All papped up!

[SnoringinDXB]

I took delivery of my Resmed S9 Auto today. The Swift FX mask was out of stock so I have a LT for a couple of weeks until the LX arrives. I ended up having to buy locally as UK and US suppliers would not recognise a foreign issued prescription. I had to pay almost exactly double for the machine as I would have paid if buying the US - not ideal but it is what it is.....

Still have lingering doubts about the pillow masks due to having a deviated septum, but I will give it a go. If the septum is too much of a problem, I'll have to go with a nasal mask I guess.

So starts the rest of my life. Looking forward to waking up feeling refreshed in the near future, if not tomorrow morning.

[NotLazyJustTired]

Congrats on the new machine. Some here prefer the LX over the FX. I am using the FX and pretty happy with it so far. I may try the Aloha at some point as it seems to get good feedback from folks here.

As a fellow newbie, let me tone your expectations just a bit. Do not get discouraged if you don't feel that "instant relief" on the first night or two. I've been on the hose for almost two weeks and I can tell you I've only had about 3 or 4 good nights in that time, but let me tell you, the days following those nights were awesome. But some of those nights were some of the worse I have had in a while. You may have to take a few steps backward before you start moving forward. Getting use to this whole new way of sleeping and breathing may take a couple of weeks, but you do acclimate and it does get easier. I have a feeling the best is yet to come, and that hope keeps me going. Please let us know how you get along. We are here to help, so don't hesitate to ask.

[SnoringinDXB]

Thanks for the message of support. I am not getting too excited - in fact my wife commented that my expectations were low and that I should be more excited!

I'm hoping that things will turn around maybe within the next month, little by little, but I am not expecting miracles.

I think the big challenge will be adjusting to wearing all the kit. I found it ok during the sleep study, except for a brief time where I woke up and wanted to just rip it all off - it felt claustrophobic and weird. Hopefully I will adjust quickly.

It is good to know that there is a support function available from fellow sufferers on this forum who have been there and done that.

[cosmo]

Congrats on the gear. Too bad you had to pay double for it. The Swift LT is a good one though. Its easy to clean and assemble.

You mentioned in a different thread that you traveled to Thailand to have the sleep study done. How was that experience and what type of cost did you encounter?

[NotLazyJustTired]

Good, it sounds like you have a good perspective. Sorry if I read too much into your earlier post. Who knows, you may be one of those lucky sorts that gets miracle relief immediately. Good sleep to you!

[SnoringinDXB]

Notlazy - I read enough on here not to have my expectations too high. As it turned out, the first night went very well. Got off to sleep ok without using ramping. The LT mask fit was ok but I did change the pillows from S to M pretty much immediately. Only woke up once for the bathroom at around 2am and it took maybe 15 minutes to go back to sleep. Stats in the morning showed 7.7 hours and AHI at 0.7. Pressure on waking up was 7cm. The sleep lab doctor recommended 16cm which seems high, but I think it was because they used S size pillows on the FX mask during the test. I think it was a bad fit with a lot of leakage so they compensated by upping the pressure. So, night number 1 was pretty good and hopefully indicative of the future. It might be my imagination but I felt a bit more refreshed than normal. I don't think my apnoea problem is that strong. Let's see how I feel in a couple of weeks - that will be a better indicator. My major concern is that although I like pillow masks as they are minimalist and comfortable, I have a deviated septum and it was sore just after 1 night of using the mask. Give it a week and it could be agony and the mask unusable. I asked for the FX and it was out of stock so they have given me the LT as a stop gap. If my septum is too sore I will have to drop the pillows and go with a nasal mask I guess.

Cosmo - the sleep study in Thailand sounds different to the study people write about on the forums here. From what I can tell, you guys have a sleep test and then a separate titration test. For me it was rolled into 1. I think they had plenty of my snoring and arousal data after a few hours. The data using the CPAP was way better. See above regarding the pressure issue. We go on vacation to Thailand pretty frequently, and we use the Bumrungrad International Hospital there for everything that is not covered by our medical insurance in the UAE (which is a lot! It is a p-o-s.) - I do a full physically every 2 years, we get our teeth done every visit, and we have various other things done or investigated. Prices are way lower than in the UAE and the quality of doctors, staff, treatment, equipment etc is very good - no complaints here. The hospital room for the sleep test was more like a hotel room. It was 15,000 Baht for the study and 2 consultations. That's something like USD 500. How does that compare with prices there?. The follow up consultation in the morning was very rushed as per an earlier post I made, and they were pushing a Breas i20 on me, which a forum member subsequenty described as a brick. There was no way I was going to buy that straight off the bat without doing some research, and it was very pricey too. In the end I bought here in the UAE and saved some money and got a better machine, but still paid double what a US patient would pay.

