So I guess I have OSA - what happens next?

RyN wrote: ↑

Sat Aug 20, 2022 11:59 am

ResMed AirTouch F20 full face mask with headgear

Find this mask on youtube and carefully watch three or four videos from different sources about fitting and adjusting. https://www.youtube.com/results?search_ ... +face+mask

That mask may turn out to be perfect for you. I use that model for occasional naps. But there are FFMs with smaller footprints and lighter weights. You may want to try one later. I like having multiple FFM styles in my "arsenal".

I tried that mask at my mask fitting 2 weeks ago and hated it. It was too big and all up in my line of sight. Comfortable, but the past 2 weeks have me thinking it would have leaked like crazy since I'm a side sleeper and every other mask has had that issue.

My (very) short experience has me agreeing with a previous poster. I started with a ramp setting of 4 and it was awful. I felt like I was suffocating and needed to open my mouth to breathe and then the most awful noises would come out. I turned it off after the 3rd night and haven't noticed any issues with falling asleep.

Ramp on a cpap is like training wheels on a bike.
Once you get "in the groove", they are usually just a nuisance.

I’m going to call night one a rousing success! I had a very typical/normal night of sleep for me which isn’t always great, but I’m thankful that I was able to sleep most of the night without any major issues while using the new mask and machine.

I should note that I’ve had insomnia issues for as long as I can remember, well before any sleep apnea I’m guessing. Even back in my early teens or preteens, I’d have issues with waking up in the night and not being able to get back to sleep.

I’m also dealing with some other ongoing health issues that can have my body a little more stressed on some nights with a higher HR and just a lot more restlessness. So I’m always tweaking things on the sleep side and during my daytime activities to try to help that as well.



And here’s the same data on SleepHQ: https://sleephq.com/public/8a6251e0-cba ... 7af03e6b20

I fell asleep just fine. I did my usual one trip to the bathroom around 2-3am and was able to get the mask off and on in the dark without issues and fell right back to sleep.

Once 3:30a-4a rolls around, I typically get very restless. I start waking up every half hour and fight as hard as I can to get an extra hour or two of sleep. I couldn't fall back asleep this morning, so I ended up sleeping a little under my usual total sleep time, but totally within a normal range for me.

Thank you to everyone for the tips and tricks; they absolutely helped.

I’m looking forward to hearing your thoughts while I learn how to read all these graphs for myself

RyN wrote: ↑

Tue Aug 23, 2022 8:03 am

Here’s a link to my OSCAR data screenshot: https://ry-n.link/Sm1pke

Not much to see; leak rate under control; flow limitations minor; cluster of clear airway events around 7:00 a.m. is probably awake breathing and nothing to worry about.

If that were my chart, I would change the minimum pressure to 8.0 since the machine rarely runs below that.

Good job!

ChicagoGranny wrote: ↑

Tue Aug 23, 2022 10:54 am

RyN wrote: ↑

Tue Aug 23, 2022 8:03 am

Here’s a link to my OSCAR data screenshot: https://ry-n.link/Sm1pke

Not much to see; leak rate under control; flow limitations minor; cluster of clear airway events around 7:00 a.m. is probably awake breathing and nothing to worry about.

If that were my chart, I would change the minimum pressure to 8.0 since the machine rarely runs below that.

Good job!

I started a reply earlier but never finished it - typical! The day got away from me.

Thanks for the feedback!! Is 'awake breathing' a term I should know or could look up? I only ask since I can put two and two together and guess what you mean, though I didn't know if it was there was a hip CPAP meaning for it.

I know during the late morning hours (towards the end of the night), I had one of my gf's daughters in the room with a nightmare, I was nervous I was scaring everyone with my new mask on, and I was fighting hard to get an extra hour of sleep but was having a hard time falling back asleep. I noticed several times I almost did, but got kind of startled awake with breathing issues (both a feeling of gasping for more air at some times, but also feeling like the machine was pushing too hard at other times).

For anyone and everyone - is it best practice to keep your mask on at any time you're sleeping? The 4am wakeups are my Achille's heel as I'd give almost anything at that point to get an extra hour of sleep. Which could include taking my mask off purposefully if I thought it would help. Is that a no no?

RyN wrote: ↑

Tue Aug 23, 2022 8:22 pm

For anyone and everyone - is it best practice to keep your mask on at any time you're sleeping? The 4am wakeups are my Achille's heel as I'd give almost anything at that point to get an extra hour of sleep. Which could include taking my mask off purposefully if I thought it would help. Is that a no no?

It's a no-no because that would give your last hour or two of "sleep" putting you into the position of potentially having a bunch of untreated apnea events happen so it wouldn't be all that great of a quality of sleep and your body will remember that last hour of apnea filled sleep much more than it might remember the prior 6 or 7 hours of very nicely treated apnea free sleep.

