Newbie to group

[melikou1]

Hi,

Another newbie. Began having having a few symptoms of sleep apnea, but my lovely wife of 37 years swears she never heard me stop breathing, nor would I wake up gasping for air. I attributed my getting up more frequently in the night to go to the bathroom to knowing that I have a constricted bladder neck. But 6 weeks ago I had rotator cuff surgery and bicep tenodesis, and received a nice extra piece of paper in my discharge packet telling me I have presumptive sleep apnea.

So, did the home study and my AHI was 38. I'm now wondering if my wife was looking forward to the life insurance...lol.

I just got my Dreamstation AutoCPAP with heated humidifier two days ago. Because I'm a horrible mouth-breather, had to go full face mask, and got the AirTouch F20. Auto setting 4 to 20 with 30 minute ramp. Fortunately I'm a good sleeper, and I know it's going to take a bit to get used to, but really not too much problem the first two nights. I would prefer sleeping on my side, but because of the rotator cuff repair, still trying to sleep primarily on my back.

Last nights AHI was down to 25.9...still not great but at least its below Severe . I know when I am able to sleep more on my side, it should come down further as gravity will be less of an issue. And it might be mind over matter, but yesterday was the first time in probably 6 months that i didn't feel narcoleptic in the afternoon, and didn't need to catch a 20 minute to hour nap.

Looking forward to learning more about managing my condition here!

[Pugsy]

Welcome to the forum.

Go here and follow the links for the software and get SleepyHead.
https://sleep.tnet.com/equipment

Assuming the bulk of your AHI is either OA or hyponea you can probably very easily improve it significantly with just more minimum pressure. Need to see what is going on first.
See here for examples of what you can see.
viewtopic/t158560/How-to-post-images-for-review.html

[melikou1]

Thanks Pugsy,

Just loaded Sleepyhead and will post the stats soon. Wow, what a load of information!

[D.H.]

That 4 to 20 setting is not a good permanent setting. It's a good initial setting, but you need to use SleepyHead and you will be able to tell what's a permanent setting.

BTW, you'll need to lower the upper number only if you experience discomfort (including but not limited to leaks and noises) from the higher pressures or "Clear Airway" events at the higher pressures.

Also, you can change the pressure setting no matter what you've been told.

[melikou1]

Here's what I have so far from SleepyHead (two night use). Hopefully this is what you're looking for.

2018-06-21.jpg (828.23 KiB) Viewed 16913 times

2018-06-20.jpg (856.99 KiB) Viewed 16913 times

[Pugsy]

Are you spending much time awake with mask and machine on?

The chunks of dense clusters of CAs....30 minutes or so at a time...any chance you were awake and not asleep?

[melikou1]

Assuming you mean CA as Clear Airway represented by purple, yeah, the 0230 AM and 0530 times on last nights graph are when I got up for bathroom. Didn't think it took that long to fall back asleep, but might have. Think I was just trying to get settled in at the 2300-2340 area. Arm was hurting after doing exercises for rotator cuff repair.

[Okie bipap]

Make sure you ice down your shoulder after exercising. Been there, done that (both shoulders).

[melikou1]

That 4 to 20 setting is not a good permanent setting. It's a good initial setting, but you need to use SleepyHead and you will be able to tell what's a permanent setting.

BTW, you'll need to lower the upper number only if you experience discomfort (including but not limited to leaks and noises) from the higher pressures or "Clear Airway" events at the higher pressures.

Also, you can change the pressure setting no matter what you've been told.

Hi...meant to ask earlier, how can I change the pressure setting? I wasn't told that I couldn't, but when looking at the unit I have limited access to the set-up menu. So is there a "jailbreak" code or something?

[Pugsy]

Go here and request the clinical/provider manual for your machine.
In the manual is the "jailbreak" code. It's easy.
https://www.apneaboard.com/adjust-cpap- ... tup-manual

Hard to say for sure where the minimal might need to be but probably at least 7 or 8 cm.
When awake the machine will often flag awake breathing irregularities as some sort of apnea event. Most often the Clear Airway event but can be the other events as well so not sure how much of that obstructive AHI is real or not.

Until you can actually sleep more soundly it's going to be a bit difficult to figure out optimal pressures.
You have a lot going on...new to therapy...leaks...pain in the shoulder...all which can make it difficult to fall asleep and stay asleep.

[melikou1]

Thanks very much...

