pressure range questions

[Pugsy]

I started out the first few hours with the bleep mask. The water in the mask woke me up on one occasion which I ignored as a "tickle" and rolled over to go back to sleep but when it woke me a second time I went and put my N30 on. (I had a cozy on the bleep too and it wasn't enough. Problem for another day.)

Cozy on the short hose of the Bleep or a cozy on the Bleep itself????
A P10 barrel cozy can be modified to cover the Bleep barrel...I have done it.

Water in the barrel itself or elsewhere?

I know it is a problem for another day but should you opt for the Eclipse we have to at least be thinking about solving the problem.

[lynninnj]

I started out the first few hours with the bleep mask. The water in the mask woke me up on one occasion which I ignored as a "tickle" and rolled over to go back to sleep but when it woke me a second time I went and put my N30 on. (I had a cozy on the bleep too and it wasn't enough. Problem for another day.)

Cozy on the short hose of the Bleep or a cozy on the Bleep itself????
A P10 barrel cozy can be modified to cover the Bleep barrel...I have done it.

Water in the barrel itself or elsewhere?

I know it is a problem for another day but should you opt for the Eclipse we have to at least be thinking about solving the problem.

I am absolutely keeping my eye on the eclipse! I wish Stuart could solve that issue on his end. I don't have that problem with similarly sized N30 hose.

I used a sock to keep the hose cozy but did not extend it all the way up to my nose. (yes it was a clean sock! I just didn't go that high with it.

I will see if I can figure out a way to rig that up today. I have some fabric I could play with. Maybe give it another go tonight.

I didn't read up to see if there were more comments on the pressure range questions but hopefully there will be some way to figure out the best practices for me to have the optimal pressure range.

Thanks.

[lynninnj]

Maybe 3 real asleep centrals....probably sleep onset. Rest of the centrals are probably arousal related and to be ignored except that they point to a potential arousal or awakening.

First OA flag was the real deal and there was one other later that appeared to be asleep related. The rest of them are most likely arousal related.

Leaks aren't horrible but there does appear to be some increased leaks at a lot of times when there is evidence of arousal breathing. Which came first...don't know for sure. Not always easy to tell.

The machine at the current settings seems to be doing a great job.

Leaks could be causing arousals....they don't have to be big to disrupt sleep.

Thanks. I clicked on the notification first and then went back to see this post.

sometimes the nose itches. Because it has a soft cushion its easy to get in there and give it a scratch but it does cause leaks. I am sure as I hear them. sometimes that then requires pulling mask away from my face to reposition quickly.

Interestingly, there are virtually no leaks at all with the Bleep on.

I sometimes swallow or yawn kinda in my mouth to clear my ears and that likely changes pressure as well. I did that a fair bit last night and wonder if that triggers some sort of false flag? (mainly when I first laid down but not impossible I did it later maybe even after changing masks?)

So it looks like, to me, that the OA around the 12:30 mark as you said was prob the real deal, then the pressure goes up from the machine and maybe I experienced an arousal right around that time as well? Possibly followed by a yawn or gasp (leak increase)? It all happens between 1230-1231.

I try to make a concerted effort to breathe when I roll over and wonder what sort of imagery that produces on my chart. Pretty sure the early CAs were when I was still awake but not entirely sure.

I am learning a lot. Thanks!

[Pugsy]

I wish Stuart could solve that issue on his end. I don't have that problem with similarly sized N30 hose.

Stuart can't be expected to fix the rain out issue on his end. Too many variables in play.
The very first Bleep had a much shorter and less flexible hose but people bitched about that.
So you give them a longer more flexible hose and that increases the chances for rain out. Damned if you do and damned if you don't.

Don't forget also that our own breath contains moisture when we exhale so that gets added to the mix.
I know of people living in the high desert who don't even use a humidifier at all and they complain of rain out and that comes from their own breath and the temperature of the bedroom.

Cover as much of the Bleep hose as possible....even if you have to use 2 socks and be generous with the insulation.
Don't use a skinny sock....use a nice bulky warm sock or wrap some fleece around the entire Bleep hose.
I finally bought a "short" hose cozy from padacheek.com and even the longer short hose cozy doesn't quite cover all the hose but it does a good enough job that it doesn't seem to matter except for a tiny bit of condensation in the cushion part of the Bleep that attaches to the ports. That's my own exhaled breath doing that and if it should become a big enough annoyance I will add a barrel cozy but so far it hasn't been that big of a deal.

