General Questions from the Newbie

Hi, everyone!

Here's my third post. I've only been using my new machine for two nights now (gave up on my initial machine 5 years ago because it was utterly impossible for me to sleep). I have some general questions as I educate myself through this forum:

How often do you change your distilled water in the humidifier chamber?
How often do you REALLY clean your tubes, humidifier, nasal pillows, headgear, other?
Please explain the ramp feature. I just don't get it!
How many mouth breathers suffer from waking up from the startling air coming through their throats? Did your brain eventually adjust to this and keep your mouth closed?
How often do you replace any of your equipment? Nasal pillows? Tubes? Head gear?

Thanks!

Hi -

- I don't use humidifier enough to comment (someone else will)
- never clean the hose, use alcohol-free baby wipes on mask weekly and rinse afterward, headgear never (I have extras but straps last a long time)
- ramp - if your prescribed pressure settings are e.g. 7 and 11 (or whatever) and you don't use the ramp, the machine immediately starts out pumping air at 7 (your low setting). If you can't take the pressure all at once, you set the ramp to get to 7 in whatever span of time you decide from 5 to 45 mins - realizing of course that during that slow steady increase you're not being fully treated (at 7) but only at whatever increment the ramp is up to at a given minute prior to the eg. 10 minute setting - if you set the ramp for 10 mins, you have 10 mins of increasing pressure - until 7 (prescribed pressure) is reached, all of those minutes at a lesser than prescribed pressure. Unless we have quite a high (<15) pressure setting, most of us don't bother to use the ramp at all, just put on the mask and 'take' the initial blast (at e.g. 7), the effect of which quickly fades as we fall asleep (or much sooner usually).
- "How many mouth breathers suffer from waking up from the startling air coming through their throats?" I actually don't understand what you're asking... what you mean by waking up with 'startling' air coming thru their 'throats'. Do you mean out of their mouths? Could you clarify?
- Your brain is not really involved (except consciously) in keeping your mouth closed... you are (consciously), but really it's so much easier and much more reliable - once you're asleep you have no idea what's going on after all - to use FF masks, or tape, or at least soft cervical collars, etc.
- And as for replacements, being in Canada and not on your insurance system, we only replace stuff when necessary (and when our private insce. co's allow), but I know many if not most of your plans allow for replacement pillows, hoses, mask cushions etc. all the time (way, way more than ours and way more than we need), but if I lived there, I wouldn't accept more stuff than needed according to how fast it really wears out because all that (old/ex) stuff is going into a landfill somewhere... incredible waste!

OK?

Actually during ramp when using the 560 machine (which you have) and auto (apap) mode your machine will indeed increase the pressure (within prescribed settings) in response to apnea precursors.
Since you are using 4 cm starting point ramp can't really do anything for you though because the lowest the machine can go is 4 cm. Look in your other thread for what I suggest you try to help with exhale/inhale issues at 4 cm.
You might as well not even be using ramp because it can't do anything since your minimum pressure is already where ramp would start.

To answer your other questions...there's a wide range of responses and you just need to work out what works well for you.
Me personally...I don't clean my heated hose...I don't think it gets dirty and with the machine I use (it blows at a low volume for about 45 minutes after I turn it off to dry out the hose so I don't worry about moisture being a problem in the hose) I just don't see the need.
I don't change the distilled water daily either..I normally top it off nightly and maybe once a month I take it and dump the water and give it a good hot soapy wash and rinse.
My mask is the nasal pillow kind. I usually wash only the nasal pillows once every week or two. Headgear maybe once every 3 to 4 months if I think about it.

Replacement...I have always got months and months out of my nasal pillows...like 6 months or more.

Headgear...depends on the headgear.
Frame...usually they are indestructible and no real reason to replace silicone or plastic parts.
Hose...I have been using the same heated hose for about 3 years now. I do keep a spare of everything though because I have pets and I never know when they might decide to play with my mask or hose.

Mouth opening....is your mouth opening out of habit or nasal congestion?
If it is habit then the brain can learn a new habit of keeping the mouth closed but if you have nasal congestion issues and you can't clear the nose enough to breathe only through your nose then you have to use your mouth and that's a whole different story.
So...do you breathe through your nose primarily?

Here's a list of various threads and discussions about all sorts of common cpap questions.
viewtopic.php?t=17435

So for cleaning...if you are a germaphobe you probably would be happier with a cleaning schedule that is not as lax as mine...or if you are like me you might be happy with the least amount of work you can get by with. Now my immune system is healthy and I am rarely ever sick....if I had a compromised immune system or otherwise prone to all sorts of ailments then I would probably not be so lax with my cleaning.

Thank you both for these great answers. I'm surprised my 4.0 level is so low because I was diagnosed with severe sleep apnea. Any idea why they would set this so low or is this common for starting therapy?

Also, I breathe through my nose just fine, but naturally open my mouth when I fall asleep. Just what I do.

So basically, I'll just ignore the ramp and turn the darn machine on and not worry about the other settings. And I'll wash the nasal pillows and tubing as needed.

Thanks again. I just hope I can get used to this and that it won't take months.

One final thing: My nasal pillows fit great, but I notice my nostrils are tender. I guess this is normal for having foreign objects in my nose for hours?

I agree with Pugsy; cleaning is like sleep hygiene.
You do what you need to, whether it is for physical reasons or emotional ones.
Neither the clean freak or the slob should feel shame for whatever fits his/her needs.

Go to some place like WalMart and in the baby aisle is a product that breast feeding mom's use for nipple soreness...Lansinoh lanolin ointment/cream.
Use liberally during the day and a tiny dab on the nostrils at night.
It will help the tenderness caused by the nasal pillows.
Eventually you probably won't need it but for right now the nostrils are pretty much virgin territory and not used to having anything up against them. The Lansinoh will help.

Pressure needs have no relationship to severity of OSA.
A person can have really severe OSA (like 100 AHI) and maybe a pressure of 5 or 6 will totally take care of it and another person might have mild OSA (like 12 AHI) and need 20 cm.
It's all about how much pressure is needed to hold the airway open and not about how many times it tries to collapse.

Thanks! I didn't know about the lower pressure being suitable to someone with severe OSA like me. I'll trust that it's the appropriate setting.

And thanks for the recommendation for my nostrils. I'll pick some up when I'm at the store next!