You will feel like crap.

If you even think you will fall asleep....you put the mask on and that includes power naps.
Even now after 13 years on cpap I always put my mask on before I lay down in bed because I don't want to risk falling asleep without the mask/machine on. Final mask adjustment is done laying down but the putting on of the mask happens while I am sitting up in bed before I lay down.

Pugsy wrote: ↑

Tue Aug 23, 2022 8:52 pm

It's a no-no because that would give your last hour or two of "sleep" putting you into the position of potentially having a bunch of untreated apnea events happen so it wouldn't be all that great of a quality of sleep and your body will remember that last hour of apnea filled sleep much more than it might remember the prior 6 or 7 hours of very nicely treated apnea free sleep.

You will feel like crap.

If you even think you will fall asleep....you put the mask on and that includes power naps.
Even now after 13 years on cpap I always put my mask on before I lay down in bed because I don't want to risk falling asleep without the mask/machine on. Final mask adjustment is done laying down but the putting on of the mask happens while I am sitting up in bed before I lay down.

Thanks for the quick and clear answer! I’m excited to put the mask on for night two anytime here. It’s been an eventful two days for me.

RyN wrote: ↑

Tue Aug 23, 2022 8:22 pm

Is 'awake breathing' a term I should know or could look up?

It just means you are awake. The machine is good at detecting breathing events when we sleep. When we are awake, our breathing is irregular, and the machine is not so good at identifying events.

Thank you for all the info and tips! Nights 2 & 3 went just as well as the 1st. I think I've personally slept a little worse, but I have no idea of that's due to me wearing a mask for the first time, or if it's just my usual poor sleep quality. I also keep forgetting to bump the minimum up to 8 as suggested. And I just today changed the time zone on my Resmed machine, so the times are all wrong (though I used the time adjustment in OSCAR to fix those two at least).

Night 2: https://sleephq.com/public/7df34d05-505 ... c3f75f55c0




Night 3: https://sleephq.com/public/fe7ef944-d36 ... aa4e04fc90



I think the one complaint I have so far is with the AirTouch F20 mask, which pinches my nose a good bit. Since I'm often congested on at least one side, the extra nose pressure can close it up pretty easily, which annoys me any time I'm awake.

I'm not looking to run out and get a new mask this quick, but I am curious what other full-face masks are crowd pleasers? I love the seal on the AirTouch. And I have noticed that I do switch to mouth breathing around 2/3 of the time with the mask on.

And finally, which stats do people tend to check on their OSCAR reports? I have a pretty decent idea of what most of them mean, but I wouldn't know anything was a problem or see any red flags on my own.

RyN wrote: ↑

Thu Aug 25, 2022 3:37 pm

I think the one complaint I have so far is with the AirTouch F20 mask, which pinches my nose a good bit. Since I'm often congested on at least one side, the extra nose pressure can close it up pretty easily, which annoys me any time I'm awake.

Go to cpap.com and look at these masks which don't fit over the bridge of the nose.

ResMed AirFit F30i FFM

ResMed AirFit F30 FFM

DreamWear FFM

The F30i is my favorite mask and over the years, I have used about a dozen masks.

RyN wrote: ↑

Thu Aug 25, 2022 3:37 pm

And finally, which stats do people tend to check on their OSCAR reports?

Start with AHI and leak on the Daily chart.

Pugsy wrote: ↑

Tue Aug 23, 2022 8:52 pm

RyN wrote: ↑

Tue Aug 23, 2022 8:22 pm

For anyone and everyone - is it best practice to keep your mask on at any time you're sleeping? The 4am wakeups are my Achille's heel as I'd give almost anything at that point to get an extra hour of sleep. Which could include taking my mask off purposefully if I thought it would help. Is that a no no?

It's a no-no because that would give your last hour or two of "sleep" putting you into the position of potentially having a bunch of untreated apnea events happen so it wouldn't be all that great of a quality of sleep and your body will remember that last hour of apnea filled sleep much more than it might remember the prior 6 or 7 hours of very nicely treated apnea free sleep.

You will feel like crap.

If you even think you will fall asleep....you put the mask on and that includes power naps.
Even now after 13 years on cpap I always put my mask on before I lay down in bed because I don't want to risk falling asleep without the mask/machine on. Final mask adjustment is done laying down but the putting on of the mask happens while I am sitting up in bed before I lay down.

I am trying to learn from others and hope it is ok to ask questions here. When looking at the chart RyN posted, do you look at the pressures and shoot for just above or below the median number for your low end of your settings? (Someone suggested 8?) And ideally based on the median from several nights data and not just one in order to get a better idea of where it should be set?

