New User Questions

[RyanMW]

Hi guys. Thank you so much for your help so far. This forum is incredibly invaluable and I'm so glad I found it.

I'm using an old Remstar pro2 c-flex model with a nasal pillow mask that I got from my friend. It's been two nights. I have a few questions.

First, The air rushing out of the small holes on the top of the mask, opposite of the nasal pillow insertion points, can be quite loud. I have still been able to fall asleep with the mask, but it can be a little annoying. Is this normal, or is it an air leak?

I tend to sleep flat on my face. This seems to be less effective in getting the air into my airways than sleeping on my side, so I'm trying to amend my sleeping position. I've also read that sleeping in such a position with the nasal pillows can eventually change your face structure. Is there any truth to this at all? I would like to remain beautiful.

How long until one generally starts to see the benefits of treatment?

How do I determine when I should change my pressure settings? My machine is old and doesn't have data, so I went off of some online recommendations due to my age/weight/neck circumference and started with 6 cm/psi.

I apologize if this is redundant or overly lengthy. I really do appreciate the help you have all given me here.

[palerider]

First, The air rushing out of the small holes on the top of the mask, opposite of the nasal pillow insertion points, can be quite loud. I have still been able to fall asleep with the mask, but it can be a little annoying. Is this normal, or is it an air leak?

it's a normal and intentional air leak, it vents air so you don't rebreath your exhaled air, normal vent rates are from around 20 to 50 liters/minute of air, depending on pressure.

[Pugsy]

First, The air rushing out of the small holes on the top of the mask, opposite of the nasal pillow insertion points, can be quite loud. I have still been able to fall asleep with the mask, but it can be a little annoying. Is this normal, or is it an air leak?

Probably what you are seeing would be the vent holes. Since you didn't tell us which mask (vent holes in different places with different masks) we don't know for sure but all masks have some sort of venting system or holes. Some masks will have louder venting than others.
The P10 mask I am using now (see link in my profile) is probably the quietest venting system of any nasal pillow mask that I have ever tried and I have tried a lot.
I doubt you are using the P10 though as it was only released this year.

I tend to sleep flat on my face. This seems to be less effective in getting the air into my airways than sleeping on my side, so I'm trying to amend my sleeping position. I've also read that sleeping in such a position with the nasal pillows can eventually change your face structure. Is there any truth to this at all?

No truth to that at all.

How long until one generally starts to see the benefits of treatment?

Unknown time frame. Even with everything optimal (and we can prove it with software reports) it doesn't guarantee that we see anything.
Though I wish I had a dollar for every time I see this question...then maybe I could get my crystal ball fixed.

How do I determine when I should change my pressure settings? My machine is old and doesn't have data, so I went off of some online recommendations due to my age/weight/neck circumference and started with 6 cm/psi.

Actually if you have the Pro with the "2" as part of the model name I think it does offer some data but I don't remember what it offers. The old Legacy series Pro machines didn't offer any data but the later ones with the "2" as part of the model name offered data....probably AHI and leak similar to the newer M Series machines which came after the Legacy Pro 2 model machine. You would need both the Encore Pro Smart Card and the Infineer DT3500 card reader to get access to the data though. Both are still available for purchase though...Card reader can be found for $40 plus shipping and handling and the smart card for around $12. Does your machine have a slot in the back for a smart card? I don't remember if this model machine require a special module or not to put the SD card into the slot.

Without data the only thing you can go on is how you feel as there is no way to measure anything.
I would say give a setting at least a week though...to see how you feel.

[RyanMW]

First, The air rushing out of the small holes on the top of the mask, opposite of the nasal pillow insertion points, can be quite loud. I have still been able to fall asleep with the mask, but it can be a little annoying. Is this normal, or is it an air leak?

Probably what you are seeing would be the vent holes. Since you didn't tell us which mask (vent holes in different places with different masks) we don't know for sure but all masks have some sort of venting system or holes. Some masks will have louder venting than others.
The P10 mask I am using now (see link in my profile) is probably the quietest venting system of any nasal pillow mask that I have ever tried and I have tried a lot.
I doubt you are using the P10 though as it was only released this year.

