Just Diagnosed / Encore Basic

[James-UK]

Hi,

I'm a 25 year old male and after a very long time of feeling rough and numerous blood tests I have finally found something which I'm hoping is causing my problems.

I had a home sleep study that was inconclusive due to my lack of sleep while wearing the device, after re-booking and having another home sleep study I
have just received my result. It says I have severe obstructive sleep apnea with an AHI of 57 and my lowest oxygen saturation was 74%.

I'm thinking about buying the System One REMstar 60 Auto CPAP System but I have no idea as to what mask to purchase?
I breath through my nose most of the time but I have chronic sinusitis and my nose randomly becomes blocked/irritated (this is with treatment,
before it was blocked/irritated 24/7) at which point I have to switch to mouth breathing. This is making me think a full face mask would be better.

As mentioned I had a home study and as a result I don't know my lower or upper pressure numbers, is this likely to cause any problems when using the above machine?
The company I had my study with states the lower pressure will be left at 4 and upper as 20, if these aren't known.

Lastly, I would also really appreciate it if someone could link me to encore basic. The cost of the machine and mask is going to hit my wallet quite hard, I also
have a feeling that I will not be happy with my first mask and may even need a humidifier.

Thanks for reading.

[DreamDiver]

Welcome!

I really like the Quattro FX Full Face in combination with the PapCap.
(Check my equipment profile.)

If you're self titrating with an auto, there's no point in starting at 4 (lower pressure) if you feel like you can't breathe properly. Start with a pressure that's comfortable enough to actually get air. I'd start around 6 or 7 if this were my machine. Others will follow with additional ideas and links on where to start.

Check your pm for the link.

[Pugsy]

Check your PM box for software information. At least it won't hurt your pocketbook.

When you look through all the mask choices...which ones look interesting enough to want to try?

I might be able to help...but need an idea what you want to try and what size.
Can you check out this link here and tell us what size you measure up for in the Mirage Quattro?
http://www.resmed.com/us/assets/html/ma ... lates.html
I might have a Quattro FX you can have but unsure of the size that I have or that you would need.

Also...please check out the nasal pillow masks available...if you can normally breathe through your nose just fine during the day you may do very well with the nasal pillow mask. Lots of people say it actually helps reduce congestion.
Worth a look and a try.

[DiverCTHunter]

First off, welcome aboard

I don't know how the mask purchase system works on your side of the pond, but there should be some version of the mask trial program where you're allowed to swap masks for little or no charge during the first three months.

As far as mask styles are concerned, I'd recommend starting with a nasal only, then move on to a hybrid or a full face mask.

[Julie]

I disagree about starting with a nasal mask - too many do and just end up with a FF anyway, if not 'taping' or a not-always-effective chinstrap. There are many FF options now so I don't see that you should have a problem finding one - Cpap.com has very good descriptions with enlarge-able pix in diff. views, plus reviews as well.

[DreamDiver]

I disagree about starting with a nasal mask - too many do and just end up with a FF anyway, if not 'taping' or a not-always-effective chinstrap. There are many FF options now so I don't see that you should have a problem finding one - Cpap.com has very good descriptions with enlarge-able pix in diff. views, plus reviews as well.

+1 Here, here!

[Pugsy]

If someone can normally breath just fine through their nose during the day and most of the night ...why jump immediately over to a full face mask for something that "might" happen later. It might not happen too.

I got a full face mask for one of those "might" situations long ago. It was a disaster...all night disaster.
I gave it away...and in over 4 years I have yet to experience any nasal congestion that I couldn't get cleared up enough to use my nasal pillows. I haven't missed the FFM one little second.

Newbies have enough to deal with than fighting a mask that even forum veterans have to fight from time to time.

Start with something relatively easy to use and see if there is even a problem warranting full face mask then worry about it.

[mellabella]

I have tried close to a dozen masks, but without knowing your face shape or more about the nature of your blockage, it will be tough to recommend anything specific.

The very best full face mask for me, given the angular planes of my face, has been the Mirage Quattro--lowest leak rates for full face. I thought that because my mouth parts open when i sleep, I was stuck with a full (or even total) face mask, but it turns out my tongue blockage is bad enough that it seals off my mouth from leaking air--so I've been able to use nasal pillows (I've also used a nasal prong mask, the Nasal Aire II, because it had no hard parts, but the frame on the pillow mask I have now--the Swift FX--is entirely soft silicone now and it's been great). Unfortunately, this is going to involve trial and error on your part. Some local sleep centers host "mask clinics," where a DME will bring in samples to try. Occasionally someone on the board will be willing to swap, or just get rid of, a mask they tried and just didn't work. You can also use CPAP.com's mask return insurance option as well.

