Starter happily on board!

[BassDriver]

Hi all

This forum seems very active with lots of warm supportive people and I will accept and thank any opinion.

I am a CPAP starter - experimenting through the maze of getting friends with CPAP.

I went through sleeping evaluation procedure and got results that you may assist to analyze-
Could anyone contribute this post as I am lost in the depth of knowledge - will be highly estimated.

Recorded feagures:
Age 42, Male, BMI 28.3, Diabities type II.
- Sleep time ~5 hours. - Sleeping Efficiency - 71%. - 64 full breath stops. - 22 partial breath stops. - Total average stops 17 per hour.
- 59% sonring during sleep time

I was suggested to try CPAP. The technician gave me auto machine (can't remember manufacturer) and classical mask.
First night was OK - mask interupted but I could sleep - my wife complained about the residual air interrupting her. On morning I felt much more refreshed than ordinary night.
Second night was same third night I took it off.
A day after, the technician analyzed the figures and said that the device lowered the breath stops to average of 10-11 per hour.
He gave me fixed pressure device set to 11 cm and mirage swift mask. I used the ramp feature - but the pressure seemed to high and leaks came out of mask - I couldn't use it and gave it back day after to the technician.
Today I visited a neurological doctor specializing in sleeping disorder. He highly recommended to try again CPAP, and this time, invest more time and efforts in matching the pressure and mask to my personal needs.
I am now waiting for a visit with the technician.

What should I do? What kind of machine and mask would you suggest? How should I use it and what to expect?
What are the considerations I need to make in terms of daily usage and what measurements can be taken to track CPAP efficiancy?

Thanks in advance for your kind assistance
And have a great and happy new year!

R. B. (Tel-Aviv Israel - that's why my English is not that sharp..)

[Slinky]

Your English is a whole lot better than my Hebrew!!!

Full breath stops = apenas (you had 64)
Partial breath stops = hypopneas (you had 22)
AI = number of apneas you experienced PER HOUR
HI = number of hypopneas you experienced PER HOUR
AHI = combined number of apneas and hypopnease you experienced PER HOUR (yours was 17) You want this lowered to 5.0 OR LESS
Titration = determining the pressure needed to eliminate or at least drastically control your apneas and hypopneas.

Your neurologist is CORRECT and we're glad to see that you're willing to do as he suggests and will try CPAP again! You will be glad too once we can help you master the "art" of sleeping w/CPAP!

You are going to want and insist upon a fully data capable auto PAP (APAP). I happen to prefer the Resmed brand, not because they necessarily provide better therapy but because theirs is the easiest to access the most data via the LCD screen than any of the other brands. On the other hand, the Respironics brand does have a software particularly for patients whereas w/the Resmeds their software is intended only for professionals. Of course, we can get the professional version of both software if we really want them. We're an innovative bunch of patients. I would strongly suggest that you also get an integrated heated humidifier w/your APAP.

Ask the provider of your equipment if you can at least try a full face mask, a nasal cushion mask AND a nasal pillows mask before deciding on one or the other. The new Resmed Swift LT seems to be fairly popular nasal pillows mask right now. I wouldn't even consider the original Swift or the Swift II.

We really can't be a whole lot of assistance to you until we know what brand and model of APAP you get and which mask so when you get your equipment post it here. In fact, when you get your equipment, go back into the Control Panel at the top of the page, then into your Profile and add your brand and model of APAP, mask and humidifier (text version is best). That way you won't have to constantly repeat them in each post and/or we won't have to ask in each post.

When you do get your APAP and mask, try just sitting down during the day or in the early evening w/your mask on and APAP turned on and just read a book or magazine, watch TV, work a jigsaw or crossword puzzle, anything to occupy your mind and distract you from dwelling on "I've got to get to sleep!". That will help you get used to having the mask and feeling the pressure so that you don't remove your mask during the night whilst asleep. (There were several times I woke up during the night, took my mask off to go to the bathroom, went back to bed, promised myself I would put my mask on "in a minute" - and woke up the next morning w/no mask on)

Good luck and welcome to the forum. We'll get you acclimated to sleeping w/APAP if you just hang w/us.