I tend to sleep flat on my face. This seems to be less effective in getting the air into my airways than sleeping on my side, so I'm trying to amend my sleeping position. I've also read that sleeping in such a position with the nasal pillows can eventually change your face structure. Is there any truth to this at all?

No truth to that at all.

How long until one generally starts to see the benefits of treatment?

Unknown time frame. Even with everything optimal (and we can prove it with software reports) it doesn't guarantee that we see anything.
Though I wish I had a dollar for every time I see this question...then maybe I could get my crystal ball fixed.

How do I determine when I should change my pressure settings? My machine is old and doesn't have data, so I went off of some online recommendations due to my age/weight/neck circumference and started with 6 cm/psi.

Actually if you have the Pro with the "2" as part of the model name I think it does offer some data but I don't remember what it offers. The old Legacy series Pro machines didn't offer any data but the later ones with the "2" as part of the model name offered data....probably AHI and leak similar to the newer M Series machines which came after the Legacy Pro 2 model machine. You would need both the Encore Pro Smart Card and the Infineer DT3500 card reader to get access to the data though. Both are still available for purchase though...Card reader can be found for $40 plus shipping and handling and the smart card for around $12. Does your machine have a slot in the back for a smart card? I don't remember if this model machine require a special module or not to put the SD card into the slot.

Without data the only thing you can go on is how you feel as there is no way to measure anything.
I would say give a setting at least a week though...to see how you feel.

Yeah, the smart card is in the machine..i just don't have the reader--i don't think. Right now I don't really have the cash for a reader, unfortunately, so I will just have to go on how I feel, I imagine.

Aside from being generally fatigued throughout the day, sore and short of breath, my back is especially sore. Is this a typical symptom of OSA or could it be my mattress or something like that?

[Pugsy]

Some people will experience some sore muscle type of pain in the back or chest wall from the extra "work" that is involved from having to exhale against the pressure from the machine. Some people more than others will experience this sort of discomfort. Very similar to when you exercise and you use muscles that haven't been worked in some time...those muscles get sore initially but with a bit of time and continued "work" the discomfort will reduce.
Might also be simply your mattress or just maybe staying in one position or a different position even.

my back is especially sore. Is this a typical symptom of OSA or could it be my mattress or something like that?

For your general fatigue complaints....you know if the fatigue is caused by something other than OSA then the chances of the cpap machine fixing things is not real good. I understand that you are simply trying anything that might remotely help and given your history I would do the same.
If I remember right...aren't you on some sort of anti anxiety or anti depression meds? Reducing the dosage if I remember but still taking some? If that is true then you need to remember that some of your fatigue very well could be related to meds side effects.
It's going to be doubly hard for you to try to measure cpap effectiveness, given your history, without the help from software data.
1...we don't know that all your problem is OSA related and could possibly be fixed with cpap therapy. Your pre cpap AHI wasn't horribly horrible so we can't say with 100% certainty that OSA is your only problem.
2...even if your problem was totally all related to OSA it makes it hard to evaluate therapy effectiveness when we don't have any data.
3...heck, maybe you are looking at a UARS type of thing going on and that's hard to manage even with software data.

You are caught between a rock and a hard place no matter which way we look at things.
Even with data there is no guarantee that optimal cpap therapy will fix your issues.
Without data you have to take a real big dose of "patience" and understand that going this way with this machine is simply going to take a LOT of time and even then there's no guarantee it will fix things.

You do need to leave your settings unchanged for at least a week though before changing anything in terms of increasing the pressure. Especially here at first when you also are having to adjust to sleeping with the mask on your face.
Things to keep an eye on while you are "giving the settings time"..
Hours of sleep...
Are those hours of sleep fragmented with a lot of wake ups for any reason and if so, why?
Maybe make a journal of sorts so you can keep track of how things went each night.
Like "got so and so hours of sleep last night and woke up 3 times during the night and feel like whatever".

[Julie]

Hi, be careful to NOT cover that CO2 vent with bedding or anything because you don't want to re-breathe CO2. Your back may be sore because of how you sleep, because you need a different mattress, or because you have some condition which you need to get checked out by a doctor... which we cannot diagnose for you long distance.