First nigh on new machine - not good - worth persevering

After a very long delay, I finally got to try out my Philips Respironics A40 machine for the first time last night.

It didn't go well. Ice woke after about four hours' sleep feeling terrible, that I had had very light and fragmented sleep and had also had bad nightmares. I swapped over to my trusted Philips Respironics BiPAP machine for the rest of the night and slipped a little better but still feel rank today.

With an appointment with the sleek nurse looming in 10 days, I don't even see the point of another terrible night and terrible day unless it's to try out some new settings. Finding time where I can simply budget for doing nothing for a day is not easy.

My question is though whether it would in any case take time to adjust to a new machine and whether you should expect a decent night the first time round. Or if it works for you and the settings are right, would you expect to feel better from the first night on?

Everyone's different, and whether you'd necessarily feel a measurable difference after one night is impossible to say for a given person, machine, etc. etc.

It is not unusual to take a few weeks to get somewhat comfortable using cpap.
Given enough hose time, it feels weird not to wear the mask.
It is now my trigger for going to sleep.

As others have said, trying any new machine may result in some rocky nights at first. Could you tell us why they switched you from the regular BiPap to the A40?

One reason to keep at it with the A40 is to generate more data for review in ten days so the nurse can figure out what changes to the settings might help you. It's unfortunate that your machine is not supported by Oscar, so the experts here can' t review data to try to help you. What data can you see on the machine?

Miss Emerita wrote: ↑

Sun Feb 09, 2020 8:24 pm

As others have said, trying any new machine may result in some rocky nights at first. Could you tell us why they switched you from the regular BiPap to the A40?

It is really an attempt to get my AHI back below 5 and treat my complex sleep apnoea and indeed complex sleep problems that also include Periodic Limb Movement Disorder.

It came about after I asked for an ASV. From a thread I started last year I learned that the A40 is not ASV but AVAPS and actually overkill as I do not have a bronchial disorder that requires a kind of ventilator.

I also feel odd without the hose now, after so many years' use.

Thanks, Chalkie. It sounds to me as though there will be value in generating more data and more subjective experience to report back at your upcoming appointment. And to me me it sounds as though you may need to press the question why you’re on an AVAPS machine instead of an ASV. (And what are they doing about the PLMB? Any try-outs of drugs for it?) There’s no telling whether you’d find an ASV more comfortable, but wouldn’t it be nice just to have the chance to try?

But I hear you when you wonder how many rocky nights you can manage between now and the appointment. Could you maybe do at least some time each work night on the AVAPS and maybe all night when you have a break in work?

But on the third hand, you’ll want to give your body a chance to get used to the AVAPS, which must feel very different from what you are used to. Can you speed up adaptation by using the machine for an hour or so in the evening while you read or watch TV?

Whatever you do, I hope the nurse will listen carefully to what you are reporting and requesting. Sometimes for these important consultations, it helps to have a family member or friend in the room. Anyone you might want to take with you?

Thankyou, very useful suggestions.

I wanted ASV but the sleep nurse and the guy from Respironics who did the titration insisted I needed AVAPS.

Consensus on the forum was that it was massive overkill.

I think only if they feel this has not worked might they then try me on ASV.

I am actually going through different meds under a separate clinic for the PLMD. Just about to start Mirapax (Pramipexole).

Some of what you are experiencing reminds me of what I've been through very recently. Like you, I had been having unusually vivid dreams and nightmares for the past several months in particular. I have 2 BiPAP machines: a ResMed S9 and a ResMed AirCurve VAuto. The AirCurve was new about a year and a half ago, but because I work overnights 3 nights a week, I have a blacked out bedroom I use after those shifts and keep the S9 in there. So anyway, to make a long story short, when I had my followup appointment with my provider a few weeks ago, they were disturbed because my numbers were way high on the AirCurve for the past few months (AHI and leaks up) but normal on the S9. They confirmed that the pressure settings were the same on each, so it was a mystery. It took some time, but I eventually isolated the problem myself to an optional clinical setting on the AirCurve called "Easy-Breathe". What this does is regulate the transition from EPAP to IPAP and vice versa so that it closely matches your breathing pattern and feels more natural, With this setting off, it was going from the low pressure EPAP setting to the doubled high pressure IPAP setting almost instantly. I believe that rapid pulsing was leading to my mouth opening up and leaking (which normally I don't have a problem with but my wife had noticed happening in recent months). Once I realized this was happening, I couldn't un-see it (I switched years ago from an S8 to an S9 because the S9 was so much more natural in this regard). I've been tracking my data since making the adjustment and there's no question this was the culprit. There may be a setting on your machine that serves a similar purpose, but it should be in the clinical menu. If your old machine has this on and your new one doesn't, then you may have your answer here.

What mode and exact settings are you currently using? The more details the better. It's hard to keep track with multiple threads over time.

Sorry for not replying sooner. The hospital just grabbed it back. Back on BiPAP.