2 Days into Therapy and Min Presure is ruff..

[JonSnow]

ok so I am new to therapy. I saw when they delivered the machine the tech set it up as Min Pressure 4 and Max Pressure 14 which is what my doctor told me was my pressure. Problem Is when I put it on that its starts as 4 I feel like I can't breathe. Ok I know that i can breathe and I know I wont die because the machine is giving me air but i feel like I am taking deep breathes like not the way I would normally breathe. Is this something that I will get use to as time goes on? I assume I will need to get use to sleeping with my machine but jesus that 4 is ruff to start with. I was thinking of upping it to 5 but just wanted to have a general idea of what you guys/gals have has your min pressure.

Also I am getting severe irritation on my right nostril. Not sure if its just me getting use to the NP but its pretty raw. The tech set me up with the MED size I am going to change the size tonight and see if that does help but is this something I look forward to? Is this happening to other people with nose pillows?

[kaiasgram]

Jon, almost no one leaves their min pressure at 4 because of the issue you described -- feels like you're not getting enough air. It doesn't really matter that you know you're getting enough air, it's just too darn uncomfortable and distracting, and struggling with it doesn't promote relaxation > sleep.

A lot of people get some irritation when starting out with nasal pillows. Usually it's temporary. Is it your skin, or inside the nostril? It could be if you're using the wrong size pillow, trying a size smaller -- or even larger -- could solve the problem. I used a bit of pure grade lanolin (brand name Lansinoh) in the early weeks and was fine after that. Just use a very little bit. I've also heard some people do well using a water-based gel like Ayr.

To clarify: There is no S9 "Escape Autoset" model. Do you have the Escape Auto? The Escape Auto is a limited data machine (no AHI category breakdown and no leak data) Since you're early in your therapy you may want to consider pursuing a full treatment data machine -- in the S9 line, it would be the S9 Autoset.

[SunnyBeBe]

I am on day 10 of therapy and have been doing quite well, but I realized last night that the advice I got here about the size of the nasal pillow was the best. At my titration study, I was told I needed a size small nasal pillow. It seemed to work fine. The medical equipment rep said the same and that's what she gave me. She also gave me medium, just in case. I didn't seriously consider trying the medium, because I was doing so well, but when I had a sore nose and developed a pimple on my nostril, I figured I would try the medium since I had read here that using a LARGER size would help. The material I read from the company, said to use the smallest size possible, but that's not true, IMO.

Last night I slept great with the medium. It was super comfortable and a totally different experience. No discomfort at all. I'm so happy. I'm wondering why the professional material doesn't cover this and seems to give unhelpful advice.

[Janknitz]

Two of my blogposts will be helpful for you. See my signature below.

The first is "swift fx fitting tips". Different mask, same fitting technique.

Second, read "Help, I'm stuck with a brick!" Not only a brick, but an older model brick. The current ResMeds are S10's.

[SunnyBeBe]

Two of my blogposts will be helpful for you. See my signature below.

The first is "swift fx fitting tips". Different mask, same fitting technique.

Second, read "Help, I'm stuck with a brick!" Not only a brick, but an older model brick. The current ResMeds are S10's.

THANKS! Good information. I am learning to verify what I'm told about cpap, unless it comes from someone who actually deals with it first hand,

I'm just thrilled that I did try the medium pillow. Just think.....I might have gone on with that nonsense aggravating my nostril for no reason.

[yaconsult]

Yeah, 4 is not enough to be comfortable. We all need to monitor our results and tweak our setup as needed as we adjust to the therapy.

For example, I have severe apnea at 80 AHI. Though experimentation and the wonderful advice here, I have found that what works best for me is a minimum pressure of 13 as this is enough to stop most of my events. During the night, if necessary, my auto machine will go up as needed to treat events. I've seen it go as high as 17 or 18.

Luckily, my new sleep doctor is progressive and, while surprised that I knew so much about my treatment and that I looked at the data in detail, was fully supportive.

[RogerSC]

I didn't have any problem with nose soreness initially, but also had the low pressure problem. Since I didn't get enough sleep at my sleep study to do a titration, my sleep doctor took a stab at what I needed from my sleep study data, and had the DME set the machine at 4-10cm initially, with a 30 minute ramp. I felt like I wasn't getting enough air, so I moved it up to 6-10 pretty quickly, and got rid of the ramp. Getting rid of the ramp really helped with my comfort level too. So these are things to look at.

As far as nasal pillow mask irritation goes, be sure to catch the videos on youtube about fitting nasal pillow masks. Each mask manufacturer has videos there, and there are also people that make their own helpful videos about mask fitting. The key to fitting a nasal pillow mask (for me) aside from using the right size nasal pillows, is to have it as loose as possible to minimize leaks. You're never going to get rid of leaks, especially if you're a side sleeper like me and move around a lot when you're sleeping, but it's usually fairly easy to stay below the magic 24 L/min. red line (except for the odd spike above that). That's for ResMed, other cpap manufacturers measure leaks differently and don't subtract out the "resting" leak rate for masks, using an "absolute" leak rate.

After about 2+ years, I ended up with a range of 11-15cm, after slowly trying a whole bunch of different things, including straight cpap, and essentially moving the range up until my data looked like the pressure was able to go as high as the machine needed to push it, and I was getting the maximum amount of therapy. Been there for some time now, and things seem to be going well.

But initially, for comfort, I got rid of the ramp and moved the lowest part of my range up to my comfort level. That really helped. That and using Ambien for the first week. And earplugs, too. Still using earplugs, but not Ambien *smile*.