made it through 2 nights so far

I have obstructive sleep apnea and I got my equipment (listed in signature) 2 days ago. Since I was miserable during my sleep study and never entered REM sleep, they prescribed me automatic pressure that goes between 6 and 12. Part of the reason I was miserable was all the stuff they have you hooked up to obviously, but also the mask they had for me was making me very claustrophobic and it was freaking me out having this big thing fastened onto my face.

Because of this when I met with my durable medical equipment company 2 days ago to pick everything up, I asked for a nasal pillow mask instead. I explained I felt I needed to feel more freedom than a full face mask provides. I'd also like to have the mask & my glasses on before I go to bed, and I can't do that with the full face mask. Lastly I sleep from back to side to other side to back, basically all over the place, and I felt the pillows would be best for my maneuverability as well. So she agreed and recommended I try the Nuance mask, which seemed fine to me so I did.

So as luck would have it I get a cold a couple days before I need to pick up my machine and I now have congestion to deal with. My insurance makes me rent it for 3 months, then it can be converted to a purchase, so I couldn't just pick it up and wait til my cold goes away to use it, I was on the clock. It has a cellular transmitter on it that beams the info up to the mothership to make sure I am "compliant". I think the requirements of my compliancy are at least 4 hours a night, 70% of the time. I also didn't want to cancel my appointment to pick it up because the appointment availability seemed few and far between.

So the first night I put it on. It took me a couple minutes where I felt like I was breathing through a straw, but I don't know if I adjusted more to it, or if my breathing slowed down more, but it was tolerable. I decided my first night, I want to give myself the best chance for success and do this with no congestion from my cold, so I took the mask off and went ahead and used Afrin to clear my nose. I put my mask back on, again it was kind of like breathing through a straw for a couple minutes, and then it got better. I think I did pretty well my first night. I even had to check it was still on a couple times because it was so quiet and my breathing was so good. My wife said I didn't snore at all, success.

Last night I had a little trouble. I Afrin'd again (I know, you should only take it 3 days in a row, that was only my 2nd) and put the mask on and eventually fell asleep. I think the mask wasn't adjusted right at some point during the night so I lifted it up off my nose and tried to reposition it. I had it off my nose long enough to take a non-cpap breath, and then when I put it back on I got that breathing through a straw effect again, and I couldn't take it so I took the mask off and turned the machine off for a minute. I then decided when I tried again I would try that ramp feature which I haven't tried previously. I know my pressure is pretty low to begin with, but I just didn't want to risk dealing with the straw feeling again. So I used the ramp (which is set to 45 min) and fell back asleep until morning.

I think I'm doing ok so far. My concern is limiting that breathing through a straw feeling, and how to avoid it as much as I can. I hope with time I will just get used to it. Also, my first night I had the humidifier set to 3 and it used 25% of the tank. The 2nd night I had it set to 4, and it used only a little bit of the water. However, the 2nd night I also noticed some water either the hose or pillows (I was too tired to investigate). I thought higher number was higher humidity? Is there a trick to it?

Like I said, my wife said I haven't snored while using the cpap, so that is a major victory to me. I don't know if I feel better or not yet, but I think that comes with time too. So, thanks for reading and I'm going to keep on going.

Welcome to the forum.

Regarding humidity selection and amount of water used....Don't worry about amount of water used as it will vary depending on amount of ambient humidity in the bedroom. Some nights you will likely use all the water and some nights you might not use any water...all depends on ambient humidity.

Does your hose have a black end on it where it attaches to the humidifier? If so, you have a heated hose and additional options in terms of setting up your humidity selection.

The breathing through the straw thing...common complaint.
Using the ramp will actually make it worse as with the ramp being used the starting pressure is only 4 cm and that isn't much air movement.
You might try going up a size in the nasal pillows if you can. More air will move and it will be more comfortable.
Otherwise you need to increase the starting pressure just a little so that you get more air movement. Not a big deal at all though.

Being unlucky enough to catch a cold when first starting therapy....that's bad luck but it happens.
Do what you can to get some sleep...don't worry about perfection...just get comfortable and get some sleep.
It will pass. Most people feel like the added humidity from the humidifier cranking out moisturized air actually helps with the nasal congestion that comes with a cold.

If you have the heated hose I mentioned above...we have additional options.
Plus ways to limit any moisture you might see in the mask if it persists and is a problem.

I personally think the ramp only makes thinks worse for me. I never liked it. My pressure is 15.5 which sounds like a lot and it is. I got used to it and it really doesn't seem like anything out of the ordinary any more. The one good thing about the higher pressure is if I have any airway open at all when I fire up the cpap it pretty much blows a pathway open and I can breath so unless I have complete cement head I can breathe at night even with a cold. Since you're being closely monitored right now you probably don't want to mess with raising your starting pressure a but you might ask the provider to raise it a bit if you feel like you're not getting enough air. I'd wait until the cold clears up until making any decisions though because you can't make any good decisions based on when you're sick.

