New CPAP User - Advice Sought (Sleephead Data)

Hello All,

I've been using my Philips Respironics DreamStation Auto CPAP since July 13 and it has been a struggle to get it working for me. I started with the Amara view mask which did not work for me, then switched to the Dreamwear Nasal for a week but I was having issues with leaking when I slept on my side and the mask slipping up off my nose. On Friday last week, I switched to the Brevida Nasal Pillow and I'm loving it. It doesn't fall off and it's pretty comfortable. However, I am removing the mask at some point in my sleep, pretty consistently around the 3 hour mark, though with the Brevida last night I had to adjust in between that 3 hour window. I am seeing my lowest AHI levels on the Brevida - my rate before treatment was 104 and last night was down to 4.67. Today I tried something different - I had a nap with the nasal pillows on but left the headband off that I was using to hold my mouth closed. My AHI over an hour was 1.29. I'm sure this isn't long enough to be statistically relevant but I plan to try again tonight.

My questions are these:

I think I'm taking my mask off because of the general feeling that I'm not getting quite enough air. When I look at the graph, I seem to be maxing out consistently at 15. The prescription I have is for a max pressure of 15, and I'm starting at 12. Should I be considering a higher max pressure rate?

The lower my AHI goes, the worse a headache I have when I wake up. My first night with treatment went down to 28 AHI and it has steadily been getting better. But the headaches are awful. My previous untreated I had really low oxygen desats. Could it be possible that the dramatic shift from 104 AHI to below 5 is causing these headaches?

I assume I'll feel more rested if I can get more than 3 hours of treated sleep, but I haven't seen any benefits yet.

Edit to add... I haven't had my final sleep study where they tweak the calibration levels for me. I was fast tracked onto a machine while I wait for it.

Thanks!

I agree. Bump it up. How about 18?

I'm new as well, but in terms of the headache, consider increasing humidification and giving Sudafed a try. For me at least, it seems to be sinus related.

jillyvn wrote: ↑

Mon Jul 23, 2018 7:01 pm

I think I'm taking my mask off because of the general feeling that I'm not getting quite enough air. When I look at the graph, I seem to be maxing out consistently at 15. The prescription I have is for a max pressure of 15, and I'm starting at 12. Should I be considering a higher max pressure rate?

Absent pressure related problems, (like bloating) there's no legitimate reason to restrict the max pressure. The machine only raises pressure in response to breathing events, and once it gets to a point where you're breathing well, it stops increasing pressure... setting a lower limit just keeps it from being able to do it's job, and extends the time it takes to find what pressures you really need.

I'd suggest opening it up to 20.

You say you're feeling you're not getting enough air... could you explain what you mean more? most of the times people saying they're suffocating is because it's too hard for them to exhale, OR they're feeling starved for air.. but that's when their pressures are much lower than yours. You saying that you're not quite getting enough makes m wonder exactly what you're feeling.

jillyvn wrote: ↑

Mon Jul 23, 2018 7:01 pm

The lower my AHI goes, the worse a headache I have when I wake up. My first night with treatment went down to 28 AHI and it has steadily been getting better. But the headaches are awful. My previous untreated I had really low oxygen desats. Could it be possible that the dramatic shift from 104 AHI to below 5 is causing these headaches?

There may be other things that are causing you issues, usually headaches are because you're not getting enough air... but, you should be getting plenty... and it doesn't look like the vents on your mask are blocked.

jillyvn wrote: ↑

Mon Jul 23, 2018 7:01 pm

I assume I'll feel more rested if I can get more than 3 hours of treated sleep, but I haven't seen any benefits yet.

Yes, you will need to get most of a nights sleep, on a regular basis, to feel good.

I think you picked the wrong mask in the profile equipment menu...you might want to go fix it.
You picked Bravo and you are using the Brevida.

Pugsy wrote: ↑

Mon Jul 23, 2018 10:17 pm

I think you picked the wrong mask in the profile equipment menu...you might want to go fix it.
You picked Bravo and you are using the Brevida.

Thank you for catching that! I have fixed it now.

Absent pressure related problems, (like bloating) there's no legitimate reason to restrict the max pressure. The machine only raises pressure in response to breathing events, and once it gets to a point where you're breathing well, it stops increasing pressure... setting a lower limit just keeps it from being able to do it's job, and extends the time it takes to find what pressures you really need.

I'd suggest opening it up to 20.

You say you're feeling you're not getting enough air... could you explain what you mean more? most of the times people saying they're suffocating is because it's too hard for them to exhale, OR they're feeling starved for air.. but that's when their pressures are much lower than yours. You saying that you're not quite getting enough makes m wonder exactly what you're feeling.

There may be other things that are causing you issues, usually headaches are because you're not getting enough air... but, you should be getting plenty... and it doesn't look like the vents on your mask are blocked.

