Needs help choosing the right mask. Adjusting to CPAP.

It's pretty good fora start, I've seen much much worse.

I just noticed that the screenshot I uploaded didn't include the AHI (which was 7.72 anyway) so I had to go back and edit it.

palerider wrote: ↑

Sat May 02, 2020 10:26 am

It's pretty good fora start, I've seen much much worse.

Thanks for the motivation. I'm not giving up yet. I'll talk to him tomorrow morning to see what he felt that had gone wrong for him. During that 1,5-hour-sleep he did open his mouth a few times which led to air escaping through his mouth. I wonder if that was what led to a total leaks of 51.0? Anyway I think I'll have to ask him to try again tomorrow with the Dreamwear full face mask on.

I hope he won't complain about the dry mouth tomorrow morning because that would mean I have to increase the humidity to 5 as well as turn on tube heating! I read that such high setting could potentially lead to rainout. Oh my, problems after problems!

i just lost a detailed response I had written, sigh, it didn't send, I can't rewrite it now but I did wand to let you know about this mask:

Respironics Wisp

I've tried many types of masks in the last 7 years,both full-face and nasal, none gave me as much air as the Wisp does!
And none was as comfortable, and stayed in place.

It's made like a full-face mask, with a plump cushion all-around the mask, but is tiny, it only covers the tip of the nose.
It ties on using magnets, so very quick to take off if you need to get up at night.
A chin strap (sold separately) must be wrapped tightly to prevent air escaping the mouth.

To alleviate being conscious of my breathing, I use a small radio near my pillow, and set it to play at low volume, a low-key, congenial talk show like the BBC (playing on the local public radio)

Hope this helps !

samurai3005 wrote: ↑

Sat May 02, 2020 10:40 am

I just noticed that the screenshot I uploaded didn't include the AHI (which was 7.72 anyway) so I had to go back and edit it.

palerider wrote: ↑

Sat May 02, 2020 10:26 am

It's pretty good fora start, I've seen much much worse.

Thanks for the motivation. I'm not giving up yet. I'll talk to him tomorrow morning to see what he felt that had gone wrong for him. During that 1,5-hour-sleep he did open his mouth a few times which

Removing the mask while asleep is a thing many people contend with when starting treatment. It's rarely a conscious decision.

palerider wrote: ↑

Sat May 02, 2020 12:17 pm

samurai3005 wrote: ↑

Sat May 02, 2020 10:40 am

I just noticed that the screenshot I uploaded didn't include the AHI (which was 7.72 anyway) so I had to go back and edit it.

palerider wrote: ↑

Sat May 02, 2020 10:26 am

It's pretty good fora start, I've seen much much worse.

Thanks for the motivation. I'm not giving up yet. I'll talk to him tomorrow morning to see what he felt that had gone wrong for him. During that 1,5-hour-sleep he did open his mouth a few times which

Removing the mask while asleep is a thing many people contend with when starting treatment. It's rarely a conscious decision.

I asked him this morning and he said he felt suffocated at that time, which was why he just wanted to "get this thing off me". He said that during the first hour after closing his eyes, he had to "stay awake to make sure my mouth doesn't drop" which he felt was very uncomfortable. I don't know what I should do next.

samurai3005 wrote: ↑

Sat May 02, 2020 11:12 pm

palerider wrote: ↑

Sat May 02, 2020 12:17 pm

samurai3005 wrote: ↑

Sat May 02, 2020 10:40 am

I just noticed that the screenshot I uploaded didn't include the AHI (which was 7.72 anyway) so I had to go back and edit it.

palerider wrote: ↑

Sat May 02, 2020 10:26 am

It's pretty good fora start, I've seen much much worse.

Thanks for the motivation. I'm not giving up yet. I'll talk to him tomorrow morning to see what he felt that had gone wrong for him. During that 1,5-hour-sleep he did open his mouth a few times which

Removing the mask while asleep is a thing many people contend with when starting treatment. It's rarely a conscious decision.

