New to CPAP - Advice from experienced users would be welcomed

Slobdiddy · Post by **Slobdiddy** » Tue Feb 14, 2023 8:58 am

By chance I found that a friend has been on a CPAP for years. He had just ordered the RESMED AIRSENSE 11 AUTOSET which comes complete with a heated tube and ships anywhere in the world for free at USD970. This is a 2022 model and seems to have all the features mentioned above. I made the same order so am hoping to get started with CPAP in a week or so once it has been delivered. My friend told me he puts his mask in the dishwasher daily and not to worry with the professional cleaners.

He told me that in Hong Kong the CPAP providers fit the mask and set the machines up, but charge stupidly inflated prices for the equipment, plus they also charge a monthly maintenance charge. After years of doing this, he ordered the above model. He told me that I may end up trying several different masks before I find the best option for me but said that this is cheaper than getting involved with the professional providers.

I may order one or two masks. Right now, for masks, I like the look of the bleep mask free solution, the Resmed Airfit P10 or N30 minimalist masks and AirFit P30i which is the move around a lot mask. I also like the look of the pillow with the cutaway segments - has anyone tried these?

Once I have my main machine going I will need one for long haul plane journeys. I guess the Resmed mini although my friend warned that this is quiet noisy.

Thanks again for all the advice and I will report back on whether this solution works for me.

Slobdiddy · Post by **Slobdiddy** » Tue Feb 21, 2023 8:03 pm

First night with ResMed AirSense 11 Autoset plus P30i mask.

Took me about an hour and a half to get to sleep as the noise of the air flow in my nose was new, but machine was silent and mask was surprisingly comfy (and I had no issues moving around a lot as the tube feed is from the head).

I wouldn’t have chosen this mask but it was the only one that the supplier - cpap specials- had for sale. Having used it I think it’s the right one for me.

I went through the set up process and was pleased that everything is automated and nothing needs adjustment for a regular user.

Still some issues to resolve (such as the data from last night didn’t seem to immediately upload and I couldn’t work out how to do this).

Did I feel more refreshed in the morning? Not sure yet but I had the energy to get up early and hit the gym for an hour which is something I’ve been struggling with.

Main thing is my wife reported a quiet night from me which solves one of my major issues.

My next issue is to find a local ENT doc who can quarterise my nose so that I can lie flat without getting massively congested at night.

Anyway - I’ve managed to do this myself using a forum assisted approach rather than getting involved with the local rip off cpap “service providers” which is great.

Miss Emerita · Post by **Miss Emerita** » Tue Feb 21, 2023 8:12 pm

Quiet night? Got up early to hit the gym? You’re on the road to success!

Do you have an SD card in your machine? And do you have a laptop or desktop computer? Then consider using the Oscar software (free) and posting a daily chart to see whether there are tweaks to your settings that might help.

Slobdiddy · Post by **Slobdiddy** » Wed Feb 22, 2023 2:33 am

Will find a way to get the stats off the machine and will post here - thanks for the advice.

Slobdiddy · Post by **Slobdiddy** » Fri Feb 24, 2023 6:23 am

Havent resolved how to see data yet (it's a job for the weekend) but found out last night that nasal congestion really works against the machine with a nasal pillow mask. Pressure rose above 8 so that I couldn't comfortably exhale through my nose and I kept needing to exhale through my mouth (usually I'm a nose breather) to stop my lungs from blowing up like a balloon. Not a nice feeling. I ended up probably taking too much Nasonex and more Sudafed to decongest. I'm seeing an ENT doc in a week or two to look at minor surgical options to help with decongestion.

robysue1 · Post by **robysue1** » Fri Feb 24, 2023 8:11 am

Slobdiddy wrote: ↑
Fri Feb 24, 2023 6:23 am
Havent resolved how to see data yet (it's a job for the weekend) but found out last night that nasal congestion really works against the machine with a nasal pillow mask. Pressure rose above 8 so that I couldn't comfortably exhale through my nose and I kept needing to exhale through my mouth (usually I'm a nose breather) to stop my lungs from blowing up like a balloon. Not a nice feeling. I ended up probably taking too much Nasonex and more Sudafed to decongest. I'm seeing an ENT doc in a week or two to look at minor surgical options to help with decongestion.

