APAP or CPAP? Very confused

[Bama Rambler]

Thanks for sidetracking it a little! I like the looks of that. I may get the DW and myself a pair of those.

[Luthie2006]

To Pugsy and Scott: Wow, Scott: What a very cool night table. I just have a night table where I put the machine on and hang the hose over the bedframe (which I don't think you are supposed to, are we? I think Pugsy or someone else may know this.

As for Pugsy, thank you again for the information. We are exactly the same age. I am so sorry read about your neck and back issues, especially at such a young age of 35 years old. I am so sorry for you, you seem so sweet and "tell it is like it is" kind of gal, and have helped so many people on here. Nobody should have to endure that. But at least on the bright side, you found Amitryp. for your night time pain to keep you from waking up. My being on both Celebrex every day 200 mg, and Cymbalta (60 mg) keeps the pain away when I sleep totally. This is most likely why my Primary is so reluctant to have me get off the Cymbalta. The old "If it ain't broken, why fix it?" I believe that I have gained weight too with Cymbalta, but he believes that the Cymbalta is doing more good than not. It pissed me off last night when I emailed my Primary and asked him if the Cymbalta could be causing me to wake up at night with awakenings and he said, "I am not aware that Cymbalta causes insomnia." I read it too, Pugsy, not only on Wiki but on other web sites a long time ago, but you know when the pain is that bad, we will try anything. Both these meds are keeping me off pain pills. I did take Tramadol too and it made me fall asleep on my couch. I work 9 hours every day, 5 days a week at a hospital and have to drive to work far and be totally alert all day long. It only worked for 4 hours (prior to Celebrex/Cymbalta) and like I said, I fell asleep on the couch. There was no way I could drive. And he would only prescribe 30 pills or less I remember. I will ask about the Elavil though too, just don't know about daytime what I would take? I guess still the Celebrex.
What I would like to do (with the new doctor's permission at the end of July) is wean off the Cymbalta and if the debilitating pain comes back, I will have to get back on it. We are not sure which med is working for the chronic low-back pain, but he thinks it's a combo of both?? All he cares about is that my pain level for the most part is a 1-2 most days. So I will get a second opinion. I am not thrilled about being on Cymbalta at all, but if it is helping with this pain, that is terrific. Thanks again, Pugsy. I was able to make the change on the ramping last night, and glad I moved it up. AHI. 0.5, not sure about the pressure though. Thank you, and bless you, no more pain!

[Pugsy]

You can hang your hose over the bed frame if you wish. Lots of people do that or even use some sort of hose management system to keep it way overhead.
What made you think it was wrong to do that?

Funny how different meds affect people differently isn't it? Tramadol acts like speed to me and puts you out like a light. Drowsiness is the most common side effect though..that's why it comes with the "may cause drowsiness" sticker.
At best if I take it at bedtime I might get 2 hours of sleep and then I am totally awake and cleaning house at 2 AM. Doesn't make we want to clean house at 2 PM though...never figured that out. Still hoping for that one especially today as I need to get off my computer and get some work done.

Anyway, you don't have to make any hard fast decisions about your meds today.
We do the best we can on any given day and since you have no choice but to use the cpap machine...well we use it and see what happens and deal with it or just accept it. Not like you have any choice about that anyway.
Maybe the sensory thing will lessen. It wouldn't be impossible and it really wouldn't be all that uncommon for it to lessen.
I think that when people have issues that it is rare that there is a lone single culprit that is 100% to blame for any problem. I think that most of the time it's likely a combination of issues that makes a problem potentially worse.
Once you get a handle on the software reports we can look to see what the pressure itself is doing...maybe it's a partial culprit if it is dancing around a lot. That wouldn't be impossible either and in fact is fairly common especially if someone tends to wake easily anyway.

My thoughts are just keeping looking at potential culprits when we can and try fixes on the things we can try to fix easily. Fixing the meds thing isn't so easy so it gets put on the back burner for now but your getting comfortable with the software and evaluating the leak or pressure graph is an easier thing to try and something that you need to do anyway. Besides...it gives you something educational and instructive to do while "giving it time".
Maybe we get lucky and by fixing some little things that the waking up isn't such a big of a problem in a couple of months. May never be perfect (mine sure isn't) but maybe manageable.