When looking at leak rates, for some reason I thought it might be a scale of 1-100 and expressed as a percent but I see that isn't the case when looking at RyNs. I am trying to determine what is considered a good leak rate, an acceptable leak rate and downright perfect leak rate (which I have seen with the Bleep btw)? Because if I am reading his numbers right his is considered good because while he does have one that is very high, he doesn't have many. Is that right?

I appreciate any polite correction or building on this, and hopefully that helps RyN as well as any others reading along.
(PS it almost feels intrusive looking at someone elses breaths while they sleep but this is really helping me learn!)

As for your insurance, it sounds similar to mine. I pay a monthly copay for 12 months as does the insurance company, but I must use the machine at least 4 hours per night and 20 days per month for the first 3 months. At the end of the 12 months, the machine is paid for and it is mine. The machine has a built in cell and sends usage to my DME monthly.

lynninnj wrote: ↑

Sat Aug 27, 2022 10:21 am

When looking at the chart RyN posted, do you look at the pressures and shoot for just above or below the median number for your low end of your settings? (Someone suggested 8?) And ideally based on the median from several nights data and not just one in order to get a better idea of where it should be set?

I want weeks and weeks of data to review before I start looking at just any sort of number as the basis for anything.
Especially for someone brand spanking new to cpap therapy like RyN happens to be.

lynninnj wrote: ↑

Sat Aug 27, 2022 10:21 am

When looking at leak rates, for some reason I thought it might be a scale of 1-100 and expressed as a percent but I see that isn't the case when looking at RyNs. I am trying to determine what is considered a good leak rate, an acceptable leak rate and downright perfect leak rate (which I have seen with the Bleep btw)? Because if I am reading his numbers right his is considered good because while he does have one that is very high, he doesn't have many. Is that right?

The unit of measure for leak graphs is L/minute.

First of all any leak no matter how big or small that disturbs sleep is unwanted and needs to be fix if nothing less than because it is disturbing sleep.

Second...leaks that we sleep through....It depends on how deep we might go into large leak territory and how long we might stay there whether or not it is a big deal or not. Big deal as being a negative impact on therapy itself.
5 minutes at 50 L/min isn't really that big of a deal but 50 minutes at 50 L/min probably should be looked at.

Me personally....I always look at both how big and how long any big leak might be and I don't even bother to look unless I see that I am spending much time above 30 L/min with ResMed machine.

Extremely brief spikes in the leak graph....most likely a quick refitting of the mask. Not a big deal except it probably also reflects an arousal/awakening of some sort which of course we don't want.
Now if I spent an hour at 100 L/min leak...that's bad. The machine would be clueless for sure. Probably wouldn't have any events flagged because the machine would lose all sensing abilities with that much leak.

Pugsy wrote: ↑

Sat Aug 27, 2022 11:21 am

lynninnj wrote: ↑

Sat Aug 27, 2022 10:21 am

When looking at the chart RyN posted, do you look at the pressures and shoot for just above or below the median number for your low end of your settings? (Someone suggested 8?) And ideally based on the median from several nights data and not just one in order to get a better idea of where it should be set?

I want weeks and weeks of data to review before I start looking at just any sort of number as the basis for anything.
Especially for someone brand spanking new to cpap therapy like RyN happens to be.

lynninnj wrote: ↑

Sat Aug 27, 2022 10:21 am

When looking at leak rates, for some reason I thought it might be a scale of 1-100 and expressed as a percent but I see that isn't the case when looking at RyNs. I am trying to determine what is considered a good leak rate, an acceptable leak rate and downright perfect leak rate (which I have seen with the Bleep btw)? Because if I am reading his numbers right his is considered good because while he does have one that is very high, he doesn't have many. Is that right?

The unit of measure for leak graphs is L/minute.

First of all any leak no matter how big or small that disturbs sleep is unwanted and needs to be fix if nothing less than because it is disturbing sleep.

Second...leaks that we sleep through....It depends on how deep we might go into large leak territory and how long we might stay there whether or not it is a big deal or not. Big deal as being a negative impact on therapy itself.
5 minutes at 50 L/min isn't really that big of a deal but 50 minutes at 50 L/min probably should be looked at.

Me personally....I always look at both how big and how long any big leak might be and I don't even bother to look unless I see that I am spending much time above 30 L/min with ResMed machine.

Extremely brief spikes in the leak graph....most likely a quick refitting of the mask. Not a big deal except it probably also reflects an arousal/awakening of some sort which of course we don't want.
Now if I spent an hour at 100 L/min leak...that's bad. The machine would be clueless for sure. Probably wouldn't have any events flagged because the machine would lose all sensing abilities with that much leak.

Thank you for the clear and concise answer. I very much appreciate it. So if my N 30 has a slow but steady/intermittent (maybe based on positioning) leak and doesn’t really wake me up Is probably okay? I think mine were below five. But if it’s waking me up and I’m not aware of it then that’s a problem. That’s what I’m getting from what you’re saying.