[NotLazyJustTired]

I wish my first night went that smoothly. You are off to a great start!

[cosmo]

The soreness might go away after your nose gets used to the nasal pillows. Also make sure you don't have it on too tight and your nose gets squished like a pig's nose. The cushion the Swift FX and LT are pretty much the same in size.

Due to your location, it might be a good idea to source a lot of white filters for the machine or find a similiar filter sheet that might be suitable and trim your own.

Sleep studies stateside generally cost around $3,000 USD. I haven't came across anyone who had a sleep study abroad in Asia so that was why I was curious about the cost and experience. It sounds like a good viable option for folks.

[Tino2You]

This may be a good time to say something about Lansinoh. It is a lanolin product used by nursing mothers. In our world it can be used in very small quantities to help seal your nasal pillows and provide healing for your nares. A small tube costs about 15 dollars in the US and lasts well i am not sure how long, I bought mine in May and it is still mostly full.

I've been using the Swift FX and it is my full time mask. My head gear is rather loose. The pillow just makes contact with my nares. Sometime if I am having a restless night, I will actually knock it off my nose and wake up in the breeze! I usually just pull it away from my nose and let it reseat.

A key for nasal pillows, get the largest size you can get without leaks. Most people will use medium but give the large a try. ResMed gives you all three in the starter pack (at least here in the States).

You are off to a great start. You have a great attitude. Keep it up!
-tino

[Guest]

Thanks to all for the supportive comments!

My 2nd night was not so good. Found it very difficult to be comfortable with the mask.....it is probably not the right one for me. AHI was 0.3 so all good there however. As for pillows, my septum is quite markedly deviated. This isn't just a case of a I have a normal nose and I have to adjust to the pillows. The left nostril is fine - no soreness. The right one is a little inflamed already and I am conscious of it most of the time. Maybe I have the mask a little too tight but if it is too loose it moves around on my head as I move in bed.

I have called the medical supply company about a nasal mask and they said they are happy to swap it out at no charge.

Apart from the septum issue, I think a nasal mask will be good for other reasons - perhaps you guys can confirm my understanding here. With a pillow mask I can't use the auto start/stop feature because the pressure is below 7. I presume this numerical limitation doesn't apply with a nasal mask? When I get up for the bathroom and take the mask off, the pressure shoots up and the noise is crazy. There is no way my wife will put up with that, but she is away at the moment. I need this sorted out before she gets back.

As for nasal masks, I appreciate that taste is personal, but any recommendations for a ResMed mask that is as minimalist as possible? Thanks!

[cosmo]

The auto start should work with any mask. I wouldn't do the auto stop though, push the button to stop. Your data will show a huge leak and it will mess up your averages if you like to look at your data.

Have you done nasal rinses?

Some people do still use nasal pillows with a deviated septum.
viewtopic.php?f=1&t=84770&st=0&sk=t&sd= ... 15#p772649

[Guest]

Thanks for the link Cosmo. The discussion seems to be around allergies/nasal congestion. That's not really an issue for me. I still get oxygen through the narrower nostril, just not as much as the completely clear other side. The issue is about comfort. I can't even feel the nasal pillow in the clear nostril, but I can feel it in the narrower nostril instantly, and during the course of the night it is pushing against the septum non-stop. I wake up with soreness and a little inflammation, both of which subside as the day goes on. But as I am only 2 days into CPAP use, I can't see me being able to tolerate the soreness and inflammation, which are only likely to get worse with more use. I don't see how sprays and other medications or ointments can help with that?

On the stop start mechanism, I tried to switch this to active on the S9 menu but it brought up a message saying stop start cannot be used with nasal pillows at less than 7cm. It's an in-built thing so I doubt it can be overridden.

A tech is delivering Mirage Micro, Activa and Softgel masks to my office this afternoon for me to try. I would love to take them home and trial them all, but I think they will want me to make a choice there and then. That's pretty difficult as a mask might feel great with no air,but it is likely to feel somewhat different with air. I have read some product reviews and one issue is that nasal masks can rise and fall on your face with the air pressure increasing and decreasing - I have it set to decrease on exhale.

If my septum was ok I would be perfectly happy with a pillow mask. If I can't make things work with a nasal mask, I don't really want to FF, so maybe surgery to correct the septum would be one less than ideal solution. I am already scheduled for hernia surgery in May, and had non-invasive surgery for kidney stones last year.....I might as well get a season ticket