Two questions:

1) How do you know the pressure rose above 8cm? (Note 8 cm is a pretty low setting, by the way)

2) Is EPR on? If so, what's it set for? If not, try turning it on.

And a comment about the nasal congestion: As you are already aware, taking too much decongestants is not a good long term strategy. Have you ever used saline nasal sprays and/or a nasal rinse (i.e. a neti pot)? They can help quite a bit with nasal congestion without the risk of triggering rebound congestion.

Slobdiddy · Post by **Slobdiddy** » Fri Feb 24, 2023 11:40 pm

robysue1 wrote: ↑
Fri Feb 24, 2023 8:11 am

Slobdiddy wrote: ↑
Fri Feb 24, 2023 6:23 am
Havent resolved how to see data yet (it's a job for the weekend) but found out last night that nasal congestion really works against the machine with a nasal pillow mask. Pressure rose above 8 so that I couldn't comfortably exhale through my nose and I kept needing to exhale through my mouth (usually I'm a nose breather) to stop my lungs from blowing up like a balloon. Not a nice feeling. I ended up probably taking too much Nasonex and more Sudafed to decongest. I'm seeing an ENT doc in a week or two to look at minor surgical options to help with decongestion.
Two questions:

1) How do you know the pressure rose above 8cm? (Note 8 cm is a pretty low setting, by the way)

2) Is EPR on? If so, what's it set for? If not, try turning it on.

And a comment about nasal congestion: As you are already aware, taking too much decongestants is not a good long term strategy. Have you ever used saline nasal sprays and/or a nasal rinse (i.e. a neti pot)? They can help quite a bit with nasal congestion without the risk of triggering rebound congestion.

Thanks so much for your comments.

For the pressure, I can see this from the sleep view - the range is 4 to 20. It starts on 4 and then ramps up to somewhere in the 7s most of the time. If I'm congested it goes haywire and 2 nights ago was around 13 to 14 and so uncomfortable that I woke up gasping. I've suffered from nasal congestion my whole adult life and have tried everything - I use saline as a prep before Nasonex (saline alone won't cut it) - during Covid, I needed to use Sudafed to breathe through my nose at all - and since Covid, my nasal congestion has got worse and Nasonex alone no longer does the trick. Just saying that serious nasal congestion defeats a positive pressure machine because as the pressure rises so does the exhale pressure and it got to the stage where I couldn't breathe out fully through my nose. Im seeing an ENT doctor soon and from what I have read there are multiple minor surgical options to treat nasal congestion so I will explore these.

Thanks for pointing out the EPR control as I haven't messed with the settings too much yet. I have looked this up and there are multituides of YouTubes on adjusting and optimizing this - I think EPR is on by default but I will feel more comfortable with a little more pressure relief on the exhale.

For now, I have temporarily set my pressure range to 5.6 to 8 as 4 feels uncomfortably low as a starting pressure and I don't want the pressure soaring again as I felt like my lungs were blowing up like balloons. As I get to know the machine and set the EPR properly I can change the pressure range.

Although I can't upload my data to the app (doesn't work on Resmed 11 outside of the USA!) I have seen the following readings on the Advanced display for last night: AHI 2.2, Total AI 1.0, Obstructive AI 0.2, Central AI 0.7 (which I think is quite good given that I was waking the whole house up previously and my wife reported long scary apnea moments). On the night of my congestion, the same readings were far higher: AHI 5.9, total AI 5.2, Obstructive AI 3.8, and Central AI 0.9.

ozij · Post by **ozij** » Sat Feb 25, 2023 1:46 am

Slobdiddy wrote: ↑
Fri Feb 24, 2023 11:40 pm
Just saying that serious nasal congestion defeats a positive pressure machine because as the pressure rises so does the exhale pressure and it got to the stage where I couldn't breathe out fully through my nose.

Nasal congestion fools the Auto algorithm into thinking your airway is obstructed, or on its way to obstructing.
So, not knowing better, the algorithm just raises the pressure higher and higher.
Of course, breathing out fully is also more difficult when your nose is congested. An EPR=3 full time may help breathing out against pressure, but not if congestion is the culprit.

