New APAP user without sleep study looking for advice

GrumpyHere · Post by **GrumpyHere** » Tue Jul 13, 2021 10:32 am

gadgetmaniah wrote: ↑
Mon Jul 12, 2021 1:09 pm
I actually sleep on the floor on a mattress these days

gadgetmaniah wrote: ↑
Tue Jul 13, 2021 9:04 am
the weight of the heated tube added to the discomfort and I think it would be more comfortable to use with a normal slim tube.

You could buy or rig up a hose manager like the pictures below to take the hose weight. With the bonus of getting the hose out of the way.

Some diy efforts:
viewtopic/t59798/Which-hose-management- ... 15#p598461

viewtopic/t72611/Let-us-see-your-machin ... ml#p667875

viewtopic/t111990/Hose-management-devic ... 5#p1375545

viewtopic/t40917/Which-hose-management- ... 15#p358891

Links to a lot of hose hangers and discussion of hose management
viewtopic.php?t=10640

This one looks diy but is actually commercial!!!

JLROhio · Post by **JLROhio** » Tue Jul 13, 2021 11:00 am

I think having it on the floor is ok as long as it is out of the way and is not likely to be kicked or tripped over by someone. The only concern of being on the floor would be the concern that the machine is lower & closer to dust and dirt that could be on the floor. I would recommend putting it on some sort of carpet or rug to help keep the dirt away - then again, I don’t really know how carpet/rug fibers would be just as bad. Ensure you either keep the floor clean & change the filter (filters are relatively cheap).

As to your mask, hose, new machine, etc. you’re introducing a lot of changes all at the same time.
Go back to a slimline type hose & the most comfortable mask you have and get used to them. After that, then consider changing either a mask type or hose type, one at a time so you can adjust and the adjustment is only one thing at a time.

We all have been through what you are going through in changing equipment/masks, etc.
Like most things that change, we have to get used to something new before we decide we really like it. You got this!!

gadgetmaniah · Post by **gadgetmaniah** » Wed Jul 14, 2021 4:49 am

GrumpyHere wrote: ↑
Tue Jul 13, 2021 10:32 am

gadgetmaniah wrote: ↑
Mon Jul 12, 2021 1:09 pm
I actually sleep on the floor on a mattress these days

gadgetmaniah wrote: ↑
Tue Jul 13, 2021 9:04 am
the weight of the heated tube added to the discomfort and I think it would be more comfortable to use with a normal slim tube.
You could buy or rig up a hose manager like the pictures below to take the hose weight. With the bonus of getting the hose out of the way.

Some diy efforts:
viewtopic/t59798/Which-hose-management- ... 15#p598461

viewtopic/t72611/Let-us-see-your-machin ... ml#p667875

viewtopic/t111990/Hose-management-devic ... 5#p1375545

viewtopic/t40917/Which-hose-management- ... 15#p358891

Links to a lot of hose hangers and discussion of hose management
viewtopic.php?t=10640

This one looks diy but is actually commercial!!!

JLROhio wrote: ↑
Tue Jul 13, 2021 11:00 am
I think having it on the floor is ok as long as it is out of the way and is not likely to be kicked or tripped over by someone. The only concern of being on the floor would be the concern that the machine is lower & closer to dust and dirt that could be on the floor. I would recommend putting it on some sort of carpet or rug to help keep the dirt away - then again, I don’t really know how carpet/rug fibers would be just as bad. Ensure you either keep the floor clean & change the filter (filters are relatively cheap).

As to your mask, hose, new machine, etc. you’re introducing a lot of changes all at the same time.
Go back to a slimline type hose & the most comfortable mask you have and get used to them. After that, then consider changing either a mask type or hose type, one at a time so you can adjust and the adjustment is only one thing at a time.

We all have been through what you are going through in changing equipment/masks, etc.
Like most things that change, we have to get used to something new before we decide we really like it. You got this!!

Thanks for the advice!

I tried tightening the mask today and used a slim tube rather than the heated tube. It was more comfortable, and I experienced less leaks than last night. There was a large leak for 25% of the time, which is much better than the 60% large leak I experienced the previous night. I could try it with more adjustments to see if I can eliminate the leaks, but something I noticed was that my nose hurts when I tighten the mask, and if I don't tighten it it leaks. So I'll try again but otherwise I'll just go back to my old mask, which is basically a replica of the F&P Simplus (the BMC F5 mask) and is a good mask. Other than that, I do like the new machine and I like the feeling of breathing humidified air. It's probably better for my airway as well.

gadgetmaniah · Post by **gadgetmaniah** » Sat Jul 17, 2021 4:06 am

Ok so today I feel quite good and the headaches that I would experience with the Dreamstation have dissipated as well, which is a big relief. I'm guessing the headaches on the Dreamstation were a result of the toxic gases from its foam.

One thing that I've noticed is that the Resmed's pressure seems more 'forceful' than Philips'. I have EPR on 3 but when I breathe in I feel like the machine is rapidly blowing air into my mouth, which even causes my mask to jolt a bit against my face. On the Dreamstation the pressure seemed much more gentle.

However, this could have something to do with my mask. I'm using the BMC mask but when I tried the F30i mask the pressure felt quite gentle. I would like to use the F30i but I think I'll need to buy a small sized cushion instead of the small-wide cushion that I have right now, and perhaps even a larger frame.