[sleepycarol]

Welcome to the forum!! Glad you found us!!

Slinky's comments are excellent and she has lots to share.

Instead of a Resmed brand machine, I have an M series Apap with c-flex. I love my machine and wouldn't sleep without it now. Recently we had a power outage and I don't have any battery back-up. We were without power for approximately 5 to 6 hours in the night. Let me tell you I didn't sleep worth a hoot!!!

You too can become so used to your machine you can't imagine sleeping without it -- let us help you in that transition.

[BassDriver]

Thank you slinky and sleepycarol

I'll grab a new device and mask and let you know.
I can't wait untill I'll use this machine to sleep better.
Enjoy the weekend!

[RipVW]

Hello & Welcome, BassDriver! Glad you found this forum--SO much useful info and SO many helpful people here! Great to have you with us!

cpaptalk.com save my life with all of the helpful advice. My first year of CPAP was a disaster, then I found this forum, got my auto machine, and all has been great ever since. Good luck!

"You are getting sleepy . . ."

[BassDriver]

Thank you so much!

Questions-
1. Why is it preffered to take an auto machine rather than fixed pressure?
2. What is the benefit of using humidifier?
3. I had problems using temporary fixed pressure machine (set to 11cm) with Swift mask.
Will auto CPAP with EPR and Swift LT do better?

Many many thanks!

[GumbyCT]

Thank you so much!

Questions-
1. Why is it preffered to take an auto machine rather than fixed pressure?
2. What is the benefit of using humidifier?
3. I had problems using temporary fixed pressure machine (set to 11cm) with Swift mask.
Will auto CPAP with EPR and Swift LT do better?

Many many thanks!

Q1 & 3 may be related. One of the many benefits of APAP's is that you can have a lower pressure until you finally need it - then it automatically raises to help with the obstruction or other event. This can provide much relief to the new user. APAP's also will have data capability and can be set to straight CPAP if needed.

In General, an auto (APAP) is a much more flexible and useful machine.

A humidifier will help to keep your airway from drying out due to high winds.

[BassDriver]

Thank you for your kind reply.

Is it possible that after using APAP I will discover that I sould use more or less stable pressure and no longer have usage for the APAP?
Will I need to change to fixd pressure CPAP (P.S. what is the term for such machine?)

Thanks

[CorgiGirl]

Thank you for your kind reply.

Is it possible that after using APAP I will discover that I sould use more or less stable pressure and no longer have usage for the APAP?
Will I need to change to fixd pressure CPAP (P.S. what is the term for such machine?)

Thanks

Welcome, BassDriver!

One of the reasons many of us recommend APAPs so strongly is the flexibility of the machine. They can run in auto mode or in fixed CPAP mode if you find that's better for you.

My husband and I both have APAPs and have taken to putting a small pillow standing up between us to block the exhaust flow from our masks. It works pretty well, most of the time....

Hang in there. Finding the right mask is most of the battle, in my opinion. I went through 8 of them before finding the one that works for me.

[rested gal]

Welcome to the message board, BassDriver!

Your English is very, very good.

You are in luck! In addition to the people who have already responded and are giving you good advice, another member of cpaptalk is a very smart, helpful woman who lives in Israel. Her message board nickname is ozij. I'll bet she will be able to help you, too, when she sees your post.

You mentioned, "my wife complained about the residual air interrupting her" ...

There is a mask that has the vent located so that the exhaust air will not blow against your wife. The "Headrest nasal pilows" mask made by Aeiomed has the exhaust vent placed up above your eyebrows. The exhaust points straight up -- like a little chimney. The venting air won't hit your wife, or your arm, or your head pillow, or the bed covers. The Headrest mask looks very bulky and heavy in pictures, but it's actually very lightweight.

ozij has the Headrest mask. She can explain more about it to you. She's also very knowledgable about the machines.

