NEW user - CPAP machine - Few questions

Evening All

Will try and keep this as short as possible... Few yrs back i was diagnosed with sleep apnea and did not take this very serious until recently when i was waking up choking and almost vomiting. So i started digging out my old script and went in search for a CPAP machine.

I ended up buying the following CPAP machine and mask

devilbiss (sleep cube standard plus)
rezmed quottro FX face mask.

The pressure setting on my script was 7psi.

I have used it for alittle over about a week, first few nights were really hard. but after that its been rather good and ive been happy with adjusting with the mask. BUT a few questions i have which concern me and i believe i might need to go back to do another sleep study, but anyways here i go . yet to really work out how to sleep on my side but i thought id wait abit longer to try that out.


Mainly around the unit itself
I have found that when i first bought the cpap machine it already has some hours on it... and every day i go to see my read outs from the night before it will commonly say my AHI is 33.3+ and mask leakage is at 33% and the hours are at 9.5 (which it cant be as i don't sleep that long) but i see no information over a 7 day period and sometimes i cant retrive information on the sleep i just had... coudl the unit be malfunctioning ?

Around the sleep myself... My wife tells me she doesnt hear me snore anymore and loves the machine for it i dont wake up with swollen / sore throat anymore but in saying that i don't really feel like i have alot more energy either i kinda feel the same still (in regards to tiredness levels) could it be that while the current setting of 7psi is preventing me from snoring it is not keeping my airways opened completely ? and since the sleep test was done many years ago should i look at getting another one done as the pressure might have changed ?

these events have kinda put me off the machine alittle bit in the sense of i ave spent all this money to help me get better with this condition and i feel its not working completely ?

Any assisitance any the above matters would be greatly appreaciated.

Regards

Spakis007

Welcome to the forum spakis007,

I am not very familiar with the Devillbiss machines. Hopefully a Devillbiss user will stop by and answer your questions about whether the machine is new or used and whether it appears to be recording the data correctly.

But you also have some questions about your OSA itself and I do feel like I can answer some of them.

spakis007 wrote:Evening All

Will try and keep this as short as possible... Few yrs back i was diagnosed with sleep apnea and did not take this very serious until recently when i was waking up choking and almost vomiting. So i started digging out my old script and went in search for a CPAP machine.

How long ago was the sleep test? Do you remember if you were diagnosed with mild, moderate, or severe OSA?

I have used it for alittle over about a week, first few nights were really hard. but after that its been rather good and ive been happy with adjusting with the mask. BUT a few questions i have which concern me and i believe i might need to go back to do another sleep study, but anyways here i go . yet to really work out how to sleep on my side but i thought id wait abit longer to try that out.

Side sleeping can be done, but you are correct: There is a learning curve when it comes to sleeping with a six foot hose attached to your nose.

Side sleeping is easier in some masks than others, but it can be done with just about any CPAP mask. You say you're using a Resmed Quattro FX face mask. First and foremost, make sure you are fitting the mask properly each night. JanKnitz has an excellent fitting guide for the Quattro family of masks on her blog. So read her Taming the Mirage Quattro and follow her instructions.

Sometimes hanging the hose will help with side sleeping. Sometimes a pillow with a cutout for the mask to hang into will help.

Finally, you might also want to consider getting a nasal mask or a nasal pillows mask. They're smaller on the face and they are typically easier to sleep with when you're on your side. If you are not a dedicated mouth breather during the day time, you may find that you don't breathe through your mouth as much as you think you do at night.

Around the sleep myself... My wife tells me she doesnt hear me snore anymore and loves the machine for it i dont wake up with swollen / sore throat anymore but in saying that i don't really feel like i have alot more energy either i kinda feel the same still (in regards to tiredness levels) could it be that while the current setting of 7psi is preventing me from snoring it is not keeping my airways opened completely ? and since the sleep test was done many years ago should i look at getting another one done as the pressure might have changed ?

