Equipment recieved: First BiPAP tonight

Good Evening!

First, thanks to all who have provided advice and comments in all of my posts. The knowledge you imparted on me has been very valuable. I would have been completely lost without y'all, but thanks to you I was prepared to do battle and get what I wanted rather than what they first tried to give me.

The DME arrived two hours early, which I was surprised and appreciative of. Nice guy, seemed knowledgeable but was obviously in a hurry. As we were conversing he was immediately surprised at my grasp of all the terminology and what the equipment did. I got a very basic introduction to the machine. It's pre-programed to automatically use the B-Flex function, and a 20 minute ramp. My full pressure is 11/7. When he got to to the "setting" selection he said that wasn't something I would have to worry about and didn't provide any info on that. I knew I'd probably get some push-back, so I am going to request that clinician's manual so I can play with the ramp and Bi-Flex settings. He didn't explain any of the info functions at all. It came with a SD card, but I have to mail it to the company in 30 days so that they can "determine if the therapy is working." At least they gave me a prepaid envelope. While I am sure that is part of it, I bet it is more so a compliance thing and if it doesn't come up how they like it, i'll be getting a nasty call from my insurance company.I'll be buying another SD card I guess. I don't have any software to read the card at the moment. I saw some Encore software at cpap.com but it is like $100.00 and I can't spare that right now.

It was obvious that this place prefer to issue Respironics products as that is what the machine is and virtually all the masks he had. I tried on the Comfortgel Nasal Mask, ComfortClassic Nasal Mask, Optilife Nasal Pillow, ComfortFull 2 Full Face, and Quattro, the only non-Respironics one. I tried on the nasals for comparisons sake. The masks were okay, but I had pretty much already made up my mind I wanted a full face if I could get one to fit, not leak, and be comfortable. I tried the nasal pillow because I didn't try one during titration. I couldn't do the nasalpillow at it felt like I was suffocating. When it came to the full face, I had to specifically request the Quattro, and he went back to his car to get it.

Interesting, during my titration I was fitted with a small ComfortFusion nasal mask and a small Quattro. The ComfortFusion leaked a little bit but put uncomfortable pressure on my gumline. The Quattro leaked a lot into my eyes to the point I had to switch to the ComfortFusion. Surprise, surprise, when the DME fitted me, I was a medium. Hah! No wonder the full face didn't work during titration. I did like everyone suggested as I tried each mask while lying down, shifted positions, layed on my side, & etc. The Quattro was the clear winner. Comfortable as one could hope considering, didn't leak much at all, and I could lay on my side. It quivers weirdly as I inhale/exhale, because of the BiPAP I guess, so that will take some getting used to. So upstairs I have a shiny new BiPAP system with Quattro FFM awaiting its debut tonight. I'm scheduled to get replacement cushions and hoses every 3 months via mail. Slightly annoying, they "forgot" my prescription. I'll be calling them about that tomorrow.

I'm a bit nervous on what the night will bring, but ever onward! I wish everyone sweet dreams! I'll respond to this tomorrow and let y'all know how it went.

Glad to hear you've gotten a good machine and mask. Let the good sleep begin!

Sleep well tonight!

Yeah! Which DME did you end up choosing??

oh the anticipation!

I cant wait to hear how it goes, because Im going to try a bipap next month. If I buy one it will be the resmed vpap auto 25 bilevel.

Im glad you got a mask to fit.. OH, and those nose pillows and the suffocating thing.. YOU know I never experienced that feeling with
the opus 360 and the f and pillows, however when I tried the swift fx and the pressure started at five, THEN I knew what ya all were talking
about! I had to breath thru my mouth to get enough air.. I was about to crank up the pressure, (still felt like I was not getting enough air) and
I saw the pressure was at 7.5.. Interesting!

Have a good night tonight, we are all pulling for you, and if I get a bipap can I be in the bipap club?

elena

Mask2sleep wrote:Slightly annoying, they "forgot" my prescription. I'll be calling them about that tomorrow.

They didn't forget anything. You need to request it in writing, that starts the clock. If they don't have it in writing they will keep yanking you.

Ask them for another SD card BEFORE you send in this one, so now is a good time to ask.

Good Morning!

Night 1 complete! I didn't have any compliance issues, I had the mask on all night long. After a little while the pressure didn't bother me, and the ramp feature certainly helped at first. I had the humidifier set at "2" but it was still a little dry for me, so I think I will try "3" tonight. Why is it 5 minutes after putting the mask on I got an itchy nose? It's darn near impossible to get a finger in between the mask seal, so I had to loosen the whole thing to get it!

Since I don't have software for the machine I don't know how I did, but I will check the display when I get home from work tonight and hopefully it will have some useful information. I only got up once all last night to do a baby feeding, and wonder of wonders, NO nocturias. That's worth the price of admission right there. I certainly wasn't asleep the whole time in bed by far, but I haven't only gotten up once at night in the past 10 years one time before this... at my titration.

