CPAPtalk.com

hifiaudio wrote:Does the machine think "he is at a 12 but all of a sudden I think he needs 16" and it just jumps up immediately? So from time to time you may get a blast of largely increased pressure?

No, the apap algorithm doesn't do anything like a big blast and it doesn't respond that fast.
It does a hunt and peck thing where it tests the airway and goes up rather slowly over a period of a few minutes. It also doesn't reduce the pressure all that fast once it decides that it doesn't sense a need for more pressure.

RobySue has a good description of how the Respironics algorithm works. Let me see if I can find it.

Check out RobySue's post here in this thread.
While she is actually comparing Resmed to Respironics....down at the very bottom she talks about the algorithm that each machine uses.
viewtopic/t94287/viewtopic.php?f=1&t=82 ... 5&#p866535

Now there are machines that do give people a sudden high burst of pressure but those are the specialty machines like the ASV models used to treat central apneas. That sudden burst is what sort of jump starts the respiratory system when the brain has forgotten to tell the body to breathe.
Your current machine will not ever do those sudden bursts.

Oh- one general thing I forgot to mention. I like to grow and keep a beard. Nothing huge ... what I would describe as around a month to 6 weeks of growth constantly evened out and trimmed. For the sleep study I shaved just in case it would interfere with the mask. Now its growing out a bit as I am trying all of these masks. I dont think it has affected much, except for maybe last night / this morning because of the taping. Maybe a little residue from the tape left that would not have been. So do many people who use CPAP keep beards, or is that something that is just asking for more leaks, etc?

Facial hair and full face masks present more of a challenge than a nasal cushion or nasal pillow mask but it's not a challenge that can't be mastered.
Years a go I remember seeing a picture of a guy with a Santa Claus beard and he used a full face mask quite successfully. I am sure he had some special challenges but it someone wants something bad enough ... it can be done.

I used the hybrid Mirage Liberty last night and ... nope. NO way. The small mouth area seems to have very little cushioning around a pretty thin and somewhat hard inner seal that is quite painful on the area around the mouth once it is tight enough to seal. And even then it was leaking for me. So I went back to the only thing I had on hand that works at all.. the Swift FX. Man I will say it again, that thing is great. MY STUPID MOUTH BREATHING WONT LET ME USE IT. Here is how bad I must want to breathe through my mouth once I am asleep. I used the micropore tape again last night. I did a slightly different taping method kind of like what was described a few posts back. Long story short, I woke up multiple times, but the telling evidence is I would wake up mouth breathing through the tape. So my brain / body would rather try to breath through restrictive tape than to take the heavy pressure flow of filtered air being shot through my nostrils. Not sure how I am going to overcome this. I guess I will try taping that lets less air through (I also had horrible bloating and pain / gas again last night. That is getting really old.

Gonna finally go get the full face mask that the Dr. talked me out of in the first place. I can't remember the name but it seems quite soft and is the mask I slept for 2.5-3.5 hours on in the last part of the titration. Surely if I slept on it the first night ever I could sleep with it after starting to get used to the therapy in general.

I will get the name and report back.

I think the mask I was talking about is the Simplus full face from Fisher & Paykel.

I am concerned about your aerophagia issues (that belly pain and bloating).
If it doesn't subside you may need a pressure reduction to see if it helps but then your sleep apnea problem may get worse.
wiki/index.php/Aerophagia

While I have been lucky in that I haven't had it really bad except for a couple of times but I had it bad enough it made me ill so I certainly can empathize with you and it needs to be dealt with. Minor burping and farting is one thing but major pain and being ill is totally not acceptable.

I see a lot of good reviews for the Simplus.. let's see how it goes with the leaks and mouth and belly pain and go from there.

OK I got my Simplus mask. Initial try out seems comfortable. Wish me luck tonight!

Luck!!

Went "kind of" OK last night with the Simplus. I found it pretty comfortable and did doze off initially, but woke up with some leaks and then for some reason fought with it for 30 minutes or so to get it comfortable and not leaking. Not sure why... initially in the night I had little problem with it leaking. So around Midnight I got up and went where I could look at the instructions and adjusted the straps, etc. This seemed to help and I got back to sleep until around 3 when something woke me up... not sure if it was the mask. Had bloating again so I walked around a bit and lied back down just to make my stomach move around to relieve some pressure and accidentally fell asleep without the mask. So I got 3-4 hours total with the Simplus, but overall it may be OK. I think I need a large size rather than the medium that they gave me, so I will just order on on Ebay.

Unfortunately I forgot to put the SD card back in, so all I have is the modem data that was sent to the Sleepmapper app. It still shows an AHI of 28 (39 was my raw original AHI with no treatment), so things still have not improved on that front. I dont think I go nearly as long without breathing though.

So I will try again tonight. I leave tomorrow for a school camping trip with my son so I wont have it for a few days after tonight.

Actually with the PR S1 machines you don't lose all the data graphs if you forget to put the SD card back in the machine.
You only lose flow rate graphs.

So go ahead and put the SD card back in the PR S1 and let it write the data to the SD Card that it has stored in its internal memory...then pull it out and go to Sleepyhead and import again. You lost very little and nothing of great importance.

Ah.. great, thanks. In that case here is the readout from midnight to 3 am. I believe I was asleep this entire time. Taking out the earlier hours that I was either awake or barely asleep for minutes at a time reduced the AHI significantly. Still too high of course.

Just got off the phone with the doc. They are going to change my machine into Auto pap mode and see how things progress. He also said that we may look into changing to a bipap to relieve some of the bloating if that doesn't improve.

Well this looks better! Even though I did wake up in the middle of the night and had a bit of a spell trying to make myself keep the mask (I ended up getting up, putting water on my face and making it feel better, then got the mask back on and went back to sleep), I was finally able to get a whole night with the mask on! The Simplus is a big improvement for me.

Also, the Dr. changed the machine to an Apap with a base pressure of 10. It never went over 11.50 and almost always 11, so never the 13 that it was set on in CPAP mode.

My AHI is way better, and if I take out the first session early in the night, which I was awake for a good bit of, the AHI is under 5. I will be at a school camp retreat with my kid starting today and until Friday, so I wont be able to wear the mask again until then. Thanks for the help, I am definitely encouraged.

That's awesome.
How's the belly issues?