Newbie with questions

Hi, I'm new here and would like to start off by saying I am so happy to have found this group! It was recommended by 2 of my cousins separately, and I had already gotten quite a few of my questions answered just by searching google and having the relevant posts from this forum show up in the results. So thank you for being here!

After my sleep study, the recommendation to my doctor was: 18 cmHO with 3 of C-FLEX with heated humidity and the application of a chinstrap if needed. What I received was a PR System One REMstar Plus. When I figured out that the machine I have doesn't provide any data other than usage, I asked my DME if I could get the next level up, the Pro, they said that my doctor needs to prescribe the machine if she wants data. Well that means I have to go to my doctor and ask for the machine I want. One point she made was that if I'm going to ask the doctor for a new prescription I may as well go all the way and order an Auto CPAP machine.

I am also lucky enough that my DME allows 60 days to find the right mask, and not only that but they allow you to keep the old mask! I started with the Quattro Air Full Face mask, and had to have it so tight my face felt bruised, but I knew from the first night that I was sleeping better already! However, the bruised feeling on the face, along with the fact that I had minor leaks that were very annoying, led me to try the Wisp Nasal Mask. With the Quattro Air, I had very little "rain out" and had my humidity level up to 5. With the Wisp I am having major issues with "rain out" and I am even feeling droplets from the vents hitting my face if I roll onto my back at night. Turned the humidity down, and I'm still having this issue.

Oh yes, I am a tosser. I go from side to side throughout the night, and need a mask that will go with me without leaks. If I don't move at night I am so stiff in the morning that I can't move. I am able to sleep on my back and breathe with the mask, at least most of the time, but I still puff air out of my mouth now and again especially on my back.

Sorry about the long windedness, but now that you know more about me than you want to know, on to my actual questions.
1) CPAP vs Auto Pap:
In asking the doctor for a particular machine, should I ask for the REMstar Auto? Is it worth it? I have researched, and read, and it seems the auto setting is only for short term use? I'm not sure I understand that. Or should I just ask for the REMstar Pro so that I can have the data that I want?
2) Mask:
What mask should I ask for next? My first thought is to go with a Full Face mask, as I like the ability to open my mouth if needed. I haven't yet tried the nasal pillows, should I try the Swift FX first? The Quattro FX? or the Hybrid? I haven't seen a lot about the hybrid on these forums. Or maybe something I haven't come across as of yet.
3) Heated tubing vs. hose covers
The "rain out" has me baffled. It is getting my mask wet and when it gets wet it leaks. Will a cover help with this? Or should I ask the doctor for heated tubing? And does the heated tubing actually work?

Oh, the last thing I would like to point out is that I have never had any issue keeping the masks on at night, as I know I am sleeping better with that I did without. It's just still annoying to be awake in the middle of the night for leaks, bruising, a wet face.

1) the autopap can do everything the cpap can do plus it can result in lower pressures during parts of the night if that is all you need. Also, if your therapy becomes less effective over time, the autopap can help retitrate without a sleep study. The autopap could always be run in cpap mode if you'd rather. Not sure where you got the info that it is short term only - this certainly isn't the case. By all means find a way to at least get a full data machine - there is no way short of another sleep study to tell if your therapy is working without the data. If I were you, I'd also lobby for the autopap.

2) Masks are so personal that it is hard for anyone to give you advice - other than what has worked for them. I've found the Swift FX pillows and Airfit P10 pillows to work well for me - that is no reason to expect them to work well for you.

3) If the rainout is coming from the hose and not the mask, then a cover or heated hose will help. I'm very happy with ResMed's Climateline heated hose - but you have to be using a ResMed machine to use that hose. It also helps if the CPAP machine is located lower than your head. If you are using a ResMed S9 and overfill the humidifier tank, you will get water in the hose and your face. By the way, what is the weather like where you are? A cold, dry room results in more rainout than a warm, humid room.

First point: if the headgear is either too tight or too loose, you will have more leaks. Tighten to the point where you can get your finger between your head and the strap. I started this journey 6 months ago with Quattro Air, and the way it is made, it seals best if you do your final fitting when lying down in bed; it fills with air like in a balloon, and the double cushion expands to create the seal.

Second point: Quattro Air is one leaky mask; my first few nights were filled with constant leaks and farting noises from the leaks. Then I found this forum and learned about the proper way to seal, and also about mask liners. I could not tame the leaks, but once I started using mask liners, that was a game changer. I use them every night; some major leaks still occur, but quietly, and they don't wake me up. Have you tried liners? There is another mask you could try; the AirFit F10. It uses the same cushion as the Air, but does not have the forehead arm/forehead strap. I've switched to it as my primary mask, and I kept the Air for a backup mask. The headgear of the F10 is much more comfortable, in my opinion.

I am also a tosser... all night long, most every night, and the Air and F10 both work for me. I hope these hints help you. Good luck, and welcome to the forum! Come back as often as you need to for answers.

