CPAP user for 6 months

[iNeedis]

Hello All. I have been reading this forum for past few weeks and finally decided to create a post to get some input from experienced CPAP users.

So let me start with my story. I have been diagnosed with severe sleep apnea this past summer and finally got CPAP machine ( Resmed auto set 10 for her) 6 months ago. My sleep clinic doctor recommended me the Resmed F20 full face mask as I tend to have my mouth open while I sleep. I have no problems with the seal with this mask, I just have a problem with staying a sleep all night. I either wake up from aerophagia or from sleeping on my side and being woken up by drool breaking my seal on my mask. My pressure is set at 18.6 ( as prescribed by doctor) I have had many nights of good results although I can only
Count a handful of nights that I have actually slept all night without being woken up to this problems. I am now leaning towards a P10 nasal pillow mask as I won’t be drooling in a mask and could possibly eliminate the sharp pains from Aerophagia.

Can anyone give me recommendations to help my problem. I know when I do use the cpap machine I do feel better than I did before but I know it should be better. Should I switch the mode to AutoSet instead of cpap?

[Julie]

No point in switching to auto unless you have a set of pressures to enter once you switch - and the doctor usually prescribes what those are, except in so many cases they tell the DME (dealer) to just do default settings of 4 min. and 20 max (and we'll often suggest minor tweaks to those as most people find 4 hard to breathe at). But you're at quite a high Cpap setting - is there a reason it's so high (never mind the aerophagia!)? Because I would normally suggest going to auto, trying a min. of 6 and high of 20 and see how things go for a few days at least, but not knowing where the somewhat unusual setting you have came from, would not just advise the change until you find out. See if your doctor can explain the setting - why he chose it, etc. and come back to this thread with the news and then we'll advise if necessary.

[iNeedis]

Reason for my high pressure setting is because I had 70 events per hour when I did my sleep test. I guess they said they pressure setting is what works best for me but I only have discomfort with it.

[Pugsy]

Did you have a sleep study where they used the cpap to come up with the pressure setting?
Or did they just decide on 18 because your AHI was so high on the diagnostic sleep study?
If you didn't have a sleep study using the cpap machine that 18 cm might be simply too high.
The severity of the AHI doesn't dictate the pressures needed.
Some people might only have a nice mild AHI number of 13 and they might need 15 cm or more to hold the airway open and someone else with 60 AHI might only need 6 cm.

The high pressure is sure going to feed that old aerophagia monster though.

I would suggest switching to auto mode and reducing the pressure a bit and just see for sure how much pressure you might be needing. Might be enough lower to get rid of the aerophagia.

Besides...even if you do need higher pressures for part of the night you won't necessarily be using the higher pressures all night.
During REM stage sleep I might need 15 cm but REM is only about 20% of the night. The rest of the night I do really well with about 9 cm. Using auto mode I only go up to 15 at the times I need it. So much easier to deal with than what it would be if I used 15 all night just to take care of the REM stuff.

What I suggest is maybe auto mode...10 cm minimum 20 cm maximum and add in EPR set to 3.
Using EPR will help with the aerophagia no matter what pressure you end up needing.

Are you okay with changing things yourself? Do you know how?

As for changing to the P10...by all means give it a go but don't expect it alone to relieve the aerophagia issues.
The aerophagia is directly tied to the pressures used and not so much the mask used.

[Pugsy]

Oh...and get OSCAR so we can evaluate the reports to figure out what pressures you need.
If your machine doesn't have a SD card in it...get one because it must be in the machine during the night to have the detailed data you need to evaluate things.

Any generic SD card will work...32 GB or less. Actually 4 or 8 GB will work but they are hard to find and pricey.

OSCAR https://www.sleepfiles.com/OSCAR/
http://www.apneaboard.com/wiki/index.ph ... stallation
http://www.apneaboard.com/wiki/index.ph ... rpretation

viewtopic/t158560/How-to-post-images-for-review.html

[iNeedis]

Thank you Pugsy! I will give it a try to night. Just this past week I finally figured out how to change my clinical settings.