First and foremost: Most people don't feel better immediately. You've only been PAPing for a week. And for most people it takes a couple of weeks to a couple of months to get everything sorted out where they're getting high quality sleep with the machine. At the beginning your brain has to learn to trust this alien on your face rather than (subconsciously) fighting it. And that takes a bit of time. And once you're sleeping well with the machine, it takes a couple of weeks to a couple of months for most of us to start feeling better in terms of daytime energy and daytime sleepiness.

That said: If your machine is working correctly, then the reported AHI = 33.3+ and mask leakage = 33% are both too high for effective therapy. So it looks as though you're either dealing with a machine that has problems or ineffective therapy because the pressure is too low or the leaks are too high or both.

It could be that the AHI is too high because the pressure is too low. Pressure needs can change with time and the severity of the untreated OSA typically worsens over time. If your weight has significantly changed since you had your sleep study that can also affect the pressure needed to control the OSA. So in my humble opinion, since it's been several years since your last sleep study and you have been untreated the whole time, it is worth getting another sleep study done---if the OOP costs are reasonable.

But that extra high AHI number could also be because the mask leaks are just too long and too high for the machine to maintain the needed pressure to keep your airway from collapsing in the first place. In other words, fix the leaks and the AHI might go down and you might start sleeping better and feeling better.

these events have kinda put me off the machine alittle bit in the sense of i ave spent all this money to help me get better with this condition and i feel its not working completely ?

Many newbies need some time to effectively tweak the settings on their machines. Some folks rely on the sleep doc's office to make (or authorize) every pressure change. Others are more comfortable with changing the pressure on there own.

Here's what I'd suggest doing for the time being:

1) If you don't have the clinical manual for your machine, get it. You can go to http://www.apneaboard.com, register as a user, and request the clinical menu from them.

2) If you purchased the Devilbiss (sleep cube standard plus) from a brick-and-mortar DME, take the machine back and show them the problem with the on-board data. While you are there, have them check the machine out mechanically to make sure everything is working ok. If you bought the Devilbiss from an on-line DME, call them and report the problem. If this was a "new Machine" purchase and there are problems, they may be willing to exchange the machine.

3) If you purchased the Devilbiss from an individual, you may be out of luck. You can call the person who sold it to you and complain that the machine is not working as advertised, but if they sold you the machine "As Is" there may not be much you can do about it. You could try taking the machine into a brick-and-mortar DME and asking them if they'll do a service check on it. They may charge you something to do it, so make sure you get that straightened out before they check the machine out.

4) Contact your insurance and your PCP about setting up a new sleep test. If the out of pocket cost is not too expensive to you, follow through on getting the new sleep test done. I'd suggest scheduling either a split study (half the night without CPAP and half with) or if you can afford it, a diagnostic test (without CPAP) and a titration test (with CPAP).

5) Work on trying to fix any leak problems. If the data on your machine is accurate and if you are interpreting the leak data correctly, then you have a leak problem. In other words, if the leak figure really does mean that you are spending 33% of the night in "High Leak", that means that you are not getting an effective seal for 1/3 of the night. And when the leak is in High Leak territory that long, the overall quality of the therapy is compromised. In other words, when your leaks are in High Leak range, the machine cannot maintain the pressure, and when the pressure is not maintained, your airway can collapse much, much more easily.

Thank Robysue

Yes my sleep test was performed in like 2009 and at the time they gave me one of those nasal masks and i could use it well through out the coruse fo the sleep study as im very much a mouth breather (suffer from allergies etc) .
In regards to weight gain yes I have put on about 10kgs since then. i was diagnosed at the time as moderate.. Thank you for the link on taming the mask i shall review this now. i have booked an appointment with my GP to get another referral sleep test.

Thanks once again for reply i will touch base with you in this thread once I anymore information.

Robysue,
What a wonderful, helpful reply. You took a lot of time to explain many things. You embody the spirit of this forum and should be proud of yourself.
Ed