Thank you for responding. I got the impression that the Auto was for short term by the fact that people were using it to find titration rates, I made the assumption that once the rate was found they then moved to straight CPAP mode. The face that my pressure is so high makes the Auto really appealing, as you can imagine, though I don't have issues with breathing after the first few minutes. I don't even use the ramp up anymore as it just made me feel as if I needed more air. I will definitely lobby for the Auto! The information is my main goal, but I may as well do what I can to get the right equipment!

I've been on the CPAP for less than 2 weeks, so I guess i'm doing well just keeping the masks on all night, but no, I haven't tried liners yet, that may be in my future if I can't find a mask that doesn't leak. The Quattro air for me is extremely comfortable, until about 2:30 am, at which point I have to clean the mask and my face, but it still leaks at the bridge of my nose and in both lower corners, enough that it keeps me from getting back to sleep. I had assumed it was my facial moisture at first, but it is possible it is moisture from the humidifier. I live in what I consider a hot and not extremely humid area, but then I came from the east coast where 90 degrees and 90% humidity were so common it seemed the norm. The locals here in the Midwest complain about how humid it is when the humidity gets above 50%! I have my thermostat set for 74, but it doesn't seem to get that cool, especially in the bedroom. The CPAP machine is slightly below my head, or was last night. I have since decided that I needed a second table and pulled out a tv tray, which may be too high, we'll find out. The Quattro Air doesn't seem to have anywhere near the moisture that the Wisp does, and only one night was the hose itself full of moisture, so I'm really not sure where it is coming from, but it is moist enough to make me feel the need to clean it.

I think I will try those Swift FX air pillows first, I like the minimal size of them. I originally felt a full face mask would work better for me, but in using the Quattro Air, I found that even when I did open my mouth I wasn't able to breathe as well as I hoped, and ended up closing my mouth. I hope I find my key soon, as a full night's sleep would be so nice! I haven't seen one of those in ages.

Ishtar wrote:Thank you for responding. I got the impression that the Auto was for short term by the fact that people were using it to find titration rates, I made the assumption that once the rate was found they then moved to straight CPAP mode. The face that my pressure is so high makes the Auto really appealing, as you can imagine, though I don't have issues with breathing after the first few minutes. I don't even use the ramp up anymore as it just made me feel as if I needed more air. I will definitely lobby for the Auto! The information is my main goal, but I may as well do what I can to get the right equipment!

cpap vs auto varies per person. Some people don't sleep well with the changes in pressure, so auto is not very good for them. Also, some people do well on a straight pressure and that works very well for them.

I am somebody who uses auto all the time. My normal pressure needs are in the 11-13 range. I spend most of the night during that range. I could probably do most of the night at a straight 13 and be comfortable, but I would probably have clusters of events when I sleep on my back as my needs go up when I sleep on my back. I will have short times where I go up to 15, and shorter spikes up to 16 something. My pressure is set for 11-17, and it has only reached 17 a few times. But it has gotten to 16.9 many times.

One of the extra bonuses that I get from this range of pressure is that my mouth opens more when I sleep on my back, and the combination of mouth open wider and higher pressure means that my cheeks start to flap. This causes me to roll back onto my side, which means I spend less time at the higher pressure and less time on my back. So, without having to go at high pressures for very long, it does keep my sleep apnea under control and I rarely remember the pressure going up high. I just see it in the data.

My mom used to have a straight pressure setting of 10, but wasn't feeling well. She used my machine for two partial nights, one time at 10, and one time at 10-13. At straight 10, she had clusters of longer events. Her total ahi was still low, but the events were very long, some over a minute long. So, having a range allows her to spend most of the night at the lower pressure, while eliminating that nasty clusters of longer events.

Wow, thanks Zoocrewphoto for helping me to understand that. What you just described makes me anxious to get the auto. I have hopes that the auto will help with the leaks in my mask. I seem to do fine until 2-3 am, then I am half awake the rest of the night trying to adjust my mask. It's just little leaks, not even enough to hear, just enough to tickle my face a bit. I have yet to try the liners as well. And it's so frustrating not having data to look at.

You can set the auto machine to cpap mode anytime.

Well I got a one month rental prescription for the auto pap from my doctor, and she says we will review the data in a month and see if it is helping, now I just need to get to my DME and pick it up!

First night with a machine that isn't lobotomized! The auto cpap and new mask combination let me sleep til 5 am without waking fully, no fiddling with my mask with leaks half the night, and I actually have data to look at! AND and AHI of .27! Hope the long haul is as good as last night was!

Ishtar wrote:First night with a machine that isn't lobotomized! The auto cpap and new mask combination let me sleep til 5 am without waking fully, no fiddling with my mask with leaks half the night, and I actually have data to look at! AND and AHI of .27! Hope the long haul is as good as last night was!

well, that sounds like an all around rousing success!