So I did a sleep test without cpap and then I did one with cpap and I guess they said 18.6 is my golden pressure. I disagree as it’s very uncomfortable and clearly not giving me a good nights sleep. Each time I call the cpap supply store to change my setting they say I need to get in touch with the doctor before changing any settting. So I went ahead and found out how to change my own settings for my own preferences. I don’t agree with doctors knowing what I need after one lousy cpap test I did with them for one night that I probably only slept 4 hours cause it was uncomfortable with all the wires, never mind the cpap mask on for the first time.

My EPR is on and on setting 3.

So I should go with auto set and minimum 10 maximum 20? Btw, what is auto set for her setting?

My

[Julie]

"what is auto set for her setting?" Not sure what you mean - the settings are not done according to machines...

[Pugsy]

So I should go with auto set and minimum 10 maximum 20? Btw, what is auto set for her setting?

Let give 10 minimum and 20 max with EPR set to 3 a try and see what happens both with your AHI and apnea events as well as the aerophagia issues. May need more minimum but we have two problems to try to address
1...find a minimum pressure that does a good job of preventing the airway from collapsing.
2...find a minimum and/or max that doesn't make the aerophagia worse.


The autoset for her setting is a different auto adjusting algorithm. It doesn't work so great when people need pressures over 12 cm so I don't think it is an option that would be worthwhile for you to try.

[iNeedis]

Any advice for the drooling part? Also, when I clean my hose, how do I get it to dry out properly before next use? I always clean my hose once a week early morning and by night it’s still a bit wet and causes a hissing noise from the water that’s still inside. It obviously goes away after a bit but it is annoying to deal with when trying to go to sleep on those nights.

I will try the OSCAR thing so I can post my sleep stats here.

[Pugsy]

Sorry. No tricks up my sleeve for the drooling thing. If I did I wouldn't wake up with slobber dried on the corners of my mouth or running down my chin. It's just something that happens.
Now for full face mask users I have heard of some people putting a little bit of some absorbent material inside the mask to absorb the moisture.
Also some people use mask liners as an absorbent....you can buy them or make one out of an old TShirt.
https://www.padacheek.com/mask-liners-full-face

For the not quite dry hose.....you don't have to wash once a week for one thing. Many of us rarely wash our hoses because we don't think they get dirty. Your choice but once a month is more than enough...only thing going through it is filtered air anyway.
One thing a lot of people have told me they do to get the last drops out of the hose is they do a little lassoing with it.
Take it outside and a few whirls around the head and let centrifugal force sling the water droplets out.
And/or hook the hose up to the machine and let some air blow through it for a few minutes.
A little extra preheating kind of thing.
Also after you do wash it....hang it outside to dry and not in the house. Many people hang the wet hose up in the bathroom to dry....the moistest place in the house.

[dataq1]

Hi, please check your private messages

[GrumpyHere]

By dataq1

Check your private messages.

by CChamp

Be careful about people sending you advice privately. This sometimes happens when a member is giving bad advice and doesn't want to be corrected by more knowledgeable members. Of course, the nice thing about advice given openly is that it can be reviewed by numerous members for validity. It's a type of peer-review process.

[zonker]

By dataq1

Check your private messages.

by CChamp

Be careful about people sending you advice privately. This sometimes happens when a member is giving bad advice and doesn't want to be corrected by more knowledgeable members. Of course, the nice thing about advice given openly is that it can be reviewed by numerous members for validity. It's a type of peer-review process.

again, +1

[Miss Emerita]

The more we share publicly, the more other people reading these threads can learn -- and not just the OP.

iNeedis, if your FFM is comfortable, I'd stick with it and try a bit of absorbent something to blot up saliva, as others have suggested. But if you really want to experiment with a nasal-pillow mask, you might try the ResMed P10. Be sure to get the fit pack, which has all three sizes of pillows.

It's very good that you're feeling somewhat better, and with your readiness to take charge of your treatment, I'm betting you'll feel better still before too long.

[dataq1]

iNeedis, if your FFM is comfortable, I'd stick with it and try a bit of absorbent something to blot up saliva too long.

I'd second that thought - (do what's comfortable and works). For myself I've been using a Fisher 431 for approximately ten years, mainly because I drop my jaw and this mask provides a "shelf" to support the chin. Supporting the chin helped to keep my mouth closed, and keeping my mouth closed largely eliminated drool. YMMV.