I asked him this morning and he said he felt suffocated at that time, which was why he just wanted to "get this thing off me". He said that during the first hour after closing his eyes, he had to "stay awake to make sure my mouth doesn't drop" which he felt was very uncomfortable. I don't know what I should do next.

Try a full face mask.

He just removed his Amara View mask (sorry it wasn’t the Dreamwear FFM like I said) after 30 minutes through his afternoon nap. He said he felt like he had to exhaust energy and concentrate to keep up with the pressure (mainly for exhalation), and as such he couldn’t fall into sleep. After a while he said he felt exhausted so he had to open his mouth to exhale easier. And because his mouth was opened, the blowing air made his throat dry (although humidity was 4 already) and he couldn’t sleep with the air always blowing into his mouth.

Can an upgrade to a better machine (say: Resmed Autoset Airsense 10) will allow him to exhale easier? I’m really at no clue at the moment!

samurai3005 wrote: ↑

Sun May 03, 2020 1:42 am

He just removed his Amara View mask (sorry it wasn’t the Dreamwear FFM like I said) after 30 minutes through his afternoon nap. He said he felt like he had to exhaust energy and concentrate to keep up with the pressure (mainly for exhalation), and as such he couldn’t fall into sleep. After a while he said he felt exhausted so he had to open his mouth to exhale easier. And because his mouth was opened, the blowing air made his throat dry (although humidity was 4 already) and he couldn’t sleep with the air always blowing into his mouth.

Can an upgrade to a better machine (say: Resmed Autoset Airsense 10) will allow him to exhale easier? I’m really at no clue at the moment!

The *aflex" often makes people think they have to change their breathing to satisfy the machine, but that's not at all true.

The machine is purely reactive, it's driven by his breathing. while it's easier said than done, the best thing to do is just *ignore* the machine, ignore what it might be trying to do, and just breathe normally.

It's possible that turning aflex off might make it less annoying.

And, yes, a Resmed feels much more natural when it does its pressure relief.

Just echoing palerider here. I had a week of home "titration" on a Respironics machine, and I hated it because it always felt as though it was trying to get me to start inhaling before I was ready. Luckily, the machine they gave me for keeps was a ResMed Airsense 10 Autoset. The experience was like night and day. The ResMed machine felt as though it was following me, not trying to lead me, and following with almost instantaneous adjustment.

Miss Emerita wrote: ↑

Sun May 03, 2020 10:59 am

Just echoing palerider here. I had a week of home "titration" on a Respironics machine, and I hated it because it always felt as though it was trying to get me to start inhaling before I was ready. Luckily, the machine they gave me for keeps was a ResMed Airsense 10 Autoset. The experience was like night and day. The ResMed machine felt as though it was following me, not trying to lead me, and following with almost instantaneous adjustment.

ResMed fanboy here. These are the sentiments of many of us on this forum. Respironics is coarser in all respects with regards to therapy. If you have the opportunity, get a ResMed.

Chris

Thank you, palerider, Miss Emerita and DreamDiver for taking your time to help out a “lost cause” like mine

I’ll contact the ResMed distributor to order a couple of days of trial of the new ResMed Autoset. In here they charge 4 USD/night. But before that I’d like to ask a couple of questions:

1/ What is the equivalent of A-flex setting 2 in the Resmed Airsense Autoset series?

2/ How long did it take you guys to practice using it? Like tried to put it on and do other stuff to get this breathing in a cpap a 2nd nature?

samurai3005 wrote: ↑

Sun May 03, 2020 4:09 pm

1/ What is the equivalent of A-flex setting 2 in the Resmed Airsense Autoset series?

It's not exact because the way each brand drops the pressure to give the exhale relief is a bit different.
AFlex drop is based on how forcefully someone breathes and it isn't a per cm drop like ResMed's exhale relief (called EPR or exhale pressure relief).
So the most a person can get with using Flex is a 2 cm drop even with a setting of 3.
Probably someone using a setting of 2 with Flex is going to get about a 1.5 cm drop and that's IF they are a rather forceful breather.
If they tend to be a weaker or more shallow breather they probably won't get 1.5 cm.
Flex exhale relief also seems to be more of a timing issue and that's why some people don't do well with it. It doesn't sync up with their own breathing pattern easily...wants to rush the breath or sometimes lags behind.