[ozij]

Hi, RB
Welcome to the board. (On edit I see Rested Gal has posted a minute befor me... she's a wonderful source of information - I don't what I would have done without the things I learned from her almost 4 years ago..

There is a chance you will discover you prefer a fixed pressure machine, but there is also a chance you will discovery you do better when the machine can do some pressure adjusting. An auto will cost more - but can serve you at fixed pressure too.

There are many many kinds of masks - I eventually ordered mine from the US to Israel, and have been using the same kind for more than 3 years - I believe they still don't sell it in Israel. The mask I use - the Aeiomed Headrest has the vents pointing directly upwards - no way you can bother your bed partners with it.

10-11 events an hour is not good enough. With software to monitor you result you'll be better able to get better results.

A few tips from the people who have slept with the system:
Consider letting the hose dangle towards you from above - that helped me a lot, A humidifier is necessary for most people - probably less so in mid- summer in Tel-Aviv - but it helps more people that in bothers, even where the climate is humid.

For the majority of masks - maybe all of them - the headgear does not have to be very tight.

You aim should be to use the machine and mask every time you sleep. That means: each night, all night long, and when you take naps as well. Without it, you get choked - almost every 3 minutes according to your data - and that is bad for you health. Many of us could not achieve this, the first few weeks, but that's the aim - we got there eventually.

Happy Hanukka and Shabbat Shalom from Jerusalem.

O.
P.S. do you realize that your diabetes may have been caused by sleep apnea?

[rested gal]

Consider letting the hose dangle towards you from above - that helped me a lot

R. B., here's a link to topics where you can get a lot of ideas about how to hang the main air hose up out of the way:

LINKS to Hose hangers and methods of managing the air hose
viewtopic.php?t=10640

[BassDriver]

Thanks rested gal

And Happy Hanukah ozij!

As a matter of fact - I live not far from you - Shoham!

Usefull information both of you given.

I now need to select the gear - Not that easy taking into account that in Israel many players in the field and all have Shekels interests (seems that clinics and doctors in it too..)

Would you recommend on trying the machine/buying strait from the importing company or an internet site? how important is the need for long term service?

And I need to make some testings to find the best suit for myself - I assume after reading that it may be either S8 Spirit or Respironics Remstar M. Both are mostly common here. Humidifier would probably boost the experience. Mask - ozij - could I consult with you regarding that? Also many players here-
Swift LT is highly recommended by many users but as I wrote above - interuppted my better half..

Have a great weekend!

[ozij]

I got my machine in Israel through one of the companies that work with the sleep lab - and was glad I did, because when it broke down (within warranty) I had a replacement within 24 hours - without paying anything. I would get a backup machine on the Internet - you can import it to Israel without taxes. I could have gotten my machine in the states - was about to travel there at the time, I used that as part of my bargaining with the supplier, and I used cpap.com's price list for bargaining purposes about the other equipment too. Once you have a functioning machine, it doesn't need service (unless it breaks), you only need supplies. If you travel to the states - or know someone who does - you can have the supplies sent to a US address and brought back. My insurance (Clalit) pays for a mask once in 5 years (!) and the price difference between here and there is termendous.

You have to be more specific about the model details - The names you mention are product lines - look at the companies' sites - http://www.resmed.com (choose international as the country) and http://www.respironics.eu (That eu for Europe)to get information about specific model names. Resmed and Respironics use different names for the same model in different countries. You should get a machine that reports AHI (also calle efficacy data). Beware of machine's that only report compliance. If you're still in contact with the lab and are thinking of an automatic machine, ask for some more trial time on the different types - their treatment algorithm is different and you may respond much better to one than to the other.

The agent who helped me get my machine was very nice and helpful. I know he moved from one company to another - I will send you his name in a private message (PM). Don't forgo (אל תוותר) software.

O.