One week's treatment results

[mrCanoehead]

48 year old male, BMI 27, neck circumference 17.25" Side sleeper. Strongly deviated nasal septum, although I'm told it is not important.

Had a polysomnography study in early December, obstructive sleep apnea (moderate), 24 AHI, oxygen sat went down to 86%. Was prescribed a trial CPAP for a few months, which I have used for a week now.

The reports are coming back between AHI 0.16 and 1.23, which I am taking as optimal.

1. The highest AHI night was last night (Sat night), as shown in screenshot. I am attributing the higher number of events to the two beers I had. I guess it's way below the 5 AHI threshold, so I don't have to consider giving up alcohol?
2. If I have marks on my face in the morning from the mask retention system, should I back off the tension? I tightened them because I was getting large leaks.
3. The mask I have directs air straight ahead of my face and it blows on my wife. Any suggestions for a mask that directs the air at +/- 45 degrees or some other direction? I require a full face mask due to mouth breathing.
4. I think the doctor directed me to a shop that he has a financial interest in, because it is right next door to his clinic. Should I demand to pay no more than what the government will subsidize for my machine? Should I buy the supplies online, and where (Ontario Canada)?
5. Would appreciate any comments on the graphs. The first is "two beers" the second is "typical".

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[Pugsy]

Welcome to the forum.

Read this thread for information on how OHIP does things in Ontario.
viewtopic/t174596/Just-got-diagnosed-fo ... eight.html

For marks on the face from straps...consider making or buying some strap pads
https://www.padacheek.com/
Above link will give you some ideas on how to maybe make your own if you are handy like that.
Often the dents are related to having the straps too tight but sometimes it's just the way our skin does things even if the traps aren't tight at all. I get dents in my cheeks even with strap pads but they are small dents compared to what I would get if I didn't wear the pads and I wear my headgear extremely loose. My skin is just the kind of skin that if I sleep on a wrinkle in the pillow case I get a dent/scar from the wrinkle.

[Pugsy]

For the venting annoyance...look at masks with more diffused venting.

The P10 nasal pillow mask that I use....I have to put my hand about an inch from it to feel the air being vented.
See the link in my equipment profile. It's silent and you won't feel the venting and even more important...won't annoy the wife.

F & P also has a couple of diffused vented masks....The Brevida and Pilairo...they have optional diffusers you can clip on.

[mrCanoehead]

Thanks Pugsy. I like the mask (Philips Respironics DreamWear Full Face CPAP Mask). I was thinking of putting duct tape over the centre vents and drilling holes at +/- 45 degrees with a Dremel?

[Pugsy]

You have chosen the wrong mask in your equipment menu if you are using the DreamWear Full Face.
Right now you are showing the DreamWear Nasal mask....not the same thing as the full face version.

Do NOT block those vents with tape and go screwing with making your own vent holes. That's potentially dangerous. You need adequate venting of your own exhaled carbon dioxide so that you don't die.

Now you could maybe cover the vent hole with a bit of gauze (like 1 layer) to diffuse the air flow and not restrict the venting.
It's difficult to find something to stick to the mask though.

ResMed's AirFit F30 is supposedly less annoying with the venting....I have never tried it myself.
https://www.cpap.com/productpage/resmed ... k-headgear

How come the full face mask? Is your nose chronically congested so that you can't ever get it open well enough to just breathe through your nose? Unless you have a major issue with chronic nasal congestion I would suggest going with a nasal mask...less straps and less venting annoyance with those masks.

[D.H.]

From what I was able to google, the plan pays 75% of the price and you pay 25%. The approved price is up to CDN$1,020.00. This should just about cover the price of most APAPs assuming that the price is no higher than the U.S. price (after adjusting for the exchange rate).

If this is not within you means, there might be additional assistance available. There is also special coverage for extra expenses that might be incurred in remote areas of the provence.

Link ===> https://www.ontario.ca/page/assistive-devices-program

[mrCanoehead]

You have chosen the wrong mask in your equipment menu if you are using the DreamWear Full Face.

My bad. Fixed.

Do NOT block those vents with tape and go screwing with making your own vent holes. That's potentially dangerous. You need adequate venting of your own exhaled carbon dioxide so that you don't die.

Was planning to use a drill bit of the same diameter as the factory holes and make the same number of new holes. But since I am a side sleeper, half the holes may be blocked at any time. So maybe it is a nonstarter.