Thank you so much for your input.

I was told by the person who is working with me on my equipment (I'm on a trial machine) that I cannot set the maximum pressure higher than the prescribed range from my doctor, which is 15, unless I get a new prescription. I'm hoping that we might be able to get that before my sleep study at the end of August. I'm in Canada, so I'm not sure if things are different here. I was pretty sure my pressure should be higher, thank you for suggesting that.

As for not enough air, I think it might be a psychological thing - I know I'm getting enough air but because I'm breathing through my nose where I'm used to breathing with my mouth open, I feel like there just isn't enough air. It's tough to describe. i don't think it is the exhalation thing because I don't seem to find an issue with that. I do have to breathe harder to exhale while I'm awake, so maybe I'm experiencing more of an issue when I'm asleep?

The mask is new and the air pressure feels pretty strong before I put it on. It's interesting because if I pull it away while the machine is on, it's like the air is blasting out, but once I put it on again, I'm not bothered by the air pressure at all. I really do like the Brevida mask much better. I'm sure with time I'll get used to it.

Fetou wrote: ↑

Mon Jul 23, 2018 8:05 pm

I'm new as well, but in terms of the headache, consider increasing humidification and giving Sudafed a try. For me at least, it seems to be sinus related.

Interesting! I'll try that.

I'm excited to see that you found a mask that works better for you than the Dreamwear nasal one! I'm a new user too, have only had my machine for about a month and I am just not liking my Dreamwear nasal mask. Everywhere I go I see rave reviews about how this mask is SO MUCH BETTER than any other mask anyone has ever tried and I've been getting a bit discouraged because I just don't like it. I'm a side sleeper and it just slides all around my face no matter how tight I make it (and if I make it too tight it just slides off the tip of my nose. I don't like having air coming around the sides of my face and I feel restricted when my face is pushing on the tubes. I was starting to wonder if maybe I'm just a new spoiled user used to not wearing anything at all on my face and that this was as good as it would get

I tried ordering the Amara View thinking that maybe my problem was full face vs nasal, maybe I'll look into this mask too!

jillyvn wrote: ↑

Mon Jul 23, 2018 11:17 pm

Fetou wrote: ↑

Mon Jul 23, 2018 8:05 pm

I'm new as well, but in terms of the headache, consider increasing humidification and giving Sudafed a try. For me at least, it seems to be sinus related.

Interesting! I'll try that.

Keep in mind that Sudafed is a stimulant. You have to weigh the reduction in sinus congestion against how much the stimulant side affect may keep you awake.

jilyvn, if those were my charts...

I would print them out and make a note that the maximum pressure doesn't seem to be enough.

I would then adjust the maximum pressure up and try that for a few days. Once again printing out the charts and noting the increase in pressure.

I would then drop off this comparison at your doctors office notifying them of the change and why the change and request a change in prescription based upon the results you are seeing with the idea that your sleep study later in August should confirm what you are seeing.

Sova wrote: ↑

Tue Jul 24, 2018 8:49 am

I'm excited to see that you found a mask that works better for you than the Dreamwear nasal one! I'm a new user too, have only had my machine for about a month and I am just not liking my Dreamwear nasal mask. Everywhere I go I see rave reviews about how this mask is SO MUCH BETTER than any other mask anyone has ever tried and I've been getting a bit discouraged because I just don't like it. I'm a side sleeper and it just slides all around my face no matter how tight I make it (and if I make it too tight it just slides off the tip of my nose. I don't like having air coming around the sides of my face and I feel restricted when my face is pushing on the tubes. I was starting to wonder if maybe I'm just a new spoiled user used to not wearing anything at all on my face and that this was as good as it would get

I tried ordering the Amara View thinking that maybe my problem was full face vs nasal, maybe I'll look into this mask too!

Hi, I'm sorry for the late reply, I missed notifications on new posts here. I had the exact same problem with the Dreamwear mask. I hope you have luck with the Amara. I tried it but it wasn't for me. This F&P mask is working great though. I've moved on to Bipap and am hopeful for success now.

HoseCrusher wrote: ↑

Tue Jul 24, 2018 4:54 pm

jilyvn, if those were my charts...

I would print them out and make a note that the maximum pressure doesn't seem to be enough.

I would then adjust the maximum pressure up and try that for a few days. Once again printing out the charts and noting the increase in pressure.

I would then drop off this comparison at your doctors office notifying them of the change and why the change and request a change in prescription based upon the results you are seeing with the idea that your sleep study later in August should confirm what you are seeing.

I apologize for the late reply - I missed the notification. Thank you for your suggestions. My sleep study did confirm that my pressure levels were far too low. I'm on a bipap machine now and trying the new settings tonight.