First night

[MaxINTJ]

Well, I managed to sleep with the brand new CPAP "experience" for 6 hours before removing it. I think that's pretty good for the first night. I ended up sleeping through to my alarm which rarely, rarely happened before.

I'm hoping this is a good start.

How long should I wait before I start looking at the data the machine is producing? I am guessing one night won't be sufficient.

Also, being a stomach sleeper, I can say the Dreamwear mask is much easier to tolerate than a mask with a front mounted hose.

[Pugsy]

You can look after one night. I sure did. Just don't go getting itchy with the fingers wanting to change a bunch of stuff based on one night's worth of data.

Did you read up on how to share the images in case you want member input?

I prefer imgur to host the screen shots
https://sleep.tnet.com/reference/tips/imgur

How to organize 3 pages so be sure to read all 3...
https://sleep.tnet.com/resources/sleepyhead/shorganize

and we don't need each and every graph that you see. All we need is the basics
See this thread for examples of the basics.
viewtopic/t103468/Need-help-with-screen-shots.html
Everything we might want to see can be seen on one screenshot.

Oh...we need to make a little change in the default red line for leak in SleepyHead. It defaults to a ResMed red line threshold and your machine will use a different line. In SleepyHead go to Preferences/CPAP tab and on the right you will see 24 L/min as a red line threshold for large leak territory.
That's a ResMed number and they calculate large leaks differently so we can't use that number. Respironics never really gives us an exact threshold because it varies with the mask and pressure used ...but something around 60 L/min is a nice conservative threshold. The threshold is likely much higher but this conservative number gives you some wiggle room.
This affects the % of time above red line statistic that is seen on the left side of the detailed page in SH. If you don't do this SH may tell you that you are having major leak issues when in fact you have no leaks issues.

And...can I act like your wife and say "I told you so"...that sleeping with this whole setup isn't the end of the world and it can be done.
You got 6 hours last night...that's great and actually probably beat me by 2 hours for the entire first month I started therapy. It gets easier too. Not that there won't be some bumps in the road but bumps that can be fixed.

[Okie bipap]

you did better than me. I only lasted four hours my first night. As Pugsy said, it gets easier as you go along. I would start looking at my data now, but don't worry too much about what you see the first few nights. It is going to take a few nights for your body to adapt to the new way of breathing while you sleep.

[D.H.]

It seems like I just didn't know I was supposed to have issues back in 1999, so I didn't know to have them.

[Bertha deBlues]

...we need to make a little change in the default red line for leak in SleepyHead. It defaults to a ResMed red line threshold and your machine will use a different line. In SleepyHead go to Preferences/CPAP tab and on the right you will see 24 L/min as a red line threshold for large leak territory.
That's a ResMed number and they calculate large leaks differently so we can't use that number. Respironics never really gives us an exact threshold because it varies with the mask and pressure used ...but something around 60 L/min is a nice conservative threshold. The threshold is likely much higher but this conservative number gives you some wiggle room.
This affects the % of time above red line statistic that is seen on the left side of the detailed page in SH. If you don't do this SH may tell you that you are having major leak issues when in fact you have no leaks issues.

Aha! I've been worried that my leaks are excessive, but when I changed the red line to 60 L/min they all went away! Thanks, Pugsy.

To MaxINTJ: It sounds like you're off to a good start. The payoff is worth all the bumps you may encounter early on.

[Pugsy]

Aha! I've been worried that my leaks are excessive, but when I changed the red line to 60 L/min they all went away! Thanks, Pugsy.

Glad to help. That pesky little data point has scared the devil out of a lot of people when it simply wasn't true or needed. It did it to me too.

You could also simply turn off that statistic but most people seem to like having the reassurance of the % of time over the redline so I offer a conservative number that will work 99.9% of the time.

Mark should not have made the ResMed leak number the install default and instead should have tied it into machine used somehow. But he didn't so we deal with it.

[Bertha deBlues]

Aha! I've been worried that my leaks are excessive, but when I changed the red line to 60 L/min they all went away! Thanks, Pugsy.

Forgot to mention that I'm using a DreamStation Auto, so this advice does indeed apply to my situation.

[MaxINTJ]

Well, it seems keeping the mask on for about 6 hours isn't necessarily a good start - not when my AHI increased 1700%!

2nd night I lasted between 5 and 6 hours - still not sure what's waking me up about the same time, but I have to take it off to get back to sleep.

Will be interesting to see if the second night's data is as bad as the first night's.

[Bertha deBlues]

Well, it seems keeping the mask on for about 6 hours isn't necessarily a good start - not when my AHI increased 1700%!

2nd night I lasted between 5 and 6 hours - still not sure what's waking me up about the same time, but I have to take it off to get back to sleep.

Will be interesting to see if the second night's data is as bad as the first night's.

