Newbie Question - My First Night

thompsdw · Post by **thompsdw** » Fri Aug 03, 2018 7:08 pm

I had my first night last night with my dream station and my pillow mask. My mask is a Swift™ FX Nasal Pillow. I do have a deviated septum, but one nostril is usually open. I decided to go this route versus a full mask. Things went better than I expected. The only thing that was a little hard was the difficulty breathing out of my nose with the pressure. My mask fit was 100% and my AHI was 8.1. I had 10 clear apneas, 8 obstructive apneas, and 55 hypopneas. I did have a sleep test prior to obtaining the cpap.

So here is my potentially dumb question. I really wanted the nasal pillow but wasn't sure it would work for my case. So, if the machine detected the above figures and my fit was good - do I assume that the machine "corrected" the events? In other words, is my current setup working for me or not?

Julie · Post by **Julie** » Fri Aug 03, 2018 7:13 pm

Do you sleep on your back? If you can change that to your side, I imagine you'd get rid of a lot of those hypops and bring your AHI down...

Have you downloaded Sleepyhead?

Pugsy · Post by **Pugsy** » Fri Aug 03, 2018 7:20 pm

Welcome to the forum. I think you probably will need a slight pressure adjustment upwards.

Please see the sticky "Newbies...please read before posting at the top of the Topic section.

We need to know which brand and model machine along with what the settings are.

I have a couple of ideas to help you but need to know what the current settings are and which machine first.

The flagged events you see reported from last night...those are the ones that slipped past the defenses and happened. We would like for it to be a little lower than that. I need to see when they happened and what the machine was doing when it happened.
See this thread
viewtopic/t158560/How-to-post-images-for-review.html

and for information about getting the software to generate those reports see here
https://sleep.tnet.com/equipment

And yes...as long as you can breathe through one nostril we can make the pillows work for you. I know lots of people using nasal pillows with a deviated septum using pillows successfully.

The difficulty exhaling...once we know which machine and what settings we may be able to add some exhale relief...or maybe just increasing a size in the nasal pillow will make it easier.

thompsdw · Post by **thompsdw** » Fri Aug 03, 2018 7:39 pm

Thank You. I have a respironics dream station auto with humidifier. The current settings are the default 4-20. I am a side sleeper only due to my deviated septum. Let me know if you need other info. Good instructions on how to post. Here is my data.

thompsdw · Post by **thompsdw** » Fri Aug 03, 2018 8:12 pm

: Screen Shot 2018-08-03 at 8.05.51 PM.png (802 KiB) Viewed 900 times

Pugsy · Post by **Pugsy** » Fri Aug 03, 2018 8:15 pm

Try minimum of 7...
Set Flex exhale relief to 2 if it isn't already set to 2....but even if it is set to 2 it doesn't engage until you reach 6 cm pressure and you wouldn't usually be doing that while awake. It will make the exhale easier

If you don't know how...go here and get the provider manual for your machine.
https://www.apneaboard.com/adjust-cpap- ... tup-manual
instructions for how to request it via email about 2/3 down the page

After these changes above...get SleepyHead and let's see some reports. I can't make any other suggestions until I see a detailed report to see how these changes work and the events are getting flagged.
The 4 to 20 thing...that's the factory default...it's rare that those settings work well an it's rare that it doesn't create a problem exhaling especially with nasal pillows.
The minimum pressure is your most critical pressure.

Edit...just saw you posted a detailed graph. Good job. Confirms my idea... and I wouldn't alter my suggested settings.

Are you comfortable changing things yourself?

thompsdw · Post by **thompsdw** » Fri Aug 03, 2018 8:21 pm

Yes, I was in the menu last night. Thanks so much for the help. I will post a follow up tomorrow. Minimum pressure right? So 7-20? Changes complete. Flex Exhale was at 2 already.

Pugsy · Post by **Pugsy** » Fri Aug 03, 2018 8:36 pm

Yes...minimum 7...max 20

While awake you weren't getting the effect of the Flex setting at 2 because awake you were at 4 cm and the machine doesn't turn on Flex at all until you are using at least 6 cm and you wouldn't be doing that while awake.

Pugsy · Post by **Pugsy** » Fri Aug 03, 2018 8:37 pm

If you still have trouble exhaling at 7 cm with Flex at 2...try a size larger in the nasal pillow if you have one available.

thompsdw · Post by **thompsdw** » Fri Aug 03, 2018 8:56 pm

Thanks again. I found out the impact of the pillow size last night. I tried both the Medium and Large. Large was much better and that is what is currently installed in my mask.

thompsdw · Post by **thompsdw** » Sat Aug 04, 2018 10:30 am

Interesting night. Worse than the previous, but here is one interesting thing. I was awoken my my work at 4:40 am. At that time my AHI was in the lower 7's, but after the call I went back to sleep and things became more active. I don't have to be an expert like some here to see the difference in the traces. Any help is appreciated if settings need to be changed or just wait and see another night. Exhale did feel better with the 7-20.

Pugsy · Post by **Pugsy** » Sat Aug 04, 2018 10:47 am

Try 8 cm minimum tonight. I suspected you would need more but I wanted to go up slowly.
Next time you post the detailed report you don't need to post all the graphs.
On the right side all we need. No need to do any more work than you have to.
Events
Flow rate
Pressure
Leak

along with the usual stuff on the left.
If we need anything else we can just ask. You can get all we need on one screen shot.

Some of that stuff after 4 AM might be SWJ sleep/wake/junk so I am not too concerned about it right now but there was enough stuff going on before 4 AM that I wouldn't like to see if it were my report.

thompsdw · Post by **thompsdw** » Sun Aug 05, 2018 7:38 pm

Here are todays results. Best yet! I am starting to have some nasal dryness and discomfort. I assume turn up the humidifier? It is on 3 now.

Pugsy · Post by **Pugsy** » Sun Aug 05, 2018 7:44 pm

Good job.

Yes...if the nasal mucosa is a little dry ...try a little more humidity so yes...increase.

Also...even with maximum humidity my nasal mucosa sometimes will feel a bit dry so I keep something like Simply Saline around just to add a little extra moisture. Usually I do a couple of squirts at bedtime to just give the mucosa a little boost. Hurts nothing...
It doesn't have to be name brand Simply Saline. I think what I got at WalMart was Oceans something or other.
I also use it if I happen to catch a cold.

thompsdw · Post by **thompsdw** » Mon Aug 06, 2018 6:13 pm

Results regressed a bit. Mask fit changed a bit. Leave settings as is and refit mask, or change? Interesting that the number in the DreamMapper App is 6.7. Not sure why the report is different.

Newbie Question - My First Night

Newbie Question - My First Night

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