complete newbie troubles

I am a complete newbie and started CPAP therapy on December 13. The first few nights were hard; I would wake up feeling claustrophobic with the full face mask on at full 10 pressure. Not to mention the permanent red pressure mark on the bridge of my nose, which led me to this site where I got some handy info. I didn't notice any changes in my sleepiness or mood, but I did wake up bright and early at 8 am and couldn't fall back to sleep. I guess that's a good sign. But within a few days, I was pulling off my mask in the middle of the night because I would wake up around 3 am and not be able to get back to sleep even after resetting the ramp pressure.

Within a few days I ordered the Mirage Hybrid, thinking it would solve my claustrophobia issues. It didn't work. I didn't like the way it blew my nostrils open all night and the straps were annoying on the side of my face, so I went back to the Amara.

I want to make the CPAP therapy work. I am tired of being tired all the time and waking early morning.

I downloaded the Sleepyhead software to see how my data was working, as my machine shows limited info. The problem is my AHI numbers are all over the place. I still have 22+ assorted episodes a night. No matter I am still tired all the time! I am a creature of habit, so why are my numbers not more consistent?? And how do I help them be more consistent?

Are you using exhale relief? (Aflex,Cflex). You might want to try another mask, Resmed QuattroFF, UltraMirageFF,F&PSimplus, Quattro Air, to name a few, most people try several before they find "the one". The Amara hasn't had many good reviews. You can check cpapdotcom to compare masks and reviews.

WendiP wrote:I am a complete newbie and started CPAP therapy on December 13. The first few nights were hard; I would wake up feeling claustrophobic with the full face mask on at full 10 pressure. Not to mention the permanent red pressure mark on the bridge of my nose, which led me to this site where I got some handy info. I didn't notice any changes in my sleepiness or mood, but I did wake up bright and early at 8 am and couldn't fall back to sleep. I guess that's a good sign. But within a few days, I was pulling off my mask in the middle of the night because I would wake up around 3 am and not be able to get back to sleep even after resetting the ramp pressure.

Within a few days I ordered the Mirage Hybrid, thinking it would solve my claustrophobia issues. It didn't work. I didn't like the way it blew my nostrils open all night and the straps were annoying on the side of my face, so I went back to the Amara.

I want to make the CPAP therapy work. I am tired of being tired all the time and waking early morning.

I downloaded the Sleepyhead software to see how my data was working, as my machine shows limited info. The problem is my AHI numbers are all over the place. I still have 22+ assorted episodes a night. No matter I am still tired all the time! I am a creature of habit, so why are my numbers not more consistent?? And how do I help them be more consistent?

Hi Wendi P,

After thinking I was limited to full face masks, I have started using the sleep weaver elan mask and am making slow progress with that. Might something like that be an option?

What about trying nasal pillow masks?

What is your current pressure range? Also, regarding your 22 episodes, are they mostly apneas or do they consist of any centrals?

It sounds like you might need to raise the minimum pressure to get your AHI below 5 which is the goal. Some people need to go alot lower to feel optimally.

49er

PS - In order to make it easier for people to help you, you might want to post a screen shot of your data.

How do I post a screenshot? I know how to screen shot, but couldn't figure out how to paste it in the post.

WendiP wrote:How do I post a screenshot? I know how to screen shot, but couldn't figure out how to paste it in the post.

Sorry, I should have posted these instructions previously. Here are the instructions courtesy of Pugsy.

Once the screen shot is created save it in jpg format.
Upload the image to a host site. I use Photobucket it is free, there are others.
Once the image is uploaded then copy the ENTIRE IMG address. Be sure to include the opening and closing IMG in brackets. Paste that copied address into a post here.
If you want to use Photobucket they provide a box with the various url addresses and you just choose the last one in the box. Copy/paste that last line url address into the body of your post.
Use the preview button. If you can't see the image try again because if you can't see it we can't.

viewtopic.php?f=1&t=81072&p=737779#p737765

49er

On the 25th most of the left over events were Hypopneas; Reras; and Vibration snores. The machine is in CPAP mode. I would raise the pressure by up to 2 cm (one cm at a time per night) and see if the events subside. But before raising the CPAP pressure I would set the C-Flex on zero as to not minimizes the pressure transition during exhalation. This is b/c most events are at the upper airway and are responsive to raised exhalation pressure. Switching to Auto CPAP mode is a possibility since no untreated Central Apneas are shown. But this requires the Doc's ok.

