Self-Diagnosing, Looking for Min/Max Pressure Recommendations

[thomas5ever]

Hi,

I'm a 21 year old man from CA. I've been fit and relatively healthy my whole life, but I've always had problems with sleep. It always seemed to me that no matter how many hours I slept, I would always wake up tired. I always felt like I needed 9-10 hours just to function. Over the past couple years I've been paying closer attention to my health and habits and I noticed that I would always wake up with a dry, nasty throat, which apparently signifies that I'm sleeping with my mouth open at night. I tried mouth taping and couldn't get through the night because, for some reason, I can't breathe clearly through my nose all night. I started paying even closer attention and realized that my nose and throat close up as I get tired each night and I feel a congested from the nighttime until I wake up the following morning. I have experimented with different foods, different levels of humidity, nasal strips, dry mouth discs, and more, and I can't seem to breathe well through my nose at night. I have a deviated septum, but it's not too severe. As you might be able to see from my avatar, I tend to sleep on my stomach.

I feel confident that I have either OSA or UARS. I do not have health insurance and can't get a sleep study. A relative has shipped me an unopened ResMed S9 Autoset CPAP and it is arriving tomorrow. I am so excited to use it, given the small chance that I get lucky and it improves my sleep quality immediately. Included is the Pilairo Nasal Pillows & Mask, tubing, and a chin strap. I believe this is all I need to get started and I have an SD card to collect data.

My main question for you all, is what settings would be the safest to start out with for someone in my situation? What do you think is the best way to monitor my symptoms?

Thank you for any help!

[ChicagoGranny]

what settings would be the safest to start out with for someone in my situation?

Minimum pressure 6
Maximum pressure 20

What do you think is the best way to monitor my symptoms?

OSCAR - see announcements near top of index page

[LSAT]

Since you have already made up your mind to try the S9 Autoset....I would set it as follows:
Mode...AUTOSET
Minimum...5
Maximum...15
Ramp...OFF
EPR...ON.....2
Humidity...4
Mask...Pillow
Hose...Slimline/Standard

Some of these settings may already be on the machine when you get it...if not, make changes.

[ChicagoGranny]

As you might be able to see from my avatar, I tend to sleep on my stomach.

Oh, here is the optimal way to stomach-sleep ---> http://www.uarsrelief.com/sleeppositions.html

[slumberer]

I would recommend shopping for a home sleep study service. I did a brief search, and this seemed worth investigating:

https://lofta.com/products/sleep-apnea- ... fYQAvD_BwE

This will allow you to get a prescription so you can order supplies for your machine online though it seems you have a "family connection" that is willing to help you; however, a prescription gives you choice, especially when deciding on a mask interface, which is crucial for adapting to PAP therapy if that is what's needed. I have been using CPAP/APAP therapy successfully for the past fifteen years and I cannot stress this enough: find a mask that fits well and is comfortable. Also, it may not be Obstructive Sleep Apnea; there are two other candidates that need to be eliminated (central and "mixed").

That said, if you are using an APAP, it will provide data that you can use to see your AHI score and at what pressure (AHI = Apnea/Hypopnea Index More about that here: https://www.webmd.com/sleep-disorders/s ... per%20hour. When you see the distribution of "events" (apneas/hypopneas) within a pressure range envelope that will help you set your high and low pressures. As the machine is an APAP, it should automatically accommodate your needs. Here is another article you might find useful on this topic: https://www.cpap.com/blog/cpap-pressure-high-tell-fix/

Hopefully, this is a place to start. I imagine others more experienced and knowledgeable will soon offer advice. I remember when I was first diagnosed, this forum was indispensable at coaching me to ask the right questions and consider options I never thought to consider. I also remember reading a lot online. Needless to say, vet your sources and never take action based solely on what you find online or in these forums. Think of it as a repository of experience. Nothing will substitute for a medical diagnosis.

I hope this helps, and please feel free to reach out to anyone here for help, many of whom have much more experience than I do.


Todd

[Pugsy]

A word about the SD card and using the software available to monitor your therapy.

The S9 machine is the only machine that you need to write protect the SD card when you insert it into your computer. This is because some computer operating systems write a little text file to the SD card and while it hurts nothing the S9 machine doesn't want it there and the S9 will prompt you that the card is invalid and want to erase the card. Windows 8.0 and higher will do this and some Macs.
If you forget it isn't the end of the world because you have the data in your software but it is annoying. This pertains to some detailed data.

