Thinking of switching to Auto Set

[cj7jeep81]

My wife reminded me yesterday that I had another mask. When I had my sleep study, the person gave me my mirage quattro, but also gave me a mirage fx to try. The quattro was a large, but they only had a medium in the fx, so I never used it as it felt too small. Tried it on last night, and results are much improved. I still need to adjust it (or get a larger one), as I woke up around 2am and had to take it off as it was so tight it was hurting. Slight improvement on the leak numbers though

[digitalepiphany]

If you use a nasal pillow, don't forget to change the settings in the machine. When I first switched,I didn't know that there were settings that needed changing, and it really felt like I was suffocating. Changed the setting, and it worked great.

[Pugsy]

Last night's leak line is much improved. I would be happy with that leak line any day of the week.
Which mask did you use last night? I am unclear...was it the Quattro full face mask or the Mirage FX nasal mask?
We can't be having it cause pain though..whichever it was..so work on the fit or get another size if you can.

[cj7jeep81]

sorry, got the names mixed up. last night i used the quattro fx full face mask. Tonight I'll adjust the straps, and see if I can get it more comfortable. If not, I'll see about getting a large, as this one is a medium. Definitely encouraging though. Is there a way to see the leak rate in real time on the machine? When I go to the mask fit section, it just shows the happy or sad face. With the mirage quattro, it showed happy even when the leaks were in the 30's when I checked the next day in sleepy head.

Last night's leak line is much improved. I would be happy with that leak line any day of the week.
Which mask did you use last night? I am unclear...was it the Quattro full face mask or the Mirage FX nasal mask?
We can't be having it cause pain though..whichever it was..so work on the fit or get another size if you can.

[Pugsy]

Is there a way to see the leak rate in real time on the machine? When I go to the mask fit section, it just shows the happy or sad face. With the mirage quattro, it showed happy even when the leaks were in the 30's when I checked the next day in sleepy head.

No, that mask fit section is about all you have for real time fit.
Wonder if there was something wrong with the Mirage Quattro??? Like the valve being stuck open or something?
Or maybe it was barely a happy face when you checked it and once in bed and moving around it would have changed to sad face but you couldn't see it.

[SleepyToo2]

Definitely want to save the beard, although I'm sure my wife is thrilled that I had to trim it short last night to get a better seal. She wasn't too happy with the long beard

Agree with not shaving the beard off because of mask fit. I also find that with a full face mask the shorter my beard is, the better the seal (although still not sure if it would qualify as a good seal!). However, the beard does need a little additional TLC to help it not cause leaks. This includes regular conditioning (you can buy special beard conditioners from Amazon, but regular hair conditioner should work to get you started), and washing the beard in hot water (not scalding!) just before you put the mask on. You want the beard to be damp, not wet. If that doesn't work, try a mask liner cut from an old T-shirt (you want a real cotton cloth, with no paint/surface coloring). Make it a bit larger than the mask itself so that you have room to adjust the liner when you have put the mask on. Finally, you can try using Lansinoh (it's found in the baby/maternity sections of the larger box stores). It's actually pure lanolin, and it is used by nursing mothers to help heal the skin where the baby suckles. I also have had some success with a silicone mask sealer from a dive shop. Whatever you do, don't use a petroleum-based product like vaseline, because that will cause leaks as the mask deteriorates.

The real answer for me, though, has been to use nasal pillows. I have gone through Opus 360, Aloha, and finally TapPap (without the headgear). I still have problems with mouth leaking, so I do use a chinstrap. I woke up with a noisy "mask" early this morning, but discovered I had my mouth open! So that is a work in progress. What I have also found is that bumping up the pressure a little at a time has gotten both AHI and leaks under much better control. It may be that the mouth is opening because it thinks not enough air is going through the nose, so the extra pressure helps. I now have an AHI that has been below 2 for some time, and recently has been below 1 on most nights. The advantage of the TapPap is that because it is held in place by the mouth piece, there is much less risk of the pillows being displaced from the nostrils during the night. The keys with pillows masks is to make sure they are fit correctly, without being too tight, and the seals are as good as you can get them. They may need an adjustment of the pressure, and you probably want to make sure the starting pressure of the ramp (if you use it) is set to something above 6. If you are still snoring, that is an indication that you need a pressure increase, in my experience.