[James-UK]

Thank you to everyone for the very warm welcome .

Welcome!

I really like the Quattro FX Full Face in combination with the PapCap.
(Check my equipment profile.)

If you're self titrating with an auto, there's no point in starting at 4 (lower pressure) if you feel like you can't breathe properly. Start with a pressure that's comfortable enough to actually get air. I'd start around 6 or 7 if this were my machine. Others will follow with additional ideas and links on where to start.

Check your pm for the link.

The ResMed Quattro FX has just been put on my list, along with the ResMed Swift FX.

I just watched a video on youtube that shows how to enter a hidden set up menu which allows the lower and upper pressure to be adjusted. So I'm happy I will at least be able to experiment and that the company settings aren't the ones I am permanently stuck with. Thank you for your help and for the pm.

Check your PM box for software information. At least it won't hurt your pocketbook.

When you look through all the mask choices...which ones look interesting enough to want to try?

I might be able to help...but need an idea what you want to try and what size.
Can you check out this link here and tell us what size you measure up for in the Mirage Quattro?
http://www.resmed.com/us/assets/html/ma ... lates.html
I might have a Quattro FX you can have but unsure of the size that I have or that you would need.

Also...please check out the nasal pillow masks available...if you can normally breathe through your nose just fine during the day you may do very well with the nasal pillow mask. Lots of people say it actually helps reduce congestion.
Worth a look and a try.

Before yesterday I hadn't actually looked at masks, I was convinced that my result would be normal. The ones available through the company that I'm
buying the machine from are very limited in terms of what is in stock. I then looked on eBay and found a couple of sellers from USA/Australia.

These are the ones I've looked at on international eBay:

Respironics FitLife Full Face Mask with Headgear
Respironics Comfort Gel Blue Nasal Mask
Respironics Easylife Nasal cpap Mask
ResMed Ultra MIrage Full Face CPAP Mask

It may sound strange due to it's very large size but I like the look of the Respironics FitLife Full Face Mask. I may just buy the Respironics FitLife Full Face Mask, ResMed Quattro FX and the ResMed Swift FX.
Hopefully one will work for me, plus I wouldn't want to order one and then have to order another before I can start treatment. This could potentially prevent me getting started for a month, due to overseas delivery times.

I'm unable to print currently but my plan is to gather all sizing pdfs and when visiting my dads on Monday print everything there.
The offer for the mask is incredibly generous of you, especially as I'm a new member but I really couldn't accept it. Thank you for the offer though as well as all your help .

First off, welcome aboard

I don't know how the mask purchase system works on your side of the pond, but there should be some version of the mask trial program where you're allowed to swap masks for little or no charge during the first three months.

As far as mask styles are concerned, I'd recommend starting with a nasal only, then move on to a hybrid or a full face mask.

The company I'm buying the machine from has a limited stock of masks. They do however offer a 30day trail period.
Sadly there aren't many other UK based mask sellers. Thanks for your input.

I disagree about starting with a nasal mask - too many do and just end up with a FF anyway, if not 'taping' or a not-always-effective chinstrap. There are many FF options now so I don't see that you should have a problem finding one - Cpap.com has very good descriptions with enlarge-able pix in diff. views, plus reviews as well.

I have tried close to a dozen masks, but without knowing your face shape or more about the nature of your blockage, it will be tough to recommend anything specific.

The very best full face mask for me, given the angular planes of my face, has been the Mirage Quattro--lowest leak rates for full face. I thought that because my mouth parts open when i sleep, I was stuck with a full (or even total) face mask, but it turns out my tongue blockage is bad enough that it seals off my mouth from leaking air--so I've been able to use nasal pillows (I've also used a nasal prong mask, the Nasal Aire II, because it had no hard parts, but the frame on the pillow mask I have now--the Swift FX--is entirely soft silicone now and it's been great). Unfortunately, this is going to involve trial and error on your part. Some local sleep centers host "mask clinics," where a DME will bring in samples to try. Occasionally someone on the board will be willing to swap, or just get rid of, a mask they tried and just didn't work. You can also use CPAP.com's mask return insurance option as well.

Nice cat Julie (I'm a cat lover ).
As mentioned above I have decided I will buy both types as some are recommending full face and others are recommending nasal pillows.

Thank you to everyone and again a big thank you to DreamDiver and Pugsy for software information.

