Starting over...suggestions?

[mozart]

Hi all -

I am starting over. I was diagnosed several years ago with OSA, used my CPAP for about a year and then fell off the wagon.

It was a really bad experience for me and I never felt like I slept better with it than without. I was tired either way. Either I was fighting everything going on with OSA or I was fighting with the mask all night long.

In December of last year, I decided that I wanted to try an oral appliance. So I had to redo my sleep study. I don't even remember what the numbers were, but the Dr. said they were slightly better than the previous study. I have no idea why.

Anyway, I know I'm tired. And I know I need to be treated. I'm having other pain issues and both my pain therapist and my pain management Dr. are insisting that I revisit y treatment now. I know they are right so I've decided to start over, from scratch, with the CPAP.

I still have my previous CPAP machine and mask. I checked them out and they both seem to be in good working order. However, I'm not sure if I'm happy with either of them. Again, I never really acclimated before so I'm thinking I should change things up a bit.

I'm trying to remember and figure out what my biggest obstacles to compliance were. First, I am a side sleeper and I turn over about 10 times a night. I also sometimes sleep on my back. I need a mask that is going to allow me some mobility. I get migraines from certain kids of pillow so the only type of pillow I've been able to sleep on that keeps my neck at the correct angle is a water pillow which allows me to sleep on both my side and back. Second, I had a somewhat traumatic event that resulted in me being awake on a ventilator for 24 hours, so I am not keen on anything that makes me feel like I can't breath. My initial pressure is set at 10 and I a pretty comfortable with that.

I tried using my machine the past two nights. The first night I do ok. I wore it about 6 hours. The second night, I woke up with the tip of my nose hurting and couldn't adjust my mask to make it not hurt so I took it off. I really want to try this again, but I don't know where to begin. I feel even more confused this time because I know so much more and I know what is ahead of me. The first time I just let everyone give me what they wanted. This time I want more control.

What do suggest? I plan to call my Dr. tomorrow and ask him to write me a script for a new mask and machine, but I want to tell him specifics.

Do you recommend that I stick with the same machine or change? Do you recommend I try a different mask to start with?

Thanks,
Michelle

[palerider]

the new respironics system one machines, and the resmed s9 machines are much nicer than the old m class machines.

I personally like the S9 autoset myself (model 36005), though the prs1 autos are nice too (model 560, I believe).

it's important to check the 'ref' numbers, especially on the phillips machines, becuase the naming is confusing and not at all clear, given that all the phillips machines look alike, and all the resmed machines look alike until you squint very closely

[Pugsy]

Which M series machine are you using? It isn't showing up in your profile equipment list because those discontinued machines' links are broken. If unsure...there's a 3 digit model number on a sticker on the bottom of the blower unit...tell us that 3 digit number and we can tell which model it is.

Are you generally happy with the Swift FX nasal pillow mask? Or if you are having issues with it...what are the issues?

I also use a water based bed pillow. I also have a bad neck and if I sleep weird I pay for it with a wicked headache...I am able to use any number of nasal pillows masks and I move around all over the place. The Swift FX was my main mask for a couple of years until some new nasal pillow masks came out.
It's a good mask that allows for a lot of tossing and turning in bed with the swivel hose.

[mozart]

Thanks for the info -
I'm using the Respironics REMstar M Series AUTO CPAP with A-Flex, SmartCard and Humidifier. I am not really happy with my mask. I seem to have to keep adjusting it and it the top presses into the tip of my nose and makes it sore. I'm going to try some different things tonight though to see if I can make it more comfortable.

-Michelle

[Pugsy]

Okay....I am familiar with the M Series Auto...that was my first machine. It is a full data machine but you would need a special card reader to get the data off the Smart Card. They are still available though.
For right now though let's just figure out a mask that might work better for you or see if we can improve on the Swift FX.

Read this please
http://maskarrayed.wordpress.com/swift- ... ing-guide/
and watch the fitting video
http://www.cpaplibrary.com/nasal-pillows.html

Nasal pillow masks shouldn't ever cause pain or abrasions on the nostrils...maybe very minor tenderness at the most.
When they cause significant pain then it is usually from the wrong size nasal pillow being used or the straps are too tight and with with the Swift FX....almost always that top strap. If you look in the mirror with the mask on and the first thing that goes through your mind is "piggy nose" then you have the straps too tight especially that top strap.

If you want to try a different nasal pillow mask you might look at the new AirFit P10 from ResMed.
https://www.cpap.com/productpage/resmed ... r-her.html

If you want to change to maybe a nasal cushion mask then you might look at the Swift FX Nano
https://www.cpap.com/productpage/resmed ... dgear.html
The nasal cushion will fit on your current Swift FX headgear but the new short hose that comes with the Nano is an improvement over the hose that came with the Swift FX nasal pillow...more swivel and more flexible so you might like it better.

Let's get you comfortable sleeping with the mask before worrying about data from this machine or getting you a different machine. There's a little bit of data on the LCD screen of your M series APAP anyway. Enough to get in the ball park. Did you know about seeing the AHI and leak rate on the LCD screen?

[mozart]

Thank you so much for your suggestions! Last night I loosened the straps and went up to the "S" sized pillows. It worked perfectly. I think I only woke up once and was able to fall right back to sleep. I slept all the way until my alarm this morning without taking off my mask. That may be a record for me. I'm not even sure I was doing that when I quit using my CPAP the last time. I'm hoping to have an equally amazing night tonight!

I'm sure my machine averages on the LCD are a little messed up because it's only been 3 nights, but so far:
90% Pressure: 11.4
System Leak: 30.3 (which seems in line with what the mask guide says it should be)
AHI: 3.3

-Michelle

[Pugsy]

Glad you had success last night.
The data off the LCD machine is well within acceptable ranges. AHI is acceptable and your leak rate is right in line with the masks expected vent rate so it's unlikely that you had any prolonged leaks which might compromise the data.
If you want to invest a little money in the smart card reader send me a private message but there is no rush at this moment. I can point you to where on the internet the DT3500 can be found for around $40 with a little more for S/H.
Software is free (I can help with that part).
Depends on if you are wanting to maybe go with a newer model machine at some time in the near future. If you think you might then I would hold off on the card reader.

Right now your main job is just to learn to sleep with the mask and last night was a really good start.
When fitted properly these masks should work out like you experienced last night.