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There are some System One machines that are not the APAP version. So make sure...

SNS, thanks for posting this! Since you were clever enough to do your homework, it seems you can see the humor in this transaction. Bless that little girl's heart; makes you wonder how she finds her way home at night, doesn't it? You can't leave us hanging, though, which mask did you get?

Sounds like you got a good provider who will listen to you and allow you to be involved in directing your treatment.

14 is a pretty high pressure, it may take some getting used to and may also make mask leaks an issue depending on what you use. All the more reason to go APAP, get him to put a range with a low end a bit lower than the 14 and the high a bit higher. The machine will adjust and you may find once you are use to it you will get better sleep and do ok at lower pressure.

My original CPAP pressure rx was 12, went APAP with a range of 8-14 and after a few weeks found that 90% of the time I was below 10.5. With a set 12 I went from ahi of 114 to 7, with the APAP and the 8-14, my ahi dropped to 3-4. With a little more tweaking and time, I have been averaging an ahi of less than 2 for the past 3 years. Currently I spend most my time below 9.5.

Try several masks, they have really improved in just thie short time I have been in therapy. I've been using a Swift LT, but recently got a Swift FX. I would recommend either, I have no problems with either, both are comfortable and seal well. I like the FX better, very low profile and let's me sleep on my side without the pillow pushing it around.

No worries SU. They weren't done with me.

"I only have two full face masks on hand right now and neither one is a medium. I have a Quattro just like the one you used at the sleep center except it's a large and a Gel Mask...those are the ones with the gel...it's a small. We'll try them both and see which one is closest to fitting you."

"When will you have some mediums in? I'll be able to exchange for another if I can't use the first one?"

"Well yes, we want to work with you any way we can."

I'm thinking "No Way am I leaving here with anything but a good laugh." I did want to at least hear the Respironics machine run and see what it felt like. She explained that she would be fitting the mask at full pressure and it might be a surprise since I was asleep during the titration but that normally it would start at a low pressure and work up gradually. The machine would sense when I exhaled and lighten up for me to breath out. She wanted me to just relax and not panic. OK I get to find out what I want to know anyway.

The oversized quattro was first...I could look into the nose bridge... VROOOM WHOOSH

"All full face masks leak, it's just something you'll have to get used to. Most people tighten them up too tight and they get sores from wearing the mask too tight. Don't worry about the air blowing around the mask the machine will compensate."

Yeah I figured that out when my eyelids blew open.

The small sized gel mask barely fit over my nose and upper lip but it had a tighter seal. I got to see what the exhalation relief was anyway. I asked more questions and eventually her boss called her into another room and then came out to tell me that he had just been going over the data sheets and had discovered that this was actually a System One machine and wasn't that lucky.

I thanked both of them for their time and told them that I would be in touch if I needed them. I'll sleep with my motor idleing until my order from cpap.com gets here. I requested that they get my prescription from my Doctor and will finalize an order tomorrow. You guys saved me from a miserable mask. I don't like doing this by trial and error but it beats what those folks had in store for me. THANK YOU!

YES, it will be okay!
1. When you have the proper tools, using them will be much easier because YOU will be in charge.
2. You are motivated. (Congrats!)

Humans are nose breathers, I just heard an expert saying we all breathe through our noses when we are asleep. I expect this is why most of the masks are for noses only.
Demonstrably this is not universally true.

Good luck on all fronts.

snipsnsnails wrote:
"When will you have some mediums in? I'll be able to exchange for another if I can't use the first one?"

"Well yes, we want to work with you any way we can."

I truly feel for anyone who is trusting her for advice on their treatment. Thankfully you did your research ahead of time and knew enough to put you waders on and get out of there.

Hey Snips,

Any updates?

Sleepy Tiger

I should have a PR 1 Auto w/humidifier set for cpap at 14cm, a bunch of filters, a MEDIUM Quattro FF mask, a MEDIUM F&P HC432 FF mask, some cleaner and a hose snuggle coming tomorrow (WED) from the good folks at cpap.com. I got return insurance on the masks so if one or both are simply wrong for me I can try again. The Encore Viewer software is on backorder but will be along presently. I've made up my mind that this is going to happen. There will likely be some tough nights ahead and a rash or two, but it will be worth it. I'm not going to hate it forever, though it's going to be OK if I want to hate it on occasion as long as I forgive it and try again. Looks like the blood pressure is subsiding with a medication change and that has relieved the getting up for the bathroom already so I'm not sure how I'll judge progress unless I start greeting the 6:30 news with enthusiasm . Oh well, one step at the time and they don't have to be big steps as long as they point in the right direction. At least my Honey won't be sleeping with a sputtering engine anymore.

By the way my PA was true to his word and when cpap.com requested my prescription he just signed their form as is and sent it back, didn't even specify the pressure.

I'm sure I'll have questions as I go along and thank you guys in advance for your patience...I promise to try the search button before the panic button! Thanks once again for your help so far!

I'm truly surprised at how well my first night went. I spent quite a lot of time yesterday playing with the mask and getting a feel for it. Last night about an hour before bedtime I went and got it adjusted so that all I had to do was put it on and go to bed. That worked really well. I set the ramp for 5 minutes thinking that would get it up to pressure before I fell asleep so I could get any last minute leaks taken care of. I went right off and slept five and a half hours. When I woke up I realized that I had more than 4 hours and thought "good enough for a first run". and took it off. I couldn't get back to sleep! So I put it back on...no ramp and went out for three more hours!

