Newcomer to CPAP Challenges

[tim57]

I am brand new to the CPAP world and am scared @#%%@less wondering if I will ever sleep "normally" again!
I had a home sleep test for sleep apnea because suddenly I couldn't fall asleep anymore. I wake up just at the point of sleeping and my wife had always told me that I snored loudly, in fact I have been told that I snore loudly since I was 22, I am now 57. The test was by Watermark Medical: Overall AIH 6, Overall RDI 18 %, time<90% spO2 was 0.1%, Mean Spo2 94.5%, % time snoring > 30 dB was 12.0%
I hooked up the nasal piece and the first night was okay, I felt like I had some decent sleep, but after that night I got a terrible sinus infection and didn't use the machine for a week. Tonight I tried the machine again but I haven't slept yet, when I put the nasal piece on I either freak out due to the claustrophobia or I quit breathing even with the air flowing. Any ideas?
Also I can't sleep without the unit because I quit breathing and wake myself up.
thank you!
Tim57

[Pugsy]

Welcome to the forum.

Your "sinus" issues after the first night were likely related to humidity. Did you get a humidifier with your machine? If so at what setting did you use it?
Some people need more added moisture and some need less. If you started with a low setting....turn it up and if you started with a higher setting turn it down.
Google..."cpap rhinitis" and you will see what I mean.

What pressure do you use? Are you using the ramp?

Let's figure out exactly what machine you are using. The Respironics humidifier you have chosen in your profile hasn't been dispensed since 2007.
So..look on the bottom of the blower unit for a 3 digit number which might have DS or REF in front of it.
Tell us that model number and we can tell you exactly which model machine you are using. It's hard to know just from the words on the top of the machine.

Software...that's not for inside the machine but instead it's for using the machine to evaluate your therapy.
For Respironics machines that would be SLeepyHead or Respironics Encore. Again, tell us the model number so we can figure out if your machine can use either of those software programs.

It's most likely one of the newer PR System One 60 series machines but won't know till you tell us the model number.
Hopefully the model number will be 450 or higher so that you can use the software available.

Depending on which humidifier and which model...there are also some additional options available to help with nasal issues.

[zoocrewphoto]

I hooked up the nasal piece and the first night was okay, I felt like I had some decent sleep, but after that night I got a terrible sinus infection and didn't use the machine for a week. Tonight I tried the machine again but I haven't slept yet, when I put the nasal piece on I either freak out due to the claustrophobia or I quit breathing even with the air flowing. Any ideas?
Also I can't sleep without the unit because I quit breathing and wake myself up.
thank you!
Tim57

Do you know what your pressure settings are? And are you using the ramp feature?

Many times, auto machines are set with a starting pressure of 4 which is too low for a lot of people. We won't really suffocate, but it feels like it. Many equipment providers also set up the ramp to start at 4. If this is the situation for you, it may help to start it at 6 and see if that feels better for you.

[tim57]

Hi, I am trying to reply to Pugsy, who asked what type of machine I am using: I see an REF 560P number on the bottom of the machine. Also the sinus infection started I believe from being around folks that had colds, don't think it was machine related. I am using the ramp, but don't know how to set it or the humidity, I ran the first night with water and found myself suffocating but that may be related to humidity settings.
Tim

[Pugsy]

You have a model 560 machine.

The correct choice for it in the profile equipment menu would be
PR System One 60 Series Auto CPAP
the humidifier choice would be
PR System One 60 Series heated tube humidifier with heated tube (even if you don't have the option heated hose).

Go here and request the provider/clinical manual for your machine so that you can learn what your machine is capable of doing.
http://maskarrayed.wordpress.com/taming ... e-quattro/

The heated hose is optional. If you are unsure as to whether you have the heated hose or not. The heated hose has a black end where it attaches to the swivel connector on the humidifier.

