1st Night

[Grlnxdor35]

Good Morning. High deductible insurance plan person here who obtained access to a Remstar CPAP machine yesterday. Spent one night on the CPAP using a full face mask and woke up feeling semi refreshed. I would consider that a really good night's sleep. Found a small hole in the tubing even so am looking to figure out how I can get replacement tubing without a Rx. Even with the hole and probably not being on optimal settings for therapy am already feeling hopeful and positive that I can regain the energy that I have somehow lost over the last year due to what is possibly untreated sleep apnea for the last half a decade.

[LSAT]

Tubing is as little as $5 on ebay..free shipping..no RX

[Grlnxdor35]

Thank you, checking that now.

[Grlnxdor35]

Okay, have purchased new tubing via Amazon and also a new mask via Amazon. Current mask is probably fine but wanted a back up. Also, purchased 12 filters so I am good going forward. Going to try and figure out the whole SD card aspect of my machine tonight. Current set up is on 10 for therapy. Will use that until I can get reports printed out after a week of functioning like this to see what report data looks like to begin tweaking therapy. Thank you for this board and all the info.

[D.H.]

To the OP:

If you have a pinhole leak in your tubing, it shouldn't affect your therapy. Your machine will compensate.

Thus, you can use the old tubing until the new one arrives.

[Grlnxdor35]

Thank you for the info. Will have to check how big the hole is but actually found a seller on Amazon who is only a 20 minute ride away and will be picking up new tubing today! Will keep existing tubing as a backup and see if I can't put some duct tape over the hole. I can't tell you how excited I am to get home and strap that mask to my face and fall asleep early. I am blessed to be a person who can sleep through pretty much anything. So happy the mask while weird didn't bother me once it was on and the blowing air actually has the effect of making me want to go to sleep.

[palerider]

Will keep existing tubing as a backup and see if I can't put some duct tape over the hole.

Just buy another new one...

[Grlnxdor35]

First night reading - August 1st

[TropicalDiver]

Can you help us understand why you are using CPAP rather than one of the auto modes?

What criteria did you use to set your fixed pressure?

[Grlnxdor35]

Hi there!

So I used the CPAP with the C-flex setting the first night which you are looking at and felt really decent the next day. Day 2 after reading on these pages I changed it over to the APAP and did not feel as good. Last night I tried it on the CPAP with the C-flex setting again at a bit higher pressure than Day 1 and felt a lot better upon waking up. I don't know with the APAP settings it doesn't even feel like the machine is even on. Basically I am flying blind and trying to figure out what works for me. Any input would be very helpful.

[Pugsy]

You are doing this all on your own in terms of figuring out pressure, etc????

If so...I would suggest these changes

Change to auto mode.
Leave the minimum at 10 cm you are using now (which isn't enough) and put the max at 20 and set Flex to 2 or 3 whichever is simply more comfortable for you....and see how you do.

You may or may not need more minimum than the 10 cm but we need to see what the machine wants to do before deciding.
At that time if you prefer fixed cpap mode we can mimic it in auto mode. I don't like cpap mode because it doesn't flag the flow limitations...in auto mode it does.

Was the report above one of the nights with the hole in the hose?

[Grlnxdor35]

Yes it was the first night with the hole. I am using new tubing now so that shouldn't be an issue. I also used the mask fit function to test my mask and got really good results so I know in general the mask is fitting correctly or correctly enough.

I am going to do everything you recommended for tonight and will post results tomorrow. Thank you for your help. Yes, I am doing it all without a sleep study or any other guidance except from this board.

[TropicalDiver]

A bit more context in case it is of value. Pugsy also helped me a huge amount at a couple of points in my therapy -- you are in good hands there.

The ultimate goal of therapy is to improve your sleep quality and that is done by using pressure to help keep the airway open. Use as much pressure as is needed for that but, ideally, not more pressure than is needed. More pressure isn't dangerous, but it can cause complications (swallowing air, mask leaks, and in rare circumstances a different type of apnea can arise.)

The only real way to know the correct pressure is really trail and error. So, there can be someone in a sleep lab watching your sleep (as measured by instruments) and tweaking settings to see what works for you. There are a few issues with this approach: a) It is costly; b) It is a single night sample; and c) It might not be representative of your sleep (different bed, forced setting, many wires, etc.). Your pressure needs can vary night to night (typically because of medication, alcohol, having a cold, etc.) and within the night (typically from sleep position and REM).

But we can use the auto setting to help accomplish the same goal (with the machine doing the trial and error). It is not perfect -- it doesn't know when you are actually asleep -- but it does a pretty good job (depending on the model) of monitoring things. If you need more pressure, it increases pressure (up to a limit set by you). But the pressure changes are not instant and are always reacting to some prior event and not prospective.

So, you can use an auto machine that has full data both to help optimize the settings AND respond to variations during the night. Part of that is setting the machine min to what we think will be the right pressure for most of the night -- and then let the machine increase it from there. That will suggest whether the min needs to be tweaked.

Lots of users get a machine first set to a min of 4, max of 20. Sounds great, right? The problem is that most people sleep poorly at 4 -- many feel a lack of air; and 4 is not enough to splint the airway open in most people. So you are getting shitty treatment if you are just waiting for the machine to get the pressure up where you need it. That is why almost everyone here sets the min above 4. That is the path Pugsy is taking you on...to the settings that are best for you

[Grlnxdor35]

Yes, I slept one night...when I had it on the APAP setting...which would have been night #2 and set it 4 min to 20 max....and it was no bueno. LOL. Last night I followed the directions from Pugsy to a T. I set it on the APAP A-flex setting. I made the min 10 and max 20. I set flex to 3 and this felt pretty good as I was settling down to sleep. I ended up waking up at about 2:30 AM. I was getting air leaks around my chin....little perpetual air leaks (funny farting noises) and no matter what I did ...reposition the mask, reposition myself / my head, tighten the lower strap on the mask, still the air leaks there continued...even though originally while settling down to sleep there was absolutely no leaks in this regard for a full 30 to 40 minutes. Not sure what that was all about. It was so annoying that I finally took off the mask for a few hours only to put it on again around 4:45ish when I semi woke up. I will upload my info this evening when I get home from work. Even with all the interruptions I woke up feeling pretty good. I use to wake up tense and nervous and anxious. With the machine I wake up feeling like I am not dead tired still, the brain fog I had seems much improved, and mostly I wake up feeling calm and not nervous, jittery, and anxious.

[Pugsy]

Do you by chance have any facial hair?
Did you wash your face right before you went to bed?

Not surprised you didn't do well with the 4 to 20 settings...most people don't especially when we already know they need probably at least a 10 cm starting point.

Let's see what the report shows...at least you got some sleep and likely would have got more with the mask if it hadn't been for the leaks.