So your homework for now is simply continue to use the machine as best you can (like you have any choice in that matter ) and get familiar with the software and if that scares you too much...well, I do phone consults to get people started when they have trouble. No rush though. Not something you just have to do today or even next week. The data off the machine is sufficient for now and the other stuff can wait till you feel up to it. I really don't want you obsessing over tiny stuff anyway because I think that your OSA is likely well treated now. I just mainly want to see if there is anything going on that might be a potential culprit in the wake ups...like a leak spike or pressure changing all over the place. Some little something that might be a factor that if we could reduce the factor somewhat might help a little with the wake ups. I don't expect a single fix..just maybe whittle down any potential culprits just in case we get lucky. Hurts nothing at all to try.

[Luthie2006]

Thanks Pugsy for my homework assignment! And thanks for stating that it is ok to put the hose over the bedframe. I read somewhere that it could be dangerous that it can "choke" someone if too much is hanging in front of them. I am still trying to figure out where the put the exhalation tube/hose, I still feel the air rushing up to my eyes or face. I put it over my head and it helps a little bit but constantly feeling air rushing out of the hose. I even thought it was an air leak, but it was not. Any idea where to put that exhalation opening so it doesn't blow around my bangs on my forehead?

I am happy for you that you have found a lot of peace in your life and found the meds that work so well for you, given a not so great situation.
I definitely will ask my new Primary at the end of July if he feels that Elavil will be better for me than Cymbalta. I really would love to get off of it, but like I said my Primary seems convinced that the combination of the "C & C" (Cymbalta/Celebrex) is what is helping me so much.

[Pugsy]

That pesky vent....I didn't have any success with the Wisp so I don't remember where I pointed it during my short trial of the Wisp. You need to be able to route the hose so that the vent doesn't point at your skin...might be hard to do with current routing due to the hose turning upwards. Hard to point the holes down when hose is pointed up.

Can you use a nasal pillow mask? ..the ResMed AirFit P10 venting is nearly non existent and I have to put my hand about an inch away from the vent holes to just barely feel it and I route my hose up through my headboard and bring it down over my forehead to my nose.

If you can't use a nasal pillow mask the ResMed Swift FX Nano cushion is very similar to the Wisp and the swivel hose allows for more movement and direction of the vent holes. I had good success with the Nano. I didn't have good success with the Wisp but because of nasal congestion issues and not the venting system.

If you can get a hold of the AirFit P10 nasal pillow mask to try....try it. Most people have been happy campers with it and unhappy camper rate is very low.

[The Latinist]

You can hang your hose over the bed frame if you wish. Lots of people do that or even use some sort of hose management system to keep it way overhead.

I just bought a cheap nickel-plated coat hook at Home Depot and installed it next to my bed. I drape the hose over the bottom hook at night to relieve a bit of the weight from my mask, then hang my mask by its straps from the top hose during the day. Added bonus: I can hang my headphones from the same hook.

[Luthie2006]

Hello Pugsy and Latinist. Pugsy, now that I am finally getting a little bit used to the Wisp mask, I should stick with it. I cannot use nasal pillows, tried it and it plugged up my nose. I have not tried the Nano mask as the sample I received from the sleep clinician was the Wisp and I am fairly happy with it because it looks smaller than the Swift Nano. I just don't know what to do with the darned air coming out of it. No matter where I place it, the air hits me on my bangs, my eyes or head. I really hate to switch masks now in the middle of everything when I am trying to get used to it. I will ask about the Nano one too, possibly from my DME.

[Stevoreno_55]

Why do you unplug your machine everyday? Just curious.

I completely pack it up every day and put it away. I'm thinking of getting a special nightstand though, like this:


Sorry to take this thread so far off topic. I didn't see any other threads about CPAP specific nightstands.