FWIW I think your pressure settings are just fine where they are right now.
You are still having general sleep quality issues and wake ups from various things that really don't have anything to do with the pressure settings themselves. Those need to be addressed first and then you can factor in the subjective feelings more in your determination of where your own "sweet spot" might be.

[Pugsy]

So it looks like, to me, that the OA around the 12:30 mark as you said was prob the real deal, then the pressure goes up from the machine and maybe I experienced an arousal right around that time as well? Possibly followed by a yawn or gasp (leak increase)? It all happens between 1230-1231.

Did you mean 11:30? I don't see anything at 12:30 but I do see the OA at 11:30 and you were asleep for sure and then you had a brief arousal like afterwards which corresponds with a recovery breath kind of thing. You probably don't remember any of it and that's really what we want....remembering a lot of arousals for any reason isn't good.
You are still having and remembering more arousals than we want but then you are still having various mask issues and/or rain out issues or whatever.....so that is to be expected. The goal would be to reduce those and it simply takes time and experience.

Now the 12:38 flagged OA....not so sure that is a real asleep event because of the big breaths just prior to the reduction in flow rate and flag. We don't normally take big breaths like that when we are asleep. If I see that sort of flag I put the event in the post arousal basket and shrug my shoulders and move on. The machine will still treat it as a "real" event though because it doesn't know any difference (and has no way to know) and you get a slight pressure increase.

[lynninnj]

Thanks Pughsy for the very informative and courteous response.

I think when I’m going to try to do is use some flexible athletic wrap to put around the barrel which is the only part that seem to have any liquid building up in it last night. Maybe just maybe a little bit of insulation will help keep it from rainout.

I’m also taking into consideration a prior posters comment about the problems associated with not having a vent so I want to be careful how I cover things up so that I can still breathe.

I believe you were right it was 1130 not 1230. Me and my fat fingers apologize.

This really has been an excellent learning experience. Maybe I’ll just take a Tylenol p.m. one of these days and see what happens. Maybe that will make it worse?

I am working on getting the personal stresses worked out to help with my sleep hygiene.

Thank you very much for all you do here!

[Pugsy]

I don't know what your hose air temp from the heated hose is set to but if you have some room to increase the heated hose air temp that is also an option. The idea being to get the hose air temp at the barrel level to be high enough to prevent condensation....along with the short hose cozy helping retain the warmth as well.
Sometimes all that is needed is maybe one degree more.

This is something I have battled for 13 years....sometimes I win and sometimes the rain out wins.
I don't really like breathing overly warm air but then I don't like getting cold showers from the rain out being sprayed out the vent holes either. I have to find a hose air warmth temp that I can halfway stand and use my preferred higher humidity setting and all the cozies to prevent rain out. It's a delicate balance.
Then add in winter time when I really prefer a cold bedroom.....that's why I have battled this for many years.
Heated hose helps (for my first few years on cpap there was no integrated heated hose) some but it isn't always a perfect solution for various reasons.

My own personal rule....if it wakes me up then I will usually try to fix it because anything that wakes us up is unwanted.
My sleep is already fragile enough and I don't need wake ups from something that maybe could be fixed if I put my mind to it.
If something doesn't wake me up and I sleep through it....I just don't care.
And I have years of experience to know that roughly 75% of any AHI that I see being reported is going to be arousal related flagging.
One time I had a really bad night in terms of sleep quality due to pain and my AHI was 9.4.....95% of those were arousal related. My OSA is well treated but my sleep quality often leaves a lot to be desired. Getting the good numbers is the easy part....now feeling those good numbers isn't so easy at all but usually from other stuff unrelated to the airway issues.

Your "real asleep" AHI is quite low already and now you just have to concentrate on getting more better/sounder sleep itself and unfortunately that is the hard part. Accept the fact that there will be some nights where you win the battle and sometimes you won't win the battle and your mind will thank you. Hopefully with time and experience the not so great nights will become smaller in number and your good nights will increase in number. You will get there...there will be bumps in the road at times....hell even now I have bumps in the road but they are not nearly as numerous as they used to be.

It's not about perfection so much as it is progression. We just don't sleep the same each night for various reasons.
This is why we look for patterns or trends long term and sort of throw out the weird outlier nights....like my 9.4 AHI night.

[lynninnj]

Thanks Pugsy for the well thought out reasoned and courteous reply.

