Newbie Having Trouble Adjusting to CPAP

Hi-

I am a total newbie, and was given my first CPAP last week. I was hoping I could get some tips or pointers, as I have had a lot of trouble getting used to sleeping with the CPAP. A bit of background:

I have severe apnea. My AHI was 41, on the sleep study I did a little over a month ago. I already underwent a septoplasty, UPPP and the Pillar Procedure, all in one sitting, 6 years ago. So my doc now recommended CPAP. I was just given a Philips Respironics System One Remstar Plus CPAP with C-Flex and a heated humidifier. I'm a mouth breather, so they gave me the full face mask. I'm not exactly sure what model it is, but is made by Philips Respironics and has grey straps (size large). I prefer to sleep on my side normally. They said that I need a pressure of "13" on the CPAP, per my recent sleep study, which was a split study that also tested out the effects of CPAP.

My issues are:

(1) Every time I inhale through the mask, the CPAP pulses with a surge of pressure (I guess I had figured that CPAP was more of a steady pressure, but this pulses in rhythm with my breathing). This pulse tends to really pump up the pressure inside the mask, often times causing leaks around the sides of my mouth or nose as the pressure escapes the seal. This is very distracting while trying to sleep. If I use the function on the CPAP where the pressure starts off at 4, and gradually increases to 13, I don't notice this problem while the pressure is lower, but it gets worse and worse as the pressure creeps up.

(2) In order to prevent the leaks above, I have been putting the mask on quite tight, which seems to help prevent the leaks, but is very uncomfortable. I have found myself waking up in the middle of the night to take the mask off due to discomfort. On a couple of nights this week, I woke up with the mask sitting next to me, as I had apparently ripped it off in my sleep. Sleeping on my right side seems to help also, as my pillow seems to help hold the mask on tight to prevent leaks when the pressure surges inside of it.

(3) I find it difficult to exhale against the surge of pressure that happens after every time I inhale. I can do it, but it takes more force, and I'm not used to this at all. This is also distracting.

(4) The tightness of the mask causes the top of the mask to really push hard into the bridge of my nose, which basically bruised my nose, which is red at the place where my nose makes contact with the mask cushion. It almost looks like somebody punched me in the nose.

Will I eventually just get used to these things? Is the CPAP supposed to be pulsing with pressure like that every time I breathe? Are there any accessories I can buy to either help get a better seal on the mask, or provide better cushioning to my face to prevent the discomfort/bruising? On the nights where I have been able to get SOME sleep, I have felt like the CPAP has worked as I have felt more rested than normal. But falling/staying asleep has been a real challenge to me. Any input is greatly appreciated!

davesq wrote: I was just given a Philips Respironics System One Remstar Plus CPAP with C-Flex and a heated humidifier.

Dave, I stopped reading when I saw the machine they gave you -- it is what we call a "brick," a machine that does not record any information that will help you assess leaks and how your therapy is going (is it effectively treating your apnea). Please read this: http://maskarrayed.wordpress.com/2011/0 ... h-a-brick/

OK, so you're saying I can get this "brick" swapped out for a machine that lets me download the data? My home computer is a Mac, is that compatible with the software? I'm also completely ignorant about what kinds of software I would need, but I saw something online here about "Sleepyhead," whatever that is.

davesq wrote:OK, so you're saying I can get this "brick" swapped out for a machine that lets me download the data? My home computer is a Mac, is that compatible with the software? I'm also completely ignorant about what kinds of software I would need, but I saw something online here about "Sleepyhead," whatever that is.

SleepyHead has a Mac version.

What CFlex setting are you using?
A pressure of 13 is getting up there in terms of pressures but maybe you can use CFlex at a different setting to see if it will help.
Play with the 3 different CFlex settings to see if one setting is more comfortable than another.
Heck, even try turning it off.

Also...ditto to what Kaisagram said about the model machine you have been given. It's a brick and offers you nothing to help other than how many hours you use it and you have a clock already for that.
SleepyHead has a Mac version and will work with PR System One machines.
Respironics uses Encore software...Windows only though.