Yes, a lot going on. Also failed to mention that I have a goatee (I keep it pretty short). Have read some of the input regarding using a sealant like with a diving mask, which totally makes sense. The AirTouch mask has a memory foam seal, which is pretty compliant, so I'm not sure how gross that seal would get using an oil based product since it is an open cell foam. At least I think it is, as it gets soaked with my drool. But I think I'm going to try the Beard and Mustache Balm I have as a sealant...its all vegetable based (primarily argon oil).

Only complaint so far with my AirTouch F20 FFM is that it feels that it restricts the little air I get into my nose. I'm a mouth breather as I have a deviated septum (had surgery about 35 years ago, but unfortunately cartilage continues to grow) and also seasonal allergy issues.

I think I'm going to request another FFM to compare against the F20, but I know I need to give it a bit of time.

Thanks again for all the input!

[Pugsy]

The AirTouch foam cushion isn't going to do will with any sealant type of product. It's going to probably break down faster.
It doesn't even do well with plain old water much less anything else. It will accelerate the foam breakdown and inability to seal and you can't clean it off without causing further problems.

If you look at a new full face mask and haven't check out the Respironics DreamWear Full Face Mask...give it a look.
Will relieve the pressure on the nose feeling since it doesn't touch the nasal bridge area and the silicone might just adapt to a short goatee fairly easily.
Check with your equipment supplier to see how much mask trial/swapping time you might have available...make use of that time while you can.

The silicone cushions (non foam) are more easily cleaned should the use of some sort of sealant product be tried and need to be cleaned off.

A mask liner might also help....plus if using the foam AirTouch cushion the line would help absorb any drool issues instead of going to the foam and accelerating the foam breakdown.

[melikou1]

Awesome...just looked at the Dreamwear FFM on the web....will definitely give it a try. I am really more of a side sleeper, and the top mounted hose will help greatly. A few times I've been awakened because I was sleeping on my good side, then rolled on to my back, and had the hose caught under my shoulder that had the surgery, and it gets sore enough to wake me up.

I agree about using a sealant with the silicone. The memory foam is just going to get goopy and nasty (technical terms) real quickly. It's already beginning to break down from my nasty drool pool.

Hopefully it will be available through my DME. Will find out Monday.

Thanks again...this site is an incredible resource!

[melikou1]

]Not sure if my provider made some adjustments to my unit or if I did (I dropped the ramp time down to 0 minutes as I didn't see any real value in the ramp for me.) Anyway, EPAP now begins at 7 and my Opti-Start icon shows on the screen. Perhaps it was already doing this at the end of the ramp when it was set for 30 minutes...not sure.

Anyway, last two nights, much better numbers. Will be working on getting a different FFM this afternoon through my DME, so hopefully the number will continue to improve.

Here are my last three nights:

2018-06-22 for Posting.jpg (594.5 KiB) Viewed 16768 times

2018-06-23 for posting.jpg (584.33 KiB) Viewed 16768 times

2018-06-24 for posting.jpg (605.87 KiB) Viewed 16768 times

[melikou1]

The AirTouch foam cushion isn't going to do will with any sealant type of product. It's going to probably break down faster.
It doesn't even do well with plain old water much less anything else. It will accelerate the foam breakdown and inability to seal and you can't clean it off without causing further problems.

If you look at a new full face mask and haven't check out the Respironics DreamWear Full Face Mask...give it a look.
Will relieve the pressure on the nose feeling since it doesn't touch the nasal bridge area and the silicone might just adapt to a short goatee fairly easily.
Check with your equipment supplier to see how much mask trial/swapping time you might have available...make use of that time while you can.

The silicone cushions (non foam) are more easily cleaned should the use of some sort of sealant product be tried and need to be cleaned off.

A mask liner might also help....plus if using the foam AirTouch cushion the line would help absorb any drool issues instead of going to the foam and accelerating the foam breakdown.

Not sure if my provider made some adjustments to my unit or if I did (I dropped the ramp time down to 0 minutes as I didn't see any real value in the ramp for me.) Anyway, EPAP now begins at 7 and my Opti-Start icon shows on the screen. Perhaps it was already doing this at the end of the ramp when it was set for 30 minutes...not sure.

Anyway, last two nights, much better numbers. Will be working on getting a different FFM this afternoon through my DME, so hopefully the number will continue to improve.

Here are my last three nights:

2018-06-22 for Posting.jpg (594.5 KiB) Viewed 16746 times

2018-06-23 for posting.jpg (584.33 KiB) Viewed 16746 times

2018-06-24 for posting.jpg (605.87 KiB) Viewed 16746 times