New to cpap

Hi, all,

After five years of utter exhaustion, I was diagnosed with OSA. I did a home sleep study (doctor's preference to having me in the hospital during COVID concerns) which showed an AHI of 27.5. The doctor ordered a sleep study/titration at the hospital, but then I got a call saying insurance had denied it and instead approved an auto CPAP which did not require an expensive stay in the hospital to titrate pressure.

I got my auto CPAP and mask yesterday. The mask is remarkably comfortable. The cpap is quiet. I took a long time last night to just rest with the cpap on and get used to breathing through the pressure. It took longer than usual to go to sleep, but I assume that was just the new circumstances. However, I slept very poorly and finally took the mask off after about 4.5 hours. Towards the end of that stretch, I repeatedly woke up because I couldn't exhale without conscious effort. I assume the machine was adjusting the pressure up because of events. The low and high pressure settings are currently 4 and 15.

Furthermore, when I looked at the MyAir app this morning, it reported an AHI of 21.3 for the time I had the cpap on. (It also showed that my mask fit was perfect.)

I mean, I've only had this machine one night. Does my body just need to adjust? Is it possible the automatic air settings aren't correct for me? Waking up because I had to physically force the air out of my lungs to exhale was kind of disturbing.

I'm more tired than usual today and woke up with a low grade headache that has hung on all morning.

Oh, and if it makes any difference, I'm a woman in my early 40s and have a slight build--not a stereotypical OSA patient (when I asked for a sleep study, my doc confidently assured me I wouldn't have OSA--but she still ordered the study, thank goodness).

Can anyone give me any advice on what I should do, if anything? I have a follow up with my doctor in three weeks to "see how it's going," but I won't make it three weeks on the CPAP if I have more nights like last night.

Get OSCAR so we can see what kind of events got flagged as well as when they got flagged.

OSCAR https://www.sleepfiles.com/OSCAR/
http://www.apneaboard.com/wiki/index.ph ... stallation
http://www.apneaboard.com/wiki/index.ph ... rpretation

If you want to share an image of a daily report to get member input please review this thread for formatting.
viewtopic/t158560/How-to-post-images-for-review.html

Don't worry so much right now about the reported AHI from last night. These machines don't know if we are asleep or not. They only measure air flow and our awake breathing is irregular when compared to asleep breathing and it is common for the machine to flag awake breathing irregularities as some sort of apnea event. You had trouble falling asleep and staying asleep. Very common for the first night.
It will get better as you get used to things.

Your minimum pressure of 4...that's often too low for people to be comfortable with. We won't suffocate but man it sure feels like we will. Just not enough air movement in general.
Go here and download the manual. It explains how to get to the clinical setup menu area where you can increase that minimum pressure a bit so you will be more comfortable. Something around 6 should be more comfortable.
Set your EPR to 2 to full time. and that should make exhaling much easier for you. Further adjustments can be made as needed depending on how you feel and what the reports show.

https://www.respshop.com/manuals/ResMed ... %20her.pdf

Thank you, Pugsy!

I'll take a look at the manual (getting some exhalation relief would be great!!) and also look into OSCAR.

I read some of the success stories, too. It's good to see other people had a rough start.

Hlge wrote: ↑

Thu Sep 03, 2020 11:45 am

Thank you, Pugsy!

I'll take a look at the manual (getting some exhalation relief would be great!!) and also look into OSCAR.

I read some of the success stories, too. It's good to see other people had a rough start.

welcome to the zoo!

you'll get the good advice from pugsy. pay close attention to her.

we'll soon have you all dialed in. everyone, it seems, gets off to a rough start with these darned machines. i know i certainly did.

it would help if the doctors prescribing the machines knew just a bit more about them. or at least, tell us more.

you can do this. after a bit, you'll wonder what all the fuss was about.

good luck!

Thanks, Zonker.

Last night was a little better, though I'd hesitate to say good. But at least I feel hopeful!

Hlge wrote: ↑

Fri Sep 04, 2020 9:04 am

Thanks, Zonker.

Last night was a little better, though I'd hesitate to say good. But at least I feel hopeful!

it'll get easier as you go. i wish i could predict it for you. wish i could say 8 weeks, 3 days and 14 hours.

alas, each of us is different and it takes our brain and bodies however long it takes. and you are likely to feel gradual improvement, not an overnight miracle.

continued good luck!

