KC's sleep study and therapy

[Thumper68]

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The more I study about this thing, the more questions I have. Is the humidifier needed/helpful?
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The humidifier is also a personal preference item. Some people don't use them, but the majority do use them.

[Pugsy]

Is the humidifier helpful or even needed? That all depends on what happens to your nasal mucosa once cpap air flows over them all night long.
For me it's mandatory because my nasal mucosa don't like getting all that air moving over them...they get dried out and give me some nasty allergy like responses...swelling, congestion, itching, sneezing, running, sinus pressure, etc.
Other people do better with less or even none added moisture. It's a highly individualize personal need and we never know what someone else will need.

Google "cpap rhinitis"...read up.

Most people will need at least a little bit of added moisture to be comfortable and keep the nasal mucosa happy and some people will need a lot of added moisture. I fall into the later category...my nose needs pretty much as much added moisture as the machine can provide.

I do always suggest at least having the humidifier available. Here in the US most cpap prescriptions will include "heated humidifier"...it's that common of a need.

The ResMed AirSense machines...have the humidifier built in. No need for a separate purchase and if it isn't needed it can simply just be turned off. Best of both worlds.

Will you be buying online or locally?
I have no idea how the prices might compare but you might check out secondwindcpap.com for machine choice. They will ship internationally without a hassle. Good people. You can trust them. Trusting your customs though...another story.

If you can tell me which masks you might have available locally (if that is what you are leaning towards) I can maybe help with pros and cons for them and give you a better idea what to expect.

I did one time send a box of masks to a guy in Romania but customs on your end delayed it for 2 months and picked through what I sent and stole the good stuff. He didn't get nearly what I sent and it took forever for him to get the box. I am sure that doesn't come as a big surprise to you. I was really pissed though. The guy really needed the stuff and had no money to buy it locally. He was using cpap 24/7 because of a neuro muscular disorder and was at death's door.

[KC1965]

Thank you all for the replies.

Will you be buying online or locally?

Still looking and haven't decided yet. I wanted to rent for a month, to try it, BUT: 1. just Philips available locally/nearby, no ResMed 2. they do not allow me to change the machine settings!

Found a good price (I think, compared with others in European Union) in Germany.

Grr, what a story about RO customs! I've also had some unpleasant encounters with our customs for deliveries from outside EU. Plus taxes. That's why I'm considering only EU for now.

[Pugsy]

About changing the settings....once you get your own machine they can't do a darn thing to you if you change something.
Or even during a rental trial.
It's easy to figure out the secret handshake to bypass them trying to lock you out.
Besides..what are they going to do to you anyway? All they can do is chew you out and slap your hands.

Respironics makes a nice machine. I started my own cpap therapy some 10 years ago with one...it can do a good job but the ResMed is better. It's more responsive but you can still get good therapy with Respironics...you just might have to use a little more baseline minimum pressure to get it done.

Example...on a Respironics apap machine I need a minimum of 10 cm to optimally hold my airway open.
With the ResMed machine I can get by with 7 cm minimum and it actually does a better job than the 10 cm of Respironics.
I can or could use the Respironics if I had to but while the difference isn't huge in terms of comfort....7 is more comfortable than 10 at the beginning of the night.

[KC1965]

For a nasal pillow mask...I suggest looking at
ResMed AirFit P10
ResMed Swift FX
F & P Brevida
Respironics DreamWear gel pillows

For a nasal cushion type of mask look at
DreamWear under the nose cushion (a plus with this one is you can use the gel pillows with the frame and headgear so actually 2 masks in one.
ResMed Swift FX Nano
ResMed N30i

come back here with specific questions if you have any about one of the masks.

Argh, so hard to decide!
Either ResMed AirFit P10 or ResMed Swift FX Nano.

I have a problem with my dried nostrils which makes me uncomfortable. Which of these two will not dry them even more?

And one more question. Is that QuickFit™ Elastic Headgear of the P10 suitable for all heads? No fasteners, nothing, just the elastic. I've read someone's review complaining it was too tight, with no possibility to adjust. Not that I have a big head but still wondering.