You did well to limit the maximum pressure.
And your results when you're not congested look good.

Slobdiddy · Post by **Slobdiddy** » Thu Mar 02, 2023 11:30 pm

This morning's results were the best so far. AHi 1.5, Total AI 1.0, O AI 1.0, C AI 0.0 Average pressure 10.5 which seems to be creeping up day by day. Still not quite used to the mask and it does take a while to get to sleep.

Seeing the ENT doc next week and hoping for a way to treat my nasal congestion.

ejbpesca · Post by **ejbpesca** » Sun Mar 05, 2023 11:22 am

Interesting that you went from ENT straight to CPAP provider without a sleep study. A sleep study may have shown that nasal masks do not work for you.

I too have severe apnea and rattle windows with snoring...for decades. Being informed about my ceasing to breathe for up to a minute, repeatedly got me in for a sleep study 30 years ago. It was negative for apnea, but I knew it was a botched study. 15 years later I got a second sleep study to find severe apnea. 3 more sleep studies later and on my 5th machine I still struggle with the therapy.

I use a full face mask due to mouth breathing I cannot correct by taping nor chin strap. This was discovered during sleep study 2. I was wakened and given a full face since the nasal pillow rig would not work for me. I measure for size M but use size L since my mouth opens wide to breathe during sleep. Snoring has been greatly reduced by CPAP therapy.

Getting use to the mask was a bit bizarre. I would pull the head gear off during sleep without releasing straps and not know it till I woke. I thought would not adapt but after a few weeks, I kept the mask on for up to 7 hours in sleep.

You may also find that nasal masks are not an option.

CPAP gear is available online with more choices than just Philips. Within the past 2 months I've gotten in a new Philips DreamStation 2. It has a very cheaply made fit and finish to it compared to the brand ResMed. I got a new ResMed AirSense 11 two weeks ago. I returned it for a second AirSense 10 due to the 11 producing a chemical off gassing smell and the filters being of fibers that are loose and come off the filter. I used an AirSense 10 for 5 years. It worked well. The water tank seal was not doing well so I ordered an 11, now back to a new 10 due to the chemical smell of the 11 and what appears to me as defective filters. (photo of one on a post here).

CPAP sales companies called DMEs can be found online and locally. I went through 2 local ones that had not a clue about CPAP at the time and were difficult to deal with so I opted for online sales for 14 years. Just two weeks ago I switched back to a local DME. As with my other 4 DMEs they are about sales and service of the machines, and offer no CPAP therapy advice.

The only help, advice, I've gotten for CPAP has been here on this forum and another. My pulmonologist doctor has never seen an OSCAR report of mine, nor any report. It took 14 years for that clinic to ask me for a compliance report.

I have seen CPAP gear go up and down in quality. ResMed machines and gear have been of the highest quality but my newest gear is showing a reduction in quality by the hose and filters. My latest hose is very stiff and the new AirSense 10 filters have loose fibers like I found with the AirSense 11. I have written ResMed about the loose fibers with no explanation back yet. I see no replies to my post about the loose fibers here yet. I guess no one else is concerned.

I ran though 5 full face masks to settle upon the AirFit F10. I've tried two more, but come back to the F10. I mostly side sleep. To accommodate the mask I use a fairly thin, single foam pillow pushed back so the mask is at the edge of the pillow. This has worked okay, but I still break the seal on the mask often due to movement during sleep and part of that movement is due to the irritation of the mask. Another Airlift model produced a rash. Come to find out fro the DME that others have experienced the same from that mask, some do not.

Best of luck with you therapy. Hopefully it will stop the snoring. I too have had many complaints over the years about my snoring that was described as incredibly loud.

Slobdiddy · Post by **Slobdiddy** » Mon Mar 06, 2023 7:32 am

ejbpesca wrote: ↑
Sun Mar 05, 2023 11:22 am
Interesting that you went from ENT straight to CPAP provider without a sleep study. A sleep study may have shown that nasal masks do not work for you.