Using the ramp starts the pressure out at 4 cm which is the lowest the machine will go and often it is why people complain of suffocation feeling. 4 cm won't let us suffocate but it sure feels like it.
It may have been the pressure and not humidifier settings.

[tim57]

The correct choice for it in the profile equipment menu would be
PR System One 60 Series Auto CPAP
the humidifier choice would be
PR System One 60 Series heated tube humidifier with heated tube (even if you don't have the option heated hose).

Pugsy,
thanks for the replies:On my machine I have four panel window that lights up with choices for Therapy, C Flex, Info and Set Up
When I go into set up I see: C Flex-set at 3, system-set at on, humidifier-set at 3, ramp time-set at 10 min, ramp start-set at 4.5, tubing type-set at 22, auto on, auto off, mask alert, humidifier led----these last 4 are all set at off, silent mode is on and language is english.
I don't see the option for the PR System or humidifier choice, maybe I don't need them?
Do other settings look reasonable, my fear is suffocation, while probably unreasonable, nonetheless it is still there.
thank you so much!
Tim57

[tim57]

You have a model 560 machine.

The correct choice for it in the profile equipment menu would be
PR System One 60 Series Auto CPAP
the humidifier choice would be
PR System One 60 Series heated tube humidifier with heated tube (even if you don't have the option heated hose).

Go here and request the provider/clinical manual for your machine so that you can learn what your machine is capable of doing.
http://maskarrayed.wordpress.com/taming ... e-quattro/

The heated hose is optional. If you are unsure as to whether you have the heated hose or not. The heated hose has a black end where it attaches to the swivel connector on the humidifier.

Using the ramp starts the pressure out at 4 cm which is the lowest the machine will go and often it is why people complain of suffocation feeling. 4 cm won't let us suffocate but it sure feels like it.
It may have been the pressure and not humidifier settings.

I couldn't find the manual for my machine at the maskarrayed.com page but would this be the correct manual: http://www.apria.com/wps/wcm/connect/30 ... OD=AJPERES

[Pugsy]

First thing I would look at for the suffocation feeling is the ramp starting pressure of 4.5.
You don't have to use the ramp feature if you don't want to or feel you need it. While some people are okay with the low pressures the majority of people will feel better with a starting pressure of at least 6.0 cm.

You don't have the heated hose if the tube size is 22 mm. The machine would sense the heated hose and automatically make the hose selection if you had it.
A setting of 3 with non heated hose is pretty much middle of the road in the "new system one humidification" mode which is the default for this machine when heated hose is not used.
The heated hose option requires a special lid to the humidifier as well as a special power supply. You may or may not have the lid or power supply but most likely don't. You can check for the power supply by looking at the brick...60 watts vs 80 watts. 80 watts is needed to use the heated hose.
At this point you may not even need it though.
Are you getting any condensation in the mask or hose? If so, where at?
Without the heated hose you have minimal choices for humidification...this default mode and Classic mode which increases moisture delivered. Doesn't sound like you need more moisture at this point.

Use the machine while awake while reading or watching TV to help you get used to and past that suffocation feeling.
While awake and not trying to sleep we are in better control and things aren't so scarey.
Consider turning the ramp off or increasing the ramp starting pressure to help with the suffocation feeling.

[Pugsy]

Crap....my copied link didn't work and I didn't catch it. Got you the wrong link. Sorry about that. There are no manuals at the maskarrayed site.

Go here and request the provider manual
http://www.apneaboard.com/adjust-cpap-p ... tup-manual

The link you found at the apria site is for the user manual (not clinical/provider manual) for the 50 series machine and while it is very similar....the 60 series manuals have the additional information about the heated hose.
Also the provider manual has more information than the user manual about some features.

[tim57]

I went into the clinician's menu on my machine and set the following: I changed auto min from 4.5 to 6.0, I presume that will keep the lowest pressure at 6.0, I also changed initial ramp pressure from 4.5 to 6.0.
Will try sitting in front of the tv with the mask on to see if that helps the paranoia.
thank you,