8 weeks into therapy and still feeling more tired than I felt before starting CPAP, although I'm no longer feeling bone-achingly tired like I did the first 3 weeks or so. I'm also still experiencing much more daytime sleepiness than I ever did before CPAP.

And I'm just as tired on the days where I get nine or ten hours of sleep as I am when I only get five or six hours.

I hear a lot of people ooking at their results through ResMed. When I asked the clinic, they mentioned the software to get the results was only for clinics and not the public, but it appears this is incorrect (or, they use different software). I would like to be able to see my own data more than once a month, etc. Do people on this forum generally recommend/find it's worth it to buy the software?

Try contacting a user here named Uncle_Bob or search for posts by him. A lot of us got a link to the software download through him. So if you search his posts, you may find the link. Otherwise, you could try pm'ing him.

Lastly, does anyone know if the S9 should keep any sort of accurate data on the info screen? I seem to only get 'last night's' data, and sometimes that is incorrect (Saturday night it said I slept 0.2 hours with the device, rather than the 5 or 6 I did).

The S9's "day" is supposed to run from noon to noon. The LCD screen's detailed Sleep Quality menu allows the user to select the time frame between 1 day, 1 week, 1 month, 3 months, etc and provides summary data for the time period selected. I don't have any idea of why the S9 would record so little time (0.2 hours) if you had the mask on and the machine running for 5 or 6 hours. Unless you slept past noon: And in that case, when you ask the LCD for "1 Day" data, it will only show the data for the period between noon and the time you woke up.

Good luck and hope you start feeling less tired much, much sooner than me


Sorry for the lengthy post and the amount of questions. Any answers would be greatly appreciated! [/quote]

[Slinky]

# 1 rule in mask fitting is to LAY DOWN whilst fitting your mask (facial tissue like everything else is subject to the law of gravity)
# 2 rule in mask fitting is to turn your CPAP on to your set pressure or 10 cms whichever is greater whilst fitting your mask (a good fit at 6 cms quite likely is going to be leaky at 10 cms)

[dtsm]

Try contacting a user here named Uncle_Bob or search for posts by him.

Already pm'd him everything

[KatieW]

Some items that may be helpful for mask leaks and also comfort:

Mask liner: http://www.padacheek.com/PAC_Maskliners.html

PapCap: http://www.pur-sleep.com/products/produ ... category=6

Head pillow makes a difference, many of us have experimented with different ones. If you do a search, you find we all have difference preferences. I use this one: https://www.cpap.com/productpage/papill ... illow.html

Hose management is also helpful, so that your hose doesn't pull on your mask as you sleep.

I use OTC eye drops before bed, and keep my eyes closed while I am adjustment my mask, so air doesn't rush into my eyes.

You mentioned that you are using ramp, and a range of 10-15. What is your ramp pressure, and how many minutes is your ramp time? If you are comfortable with it, you might try raising your ramp pressure, and lowering the time, so that your initial mask adjustment is closer to your sleeping pressure.

Also, check your humidity. I find that if my humidity is too high, my face gets sweaty, which then leads to leaks.

Good luck! Sounds like you're on the right track, and remember it takes time to figure all this stuff out.

[Mary Z]

It took me a long period of time to start feelinng better, and my numbers are still far from ideal. Finally I have no need for Nuvigil except on a rare day, but I am still making up a sleep deficit (or need a lot of sleep) and sleep 10 hours most nights.
The mask is just trial and error. You may find a bead of silicone (use Macks SIlicone earplugs rolled thinly into a bead about the size of a pencil) around the edges of the mask help you achieve a seal.
Good Luck.

[Janknitz]

I don't have your machine so others will have to chime in here, but I think your machine has a "mask fit" feature that will temporarily bump the pressure up to it's upper limit so that you can fit the mask to that pressure.

Often on an autoset the pressure starts out low, but when you go into REM sleep and start having more apnic events, the pressure increases and the mask seal set when the pressure was low cannot hold against the higher pressure. The mask fit feature helps with this.