Also the S9 machine will overwrite some of the detailed data on the SD card after 1 week...so you need to download to software at least once a week. Some of the overwriting occurs after a week and some after 30 days...so we tell people to download at least once a week to cover all bases. This is specific to the S9 models...the newer models or other brands don't do this.

You are self diagnosing for now. Just looking for evidence to confirm some sort of sleep disordered breathing related to the airway.
Don't worry about treatment at the moment. You want to look to see if the pressure changes first of all because it won't change unless there is a need for it to change. You need to be asleep first and foremost...the machine can and will respond to awake breathing irregularities because it has no way to know if you are asleep or not. Awake stuff doesn't count so bear that in mind.

[Julie]

Someone above suggested using humidity at 4, but if you're like me and live in an already relatively humid (and I don't mean steamy like Fla.) location, e.g. Wash. state, NJ, etc. you might find it makes your congestion worse, so I'd try 2 first and see how things go - you can always raise it if necessary of course.

[Pugsy]

If someone lives in an already humid area it won't hurt to use the setting of 4. The machine simply won't use much, if any water, to keep the humidity level at 4 which on a ResMed machines is actually on the low side anyway.
These humidifiers now don't/won't add more moisture on top of ambient humidity if the ambient humidity is higher than what the setting is going to deliver.
Example...if ambient humidity is 85% and the setting of 4 will give 80%...it simply won't use any water. If ambient humidity is 70% and the setting of 4 gives 80% then very minimal water will be used because the machine will only want to deliver 80%.

Humidity settings or what the nasal mucosa might need to be happy....very much a YMMV thing because everyone is different.
I know husband and wives in the same house who prefer totally different humidity settings. One might want maximum and the other minimal to none...and we know that they are both starting out with the same ambient humidity whatever it might be.

[zonker]

what settings would be the safest to start out with for someone in my situation?

Minimum pressure 6
Maximum pressure 20

What do you think is the best way to monitor my symptoms?

OSCAR - see announcements near top of index page

oooohhhhh!!

[Miss Emerita]

When the machine arrives, try setting it up outside your bedroom and using it during the day or evening while you read or watch TV -- something pleasant and diverting. This will help you get used to the novel sensations. You might even want to do this for a couple of days before trying night-time use.

Fit your mask carefully while lying down in the position you normally sleep in. There are videos on line about how to fit specific masks, so take a look.

People definitely can self-diagnose and self-treat successfully. Do come back to this thread as you continue down your path. The most helpful thing will be for you to post a Daily chart once you get some time asleep on the machine.

[palerider]

I would recommend shopping for a home sleep study service.

Unnecessary expense since the OP is certain he has breathing problems during sleep, and already has a S9 Autoset.

Better to just work with what he has, which ends up being more informative than a sleep study.

[slumberer]

I think that is an excellent point. They're also going to upsell him a bunch of things he probably doesn't need.

[thomas5ever]

Hi everyone, I am typing wearing the CPAP right now. I live in a very dry area and often fight dry nostrils so I turned the humidity up to 4.5. I feel pretty congested right now but also felt congested before I put the CPAP on. The pressure currently sits at 5 and I feel a bit like I'm fighting for air. I feel like my exhales are somehow stunted. It's difficult to describe, but I may get used to it in time. I'm just not sure if this is the way it's supposed to feel. I've had it on for about 10 minutes and will try to keep it on for as long as I can. I still feel like I'm manually breathing and can't focus on something else too hard or I'll forget to take a breath. I'm also not sure where to put my tongue in my mouth.

Someone mentioned that I should turn the EPR on to 2. I've seen different opinions about the necessity of the EPR online. For my purposes, would you all suggest I leave it on or off?

Thank you all for your guidance so far!

[Julie]

Try the EPR at diff. levels and see what feels best for you... no one else can do that.

[Pugsy]

Set the minimum to 7 cm...EPR on full time and set it to 3 and see how you feel with your breathing.
Gotta get you comfortable breathing or you won't ever be able to fall asleep and without sleep the data the machine gathers is useless.
Turn ramp off if you have it on.