Looking for feedback on my impression of success.

[jbankson]

OK..I have posted some updates along the way but am now at a place I never expected to get to and while I feel like am winning I wanted other opinions on next steps.

When I first came here it was out of desperation and a fear of God tactic used by my GP to scare me into trying. I won't provide a lot of history here but suffice it to say while I was first diagnosed with "severe" sleep apnea in 2012, it has only been the past 3 months where I have decided to take it seriously.

I finally met the right person to speak with at the sleep clinic. Being the head administrator she worked with me one on one and spent as much time as I needed to have an open an honest discussion. While meeting with the Doctors I always felt rushed and like I was bothering them.

Anyway, after much discussion here is my latest situation. Keep in mind my original AHI was above 35. I also was showing 4 or 5 Central Apneas.

I have the Respironics A-Flex Model with the heated humidifier. (No heated hose.) I have moved to the new F20 Mask which has worked out better with fewer leaks than the former Simplus Full Face.
In order to make success I tried something that I saw many do but also saw some replies saying don't mess with it. But I did lower the top air volume setting from 18 down to 13 for a week and now am at 15. Prior to that I was ripping off the mask by 3AM and was non compliant. I wasn't worried about compliance since the machine is paid for and insurance was moot at this point. I have now gone 15 days in a row and most mornings wake with the alarm with the mask still on!!!! I am stunned that I have reached this point.
Now, the rest of the story. I wound up purchasing one of the CVS neck collars to ensure my lower jaw did not drop wide open which was killing me with leaks and farts. I looked for a chin strap which would work but found nothing I liked. I also grabbed one of those dental appliances (SnoreRX) and inserted that in my mouth. I recorded my sleep and saw I was still snoring horribly and this was also disturbing my sleep. The combination of the lower setting (15), the neck collar and dental appliance have allowed me to meet 100% compliance and get 7+ hours of usage each night. I also purchased a CPAP pillow but not sure I like it as it is not comfortable. Although it does help with the leaks.

I learned about the software tools and prefer the Sleepyhead software and am now using that to get an idea of how I am doing. I am seeing a daily AHI from a low of 2.48 to a occasional high of 5.2. I don't understand a lot of the other details at this point. So here are my questions and concerns.

I have developed a chronic case of sinusitis. I have the heated water tank and use Flonase nightly prior to hitting the sheets. While I don't have nosebleeds per se, I do always have red and pink discharge when I blow my nose. I live in the Northeast so it is cold and dry and my heat is forced air. I do have one of the more expensive humidifiers in the bedroom as well.
My question here is should I go see an ENT Doctor? Is this a common side effect of CPAP therapy?

The second part is I assume all I have done is OK but I do have two questions. Is the heated hose option a nice choice? I would have to get a hose and adapter for my unit but will do so if this reduces irritation.
Another question is on the pressure setting. I am hitting the 15 limit a lot. So I assume I should keep pushing it higher to get back to the 18 level they wanted originally. I will say however that lowering it has led to the success I have had which at least has moved me to a positive attitude and lowered my AHI significantly which I hope is the point. But if I should be pushing higher, I will.

The past piece is based on recommended feedback I have ordered the cushion liners. Many have suggested they should reduce leaks a lot more meaning raising the pressure max limit is a no brainer if better for me. They should arrive today so will see the impact it will have.

Again this board has proven to be the savior in my case. I would have given up totally by now and just accepted fate. I have read non stop and learned so much more than I had ever thought I would. I just want to make the final steps now that I have succeeded in the core program.

One final note. I would love if someone has a chin strap suggestion that is comfortable and is fairly durable which does not impact the mask fitting. Remember I use the full face mask. I really don't mind the full mask since it is such a battle to keep my mouth closed. LOL

Thanks again!

Jeff

[Janknitz]

There's nothing wrong with lowering the pressure considering the dramatic improvement you got from doing it. If your graphs show constant "bumping the ceiling" try increasing the top pressure in small increments. Wait a few days between changes and see what the data indicates.

[OkyDoky]

Glad you are making this work for you. As you get adjusted like Janknitz said you might try to slowly raise the Maximum up, since you are bumping the top of the graph, until the AHI drops a little more.
If you start to get rainout in the tubing or a cold nose, the heated hose would help with that.
As far as the dry nose try different humidity settings until you find one that helps. When I first started I did have rare nose bleeds and found thet using Ayer nasal Saline Gel at night before masking helped.