I see Uncle Bob has already contacted you. Your clinic is not supportive of your efforts to monitor your own therapy, but that's their problem, not yours. You will have more success, be much more involved, and do better if you take an active role in this. Nobody cares more about YOUR health than YOU.

[canadrian]

CPAP cannot compensate for short sleep.

True. I have made a point to get more sleep during the week, since I average about 6 hours (and 9 or 10 on weekends to make up the difference )

You need to resolve your leaks first - this might mean trying other masks if your FFM continues to leak.
It would help to monitor data, including leaks, events, etc.

I realized that when they gave me the device, the SD card was in the slot, but not completely. So after a week I have...last night's data only I looked at the data and saw that I have a leak rate of 42L/m The leak rate fluctuated from next to nothing to very high amounts throughout the night. I move around a lot, which could be the cause. I will be looking into this.

The LCD screen's detailed Sleep Quality menu allows the user to select the time frame between 1 day, 1 week, 1 month, 3 months, etc and provides summary data for the time period selected. I don't have any idea of why the S9 would record so little time (0.2 hours) if you had the mask on and the machine running for 5 or 6 hours. Unless you slept past noon

I found out how to get to the proper settings window in the clinician's manual and changed the display to 1 week. I wish I could sleep past noon, but unfortunately that is not an option for me! I did find out why it happened - the system date and time was never changed, so it was set to January 2008, 13 hours behind. The incorrect time and the noon-to-noon day must have caused this. I have corrected the time so this should no longer be an issue.

# 1 rule in mask fitting is to LAY DOWN whilst fitting your mask (facial tissue like everything else is subject to the law of gravity)
# 2 rule in mask fitting is to turn your CPAP on to your set pressure or 10 cms whichever is greater whilst fitting your mask (a good fit at 6 cms quite likely is going to be leaky at 10 cms)

I followed this advise (as my initial fitting was sitting up in a chair at the clinic). Definitely noticed leaks at my set pressure and adjusted accordingly. I am still getting significant leakage, so I will be tweaking it each night, trying out different positions, and not just on my back.

Also, check your humidity. I find that if my humidity is too high, my face gets sweaty, which then leads to leaks.

My humidity is set to 27C (80F). I may lower it by a degree or two to see if that helps, as I do notice that it seems to be a bit muggy for me.

You may find a bead of silicone (use Macks SIlicone earplugs rolled thinly into a bead about the size of a pencil) around the edges of the mask help you achieve a seal.

That is interesting! Do the silicone plugs stick well enough to be used around the outer edges of the mask? I have only used the foam ear plugs, so I have no experience with silicone ones (in fact, I did not know they existed until this moment )

Your clinic is not supportive of your efforts to monitor your own therapy, but that's their problem, not yours. You will have more success, be much more involved, and do better if you take an active role in this. Nobody cares more about YOUR health than YOU.

I couldn't agree more. If I had not gotten the software, and started to play with it last night, I wouldn't have realized the SD card wasn't inserted properly. When I sent it in to my clinic, they wouldn't see anything (or I would have to go back and bring in the whole machine). I am also glad to know I have such bad leakage problems right away, rather than waiting to see the clinic. The sooner I can get the results the better, IMHO.

Thanks to everyone for your quick and helpful responses! I am learning so much lurking on this board

[cflame1]

The LCD screen's detailed Sleep Quality menu allows the user to select the time frame between 1 day, 1 week, 1 month, 3 months, etc and provides summary data for the time period selected. I don't have any idea of why the S9 would record so little time (0.2 hours) if you had the mask on and the machine running for 5 or 6 hours. Unless you slept past noon

I found out how to get to the proper settings window in the clinician's manual and changed the display to 1 week. I wish I could sleep past noon, but unfortunately that is not an option for me! I did find out why it happened - the system date and time was never changed, so it was set to January 2008, 13 hours behind. The incorrect time and the noon-to-noon day must have caused this. I have corrected the time so this should no longer be an issue.

I know there's some on here that will disagree with me... but I think if you fix your leaks some of this will be corrected.

[Mary Z]

Yes, the silicone earplugs stick well enough to go around the outer edge of the mask. They do provide a good seal.
Get them at about any drugstore.