I've been tracking my blood pressure each morning since starting meds a while back and the trend has been down on the systolic pressure with the diastolic kind of stuck in the low 80s. Today the systolic was still on trend,120s,but the diastolic was a full 10 points lower into the low seventies and my pulse had dropped from it's normal 72-73 down to 63 this morning...that's dramatic to my mind.

I looked at the data and saw that my ahi was 8.5. The machine registered about half of the apneas as clear airway. there was a period of VS for about an hour after I went to bed and another hour after I fell back to sleep. I'm not going to change any settings for a few days and see if that changes with getting used to treatment. There were also some periods after the VS had died down that registered as periodic breathing. Don't know what that means (yet, I'm looking it up now) but they usually preceded or followed the clear airway events. There would usually be an obstructed apnea thrown into the mix as well. The leak line was straight as an arrow and only a bit above the vent rate so the Quattro served me well and was quite comfortable.

I'll get my stuff added to my sig, now that I have it. Comments welcomed but I think I'm going to stick with the staight Cpap at 14, with c-flex set on one for the time being. See what happens.

Sounds like you are on your way!

Switch that bad boy to "Auto" and watch your AHI drop even more. I have found that I get more centrals when I am at the higher end of my range. My initial setting was 12, and I went from AHI of 114 to the 7-9 range, when I went to auto and a pressure range of 8-12 my AHI dropped below 3.

Some more tweaking and now I can't remember the last time I went over 2 for AHI. I spend most of my time at less than 10 cmH2o pressure now.

Congrats on a great first night, Snips! I think you're clever to leave your settings as they are for a little while, see what your numbers are for several days running before you start tweaking. You're gonna feel so much better soon!

I just want to add another vote for it's going to be ok/ I'm glad your first night was ok. CPAP was the best thing I have ever done for my health. I had no idea how tired I always was, and now if I go without my machine I can't believe that I ever was able to function at all before.

Just keep trying things, and realize that you don't have to be constant with a mask. I use a full face comfort gel and a hybrid mask, depending on the night. I have a mild deviated septum, so if my allergies are acting up, the hybrid doesn't work.

Telephones should have breathalyzers to stop drunk dialing...I got woke up by a wrong number about midnite and took more than 2 hours to get back to sleep...arghhh. No worries though as the VS index was about half of the previous night and the AHI had dropped to 1.8. The periodic breathing was down to one short episode and I got my full 8 hours in despite the rude interruption. BP was down to 116/76 and the pulse had dropped to 59 this morning.

Thanks for the encouragement guys. I'll prolly play around with the settings eventually but right now I'm happy to just fall asleep with the mask on...and see some good numbers the next morning. I do want to dial in the F&P mask and may try that tonite. I figure two masks that fit a bit differently will help if I start having any skin issues. None so far though!

snipsnsnails wrote: the AHI had dropped to 1.8. The periodic breathing was down to one short episode and I got my full 8 hours in despite the rude interruption. BP was down to 116/76 and the pulse had dropped to 59 this morning.

Your body will be VERY happy to be back to normal. Not to mention if your BP stays that way (or gets better) you may be able to kiss off the meds.

So. "It IS OK" or perhaps even better than OK.

You are now free to resume your regularly scheduled life.

Sleepy Tiger

Hi guys! It's been a few nights now and I've got some questions. If you've got answers I love to hear them.

First off some basics. I'm running my setup just like the first night. Cpap at 14, humidifier on one,c-flex at 1 decided early on the ramp was pretty useless for me and haven't used it since the first couple of goes. My quattro is doing it's job and the leak line is pretty straight every night at around 37 lpm.

Here's what the viewer software is showing me. I go to bed around 10:30pm. the first hour or hour and a half is pretty quiet without much in the way of VS, OA, or H. After that things start downhill. Intermittant to steady snoring and two to three clumps of OAs and Hs. Each clump getting progressivly longer. There may or may not be a blip on the Periodic Breathing during the first couple of clumps but the last and longest clump culminates in a fairly long, I guess 3-4 minutes from the hard to guesstimate viewer graph, PB event ending in my waking up between 3:30 and 4:30. After which I usually get up, take the mask off, check the time, stretch, realize what time it is, put the mask back on and go down for another couple of hours that generally show no snoring and very few if any events.

The VS, OA, and H period has been getting worse each night. My AHI last night was 14. CA events have all but stopped registering. As far as I know I'm staying on my sides as I go to sleep and wake up there, although I switch sides while I'm asleep. I feel ok and haven't dozed off in front of the news since starting. The blood pressure is the best it's been in a long time. Before Cpap I remembered dreams regularly...none since starting. I understand that may mean I'm sleeping through them instead of waking to remember them.

1. Should I get a manometer to check my cpap pressure? The vent rate should be closer to 45 LPM on my mask at 14.

2.Chicken or egg? Is the periodic breathing episode just before waking at 4am causing the arousal or is the arousal just showing up as a PB event on the respironics algorithym?

3. Is it likely that these things will iron themselves out if I just leave well enough alone and let my body get used to cpap? Or should I start thinking about making changes before they get worse.

4. I see the "Change One Thing at a Time" cautions an all the advice. What's one thing I should be looking at here?

5. Does the Encore Pro software show greater detail about these events than the Encore viewer and where should I look for the animal if it does?

Thanks!