I too have severe apnea and rattle windows with snoring...for decades. Being informed about my ceasing to breathe for up to a minute, repeatedly got me in for a sleep study 30 years ago. It was negative for apnea, but I knew it was a botched study. 15 years later I got a second sleep study to find severe apnea. 3 more sleep studies later and on my 5th machine I still struggle with the therapy.

I use a full face mask due to mouth breathing I cannot correct by taping nor chin strap. This was discovered during sleep study 2. I was wakened and given a full face since the nasal pillow rig would not work for me. I measure for size M but use size L since my mouth opens wide to breathe during sleep. Snoring has been greatly reduced by CPAP therapy.

Getting use to the mask was a bit bizarre. I would pull the head gear off during sleep without releasing straps and not know it till I woke. I thought would not adapt but after a few weeks, I kept the mask on for up to 7 hours in sleep.

You may also find that nasal masks are not an option.

CPAP gear is available online with more choices than just Philips. Within the past 2 months I've gotten in a new Philips DreamStation 2. It has a very cheaply made fit and finish to it compared to the brand ResMed. I got a new ResMed AirSense 11 two weeks ago. I returned it for a second AirSense 10 due to the 11 producing a chemical off gassing smell and the filters being of fibers that are loose and come off the filter. I used an AirSense 10 for 5 years. It worked well. The water tank seal was not doing well so I ordered an 11, now back to a new 10 due to the chemical smell of the 11 and what appears to me as defective filters. (photo of one on a post here).

CPAP sales companies called DMEs can be found online and locally. I went through 2 local ones that had not a clue about CPAP at the time and were difficult to deal with so I opted for online sales for 14 years. Just two weeks ago I switched back to a local DME. As with my other 4 DMEs they are about sales and service of the machines, and offer no CPAP therapy advice.

The only help, advice, I've gotten for CPAP has been here on this forum and another. My pulmonologist doctor has never seen an OSCAR report of mine, nor any report. It took 14 years for that clinic to ask me for a compliance report.

I have seen CPAP gear go up and down in quality. ResMed machines and gear have been of the highest quality but my newest gear is showing a reduction in quality by the hose and filters. My latest hose is very stiff and the new AirSense 10 filters have loose fibers like I found with the AirSense 11. I have written ResMed about the loose fibers with no explanation back yet. I see no replies to my post about the loose fibers here yet. I guess no one else is concerned.

I ran though 5 full face masks to settle upon the AirFit F10. I've tried two more, but come back to the F10. I mostly side sleep. To accommodate the mask I use a fairly thin, single foam pillow pushed back so the mask is at the edge of the pillow. This has worked okay, but I still break the seal on the mask often due to movement during sleep and part of that movement is due to the irritation of the mask. Another Airlift model produced a rash. Come to find out fro the DME that others have experienced the same from that mask, some do not.

Best of luck with you therapy. Hopefully it will stop the snoring. I too have had many complaints over the years about my snoring that was described as incredibly loud.

Hi there, is there something about my posts that makes you think my treatment isnt working? Ive been told by a friend that my AHI is now acceptable (although I should target under 1) and I also now have silent nights (versus continuous snoring the house down before, with frequent scary periods of not breathing). Are my readings too high? My latest readings are AHI 1.2, Total AI 1.0 (obstructive 0.7 central 0.3 - but often Central is 0).

I took the decision NOT to go down the PAP provider route (which I guess would involve a sleep study but also gets you tied to their plans and products) and to take a forum assisted approach. P30i is taking a lot of getting used to but it’s very lightweight v the alternatives plus I need a mask with exit tube at the head end as I roll around a lot. My approach was to try a nasal mask first and switch to a full face if this was not working. I think the nasal mask is working and I envisage difficulty tolerating a full face mask, but if my readings are too high I may reconsider.

So far I have disabled the ramp, set the min pressure to 7 as it’s not so comfortable lower than this, and enabled EPR on 3 after some experimentation. I’d rather understand and experiment with the settings myself rather than rely on someone else to provide this service.

My remaining issue is to resolve my congestion (worse post Covid) as Im too reliant on meds right now.

ejbpesca · Post by **ejbpesca** » Mon Mar 06, 2023 10:28 am

I read over and of that <5 is a good AHI, but it is <2 when I notice an improved difference.