Cool night stand; are there companies that build night stands like that or is that something somebody custom built? Pretty cool. Just to play it safe I'd have that gallon of distilled water sitting in a metal pan; plastic bottles have been known to leak.


Stevoreno_55
MS Gulf Coast
06/04/14

[Luthie2006]

Hello Pugsy: I just called my DME and because I am under the 30-day limitation, they can order me a Swift NANO mask (wide) free of charge for me.
They are thinking a wide because my WISP mask is a large (because I wear a chin strap underneath it) and causes more real estate on my head.
Do you think a wide would work; hope not more in air leaks.

[Pugsy]

If you are using a large Wisp then the wide Nano should work.
I needed the smallest Wisp and with the Nano I used the Small (which is the smallest) and it wasn't none to big.
It's worth a try for sure. The hose is more flexible and really the cushion is very similar to the Wisp (just the cushion part) and the Nano headgear and the short hose assembly is superior IMHO.

Wonder why the nasal pillows caused congestion...unless improperly fitted or wrong size and they weren't inflating or humidity was wrong maybe.
Normally it's the other way around. I couldn't use the Wisp because it caused congestion and have had great success with any number of nasal pillow masks as long as they were fitted properly. The Nano didn't cause me the congestion though like the Wisp did. Probably something about where it rested on my nose. Even my glasses will sometimes cause congestion. I am a bit weird.

Should you like the Nano and ever want to revisit the nasal pillows...I have some new unused Swift FX pillows you can have to try for free and they will work with the Nano headgear and hose. Sounds like maybe you might need a large size and I have plenty of those available.

[HealthyandHopeful]

Hi,

I haven't read all 7 pages of responses here, but reading the first page or so has helped me. I have been on a CPAP for 2 weeks and found out from this forum that it is a "brick" with no useful data. I just picked up a new prescription from my doctor yesterday and he wrote out CPAP with high efficacy data, humidifier, settings 7-12 cm H2O apap autoset. I pray this gets me the S9 autoset. I didn't know he should write the certain brand on the prescription. I've been nervous about the whole thing and hope I've done the right thing in getting this new prescription. The sleep place mentioned a resmed 460 (I think) that is also autoset. I hope I can get the S9.

Yes, be thankful that you have a good sleep clinician. Mine has not been vert helpful. First I decided not to use my insurance and bought a used machine. They called it a "lightly used machine" and when I got home and looked at the settings it had been used 206 days, over 1550 hours. I called back and she told me that over 1500 hours is considered lightly used. Then she called and told me about a friend of hers who has a DME business and had an overabundance of cpap machines. Since I was not going through insurance she offered me a new machine at the price I paid for the used machine. She called it an "under the table deal". I was to meet her and pay cash. I didn't take this deal.

Now I got the new prescription and they have sent in for approval from insurance. In the meantime to use the machine I have until I get the new one I have to pay $6 per day rental. I just hope they will give me the machine I want with this prescription. She told me insurance may require me to rent until I can talk to the doctor and make sure I am compliant.

I've been so frustrated with it all but can't find another local DME to go through. Hopefully I will have answers soon. I'm thankful for the help I've received on this forum.

[robysue]

Hi,

I haven't read all 7 pages of responses here, but reading the first page or so has helped me. I have been on a CPAP for 2 weeks and found out from this forum that it is a "brick" with no useful data. I just picked up a new prescription from my doctor yesterday and he wrote out CPAP with high efficacy data, humidifier, settings 7-12 cm H2O apap autoset. I pray this gets me the S9 autoset. I didn't know he should write the certain brand on the prescription. I've been nervous about the whole thing and hope I've done the right thing in getting this new prescription. The sleep place mentioned a resmed 460 (I think) that is also autoset. I hope I can get the S9.

The 460 they're talking about is a Philips Respironics System One Series 60 Auto PAP with A-Flex. It is the equivalent of the Resmed S9 AutoSet. It records full efficacy data on an SD card and is fully compatible with SleepyHead. It is a nice machine and there is no reason to think of it as somehow being inferior to the S9. Besides which, if they're going to sell you the PR model 460 you do NOT have to worry about them setting you up with the S9 Escape Auto, which is a APAP half-brick: It records some efficacy data, but not all efficacy data and it uses an older auto algorithm that does not detect centrals.