I did have quite a bit of leakage issues, though. I suppose the mask shifted while I slept or I whacked it or something, as a couple times the mask kind of flapped around on the sides and I had to re-seat it. Then it started leaking around the bridge of the nose into my eyes. I re-did the forehead strap and dial, and that got the leak under control, but when I got up this morning I had a nice red divot on the bridge of my nose. No other indentations, though. Some very minor leaks around the chin as well I think, but so miniscule i'm not much worried about it. I put the mask on in the dark without a mirror last night and initially had no problems at all, but tonight i'll try the mirror in the light method. I felt a bit bad as during one leaking session I the noise and my fooling with it obviously disturbed my wife's sleep as she took the baby monitor and went downstairs for a bit.

My machine has this nifty feature where you don't actually have to turn it on, just strap the mask on and it'll sense your breathing and turn on automatically. Supposedly it will also stop automatically when the mask is taken off, but I haven't tried that.

What's your pressure, Elena? The tech put the pillow on me and it started at my inhale pressure - 11 - and it felt impossible to get any air. Being at the exhale of 7 wasn't much better. He said in 6 months or so I should be used to the pressure and could try again if I wanted. Honestly, though, at least after one night I am pleased with the Quattro. I would be honored if I could join the BiPAP club with you.

My DME is First Class Medical in Northern Virginia. They actually sent a tech from VA to Maryland, poor guy. I choose to stick with this DME because it is the preferred provider for my insurance and since they were giving me everything I wanted I saw no need to go outside of the preferred network and deal with all the associated hassels. The SD card and prescription issues are minor. I had requested the prescription via voice, and if the follow-up doesn't work I will do it via writing. I actually asked if they were going to send me a replacement SD card and they said no. honestly a SD card is so cheap i'll just buy one on my own, and until I get some kind of software to view it with, it is a moot point anyways. I don't suppose there is a free "light" version of the software for download anywhere?

Have a good day!

Mask2sleep wrote:Night 1 complete! I didn't have any compliance issues, I had the mask on all night long. After a little while the pressure didn't bother me, and the ramp feature certainly helped at first. I had the humidifier set at "2" but it was still a little dry for me, so I think I will try "3" tonight. Why is it 5 minutes after putting the mask on I got an itchy nose? It's darn near impossible to get a finger in between the mask seal, so I had to loosen the whole thing to get it!

Hi,

Congrats on making it through the night. I lasted about 2 hours the first night, so you are way ahead of the game here. The nose itch is par for the course. Itches always happen in places that are hard to get to. And if you try to ignore it, you will go insane before long. A popsicle stick can sometimes help--you can slide it under the mask seal without having to take the mask off.

You might find that you get used to the pressure after a few weeks, and will no longer need the ramp. Try getting started without the ramp every 10 days or so, and see if you still need it. Some folks consider the ramp to be like training wheels. Since some people tend to have events just as they fall asleep, it can be beneficial to start the night out at your normal treatment pressure level. Every one is different, so find what works best for you.

-john-

It sounds like you had an excellent first night! And no nocturia - yeah!

Yes, those darn nose itches! I've seen it suggested to rub your nose area briskly before putting on the mask. I see that John recommended a popsicle stick. When I used a nasal/full face mask I used a nice, smooth chopstick (not one of the rough wooden ones). The popsicle stick is flat, so that probably works even better.

The soreness on the bridge of the nose is a problem for many of us. Sometimes it's because the mask size is too small. Or the forehead dial needs adjustment. Or the mask straps were secured too tight. It may take some experimentation to solve that problem. In addition to trying various adjustments, you could try wearing a bandaid to protect that area for a while when wearing the mask. I did that for a week or two myself, until the skin there "toughened up" a bit. I've also read that moleskin can help. Just don't let it get to the raw skin/blister stage! Karen at Pad A Cheek makes a fabric nosebridge protector that helped me too: http://padacheek.com/PAC_Nosebridge.html.

Ask about your DME's mask exchange policy. If you can't get your Quattro mask to fit well, you should be able to exchange it within 30 days for one that works better.

You're off to a good start!

Right now i'm okay with training wheels, but I will certainly check what the Bi-Flex and ramp is set at tonight since I now have the handy-dandy clinician's manual. Assuming I have the energy to do it.

I think in the depth of the night when I got a leak I overtightened the straps and that is what caused the nose bridge problem. When I went to bed the mask was comfortable and it seemed to be more floating on a cushion of air than being held tightly in place by the straps.

Since noon i've crashed. Really tired, hard to concentrate, and even kind of achy. Weird.

Mask2sleep wrote:I think in the depth of the night when I got a leak I overtightened the straps and that is what caused the nose bridge problem. When I went to bed the mask was comfortable and it seemed to be more floating on a cushion of air than being held tightly in place by the straps.

Yes, that "cushion of air" is the effect that you want. You may be able to adjust the nose bridge dial out more and then readjust the bottom straps to compensate.

I'm not sure what kind of bed pillow you have, but many of us sleep on the edge of the pillow (with the mask hanging off the side) to minimize mask displacement. And sometimes a different type of pillow works better. There are special CPAP pillows, buckwheat hull pillows, memory foam, latex foam, etc. I'm mainly a side sleeper, and right now I'm using a $10 shapeable "down alternative" (fiberfill) pillow from Wal-Mart that works fine for me. Target sells one that's similar. Everyone sleeps differently so pillows are an individual preference, but may be worth considering.