It sounds like you are making good progress in taming this monster called sleep apnea. When it is under control, you will be able to get out and slay dragons as well!

[cj7jeep81]

Had my supplies person out Thursday, and she checked for mask fit, and the size I have is the correct size for me. I'm thinking now that the Mirage Quattro I've been wearing was too big the whole time. Still getting used to the Quattro FX, but the leaks are much improved. Now that the leaks are under control, any recommendations on pressure changes? I still wake up tired, and never feel like I got a good night's sleep. I didn't use the mask too much last night (woke up at 4:45 and took it off), but even on nights where I wear it for 7 or 8 hours I feel the same.

I'm currently working with doctor's on some other issues, so it's very possible that a c-pap machine won't completely fix my tiredness, and this is the best I can do until everything else gets straightened out.

Edit--Forgot to mention, that big spike on the leak was when I had an itch, and released one of the straps on my mask without turning it off.

[RandyJ]

If you play with the parameters of your leak graph (setting max at 80 or 90 for example), you'll be able to see the actual values better.

[cj7jeep81]

If you play with the parameters of your leak graph (setting max at 80 or 90 for example), you'll be able to see the actual values better.

Hmm, that doesn't seem to work right for me. If I do that, it sets it to 80 if the max value is below 80 (makes good nights hard to read), but doesn't lower the upper end if the max is over 80.

The 95% column though was 7.2, which if I'm interpreting that right (which I very well might not be), means that for 95% of the night, my leak rate was 7.2 or lower, which seems good to me.

[cj7jeep81]

Bumping this back up. Been using the new mask for about a month now, and I'm pretty well used to it, but even with the new mask (and much lower leaks), I'm still not feeling any better (except no more extremely dry mouth in the morning, which is a plus). Still tired all day, and wondering if this is as good as it will get, or if I still need to adjust settings.

I played with the auto set for a week or so, and saw that it was going up higher (maxing around 15-17). I've gone back to cpap mode, and have the pressure at 12.5, would it be worthwhile to keep bumping it up to see if I see any improvement?

[Pugsy]

which is a plus). Still tired all day, and wondering if this is as good as it will get, or if I still need to adjust settings.

It may just be that you need to give things more time. If your recent reports look like the prior one that you posted...I don't see anything in the reports that screams out "fix me".

Sometimes we just have other issues that the cpap machine can't fix.
There's a long list of possible culprits for not having the daytime energy that we would like to have.
When someone isn't feeling as good as they think their reports are looking then we usually tell people that it may just take more time and the improvements are just very gradual...and since they have to use the machine anyway while "giving it more time" it never hurts to investigate other possible causes for daytime fatigue.
Meds (OTC and RX) need to be closely evaluated for possible unwanted side effects.
Hours of sleep and are those hours of sleep fragmented...in other words...how is the sleep quality in general.
Other medical conditions?

[cj7jeep81]

which is a plus). Still tired all day, and wondering if this is as good as it will get, or if I still need to adjust settings.

It may just be that you need to give things more time. If your recent reports look like the prior one that you posted...I don't see anything in the reports that screams out "fix me".

Sometimes we just have other issues that the cpap machine can't fix.
There's a long list of possible culprits for not having the daytime energy that we would like to have.
When someone isn't feeling as good as they think their reports are looking then we usually tell people that it may just take more time and the improvements are just very gradual...and since they have to use the machine anyway while "giving it more time" it never hurts to investigate other possible causes for daytime fatigue.
Meds (OTC and RX) need to be closely evaluated for possible unwanted side effects.
Hours of sleep and are those hours of sleep fragmented...in other words...how is the sleep quality in general.
Other medical conditions?