The athletic tape that I used it very stretchy and it kind of sticks to itself rather easily. So I cut a couple squares and I wrapped it around the openings for the nasal hook up. Then I just pinch it and squeeze it to stick to itself. We’ll see how it holds up overnight. I’m hoping that’s just enough of an insulator to keep it from forming rain in the nose. after having an earwig in my nose cushion a few weeks back I’m very sensitive to things moving around in there including droplets of water! Very very unnerving!

Even though I used a thin insulated sock there was no water inside of the hose were covered up. Maybe I just need this little bit to work.

As is the practice I am going to try one variable at a time. I will try adjusting the hose tomorrow if I am unsuccessful tonight.

Thank you so much and I have to say I am feeling way better than I was before CPAP use but I just want to maximize my results as much as possible. It’s just too much at stake right now for me.

Stay wonderful.

[Pugsy]

When you do a better job insulating the short hose with a thicker sock then you stand a greater chance of the air in the hose not cooling down as much when it hits the barrel of the mask.
That's why I said a thick sock as opposed to a thin sock....More insulation will maybe keep the air warmer in the barrel of the mask....
So if the athletic tape doesn't do the trick....just try adding a thicker sock.

[lynninnj]

I will try this.

Now I have a new sd card that I hope is proper, I also gave the bleep barrels a new “poncho”. I also used athletic tape on ports and around top of hose where it sometimes winds up exposed to air if sock slides down.

Anyone know what temp the hose is when set on auto? some way to find out by looking at past data? this way i can turn up hose temp without feeling like I’m breathing hot air?

Not sure if I should set on 80 or wherever?

I laid on my back for about an hour with N30 right before getting up for day and first time I ever had moisture in there on auto hose temp setting.

[latskogkatt]

Anyone know what temp the hose is when set on auto? some way to find out by looking at past data? this way i can turn up hose temp without feeling like I’m breathing hot air?

I think setting it to auto makes it adjust the hose temperature based on the room air temperature, so it could potentially change throughout your time asleep... (and the auto setting for the humidifier would work likewise, if I'm guessing right.)

[lynninnj]

Anyone know what temp the hose is when set on auto? some way to find out by looking at past data? this way i can turn up hose temp without feeling like I’m breathing hot air?

I think setting it to auto makes it adjust the hose temperature based on the room air temperature, so it could potentially change throughout your time asleep... (and the auto setting for the humidifier would work likewise, if I'm guessing right.)

I’ve been keeping it pretty cold in there at night with the air conditioner on.

I don’t want to tweak too many variables at once. It may not be ideal to have the machine sensing the ambient Temperature. because that hasn’t worked so far with the bleep mask. I even had moisture in my n30 this morning after a short period of time.

[Pugsy]

Auto mode for hose air temp doesn't work out so great when the bedroom is very cool at all.
It just won't warm the air up enough to prevent condensation when the bedroom is on the very cool side.
I have this problem all the time due to cooler room temps and preferring lots of humidity....auto hose air just doesn't cut it.

Though I do think that the auto hose air temp is going to start out around 80 degrees or so.

[lynninnj]

Auto mode for hose air temp doesn't work out so great when the bedroom is very cool at all.
It just won't warm the air up enough to prevent condensation when the bedroom is on the very cool side.
I have this problem all the time due to cooler room temps and preferring lots of humidity....auto hose air just doesn't cut it.

Though I do think that the auto hose air temp is going to start out around 80 degrees or so.

So will turning it up to warmer temp make it more prone to condensation due to diff in temp?

Or would turning the temp down keep the condensation from forming?

[Pugsy]

So will turning it up to warmer temp make it more prone to condensation due to diff in temp?

Or would turning the temp down keep the condensation from forming?

Condensation happens when the air containing the moisture cools and can no longer hold onto the water.

Warmer air can hold more water than cooler air.

You need to increase the hose air temp when you want to prevent condensation.

The goal is to keep the air warmer when it leaves the heated hose section and travels up any short hose to the mask so that by the time the air gets to the mask it is still warm enough to hold onto the moisture it has in it and not release it because that's when you get condensation.

So when you warm up the heated hose temp then the air leaving the heated hose has a running start on hopefully being warm enough to not release the moisture as it cools down a bit.
This is why I was saying insulate the short hose with more insulating material and/or some sort of insulation around the mask itself. It will help the air retain more warmth which in turn lessens the chance of the air cooling to the point of releasing the moisture.