Since noon i've crashed. Really tired, hard to concentrate, and even kind of achy. Weird.

Some people find that they need more sleep for a time (repaying "sleep debt"), while others feel like they need less sleep because their sleep quality is better with CPAP. Many here have reported that they feel a bit achy at first too, which may happen if we're sleeping more deeply and not moving around as much as we were when we had apneas all night long. I remember feeling a bit stiff, but now I don't have any aches and pains at all.

Most of us had untreated sleep apnea for a long time, so it takes a while for our body and mind to get used to better sleep. Perhaps with the weekend coming up you'll be able to allow your body to sleep as needed. Perhaps your wife would be willing/able to take over your nighttime duties with the baby for just a little while too?

Congratulations on your great first night! All the little problems are perfectly normal, and you'll get those issues worked out. It's not surprising that you're feeling sleepy in the afternoon, it takes some time to adjust. And between apnea & the beautiful baby, you're WAY sleep deprived! But you're off to an excellent start!

RE: Itchy nose

One thought - I've found that very thorough nosehair trimming helps my nose itches. It wasn't visible before, but I guess air blowing right on my face could still cause it to tickle.

hi there!
Im so happy things went pretty well!

My apap pressure is about ten to twelve, but I have it now at five to twelve until I get my bipap rental on sept first..
then a week home titration, then I have to buy that resmed vpap.

The respironics are VERY nice, it does have an auto on and off, so the second you stickit on your face and inhale it switches on, and the second
you take it off, it switches off.. You can disable that feature if you want I think...

That was a cool tip about nose scratching with little sticks! those big skewer sticks, perfect! blunt end! OMG!

Now, can you tell me, because I dont get all this bipap stuff, what the criteria was for you, to get one?

I think everyone was amazed that you ended up with that as your titration machine.. that was very very good!

Hope you get a good night tonite, this is my third night with the swift fx pillows... I logged in eight hours last night (slept about six)
pretty good, with ahi of two.. but still felt like it was a battle..

Isnt it great NOT to have nocturia? I thought it was just because I wasnt a spring chicken anymore.. NO!
Hey, when the baby sleeps thru the night so will you kiddo!

elena

Good Morning!

Well, Night 2 is down, and I am very pleased to say it was a big improvement over night 1. Last night I actually read the little booklet on fitting the Quattro and did what it said. The tech who fitted me never mentioned that the dial should be all the way extended at # 24 before putting the mask on. So I put the mask on in the mirror, hopped in bed, hosed up and layed down. I played with the dial until there were no leaks, and lights out. I woke up a couple times with very minor leaks that I was able to fix with fiddling with the dial. No discomfort, no red marks, yay! I bet I would have slept through the night if it hadn't been for a certain 7 month old baby girl getting up twice...

I've had untreated apnea for at least 5 years. That's how long I can recall waking up not breathing occasionally. Add another 5 years onto that with being unusually tired for my age, nocturia, & etc.

Last night I made an effort not to shift around much, and as far as I am aware I slept the night on my back, which probably helped with the lack of mask leakage. When I do sleep on my side, I sleep on the edge, always have for whatever reason.

It's weird but last night I was actually looking forward to masking up & the pressure. It meant I would be able to sleeeeep and after awhile the inhale/exhale of the BiPAP becomes oddly comforting, a relaxing rhythm almost.

The feature to start therapy when applying the mask is definitely on, but I do not think the one to turn it off when removed is, as it would stay on when I took it off. I'll have to get into the settings and check.

All I know about my criteria for getting BiPAP was during the titration they got the best results for me at a pressure of 11/7. A B-Flex can change pressure as much as 3, and the difference in mine was 4, so bing, a BiPAP. That's my assumption anyways. I know under straight CPAP I was having difficult exhaling at the constant pressure so maybe that had something to do with it too.

It's awesome not to have nocturia, now if I can just get the little tike to SLEEP THROUGH THE NIGHT. Yesterday my wife got her new PJs that say "Daddy's Night Owl."

A couple questions -
On the INFO screen, under AHI, it has 22.6 for me my first night, and the same when I checked this morning. Could that be because I was having leaks at first and not seating the mask properly? I would think it would change, and my AHI during the sleep study was only 17.8 or something, so how could be up to 22 while in therapy? I think it is a little off.

What do folks do about humidifier settings? The first night I had it at "2" and I woke up with a dry mouth and it seemed like the humidifier chamber was barely emptied. Last night I did a "3" and same deal, dry mouth and the humidifier chamber still didn't look like it used much. I guess tonight i'll use a "4" (it only goes to 5). The tech said to change my water every day... but that seems like a waste, especially when it isn't using much water. What do you think? I'm using distilled.

I am cleaning the cushion of my mask every day with CPAP wipes (https://www.cpap.com/productpage/beaumo ... eaner.html). Do you think that is sufficient? Should I take the mask apart and clean it regularly too? How often to clean the hose, humidifier chamber, and filter?

Thanks!