Hang in there Hlge, and stay with the great people on this board. They got me through my start up and bumps along the way. There is a gold mine of information here, so whenever you have time do some searches on topics and read, read, read. One thing will lead to another, because right now you don't know what you don't know. So we have Covid, Social-distancing from friends and family, lots of job insecurity around, riots, and now you have to learn a new "language" with tons of terminology, charts, numbers that are completely foreign, a piece of equipment in bed with you, and this thing you have to wear on your face that forces air in your nostrils....please forgive yourself if you feel overwhelmed right now. It will take time, but you will get to where you will be comfortable with it all. I am seven years in, and wouldn't think about sleeping without my Cpap, and still come here often to read and learn. You can do this!

Thanks, shaggyzack.

I've discovered there's no SD card in my machine. Can I just put any old one in there and use it to get the data?

(Also, I'm not sure if there's an SD slot on the computer I downloaded OSCAR to...I need to poke around the back of it.)

Wish me luck, I'm going in for another night. This time I'm armed with Advil and an antihistamine.

Pretty much any old generic SD card will work as long as it isn't damaged or have bad sectors. 2 GB is sufficient. You will want to erase any old files off of it first though.
ResMed machines want blank SD cards.
There's no need to do an official format though...the cpap machine will do that for you.

(Also, I'm not sure if there's an SD slot on the computer I downloaded OSCAR to...I need to poke around the back of it.)

For a laptop the slot should be on the side, on a desktop (CPU) it would be in the front. If you have a fairly new computer, it may not have a SD slot, and you would have to buy a SD card reader with a USB connector for $8-$10 at most any place that sells electronics. Good Luck!

Oh...when you insert the SD card into the machine it will initially only write the summary data to the card because that is all that is stored in the cpap machine's internal memory ...so don't panic if you use OSCAR and you don't see the graphs and other details.
Those detailed data files that compose the graphs and stuff have to go directly to the SD card when they are being generated. The cpap machine doesn't store those detailed files in its internal memory.
SD card has to be inserted in the cpap machine during use to get those detailed data files.

So you have some data stored on the machine that will go onto the SD card now but until you actually use the machine with the SD card inserted...you only get the summary numbers.

Last night was better! It started off rough (took the mask off after the first two hours) but I tried again when I woke in the middle of the night and got four solid hours of good sleep. I was still a little sleepy when I got up, but my body felt rested instead of exhausted.

The machine is reporting an AHI of 13, so I guess I'm moving in the right direction. I'd like to see what OSCAR says, though. MyAir sent me an email suggesting I contact my clinician because in having too many events.

I'm going to see if we have an extra SD card floating around the house. I think we do. Our computer is one of those that combines the compute and monitor together, and all the plug ins are on the back of the thing (where they are hard to reach--it's set up against a wall).

Thank you to everyone for the advice and encouragement. It is very helpful.

I've got an SD card in the CPAP and a USBcard reader for my computer.

I'm going to see if OSCAR can give me some insight into why I'm waking up after an hour with such high air pressure I can't exhale (last two nights). But it doesn't happen in the early morning hours.

I had significant aerophagia last night, too. I'm typically a mouth breather. I've had trouble breathing through my nose as long as I can remember, and I was *really* pleased when I find out the CPAP pressure opened up my nasal passages enough to breathe easily. However, I already had a full face mask (because I assumed I would not be able to breathe through my nose) and if my tongue falls off the roof of my mouth (which it does a lot, I think) all that pressure pushes the air right down my esophagus. But if I had only a nasal mask, then that air would just leak out of my mouth, right? So I'm not sure what to do about that.

Going in for another night. I'm... not looking forward to waking up with crazy pressure making me feel like I can't breathe.

So here is my OSCAR information from last night.

As you can see, I am not very good at keeping the mask on all night yet.

That first little bit of information was a nap I took in the afternoon.

Unlike the previous two nights, last night I didn't wake up early with high pressure making me feel choked, it was after an initial period of good sleep. And it appears that the CPAP ramped up because of a bunch of central apneas (unless I was having arousals and didn't know it and so they don't count? I don't know how to tell).

I didn't have any central apneas flagged in the home sleep study report, so I'm not sure what to make of that.

Can someone tell me what I'm missing?

No...the central flagged events were NOT the cause of the increase in pressure.
These machines don't do anything at all if they sense a central apnea all by itself. They won't ever increase the pressure for a central apnea because it isn't part of the auto algorithm because it won't help.

Most likely the machine increased the pressure due to flow limitations and the OAs/hyponeas and the increase in pressure maybe caused an arousal and those centrals are arousal/awake related.
Watch the videos here especially the last one.
http://freecpapadvice.com/sleepyhead-free-software

You need a little more minimum pressure to better prevent the flow limitations and OAs/hyponeas from happening.