Yeah, all my reports since that one have looked similar. Leak rates much improved, and overal stats about the same. For meds, I take 5,000 units of vitamin d daily (was deficient), and 2,000mg of fish oil. I take symbicort nightly for mild asthma (normal dose is 2 inhalations twice a day, I take 1 at night). I also have low testosterone, and take 100mg of that once a week. Nothing else other than the occasionaly ibuprofen.

Hours of sleep can vary. Typically, I get between 7 and 9 hours of sleep a night. Since getting used to this new mask, I rarely wake up at night. I have a hard time judging sleep quality, as I really didn't think it was that bad before I started C-Pap, but the sleep study definitely told me otherwise.

For other medical conditions, the only ones are mild asthma and low testosterone. I was diagnosed with low-t about a year and a half ago, and sleep apnea about 4 months later. The shots have done absolutely nothing postive for me, and I'm still working with docs on that. I did stop the shots for about 2 months at the end of last year (doc thought maybe having my sleep apnea treated would help with my low t, but no go), and no chagnes. The c-pap machine has definitely helped, but not as much as I had hoped. At the worst, I was exhausted by the time I got home from work (office job), and now I'm just really tired. So it is an improvement, but I'm still no where near good.

[Pugsy]

It may be that you just need more time. I have heard of people who finally seemed to have had more remarkable improvement after 60 months. Sometimes people don't realize just how much it helps until they have to sleep a night without the machine for some reason or other.
I had that happen last year. Went on a trip and forgot my long hose and didn't realize it until too late at night to try to find one...so slept with out the machine and I got the big reminder as to just how bad things were without it.
I was never one of those people who felt the "miracle" that we read about. I knew the cpap was working because the headaches and nocturia quit but I never had that daytime energy that people talk about.
Never woke up with tons of energy and wide awake ready to tackle the world....but then I realized that even before I developed OSA I was never a morning person and come to realize that the best therapy in the world wasn't going to make me into something I never was in the first place.

How is your flow limitation graph looking? If it still looks real active a little more pressure might help but I don't know if it is going to help how you feel during the day or not. That is the only thing I can think of report wise or therapy wise...especially since you report that your machine wanted to go pushing 20 when you tried APAP mode. The flow limitations are something that will drive the pressures up...even if the AHI looks good. Some people feel better with a little more pressure to help with flow limitations even though the AHI itself doesn't point to needing a change in pressure.

It's possible that the low T is a factor.
All we know is to keep plugging away at things in hopes that either with time or luck we stumble onto something that maybe helps a little.
My OSA wasn't totally responsible for my daytime symptoms...I slept poorly due to arthritis pain...and that's an ongoing problem for me. Over the years I have discovered through lots of time on the machine.
I do better during the day if I get near 8 hours of sleep.....just a decrease to 7 hours will give me daytime sleepiness and I will want to nap.
Also if I have a "bad" night with lots of wake ups with pain....I will have a subsequent bad day and feel like I was hit by a bus.

But through all this I know that even though I may not feel like running a marathon when I wake up....at least I don't feel like I just ran a marathon and got hit by a bus at the end of it.

[cj7jeep81]

I really think there's some underlying issue that no one has found yet. 10 years ago, I could work 18 hour days on 3 or 4 hours of sleep. As long as I got at least 2 or 3 hours, I was good to go all day. Worked on many projects where that's all I got for months at a time, and was fine with it. Then about 3 or 4 years ago, started having all these problems, and 2 doctors and 1 endocrinologist later, still not much relief.

I've found that the cpap does help, as when I was trying to adjust to the new mask, I went a few nights without using it, and felt worse.

I hear you on being incrementally better, even if not feeling really good. But at 34, I'm not to the point that I'm willing to accept this as the new normal for the next 50 years.