There are lots of little things that can affect your PAP success: mask fit (too tight? too loose?), pressure (too high, too low?), mouth breathing, etc. More knowledgeable members will be along with good advice, but for now just remember that there's an adjustment period for everyone. Hang in there!

[Bertha deBlues]

Well, it seems keeping the mask on for about 6 hours isn't necessarily a good start - not when my AHI increased 1700%!

2nd night I lasted between 5 and 6 hours - still not sure what's waking me up about the same time, but I have to take it off to get back to sleep.

Will be interesting to see if the second night's data is as bad as the first night's.

There are lots of little things that can affect your PAP success: mask fit (too tight? too loose?), pressure (too high, too low?), mouth breathing, etc. More knowledgeable members will be along with good advice, but for now just remember that there's an adjustment period for everyone. Hang in there!

Until someone else chimes in, you might benefit from reading tips in the CPAP Wiki. At the top of the page, click on CPAP Wiki, then select Newbie to CPAP.

[Pugsy]

His AHI from the first night was around 10ish with about half of it being clear airway/central. I haven't seen the actual graphs yet to see when they occurred or the chance that he was just having the usual first night SWJ stuff. Especially if he is waking up and trying to go back to sleep with mask on and can't and then ditches the mask. High probability of some SWJ flags.

[MaxINTJ]

His AHI from the first night was around 10ish with about half of it being clear airway/central. I haven't seen the actual graphs yet to see when they occurred or the chance that he was just having the usual first night SWJ stuff. Especially if he is waking up and trying to go back to sleep with mask on and can't and then ditches the mask. High probability of some SWJ flags.

SWJ flags?

As for being awake with the mask on, the flags were nearly all in between going to sleep and the point at which I woke up. I do not try for long at all when it's 2-3 AM - maybe 5 minutes.

[Pugsy]

SWJ Sleep/Wake/Junk

I was actually thinking more along the lines of at the beginning or ending of a sleep session as to where the SWJ flagged events might show up.

viewtopic.php?f=1&t=114600&p=1110933#p1110933

I know this is going to be really hard to do but UARS patients (assuming that is what you have) can't fixate too much on the AHI numbers that these machines give you. You are going to have to try to evaluate based on how you feel. Numbers aren't going to be a good gauge of much of anything in your case.
And until you can sleep decently with the mask and machine it's really hard to judge how a person is going to feel and it takes some time even under the best of circumstances.

Your AHI is low without any cpap....and these machines can be fooled by awake/semi awake breathing irregularities. So the fact that your AHI is higher now than without cpap doesn't really surprise me.

[MaxINTJ]

I know this is going to be really hard to do but UARS patients (assuming that is what you have) can't fixate too much on the AHI numbers that these machines give you. You are going to have to try to evaluate based on how you feel. Numbers aren't going to be a good gauge of much of anything in your case.
And until you can sleep decently with the mask and machine it's really hard to judge how a person is going to feel and it takes some time even under the best of circumstances.

Your AHI is low without any cpap....and these machines can be fooled by awake/semi awake breathing irregularities. So the fact that your AHI is higher now than without cpap doesn't really surprise me.

This type of explanation doesn't give me good signs of hope.

I still feel like crap and it sounds like the machine stats might be totally useless. What am I supposed to do, wait 3 months with no improvement then randomly change some setting and wait another 3 months to see if I improve?

What's the point of a machine collecting data if all the data is wrong/useless?

I could handle feeling worse for a while if I knew it would get better (adjustments could be made), but it really sounds like there is nothing valid that this machine will record - do I need to have a sleep study with the 10 lbs of wires every other week so adjustments can be made?

[Pugsy]

These machines are really only designed for OSA stuff (data) and not UARS stuff (data). We make the best we can with what we have though.
CPAP is still considered the first go to option for UARS.

The machines have no way to know if you are asleep or awake. They measure air flow only. Awake/semi awake breathing is a lot more irregular than we think and certainly more irregular than asleep breathing.
The machine is accurate in terms of what it measures. It is simply limited by not knowing if you are awake or not. It's measuring the air flow no matter if you are awake or asleep.

Treating UARS is NOT a quick/fast/easy thing to do....and we don't know for sure that you have UARS but it sounds like it is highly possible. I actually think it is much harder than treating plain vanilla OSA. People seem to need a validation in some sort of number to feel successful. Going by how they feel when they already feel like crap is really hard to do.

From what I have read people with UARS tend to need higher pressures past where the "AHI numbers" are good to actually feel better.
They have to get to the point of sleeping decently with the machine all night though and that's hard to do when first starting therapy. Heck, I have plain OSA and it took me probably 3 months to get past 5 hours of sleep with a lot of wake ups mixed in those 5 hours just from having the alien on my face.
I was fortunate in that despite the short hours of sleep initially that I had 2 major symptoms of OSA that went away pretty fast so I had something to measure and validate to my mind that the therapy was working.