Amother New CPAP User & Struggling

With everything going right it takes the average Patient 4-6 weeks of consistent use to get used to "tolerating" the equipment, the noise etc. where they can sleep.

Your Pressure is 15 cm?

Start complaining to your doctor, complain at 15 cm, complain at 10 cm and keep on complaining until they agree to give you a Bipap machine.

But if you want to work with your current machine and your titrated pressure was 15 cm, keep in mind an Auto version of this machine would NOT make things any better unless it was specifically Flow limitation or Snore that caused them to land at 15 cm pressure in the lab. Because the Resmed version of the Autopap will NOT move above 10 cm pressure to eliminate a frank apnea requiring 15 cm pressure. It stops at 10 cm and so does many of the others.

Mask: Understand the mask you are currently using is the most noisy, uncomfortable air delivery type of mask you could have choose. While they are very small and light offer very good visibility when you are trying to sleep those features mean zip. The incoming air is uncomfortable because the mask interface doesn't have any dead space to diffuse the incoming air so instead of it being a soft gentle breeze entering your nares it is a sharp stream of air. If it is cold, even more uncomfortable and you won't compensate for that with the humidifier settings.

When you go with a conventional type nasal mask, it seals around your nose and is more comfortable "especially" if you have a deviated septum. With your current mask, it presses on the end of the nose, this causes any deviated septum to become MORE blocked and air flow is restricted. Did anyone ever ask you if you had a deviated septum before giving you that mask? They should have, but most don't, to them it is just a plastic silicone thing they make HUGE profits from.

I would suggest you try a conventional nasal mask, I recommend one that is quiet (quietest on the market of any mask) has good air flow delivery characteristics, great swivel and it seals very well with the lightest headgear pressure, in fact the head gear is elastic, hard to overtighten it and crush the cushion. However, it tends to run smaller than other masks of similar design. Always get larger if you use a Medium or Standard in other masks, get a Large. You don't want any mask pressing on the outside of your nose, this can lead to congestion, use your finger and probe around the outside of your nose, if it becomes blocked by doing that, assume a smaller mask will do the same.

I suggest the Soyala nasal:
https://www.cpap.com/productpage/Soyala ... dgear.html

Once you have a decent "quiet" mask to use that is half-way comfortable you can work on the machine settings to make your life easier and therapy more comfortable.

If your CPAP pressure was 15 cm, that is what you will need. Your machine should have EPR, you could use that feature and it will offer you up to 3 cm exhale relief. Settings are 1, 2 or 3.

Setup the Ramp:
Ramp is a lower setting that stair-steps up towards your therapy pressure of 15 cm. It has a timed range of 5 to 45 minutes depending on machine mfg (think yours is only 5 to 30 minutes, could be wrong).

-Set the Ramp Pressure to 7 cm.
-Set the Ramp Timer to maximum (30 or 45 minutes).

When you turn on the machine, hit the Ramp button, pressure drops from 15 cm to 7 cm. It then increments up every 5 minutes by .5 cm pressure (some advance by .2 cm). In any case it will be at your CPAP pressure by the time that timer expires. Anytime you are still awake and bothered by the current pressure, reach over and hit that Ramp button again and it will restart the timer and lower the pressure.

Next, if all the discomfort of this therapy is preventing you from sleep, don't fight it, take 2 Tylenol PM or a Benedryl to help you get to sleep. If the noise bothers you get some of those foam ear plug inserts. Unisom, SLEEP-AID and SLEEPMD all help to get you to sleep. TylenolPM is actually pretty good, if you have muscle-skeletal pains interrupting your sleep like a bad back, arthritis etc. it can help. I prefer Melatonin but it is what ever works best for you.

Note: Lowering your pressure from 15 to 10 is only a temporary measure by your doctor. They did that to help you sleep and at 10 cm pressure it will eliminate over 70% of your SDB events. If you have apnea once you get to REM you will experience an apnea and with the pressure not high enough those apnea will most likely wake you up during the night.

But you have to sleep first before you can worry about getting to REM where the most severe apnea are likely to show up.

Optionally, if you are still having difficulty with above settings, you could lower CPAP pressure down to 10 and also use the Ramp at same settings. It will then just Ramp from 7 to 10. I do NOT recommend putting your Ramp pressure lower than 6.5 cm pressure, any lower and you rebreathe too much of your own exhaled CO2 and will probably starve for air. When you are starving for air just to breathe normally even while awake, the incoming air will seem warmer, more humid and feel "stuffy". If it feels cool and refreshing it is exhausting out your exhaled CO2. Some rebreathing of CO2 is good but too much is not. If you wake up with a headache that usually means hypoxia or rebreathing too much of your own CO2.

But BEFORE 90 days is up (like next 60 days) and you feel you cannot tolerate CPAP, you should complain and take the machine back. When you do that you "fail" CPAP therapy and your insurance will now pay for a Bipap machine which makes it easier to handle that higher pressure of 15cm. Keep in mind after that 90 days has gone (from day you started therapy) you are most likely stuck with that machine for the next 5 years. Gain any weight and you may require even a higher pressure, with current machine, even more difficult to tolerate. Bipap will have 2 pressures, a higher one for Inhale and a lower one for Exhale, in addition it may have other comfort features for exhale like Biflex.

If I was stuck with those higher pressures for the next 5 years, I'd want a machine which makes tolerating that much easier.

Thank you all so much for everyones advice!!! It has been VERY helpful!! I have slept SOOO good the last few nights using the CPAP machine and alot of your suggestions. I feel sooo much more alert and energetic! It is wonderful! There is still the one issue with my sinuses that I'm still working thru. I wake up every morning with the "tingling" in my right sinus cavity that is driving me crazy. Have been using Nasonex sinus spray in the morning and before bed but doesn't seem to be helping much. A few of you had asked why the pressure was lowered from 15 to 10. The Doctor has set that temporarily until I am used to the machine and then he is gradually going to bring it up. I can live with that but I know it needs to go back up for me to have the effect the machine is supposed to provide me. Just wanted to thank everyone for their help and what a great feeling to know that good sleep is coming my way and that you are all out there for advice and peermanship (is that a word? LOL). My partner thanks you too! He is now not having to put up with my complaining!!! Thanks again and will be great chatting with you all!