Yet another newbie with questions

OkyDoky wrote:I think it is probably good to increase your minimum pressure to 6 but you know you needed 16 last night and the machine will not go higher than what you need, I wouldn't limit the maximum to less than 16 until we can see what is happening with Sleepyhead. I know that pressure seems like a lot now but we do get use to it with time. Sometimes I have to pull on my mask to see if it is on.

The reason I would limit the max is that it's going higher than the mask can handle - it's not the air pressure that bothers me, it's the excess leakage of the mask as it is being blown slightly away from my face. I think if I truly need it to go that high I'm going to need a different mask, or maybe a smaller frame. But I don't think we can really know that until I start being able to go to sleep properly with the mask on. I can't be sure of course but I think that a bunch of the events it's recording are happening as I fall asleep; it feels like I stop breathing and get woken back up, and others have reported the same thing here. So I need to get past that and then see what the real situation is.

Here is my SleepyHead data - I hope I've done this correctly. Thanks in advance to anyone who takes the time to look at it!

http://imgur.com/a/RfhZQ

Dancers Need Sleep! wrote:The reason I would limit the max is that it's going higher than the mask can handle - it's not the air pressure that bothers me, it's the excess leakage of the mask as it is being blown slightly away from my face. I think if I truly need it to go that high I'm going to need a different mask, or maybe a smaller frame.

the dreamwear appears to be rated to 30cm, according to the pressure/vent chart in the back of the manual.

the leaks are so bad, that you're having apneas and the machine can't tell what kind they are, thus the UA section of the pie chart.... but you're still having events at the higher pressure,

as to your screenshot postings, remove the mask pressure chart (drag and drop) and then all you need to post is the first page, because it'll have everything that's normally useful on it. the rest of the charts while interesting, aren't usually helpful with what we're trying to do here.

Here's what I see on your screenshot. Most importantly leaks. For almost 28% of the time you had the machine on, the leaks were over the Red Line which means above 24L/Min. ResMed says it can detect your events up to that amount and it gets iffy up to 30L/Min. You were over that and the machine says something is happening but I can't tell what. That's why there are flags in the UA (Unidentified Apnea) category. Your pressure initially increased due to the cluster of obstructives and you are probably going to need a higher minimum pressure than 6, I would begin at 7, and the maximum is going to need to be enough to cover your events.
I haven't used a Dreamwear mask so I can't give any specific help there but you have to work on decreasing the leaks to get the pressure you need. Did you get the fit pack with the different cushion sizes? If so you might try a different size cushion. Also google Dreamwear mask fitting video and see if you can get any other suggestions.

I do not know if this suggestion is for you, but another thing I do is make a little pony tail between the two straps to help keep them from riding up or down.
Also, the frame fits me better when I don't use the cushions.

The best pillow masks are the p10 and the fx by Resmed, the mask you are using is a good one but for a newbie I would try the p10 for her.
The air defuser on the p10 mask does not blow on you eyes or bed partner and it comes with different pillows to try for fitting.
Good luck.

So, another update! For last night I made four changes to the machine settings:

- set min pressure to 6.0
- set max pressure to 14.0
- set mask type to Nasal (my husband, whose equipment is identical to mine, had his set this way when he got the machine)
- set tube temp to 85

I know I most likely need the pressure to go higher, but my thought is to try to make things comfortable enough to overcome my difficulties in getting to sleep, and then let it start ramping things up.

These changes helped in some ways and not in others. I was more comfortable, yet the mask still started leaking at about 10, so I didn't fully accomplish my goal. The air in the tube was not exactly warm, but this did take the edge off of it so it was more comfortable to breathe and when blowing on me.

Here's the SleepyHead report:

http://i.imgur.com/r0wjZ8U.png

(I did not actually go to bed at 3:00 am - the time zone is off and I can't figure out how to fix it)

The AHI is terrible, but what I find interesting is the distribution of the events. As far as I could tell, I did not sleep at all during this time. However, the last pressure increase I noticed was to 11, and it made it all the way up to 14, so i have a feeling I was at least lightly asleep at that point. And after a cluster of events right around that peak pressure time, there were only two further events and the machine gradually reduced pressure back to about 8. The last thing that happens is an obstructive event, which causes the pressure to tick up and is probably what woke me up. This seems like a clue that this could end up working ok if I can just get used to it and keep breathing through the transition from awake to asleep, which does not seem to be happening very well right now.

I've emailed my DME - I'm thinking we need a mask change of some sort at the very least. We'll see what happens. I did not get the fit pack with the mask so I can't try other sizes myself, although I did print out their sizing template and I'm pretty decisively in the small area. It's hard to see how a larger nose piece would seal better but hey, anything is possible. This is clearly an art as well as a science.

I went to see the DME guy today. He is on board with the changes I made to the machine configuration. He has ordered me a small frame for the DreamWear and in the meantime I have a Wisp mask, complete with elephant hose, to try. I can see how it would solve the leak problem but it looks less than awesome, that's for sure.

He says I may get over my trouble with going to sleep with the mask on, but if I don't then they will switch me to a BiPAP machine instead.

Somehow nothing is ever easy with me. My husband is fine on the first try; I will probably be tinkering with everything for months. *sigh*

Dancers Need Sleep! wrote:(I did not actually go to bed at 3:00 am - the time zone is off and I can't figure out how to fix it)

If the machine date and time are correct, Sleepyhead has a setting for time zone. Go to File - Edit Profile.

OkyDoky wrote:

Dancers Need Sleep! wrote:(I did not actually go to bed at 3:00 am - the time zone is off and I can't figure out how to fix it)

If the machine date and time are correct, Sleepyhead has a setting for time zone. Go to File - Edit Profile.

It must be the machine that's set wrong, as that is set correctly.

Time for an update.

I have been using the Wisp mask for three nights now. The first two nights I was using the S/M nose piece. I found the mask fairly claustrophobic, partly due to it not being easy to remove fast and partly due to the nose piece being fairly close to my nose all around, so I could feel the air swirling as I breathed. I made it 1 hour on Monday and 2 hours on Tuesday. 0 events on Monday, 4.25/hr on Tuesday but almost all were centrals.

Last night i switched to the large nose piece and that was a lot more comfortable. I made it for 3 hours, but the last 30 minutes was very restless. Sleepyhead tells me why - I was having a lot of CAs and OAs. My average for the night was 9.38 per hour but the almost all happened in that last 30 minutes. I finally took the mask off and slept fine (as far as I could tell) the rest of the night. I have no idea if the events were making me restless or if my restlessness was causing the machine to record a lot of events.

I've reported all this to my DME guy and we'll see what he says. Suggestions welcome. He's also ordering me a small frame for the DreamMask, which I still would prefer to use if I can get a decent fit. I know there are many other masks to try, but I really am not loving the elephant hose...

On Monday I also bumped up the minimum pressure to 7, at the DME guy's suggestion, and that seems to have cured most of my trouble with waking up as I'm falling asleep. It makes sense - when the air pressure is too low i'm consciously taking deeper and more deliberate breaths; as I fall asleep I stop doing that and my body reacts by waking me up to take a big catchup breath. I think increasing the starting pressure should be a standard suggestion for anyone with this problem.

Restless sleep can produce what we call sleep/wake/ junk events. I'm glad the increase in minimum pressure is helping you. A lot of us feel we can breath better with the minimum in the 6-8 area. Working on mask fit and increasing use time should be goals for now.
You can change the time on your machine. There are directions in the clinical manual link I gave you earlier.