The daily data you posted does make it look like that the current pressure is not enough to properly manage your OSA.

Are you using C-Flex or C-Flex+ right now? It may be the case that you're someone who is unfortunate enough to have exhalation relief adversely affect the quality of the therapy. And turning the Flex setting down or off may help prevent more events. Or, if breathing without the Flex turned on is uncomfortable, then a 1 or 2 cm increase in the pressure may be needed.

Since you've also had some problems with getting to sleep with the mask on and pulling your mask on in the middle of the night, it's worth calling the sleep doc's office and letting them know what the data is saying. Printing out the detailed data and dropping it by the sleep doc's office with a request for someone to call you back after they've had a chance to look at the data is a reasonable thing to do as well.

Thank you for your responses and suggestions; I've learned a lot from this forum!

I think I will call my doc tomorrow and see about getting my machine pressure increased, or at least showing them the data as RobySue suggested. Right now it ramps from 4-10 max.

My hubby just got his machine and he's on a-flex and his AHI is .2! I'm so jealous. I've been struggling with sleep maintenance insomnia for about three years, and after my sleep study I really thought this would be the cure-all. I would wake at 3:00-4:00 am and either wake every hour after, or not be able to go back to sleep. I think it was linked to my REM cycles though because at the sleep study I had 34 apneas in one hour of REM. I am still waking with the CPAP machine in the early morning and can't get back to sleep with the mask on, so I've resorted to taking the mask off--then I wake with a headache. It's like a catch-22. I am not obese and I don't have any other significant health problem,s so I am hoping something will work here to provide sleep relief.

Thanks again for all your help and suggestions - I am trying everything to make this work.

Yay! I turned my Flex setting from 2 to 1, and raised my ramp minimum to 5 and my max CPAP to 11cm. Last night my AHI was .9 as opposed to the previous night's 5.7 and I woke bright and early, which I suppose means I slept well. I will leave my setting as is and watch it for a few days to see if I need to increase it one more cm.

Thanks again!

I am not Insomniac, just have ordinary OSA with very few Residual Events. Before sleep I take 5 mg of Zolpidem (half of 10 mg tablet). I think that it helps me sleep. If I wake at around 3 a. m., let's say to go urinate, I usually can fall back to sleep with no problem. But if I can't, I then take another 5 mg of Zolpidem (the other half of the tablet). This lets me sleep till 7 a.m. But I don't take the Zolpidem if I wake after 5 a.m. and can't fall back to sleep. I get up and do things. About the headache, I would take a couple of Tylenol.

About changing the Flex and reducing it, as I posted above, I am not sure about it related to eliminating the RERAs and Vibratory snore in your case. Raising the pressure could be a better approach. About those multi residual hypopneas that you have, we don't know if they are obstructive or central kind of hypopneas. Knowing it would dictate the option to take. In any case it's nice to see your AHI drop. Can you show the new SH graphs?

Good news! I'd suggest that if you do make any changes you do one thing at a time and keep it the same for at least 3 nights. If you change too many things at once you won't know what's working and what's not. I've made the same mistake many times and got so confused that I had to start over from scratch.

WendiP wrote:Yay! I turned my Flex setting from 2 to 1, and raised my ramp minimum to 5 and my max CPAP to 11cm. Last night my AHI was .9 as opposed to the previous night's 5.7 and I woke bright and early, which I suppose means I slept well. I will leave my setting as is and watch it for a few days to see if I need to increase it one more cm.

Thanks again!

Congratulations on getting a truly good night's sleep.

I'd leave the machine at these settings for a week or two. If the AHI continues to stay in the 0.5-1.5 range the whole time and you continue to sleep well enough to wake up "bright and early" and willing to get out of bed, you'll know that you've probably found the sweet spot and you might not need to increase the pressure any further.