[Pugsy]

The P10 is indeed adjustable but not in the traditional way people tend to think about "adjustments".
Tension with the P10 on the pillows is accomplished by the separation between the 2 straps...the top strap and the bottom back strap.
Closer or further apart will affect the tension adjustment. I wore it with the top strap up on the high point of my head or crown and the back strap I put way down near the base of my skull. When/if that bottom back strap would try to slide up the back of my head I found that the pillows wouldn't stay in place very well and would sometimes slip out of my nose a bit when the back strap ended up being real close to the top strap.

I don't know which mask...the cushion Nano or the pillows would be gentler on the nasal mucosa. They both deliver the same amount of air up inside the nose.

Now if you want to try both and limit expenses....get the Nano and make a separate purchase of the nasal pillows that will fit the Swift FX Nano headgear. The Swift FX nasal pillows.
https://www.cpap.com/productpage/resmed ... sal-pillow
It will fit on the silicone part of the Nano headgear...I know because I have done it.

[KC1965]

Now if you want to try both and limit expenses....get the Nano and make a separate purchase of the nasal pillows that will fit the Swift FX Nano headgear. The Swift FX nasal pillows.
https://www.cpap.com/productpage/resmed ... sal-pillow
It will fit on the silicone part of the Nano headgear...I know because I have done it.

That's a great suggestion, thanks! Now to see where to buy the nasal pillows from.

[Pugsy]

Unless your head is really big...hat size of 7 3/4 or more...the regular P10 headgear should fit. And it does stretch out over time.
We used to have people but the mask on a basketball to get it to stretch out a little faster.

[Pugsy]

I don't know if you have access to any EBay sellers where you are at but if you do...EBay is a great source for masks parts.

[KC1965]

I don't know if you have access to any EBay sellers where you are at but if you do...EBay is a great source for masks parts.

Yes, I do have access to ebay in Europe, will look there.

[KC1965]

I've ordered my equipment, updated it in my signature.

I am so looking forward to receiving it and starting to use!

[KC1965]

First night on therapy: not too bad, but not very good either.

Good:
- very few events, AHI=0.59, pretty boring graphs I think. And most of the flagged events were while I was awake.

Bad:
- adapting to wearing a mask - but I think that's normal for the first night. The most disturbing thing is the venting;
- about 5 hours of sleep (0 to 5 am approx.);
- feeling tired in the morning;
- some aerophagia but relatively minor and tolerable.

Plans for the next night:
- reducing the max pressure to 10 or 12. I was on 6-20 (as per palerider's suggestion) but maximum that I've reached this night was 9.06;
- increasing the humidity level to at least 6. I was on 4 but my nostrils and throat felt a bit dry in the morning.

That's what I think now but any suggestions/comments are highly appreciated.

screenshot-20190226-080908.png (120 KiB) Viewed 5455 times

[palerider]

Plans for the next night:
- reducing the max pressure to 10 or 12. I was on 6-20 (as per palerider's suggestion) but maximum that I've reached this night was 9.06;

Then there's no reason, at all, to change the max pressure setting. All you'd be doing is preventing the machine from helping you some night in the future if you needed more pressure.

[KC1965]

Plans for the next night:
- reducing the max pressure to 10 or 12. I was on 6-20 (as per palerider's suggestion) but maximum that I've reached this night was 9.06;

Then there's no reason, at all, to change the max pressure setting. All you'd be doing is preventing the machine from helping you some night in the future if you needed more pressure.

That makes perfect sense and I've thought about it too.

I think I'm still in a denial stage Is it possible that I don't even have OSA with these results?

[KC1965]

2. Are the values for Evaluation Pulseoxymetric something to be worried about?

Lowest Desaturation [%] 67
Min. Saturation [%] 55

2) yes 67 is *really* bad, that may coincide with the longest recorded apnea of over 1 and a half minutes.

Longest Apnea = 1:41 min was at 0:02:56 while Lowest Desaturation was at 23:46:16.

How does that usually happen? I thought the apneas are causing desaturation, not the other way around. So, what was causing that lowest desaturation then? Probably some other apneas before it or... ?

What are other possible causes for O2 desaturation? (will also ask my physician - and google - about that).