Also, I was experiencing some musty smell when breathing in and I thought it was due to the leftover water in the humidifier chamber that I was reusing. I rinsed the chamber and refilled it but I still experienced the smell. I then thought of looking at the filter and indeed that is where the smell was emanating from.

GrumpyHere · Post by **GrumpyHere** » Sat Jul 17, 2021 8:22 am

gadgetmaniah wrote: ↑
Sat Jul 17, 2021 4:06 am
One thing that I've noticed is that the Resmed's pressure seems more 'forceful' than Philips'. I have EPR on 3 but when I breathe in I feel like the machine is rapidly blowing air into my mouth, which even causes my mask to jolt a bit against my face. On the Dreamstation the pressure seemed much more gentle.

Does it bother you? If it does, you can consider changing Response from Standard to Soft.

AutoSet Response mode
For patients who are sensitive to faster changes in pressure during therapy, AutoSet Response can be set to either Standard or Soft. If set to soft, patients will receive gentler pressure rises during therapy. Available in the AirSense 10 AutoSet and AirSense 10 AutoSet for Her devices.

gadgetmaniah · Post by **gadgetmaniah** » Sat Jul 17, 2021 10:45 am

Thanks. The response mode is already set to soft actually. It doesn't really bother me too much though.

Also, I jumped the gun when I said I no longer am experiencing headaches. I'm having a bad headache today. I've noticed that it usually starts a few hours after I wake up. The only probable cause in my mind are the mask straps on my head which I fix tightly (to prevent air leaking into my eyes).

GrumpyHere · Post by **GrumpyHere** » Sat Jul 17, 2021 7:27 pm

If the leaks are within levels that your AirSense can handle (24 L/min), maybe having looser and more comfortable straps with a little bit of leak is better.

Instead deal with the attacks

to your eyes with a sleep mask.

Pugsy wrote: http://cpaptalk.com/viewtopic/t88983/Pu ... ml#p816554

You have to decide which works for you. I can't make that choice for you but I don't panic over short lived leaks (big or small) unless they disturb my sleep which that rarely happens.
.
.
.
And that is why I don't panic with a bit of "large" leak and for sure don't care about leaks from whatever cause that are below large leak territory. I sleep right through them...get good sleep and feel just fine.

Pugsy wrote: ↑
Tue May 23, 2017 8:17 pm
ResMed machines report only excess leak...so all of that 30 L/min is above the vent rate which is called intentional leak.
Mask vent rates at so and so pressure are only useful when total leak is reported. Your machine doesn't report total leak (total leaks is the mask vent rate plus excess leak).
Vent rates are not particularly useful when excess only leak is reported.

ResMed has decided to use 24 L/min excess leak as the red line for where they say the machine can start losing the ability to compensate for excess leak.
So above 24 L/min things start getting a bit iffy and the further you go the iffier it gets in terms of accuracy of sensing, recording and responding to apnea events.

From my own personal experience with a ResMed machine and large leaks...I found that between 24 and 30 the machine seemed to be still fairly accurate. Between 30 and 35 L/min excess leak I started to see some "unknown" apneas which meant the machine sensed something was going on but because of the leak it could quite decided on what it was. With leaks above 35 L/min I saw big blank spots where 20 minutes before when the leaks were at about 33 L/min I was seeing green "unknown" apnea flags...now I suppose maybe I wasn't having any events but I think that was probably extremely unlikely...I think the blank spot was because the machine lost the ability to sense and record what might be going on in the face of leaks past 35 L/min.. I think that particular night it went up to around 40 L/min.

gadgetmaniah · Post by **gadgetmaniah** » Sun Jul 18, 2021 9:02 am

Yeah, I just bought a sleep mask today but it's a low quality one so I'm not sure how well it work.

Also, last night I used the heated tube and the pressure didn't seem as strong as when I use a slim tube, even though the minimum pressure was the same. I wonder if others have had a similar experience as well.

gadgetmaniah · Post by **gadgetmaniah** » Sun Jul 18, 2021 11:23 pm

Ok, some good news. I managed to use my F30i mask (mostly comfortably) along with an eye mask and it turned out well. Even though I had to tighten it a bit, my nose does not hurt, though the skin around my nostrils does seem to be irritated. My sleep was good too and I didn't wake up while sleeping unlike I would with my other, BMC full-face mask.

I have also figured out my ideal pressure: 9. I had actually figured it out when I was using the Dreamstation because I had to keep increasing the minimum pressure until I managed to eliminate the hypopneas that would appear in my events. This has really improved my sleep quality (before this, I used to have my minimum at 6 or 6.5).

Something I noticed while sleeping with the F30i mask on is that my flow rate looks different. The curves more look jagged than usual. Does anyone know what this indicates and whether it's something to be concerned about?

gadgetmaniah · Post by **gadgetmaniah** » Wed Jul 21, 2021 6:52 am

Something quite strange happened today with my breathing pattern. For about an hour, I was breathing at a respiratory rate of 50, which I think means almost one breath a second. My normal respiratory rate stays at around 15. See the attached images for the data.

Could it be just a bad dream or something? This hasn't happened before.

gadgetmaniah · Post by **gadgetmaniah** » Mon Jul 26, 2021 9:03 pm

So today I had my mother try on the CPAP since she has also been suffering from unrefreshing sleep for quite a while now and I thought maybe she has some breathing issues as well while sleeping. She only had the mask on for about 2 hours after which she took it off. However, there's an odd breathing patttern that I noticed that took place in her sleep for a brief period. I think this is called agonal respiration? The machine also increased the pressure when this pattern started.