I understand the route you are taking. My path through doctor/test/doctor/dme/doctor/more tests/ on and on has given me ZERO information on my progress with CPAP therapy. I suspect the doctors and DMEs I've seen are more into other respiratory conditions and have not much knowledge of anything CPAP. Mine have never seen an OSCAR report, or any report. Not even a compliance report.

My insurance requires testing, doc, DME etc. so I use them.

Get set up with access to OSCAR and/or SleepHQ, post reports, and help can come from here and another site. Most of it seems very knowledgeable from experienced experts in CPAP, some of it is total opinion, you will know the difference.

Miss Emerita · Post by **Miss Emerita** » Mon Mar 06, 2023 11:29 am

Slobdiddy, things are going well for you by the numbers. If you can post an Oscar chart, people here may be able to suggest a tweak or two. But with such good numbers, I think your main way of evaluating your therapy should be how you're feeling during the day.

Slobdiddy · Post by **Slobdiddy** » Mon Mar 06, 2023 7:13 pm

Thanks for both replies and I will post some stats in a few days once I build these up. I had to reset the time zone (as I initially hoped that by telling the machine it was in the USA it might start uploading my stats but this didn’t work, and you need to erase your data to reset the time zone ).

My main issue is my congestion which most nights is treated by meds. Occasionally if I lie flat in bed (happens by accident as I try to sleep propped up) and my congestion gets the better of me and I have a bad night’s sleep (which happens about once a week). Im seeing the ENT doc tmr and am hoping for a solution that gets me off the meds and allows me to go back to sleeping flat (which I could before I had Covid).

Slobdiddy · Post by **Slobdiddy** » Thu Mar 09, 2023 10:37 pm

I saw my first ENT doc in January and again in February - this was a disaster. First visit: 1. Told him I has a deviated Septum and he examined me and said that I didn't 2. Told him I'd been reliant on Sudafed since having Covid and he said not a problem. 3. He told me to continue on Sudafed (and Nasonex) for a month and to come back for Cauterization if this wasn't working out. Second visit: 1. He decided that I did indeed have a deviated septum 2. He told me that Sudafed was dangerous to be on long-term 3. He told me that Cauterization isn't appropriate for my case.

Went to see my new ENT doc this week and he is proposing a combination surgery: correction of my septum, turbinate reduction, and removal of cysts (which need to be tested). The downside is that I will need to be under a general anesthetic and spend a night in the hospital. I will also need to 100% mouth breath for the first 24 hours after surgery (as they plug the nose) and then it will take 2 weeks to be able to breathe fully through my nose. I also won't be able to use my ResMed for 2 weeks as the pillows would put pressure on a healing nose. Quite a big deal and the person I know who has this done warns of a horrible recovery experience, but I need to bite the bullet.

The new doc was also more knowledgeable of CPAP/APAP machines and was happy with the fact I hadn't gone to the Philips equipment fitting center and had instead got a ResMed, and that a nasal mask was working out. He said that an AHI of around 2 is a good result for me given the significant congestion issues that I have - and that one side of my nose is pretty much closed up.

New to CPAP - Advice from experienced users would be welcomed

Re: New to CPAP - Advice from experienced users would be welcomed

Re: New to CPAP - Advice from experienced users would be welcomed

Re: New to CPAP - Advice from experienced users would be welcomed

Re: New to CPAP - Advice from experienced users would be welcomed

Re: New to CPAP - Advice from experienced users would be welcomed

Re: New to CPAP - Advice from experienced users would be welcomed

Re: New to CPAP - Advice from experienced users would be welcomed

Re: New to CPAP - Advice from experienced users would be welcomed

Re: New to CPAP - Advice from experienced users would be welcomed

Re: New to CPAP - Advice from experienced users would be welcomed

Re: New to CPAP - Advice from experienced users would be welcomed

Re: New to CPAP - Advice from experienced users would be welcomed

Re: New to CPAP - Advice from experienced users would be welcomed

Re: New to CPAP - Advice from experienced users would be welcomed

Re: New to CPAP - Advice from experienced users would be welcomed

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