Size DOES matter!

[PajamaGuy]

I’ve been a hosehead now for 41 nights. 100% compliance, every night, all night. There have been a handful of really good nights – but most were just o.k.

While I’m certainly no expert, I do believe I’ve found the 5 components necessary for successfully combating sleep apnea. My sleep testing indicated that I had an AHI of 63. After 41 nights of CPAP, my AHI is 3.1.
In decreasing order of importance, the 5 components are:

#1 – This forum. CPAPTalk.com – I didn’t even know how to spell “CPAP” 90 days ago. During a physical, my wife informed my doctor that she thought I had Sleep Apnea. I agreed to a test and being a techie-geek, after wearing a computerized headset with tubes stuck up my nose and having the damn thing say to me in a nagging woman’s voice, “Please adjust the headset, the headset is not adjusted properly… please adjust the headset…” – I decided to do a little web surfing. Here is where I met Pugsey and the rest of the HoseHeads. I firmly believe in reading (and contributing) user reviews – this is the place.

#2 – The MASK! “If it doesn’t fit – you will quit!” – If you get sore, continually have leaks, continually have to “adjust” it, tighten then loosen then tighten the straps, etc., and on and on…you will either cry, or give up, or both. Fortunately, my DME supplier understands that they will maximize their profits by maximizing my compliance and it is in their best interest to help me with the right equipment and the right configurations.

My first mask was a ResMed Quattro Fx, Full Face, size LARGE. I wanted it to work. It’s long story shortened, ResMed ships their masks with size-MEDIUM headgears. I think that caused the top straps to pull up instead of around – consequentially it constantly rode up and cut into my eyes, and I had strap marks for hours in the morning. After a week, I called SMS (my DME), and talked to Jane. After a thorough questioning, she recommended I try Respironic’s ComfortGel Blue Full Face mask. Since the Fx was large and I felt it not large enough, and because the ComfortGel is one which comes in Extra Large, I asked for the XL. Jane had it drop-shipped from Phillips by priority mail. BIG improvement!

But after a while I knew something just wasn’t right. To get it to seal correctly, it had to be positioned “just so”. And to keep the bridge of my nose from becoming very sore, I had to wear a Band-Aid. Again I called Jane and explained that I probably should have a LARGE mask, and not XL. She sent for one and I got it yesterday. Although it’s only been one night, I’m sure this is the mask for me.
Disclaimer – As Jane told me, with the Blue Gel, this mask is “heavier” – it may be, but I don’t notice it –my CPAP pressure runs at 15-16 cm, and the heavier gel provides a great seal.

#3 – The PILLOW! I prefer to sleep on my SIDE. And I change sides several times each night. Now when I roll over, my hand automatically reaches up and flips my hose. (My hose comes through my headboard.)
I started on my TempurPedic Contoured pillow, but it just wasn’t right for wearing a mask. I had to hang my face off the side to keep it from smushing the mask into my face. So I did the research, read the reviews, and bought the CPAPMax pillow (with the $30 kit). I love it. The accessory kit contains a pillow case (with hose-tie), a hose cover, and a jar of pre-moistened mask wipes. When we spent a week at my brother-in-law’s cottage in Vt., there was no headboard, but the pillowcase tether held my hose just fine!
I tried it without the ¾” center insert, but it became too soft, and not thick enough. Now with its cutouts and contoured shape, I can sleep on either side with no pressure on my mask.

#4 – Noise – (or lack thereof) – At home, my CPAP machine sits on a stand and is about a foot below the surface of the mattress. I hardly hear it at all. While in Vt., the bedside night table was even with the mattress top, and was a solid wood surfaced table. I was able to hear what I’d been missing – BLOWER NOISE! Yes, it did bother my sleep. Note: The higher the pressure, the more the blower works, and the louder it is. My limits are between 10 and 20 cm., and my 90% is 15-16. Placing the machine on a heat-resistant fabric pad cut some of the noise, turning the machine 90 degrees angled the noise away.

#5 – The CPAP Machine & its features – I’m no expert – others here are. This item should maybe be higher on the list – I don’t know. I do like (in no particular order):

1. Ramp – A lot of folks who need higher pressures have trouble getting to sleep when the pressure is high. Having the ability to start at a low pressure, then “ramp” up to the prescribed pressure over a variable amount of time, ensures you get to sleep before the pressure comes up.

2. Humidifier – Especially if you sleep in an environment with lower humidity – being able to adjust the humidity of the air being blown really helps my comfort level.

3. Auto-CPAP (sometimes APAP) – Different breathing patterns at different times during the night cause Auto-CPAP machines to adjust the pressure as needed to supply the lowest pressure that will result in the lowest AHI.

4. A-Flex – At least my machine calls it A-Flex – It’s the ability of the machine to sense when you are switching-over from inhaling to exhaling, and in that instant reduce its blower pressure so that you don’t have to force the exhale. Mine has 3 different levels of reduced flow available, but I find the default level works just fine.

5. Data – A machine which cannot provide data to the user is called a “brick”. My machine has an SD card and records every breath, apnea, mask leak, snore, pressure, and just about everything else that occurs while it’s on. I have software that reads the data and gives me reports so I can get really confused until I read here how to interpret the numbers, charts, graphs, and statistics.

Sorry to ramble on, but I think if all the experts are correct in saying that untreated sleep apnea is dangerous to your health, then doing everything you can to get the lowest AHI is important – and that ain’t going to happen unless you’re comfortable. If your equipment doesn’t aid but actually detracts from you getting a good night’s sleep, call your SME and get it right.

[BasementDwellingGeek]

Attitude belongs in there someplace. Embracing your new "bff" is important too.