[mellabella]

I actually ended up going from the Quattro to the FitLife total face mask once my pressure increased to the point that air was blowing out through my tear ducts (don't worry, you've got to get up pretty high before that happens!). It equalized the pressure and put an end to that. Some can't get it to work, but if it does for your face, it actually does have some advantages. I'd recommend mask insurance--and requesting a sizing guide first (or printing out the one available)--I ended up needing the XL--but with the L headgear.

[James-UK]

You must have had quite a surprise when that started happening. I've experienced it once for a couple of seconds when attempting to clear my ears (holding nose, mouth closed and blowing). I will be ordering the masks from an Australian eBay seller so sadly no insurance or returns if the masks don't fit. I plan to print out the guides tomorrow and thank you for mentioning headgear sizes I hadn't even thought about the possibility of needing a different sized mask and headgear.

Last night I recorded myself sleeping using an old Sony night vision camcorder, and I saw that my mouth was being used at times, because of this I will stick with full faces masks. I'm now hoping to buy the ResMed Mirage Liberty and the Respironics FitLife Full Face Mask.

I've done some reading and I'm concerned with pressure numbers. I have read that auto cpap machines using a full range (as mine will be: 4 - 20) can take longer to prevent sleep disturbances. The machine I plan to buy does allow the pressure numbers to be changed but I don't know how I will get those numbers. I then read that machines report the upper pressure for which a user required for 90% of their sleep. Could I then use that number (plus maybe 2) to set my upper pressure limit?

[Pugsy]

The machine I plan to buy does allow the pressure numbers to be changed but I don't know how I will get those numbers. I then read that machines report the upper pressure for which a user required for 90% of their sleep. Could I then use that number (plus maybe 2) to set my upper pressure limit?

It's not difficult to figure out the optimal pressure using the software available.
The minimum pressure is going to be your most critical pressure setting.
Here's an old thread that shows it really well and the basics are still the same.
viewtopic.php?f=1&t=39869&st=0&sk=t&sd=a
Set the minimum pressure optimally and the pressure will stabilize and often the 90% pressure is actually lower because the machine is doing a better job of preventing the airway collapse...so less pressure is needed.

[James-UK]

Thank you for your continued help Pugsy, I really would be lost without it.

I printed out some sizing guides and it seems a large FitLife Full Face Mask is too small but then it looks about right at other times. The ResMed Mirage Liberty
guide shows that I need a small but it's close, so close I'm concerned I will get the mask and wish I had gone for a larger size.

After the above experience I just wanted to find a full face mask that I can be sure would fit, I then checked the Mirage Quattro and surprisingly I need a small, I say this as I'm quite tall (6ft 2) and have a big bone structure, which includes a head and face that is in proportion. I've checked the guide many times and every time it reads as small.

So I've decided to buy the Mirage Quattro or Quattro FX from the same company I'm buying my machine, I will then be able to start treatment straight away. I do still want to buy the FitLife mask, I just need to make sure a large is too small and then I will import it as it's about 80GBP (120 USD) cheaper.

[James-UK]

My machine and mask arrived on Wednesday but I wasn't able to use the machine until Friday night, I got into bed about 3am and laid there for around 25minutes, I felt like the bridge of my nose was being squashed and when I moved the mask my bottom lip was then being compressed at the sides (when mouth breathing).

I had to mouth breath because the pressure on my nose was restricting my breathing, I readjusted the mask a number of times and then gave up. Once I removed the mask my left nostril was completely blocked for at least 20minutes. I then fell to sleep. Upon waking the first thing I did was order a FitLife mask.

Last night I tried using the machine and mask again. I got in bed about 2:30am and this time the mask felt much much better, my nose was perfect and I could breath fine. I was trying to get to sleep for about 20minutes and then I woke up at 4:50am, I actually didn't know if I had been to sleep and I was slightly confused. I then removed the mask due to my nose/breathing feeling strange and went back to sleep.

I looked at the machine data this morning and my AHI is 12. Here is a breakdown:



The time the machine was used is listed as 1hour and 25minutes. I was awake for about 20minutes.
As my average pressure was 9.2 and my 90% pressure was 14.3, I'm thinking about increasing my minimum pressure from 4 to 7, does this seem like a good number to start with?

[Pugsy]

I'm thinking about increasing my minimum pressure from 4 to 7, does this seem like a good number to start with?

Yes. For 2 reasons.
You likely need more pressure to better prevent the events and the pressure of 4 starting out often is a bit stifling. Just not enough air moving. So partly for comfort and partly because you likely will need a better head start on preventing the events than the 4 cm starting point will give.