For a very detailed comparison between the PR System One Auto and the Resmed S9 AutoSet, please see my post What's the best APAP?

[HealthyandHopeful]

Hi,

I haven't read all 7 pages of responses here, but reading the first page or so has helped me. I have been on a CPAP for 2 weeks and found out from this forum that it is a "brick" with no useful data. I just picked up a new prescription from my doctor yesterday and he wrote out CPAP with high efficacy data, humidifier, settings 7-12 cm H2O apap autoset. I pray this gets me the S9 autoset. I didn't know he should write the certain brand on the prescription. I've been nervous about the whole thing and hope I've done the right thing in getting this new prescription. The sleep place mentioned a resmed 460 (I think) that is also autoset. I hope I can get the S9.

The 460 they're talking about is a Philips Respironics System One Series 60 Auto PAP with A-Flex. It is the equivalent of the Resmed S9 AutoSet. It records full efficacy data on an SD card and is fully compatible with SleepyHead. It is a nice machine and there is no reason to think of it as somehow being inferior to the S9. Besides which, if they're going to sell you the PR model 460 you do NOT have to worry about them setting you up with the S9 Escape Auto, which is a APAP half-brick: It records some efficacy data, but not all efficacy data and it uses an older auto algorithm that does not detect centrals.

For a very detailed comparison between the PR System One Auto and the Resmed S9 AutoSet, please see my post What's the best APAP?

Thanks so much!! I just kept reading about the S9 Autoset that I thought that was the one I should get. So, if they have the 460 in stock, I should just take it and not think twice about not getting the S9 Autoset, which would have to be ordered? Sorry to ask this. I think you've already answered. I will look at that thread you mentioned now.

[robysue]

Hi,

I haven't read all 7 pages of responses here, but reading the first page or so has helped me. I have been on a CPAP for 2 weeks and found out from this forum that it is a "brick" with no useful data. I just picked up a new prescription from my doctor yesterday and he wrote out CPAP with high efficacy data, humidifier, settings 7-12 cm H2O apap autoset. I pray this gets me the S9 autoset. I didn't know he should write the certain brand on the prescription. I've been nervous about the whole thing and hope I've done the right thing in getting this new prescription. The sleep place mentioned a resmed 460 (I think) that is also autoset. I hope I can get the S9.

The 460 they're talking about is a Philips Respironics System One Series 60 Auto PAP with A-Flex. It is the equivalent of the Resmed S9 AutoSet. It records full efficacy data on an SD card and is fully compatible with SleepyHead. It is a nice machine and there is no reason to think of it as somehow being inferior to the S9. Besides which, if they're going to sell you the PR model 460 you do NOT have to worry about them setting you up with the S9 Escape Auto, which is a APAP half-brick: It records some efficacy data, but not all efficacy data and it uses an older auto algorithm that does not detect centrals.

For a very detailed comparison between the PR System One Auto and the Resmed S9 AutoSet, please see my post What's the best APAP?

Thanks so much!! I just kept reading about the S9 Autoset that I thought that was the one I should get. So, if they have the 460 in stock, I should just take it and not think twice about not getting the S9 Autoset, which would have to be ordered? Sorry to ask this. I think you've already answered. I will look at that thread you mentioned now.

In my opinion? I'd take the PR System One Auto that they HAVE in stock rather than wait for the S9 to be ordered. And if you are currently using a PR 260, you won't have to change the humidifier either.

[Pugsy]

Thanks so much!! I just kept reading about the S9 Autoset that I thought that was the one I should get. So, if they have the 460 in stock,

No, no....the 460 is not a full time APAP like the S9 AutoSet. For full time APAP you need the 560 model in the PR S1 line.
The 460 has limited APAP capabilities only..30 days at a time and I think maximum of 5 resets.

After all the APAP time is used up then it reverts to being a fixed cpap pressure machine. It is a full data machine though.