my first night

Hi everyone,

This is a first time for me on several fronts: I have never participated in an on line forum and last night was my maiden voyage with my Remstar plus M series. My MD wanted to prescribe Ambien however I refused since I pride myself in not taking any kind of drugs or medication if I can avoid it.

I was so excited about getting started I actually went to bed at 7:45 (which is about 2 hrs. earlier than normal). I woke up about 1:30 (getting about five hours sleep). My wife said that she did not hear me snore and mentioned that the lines under my eyes were not as dark as usual. I will take this as a good sign.

Here are my questions that I hope some of you may help me with: I noticed air leakage at the point at which the hose connects with the mask (I know some of you might ask at this point what kind of mask I have and to be quite honest I am not sure. The technician brought the unit and mask together. I will find out if you think it is important to know). Is air leakage at this connecting point critical to the effective operation of the machine?

Upon scanning other entries that many of you have made I noticed that everyone seems quite conversant with their sleep data. Where on my machine can I access that information? I know there is some sort of a dat card that is inserted in the back of the machine. I was under the impression that is for the doctor's use only is that correct?

Is five hours sleep the first night normal? Is there a special pillow people us to help aid in this process? Does it matter if I sleep on my side or my back or is that simply personal preference?

Thank you to those who take the time to read this entry and respond.

Sincerely,

snorenomore

snorefore wrote:I noticed air leakage at the point at which the hose connects with the mask (I know some of you might ask at this point what kind of mask I have and to be quite honest I am not sure. The technician brought the unit and mask together. I will find out if you think it is important to know).

Of course it is important IF you want help. There are just too many masks to make guesses.

Commit to memory -
1. Machine make & model. Written across the machine.
2. Your machine settings and prescription.
3. Your mask make & model. Written on back of the headgear. Also written on the box it came in and the literature enclosed in that box. Find the chart (graph) that gives you the leak rate for this mask at your pressure.

My guess is the air you are feeling is normal and coming from the exhaust (elbow) where many mask makers allow for the intended leak to exhaust your CO2.

I know it seems like a lot to remember now but you can do it. Plus your memory will get better with therapy.
Good Luck

The M-series Plus machine does not have any data capabilities. See if you can bring it back and get a machine that has full data capabilities. If you can convince them to give you an AUTO machine then even better. To get ANY useful information from your machine you need a full data capable machine.

In the Respironics lineup (since that's what your DME already gave you) you should try for an M-series Auto, if you can't get that then you can settle for an M-series Pro. Tell them that you want to be able to monitor your therapy and neither you or your doctor can do that with the machine they gave you.

To those who have responded so quickly,

Thanks so much for your input. I am supposed to go for a sleep test again with my machine and mask at the end of November. Since my machine is not set up to give me data, what specific measurements should I be concerned about in order to measure the effectiveness of my therapy?

Machine: REMstar plus M series with Humidifier
Mask: Comfort Classic

They have me started at 8cm of airflow.

Thanks again,

snorefore

There are many statistics that are available. Two that are pretty important are average Leak rate, and AHI average. Your mask must expell the CO2 that your body exhales, so there must be an exhaust port in the mask. This allows some of the pressurized air to escape. So the machine needs to create 8cm of pressure in addition to the air that is leaking out. If you have additional leakage beyond the expected leakage, then you may not be getting the air flow you need to stop the apneas.

The AHI average is Apnea, Hipopnea index. It has to do with how many breathing interruptions an hour you have. CPAP isn't for making you snore less as much as making sure you continue to breath while you are asleep.

I encourage you to read as much here as you can. A good place to start is the lightbulb icon at the top of the page, that is labelled "Our Wisdom".

Snorefore.....

if I were you, I'd dump that "plus" machine....and push HARD for a M-Series Auto with AFLEX. If you let them talk you out of it...or make it so difficult to get that you give up, I'd say that your chances of success will drop to below 50%.

We have to manage our own therapy....and a data-capable machine is vital....because we can add software that let's us know what is happening while we're asleep.

snorefore wrote:I am supposed to go for a sleep test again with my machine and mask at the end of November.
-----
They have me started at 8cm of airflow.

"sleep test again"... sounds like you had one night at a sleep lab for gathering diagnostic data only. They didn't have you using cpap or a mask for sleeping that night...right?

After that baseline night was over, then you were given a mask and machine to use, to get used to it, until end of November when they'll hook wires up again and use the lab's machine and the mask you're used to, for a "titration" night. To actually find the best pressure for you.

If I understand correctly, the pressure of 8 was just an arbitrary pressure to use until you go for your second study night...a titation night the end of November?

If that's what happened the first night at the sleep study -- no mask or cpap used on you that night in the lab -- and sent home to get used to using a machine/mask at a reasonably easy to deal with pressure to use while waiting for the titration appointment, that sounds like a pretty good way for a sleep doctor/lab to go about it. Gives you time to get used to sleeping with a mask on your face, and is giving you at least some treatment while waiting to get in again. Cool.

I wish they had chosen to use an M series Pro instead of an M series Plus cpap machine. Both provide exactly the same "getting used to it at 8 cm " experience, but the Pro would be able to provide info that might be very useful in making the titration night go well. Particularly, leak data... to give them an idea of whether you are getting a lot of leaks with the mask, or with possible mouth breathing, if it's a mask covering just the nose.

But anyway, this is going to give you some good acclimation time. Using a mask and feeling pressurized air will be "old stuff" to you by the time you go for your second night a month from now. Familiarity with a mask should help you sleep fine for the titration. The more you stay asleep that night, the better the titration can go.

Since they are not trying to get any data from the machine you're using temporarily at home (we know they aren't, cause that machine gives no detailed data at all) it wouldn't hurt anything (imho..I'm not a doctor though!) for you to try out some other pressures if you want to.

snorefore wrote: Since my machine is not set up to give me data, what specific measurements should I be concerned about in order to measure the effectiveness of my therapy?

The only measurement you can go by is how you feel when you wake up in the morning. Statistically a pressure of 10 is said to keep most peoples' airway open fine, and the 8 the doctor prescribed is pretty close to that. Personally, I wouldn't hesitate to try any/all pressures.... all the way up to 20 while awake just to see how it felt...I'm a curious person! I wouldn't want to try to sleep at the higher pressures, but I'd try them briefly just for the heck of it.

For sleeping, I'd try out anything from the 8 you're using to, say, 12 cm. The only measurement you can go by regarding effectiveness is how you feel. That's not a bad yardstick at all.
People in this study were able to find an effective treatment pressure using just cpap with no software:
"Can Patients with Obstructive Sleep Apnea Titrate Their Own Continuous Positive Airway Pressure?"
http://ajrccm.atsjournals.org/cgi/reprint/167/5/716

If you're like so many of us here and want to see some objective data directly from the machine, the least hassle would be to see if the DME will swap the M Plus for an M Pro. The Pro can show data in the machine's LCD window. They are both "cpap" machines, so if what the doctor put on the Rx was "CPAP @ 8 cm H20" and didn't specify the Plus machine by name, the DME could make the exchange for you. Same humidifier works for both, so you could keep the humidifier you're already using.

Welcome to the message board!

Welcome to these parts snorefore ...hang around & we can learn from each other tim

Welcome! 5 hours sleep the first night is not bad, especially if you felt good and rested. The first couple of weeks I only slept about 5-6 hours but felt better than in a long time, because my body was getting some real, restorative sleep for a change. You can sleep in any position. Some have less apneas when sleeping on their side so prefer that. Keep up the good work and keep us posted if you have any problems.