ResMed's exhale relief is a straight per cm drop depending on the setting. Setting of 1 is a 1 cm drop...setting of 3 is a 3 cm drop during exhale.

samurai3005 wrote: ↑

Sun May 03, 2020 4:09 pm

Thank you, palerider, Miss Emerita and DreamDiver for taking your time to help out a “lost cause” like mine

I’ll contact the ResMed distributor to order a couple of days of trial of the new ResMed Autoset. In here they charge 4 USD/night. But before that I’d like to ask a couple of questions:

1/ What is the equivalent of A-flex setting 2 in the Resmed Airsense Autoset series?

2/ How long did it take you guys to practice using it? Like tried to put it on and do other stuff to get this breathing in a cpap a 2nd nature?

1. What Pugsy said. It's readily available in the patient menu and easy to experiment with. Try it with EPR on for a night - set to 1, 2 or 3. Because it's so different from flex, the only way to know a good setting is find out how it feels for your dad. If he doesn't like it at all, just turn EPR off. So that's four different options.

2. I noticed that breathing felt more natural from the first night. I keep EPR set to 3.

Chris

samurai3005 wrote: ↑

Sun May 03, 2020 4:09 pm

Thank you, palerider, Miss Emerita and DreamDiver for taking your time to help out a “lost cause” like mine

I’ll contact the ResMed distributor to order a couple of days of trial of the new ResMed Autoset. In here they charge 4 USD/night. But before that I’d like to ask a couple of questions:

1/ What is the equivalent of A-flex setting 2 in the Resmed Airsense Autoset series?

2/ How long did it take you guys to practice using it? Like tried to put it on and do other stuff to get this breathing in a cpap a 2nd nature?

1) to echo Pugsy's comment, Resmed does a very simple pressure drop of one cm per number set, 1, 2, or 3cm, so , probably a 1... but your dad may like a 3 much better. Plus, where the Respironics wants to raise pressure *before* you start to inhale,(under the idea that having full pressure whenever you start to inhale will help keep the airway open), which makes some people feel like the machine is trying to rush them... it's really not, it'll just sit there doing nothing if you refuse to start inhaling for a few more seconds... but it still *feels* wrong, to many people, Resmed doesn't do that, it doesn't increase pressure until you start to inhale, here's an example;


2. I can't really help with that, I just put on my very first cpap and passed out, didn't wake up, (or move) till morning.

@palerider, Pugsy, DreamDiver, Miss Emerita: thanks for the detailed explanation. You gave me great cause to try out this new machine.

Update: So I got the Airsense Autoset 10 now. I have to say, the machine looks very professional. My current setting is:
- Comfort: Starting pressure: 5cm; Ramp time 15 minutes.
- Min pressure: 6cm H2O
- Maximum pressure: 15cm H2O
- EPR 3 - full time.

I also got him to try out for 15 minutes with above setting in the Airfit P30i nasal pillow. He said he felt much better than all of the previous attempts. Though he still wants to sleep without the CPAP for a full night tonight. But he's keen on practicing using it tomorrow.
We decided to go slow to make sure better adaptation. I wanted to get the Airfit P30i because I want him to be able to use his phone (he's working from home at the moment) while on CPAP, trying to ensure this becoming a 2nd nature. Then we'll try to get a full noon nap in it and we'll see how it goes from there. So fingers crossed for a busy tomorrow!

However, in the long run, I have great doubt that the Airfit P30i will be tolerable for a full night sleep due to:
- Its side tube is relatively thin and I think it'd get blocked once my dad turns his head. The pillow he's using is just an ordinary one.
- He will definitely unconsciously open his mouth which would make his mouth dry. Maybe a chin strap is the way forward?

But first thing first, I have to make sure he's getting used to the new machine. Thanks all for your support. I'll get back to you guys real soon.