ResMed's AirFit F30 is supposedly less annoying with the venting....I have never tried it myself.
https://www.cpap.com/productpage/resmed ... k-headgear

I will bring it up with the tech on Friday.

How come the full face mask? Is your nose chronically congested so that you can't ever get it open well enough to just breathe through your nose? Unless you have a major issue with chronic nasal congestion I would suggest going with a nasal mask...less straps and less venting annoyance with those masks.

I have no serious issues with nasal congestion but the air flow is restricted due to deviated nasal septum. I told the sleep tech I am a mouth breather at night so I thought I needed a full face mask otherwise air will come in through nose and go out through my mouth?

[mrCanoehead]

If this is not within you means, there might be additional assistance available. There is also special coverage for extra expenses that might be incurred in remote areas of the provence.

I have 50 000 problems but money ain't one. Don't want to pay more than I have to though.

[Pugsy]

I told the sleep tech I am a mouth breather so I thought I needed a full face mask otherwise air will come in through nose and go out through my mouth?

I was told the same thing...but there is nothing wrong with my nose and the mouth breathing I did was gasping for air due to the apnea events. Once I fixed the sleep apnea stuff the mouth breathing pretty much stopped...a little remaining "habit" that eventually went away.

Can you normally breathe through you nose just fine during the day and night?
If you can...no reason in the world you can't at least try a nasal interface mask of some sort.

[mrCanoehead]

Can you normally breathe through you nose just fine during the day and night?
If you can...no reason in the world you can't at least try a nasal interface mask of some sort.

No problem breathing through my nose during the day. At night, pillow becomes saturated with saliva so I inferred that I am a mouth breather while sleeping. I will ask sleep tech if I can try a nasal mask.

[Pugsy]

So you are a drooler...not necessarily a mouth breather.

Besides...not all mouth breathing equals a massive exodus of all your therapy pressure out your mouth. I have leak graph proof.
No time to go look it up though. Maybe later.

Get a nasal mask that has real diffused venting...trust me...much less annoying and even if you do open your mouth a little bit...not the end of the world.

[mrCanoehead]

Will do. I am hoping there will be a little less cleaning involved with a nasal mask. I was looking at cleaning machines that are approaching C$500, and they look quite big - would like to avoid.

[Pugsy]

Don't waste your money on those cleaning machines.
You still have to manually wash snot, slobber, facial oils off anything even if you use one of those sanitizing machines.
'Doesn't save you from that chore.

[raisedfist]

If you still want to use a FFM, you could try out the ResMed AirFit F20 or F30. They both use diffused venting and you can barely feel the air coming out of the front of the mask. Very quiet. I didn't have much luck comfort wise, so I use the F&P Simplus FFM...it fits my face the best, and is rather quiet, just not quite as quiet as the newer masks.

[Dog Slobber]

48 year old male, BMI 27, neck circumference 17.25" Side sleeper. Strongly deviated nasal septum, although I'm told it is not important.

Your deviated septum, might be important.

I had to have a septoplasty and turbinate reduction to tolerate CPAP.

The reports are coming back between AHI 0.16 and 1.23, which I am taking as optimal.

Pretty darn good, but not optimal yet.

Right now you're being titrated to discover your optimal pressure. The spread between your min and max is pretty high, and not optimal yet. The next step, in Ontario, is for them to order you a straight CPAP machine and set it to what they believe is your optimal pressure.

3. The mask I have directs air straight ahead of my face and it blows on my wife. Any suggestions for a mask that directs the air at +/- 45 degrees or some other direction? I require a full face mask due to mouth breathing.

As Pugsy suggested, try to get a mask with more defused venting. If it's still a problem, can you sleep on your other side, or switch sides of the bed?

4. I think the doctor directed me to a shop that he has a financial interest in, because it is right next door to his clinic. Should I demand to pay no more than what the government will subsidize for my machine?

I'm also in Ontario.

While using their loaner, during my titration they ordered my machine. They wanted to order me a straight CPAP machine, don't accept that one. Get a ResMed AirSense 10 AutoSet for Her. It's the one you're using now, even though it's an APAP machine, it qualifies as a CPAP. See the topic Pugsy directed you to.

The bill had the price of the machine after the OHIP / ADP reduction, plus other incidentals. I then submitted the bill to my insurance where they covered 85%.

Should I buy the supplies online, and where (Ontario Canada)?

I buy all my supplies online at CPAP Outlet (cpapoutlet.ca). They're in Markham, quick delivery and competitively priced.