A good question, but yes, I am certain. I have long-standing nasal congestion issues -- don't know the cause, but the effect is that I can't breathe through my nose for very long without getting into noticeable oxygen-debt even when I'm awake. When I'm asleep I know I'm breathing through my mouth a lot of the time.
I'm tense because I know I need to be sleeping, but I'm not. Also because I worry that any movement will start the mask leaking. I had the same problem during the sleep study: I stayed in one position because any movement might have dislodged one or more of the EKG and EEG wires.robysue1 wrote: ↑Tue Nov 26, 2024 10:55 amThe fact that you are lying in bed with "every muscle tight and every nerve tense" also indicates that you need to learn how to move around in bed with the mask on your face. The longer you lie in one position not sleeping, the more uncomfortable it becomes and the harder it is to finally relax enough to fall asleep.
No, I can tell the difference between the vent exhaust outside the mask and the pressure inside the mask. This is inside. On the study I had a triangular plastic mask that covered mouth and nose completely, while now I'm using a mask that covers the mouth but only the bottom of my nose. I could feel the pressure with both masks. The machine claims I have a good seal, and I can't feel any leakage around the edges, but I can still feel the pressure inside my mouth. More, I can feel it distorting the shape of my mouth, which triggers a constant feeling of "something is really wrong" and adds to the tension.robysue1 wrote: ↑Tue Nov 26, 2024 10:55 amFor most people if the mask is properly sealed, there's very little sensation of wind blowing inside the mask. So the first thing to check: Are you sure the mask is sealed properly? Because even a small leak can make it feel like there's a mighty wind blowing through the mask and hitting your face.
Next, it's important to realize that you may feel a wind coming out of the exhalation vents, and on some masks that exhaust venting can seem like a jet stream. If that's what's bothering you, then you need to switch to a mask with a diffused exhaust venting system. Yes such masks exist. And they can be a godsend for folks like me who can't stand the exhaust flow hitting my arms and chest or bouncing off the covers and back into my eyes. The difference in exhaust venting between the Swift FX (jet plane engine!) versus the P10 (fully diffused and imperceptible) is like night and day.
I contacted the doctor's office today about this and a couple of other questions. You're right, and I misunderstood the instructions I got: it's not 21 out of the first 30 days, it's 21 consecutive days of using the machine at least four hours within the first 90 days. Any 21 days, as long as it's a solid block of 21, and not 3 or 4 here, 3 or 4 there...robysue1 wrote: ↑Tue Nov 26, 2024 10:55 amIt's also worth double checking with your insurance: Most insurance policies have a 60 or 90-day period in order to meet compliance: In other words, most insurance companies don't demand that you have 21 days with at least 4 hours of usage during the first 30 days of having the machine. Rather, they demand that there is a 30 day period in those first 90 days where you met compliance for at least 21 days. In other words, if you manage to use the machine for 21 days during the second or third month, that usually meets the "compliance" requirement for the insurance company.
It's an AutoSet model. I already turned on ramp-up, and it helped but not enough. The ramp-up was on "Auto", but I've reset it to its maximum of 45 minutes. The machine was set to a steady 10cm, but the nurse I talked to was able to reset it for autosensing: now it will start at 4cm, ramp up to (I think she said) 6, and stay there unless it detects that a higher pressure is needed. I've also set the humidity to its maximum and started using a type of medicated Blistex, and that seems to have fixed the problem of chapped and dry lips. And I have an appointment with the doc next Tuesday. That should at least give me enough experience for us to figure out what exactly I'm doing, if it can be fixed, and whether I need a different mask and/or machine.robysue1 wrote: ↑Tue Nov 26, 2024 10:55 amTurn the AutoRamp feature on if you are not using it. The "wind" at 4cm H2O is significantly less than the "wind" at 10cm. And AutoRamp won't start increasing the pressure until the machine thinks you are asleep because your breathing has settled down into a nice, regular sleep breathing pattern. Timed ramps start increasing the pressure right from the start, and given how tense you are about the whole thing, I'm willing to bet that you're sensitive enough to detect that steadily increasing pressure during a timed ramp period. (I know I was, and back then, there was no AutoRamp.)
For building compliance hours, use the machine during the evening when you have no intention of trying to sleep with it.
Learn more about your machine: Is it a Resmed AirSense 11 AutoSet? Or a Resmed AirSense 11 Elite? Or just a Resmed AirSense 11 CPAP? The label for the exact machine you have is on the left (black) side of the machine right below the SD card slot. These three Resmed AirSense 11 machines have different capabilities, and if you have a Resmed AirSense 11 AutoSet, it's worth asking the sleep doc to switch you from straight CPAP at 10 cm H2O to APAP with a range that would allow you to have lower pressures for some of the night.
Oh, the nurse I spoke to confirmed something else I suspected: the machine can't tell the difference between a sleeping subject having an apneic event, and a wide-awake subject using controlled breathing to try to relax. In a way I find that reassuring: it really is a computer, and that means it's stupid. I know how to predict its behavior, and I know at least one way to trick it. (I know that sounds weird. Don't ask me to explain it, because I can't, but it's true.)