Figure out exactly which mask you are using...that way you can get more specific ideas for that mask from people who use it.
Please add your equipment to your profile...it makes it easier for us to see at a glance what you are using so we can help you faster. Please use text option as the icony images are small and hard to see model differences as they all tend to look alike.

It's unfortunate that you had the past UPPP....pretty much everyone who comes here with UPPP in past history now has trouble either optimizing their therapy or getting used to therapy. Not impossible but it sure increases the challenges and we have enough of them already without UPPP making things worse.

Ok, so thanks for the feedback. Follow up questions:

1. What the heck is CFlex (told you I was a Newbie)?
2. The people at the Sleep Center where I got the equipment instructed me to not change my settings at all on the machine. The brick is a rental, so of course I have a cellphone modem hooked up to it spying on my usage for the insurance company. Will changing the settings mess me up with the insurance company's data? I just want to avoid anything that may potentially make the insurer try to get out of paying for this.

I'll have to check to see what model mask I have when I get home.

CFlex is exhale relief.
It won't mess up anything for you to play with CFlex. Exhale relief is considered a comfort option.
See this for how to get to where you can either turn it on (if it's off) or change the settings.
There's also a video at the bottom of the page
http://www.apneaboard.com/pr-system-one ... structions

Insurance companies only care about one thing...hours of use. They won't care about anything else.

Consider nasal pillows, people are always complaining about their face masks.

Also, there are different types of face masks and people report success with one rather than the other.

kaiasgram wrote:

davesq wrote: I was just given a Philips Respironics System One Remstar Plus CPAP with C-Flex and a heated humidifier.

Dave, I stopped reading when I saw the machine they gave you -- it is what we call a "brick," a machine that does not record any information that will help you assess leaks and how your therapy is going (is it effectively treating your apnea). Please read this: (link removed)

Thanks for that - glad to see I bought one of the models recommended Ask for the System One Pro with C-flex Plus

I still don't see the data though, other than what shows up on the screen... I'm not having any problems with therapy, I just like charts and stuff. The specs say it has "MSD" software.

Sorry to hijack Dave's thread.

Reposting with my profile.

Guest wrote:

kaiasgram wrote:

davesq wrote: I was just given a Philips Respironics System One Remstar Plus CPAP with C-Flex and a heated humidifier.

Dave, I stopped reading when I saw the machine they gave you -- it is what we call a "brick," a machine that does not record any information that will help you assess leaks and how your therapy is going (is it effectively treating your apnea). Please read this: (link removed)

Thanks for that - glad to see I bought one of the models recommended Ask for the System One Pro with C-flex Plus

I still don't see the data though, other than what shows up on the screen... I'm not having any problems with therapy, I just like charts and stuff. The specs say it has "MSD" software.

Sorry to hijack Dave's thread.

sc0ttt wrote:Reposting with my profile.

Guest wrote:
Thanks for that - glad to see I bought one of the models recommended Ask for the System One Pro with C-flex Plus

I still don't see the data though, other than what shows up on the screen... I'm not having any problems with therapy, I just like charts and stuff. The specs say it has "MSD" software.

Sorry to hijack Dave's thread.

sc0ttt,

There is a setting in the clinical menu called Show AHI/leak/PB. It can either be set to ON or OFF. If it is set to OFF, you might not see any useful data on the screen, and I'll be honest, I don't know whether the data is written to the SD card.

To see the data we all keep yapping about, you need an SD card placed into the machine; the SD card is on the slot in the back of the machine. After you turn the machine off, you remove the SD card and mount it on your computer and read the data into the SleepyHead program.

The "MSD" software for your machine would be Encore. There's no real advantage to using Encore instead of SleepyHead, but if you really want it, pm pugsy and she can set you up.

OK, thanks robysue - just bought a cardreader and downloaded both sleepyhead and sleepmapper and uploaded my data.