It took me a couple weeks to get comfortable falling asleep in a reasonable amount of time and months before I wasn't randomly waking up after about four hours and taking another hour to get back to sleep. It's been about five years now and I couldn't dream of trying to sleep without it now. You sound like you're doing pretty good for two nights. Just keep at it and you'll get it all figured out.

Thanks for the comments so far.

Pugsy wrote:Regarding humidity selection and amount of water used....Don't worry about amount of water used as it will vary depending on amount of ambient humidity in the bedroom. Some nights you will likely use all the water and some nights you might not use any water...all depends on ambient humidity.

Got it, makes sense. It did rain a lot last night, so maybe it wasn't as dry inside.

Pugsy wrote:Does your hose have a black end on it where it attaches to the humidifier? If so, you have a heated hose and additional options in terms of setting up your humidity selection.

No, either end attaches to the humidifier or mask. I don't think it is a heated hose.

Pugsy wrote:The breathing through the straw thing...common complaint.
Using the ramp will actually make it worse as with the ramp being used the starting pressure is only 4 cm and that isn't much air movement.

Really? I was under the impression the lower the pressure the easier it was to breath. Shows how much I know. Maybe I won't bother with the ramp then, especially if it is making the breathing through the straw thing worse...

Pugsy wrote:You might try going up a size in the nasal pillows if you can. More air will move and it will be more comfortable.

Yeah when she tried them on me in the DME shop, she thought my nose was small and used the smallest. I think it came with 1 or 2 other sizes though, I'll have to check. You're saying the bigger the pillows, the more air I'll get?

Pugsy wrote:Otherwise you need to increase the starting pressure just a little so that you get more air movement. Not a big deal at all though.

I don't think I'm allowed to tweak anything while I'm on this compliancy period. The DME shop said they'd call to check in on me in a couple days, maybe I can ask them about that.

Pugsy wrote:Being unlucky enough to catch a cold when first starting therapy....that's bad luck but it happens.
Do what you can to get some sleep...don't worry about perfection...just get comfortable and get some sleep.
It will pass. Most people feel like the added humidity from the humidifier cranking out moisturized air actually helps with the nasal congestion that comes with a cold.

Do people suggest doing anything else to open up their noses if they are congested? I can't use the Afrin forever and don't know when this cold is going away, but are there other sprays or gels or anything that can open me up?

Pugsy wrote:If you have the heated hose I mentioned above...we have additional options.
Plus ways to limit any moisture you might see in the mask if it persists and is a problem.

Yeah no heated hose. I guess if it becomes a problem I'll be looking into that. What is the most reasonable CPAP online store that people here do most of their shopping at?

dae3dae3 wrote:I personally think the ramp only makes thinks worse for me. I never liked it. My pressure is 15.5 which sounds like a lot and it is. I got used to it and it really doesn't seem like anything out of the ordinary any more. The one good thing about the higher pressure is if I have any airway open at all when I fire up the cpap it pretty much blows a pathway open and I can breath so unless I have complete cement head I can breathe at night even with a cold. Since you're being closely monitored right now you probably don't want to mess with raising your starting pressure a but you might ask the provider to raise it a bit if you feel like you're not getting enough air. I'd wait until the cold clears up until making any decisions though because you can't make any good decisions based on when you're sick.

This is probably a dumb question, but why are these pressure levels set by prescription? Like can you actually do damage to yourself if you use a prescription higher than what you've been prescribed? It sounds like a higher pressure is what I need to blow open my congestion, although again it is just due to a cold and I'm not normally like this. 6cm - 12cm doesn't seem like a lot.

dae3dae3 wrote:It took me a couple weeks to get comfortable falling asleep in a reasonable amount of time and months before I wasn't randomly waking up after about four hours and taking another hour to get back to sleep. It's been about five years now and I couldn't dream of trying to sleep without it now. You sound like you're doing pretty good for two nights. Just keep at it and you'll get it all figured out.

Yeah I guess I just gotta keep at it and push forward. Thank you both for your comments.

While with lower pressures being used it is easier to exhale....the end result is often feeling "air starved" because not enough air is perceived to be moving. It feels like we are suffocating even though we aren't.
Some people do just fine with a nice low pressure of 4 or 5 cm but most people seem to "feel" better with a little more...especially with the nasal pillow type of masks where there is simply a much smaller volume of air moving.
So with the larger size...there's a bit more "volume" available and it does help.

Regarding the cold symptoms...for now go to the store and get something like Simply Saline and use it profusely during the day and before bedtime.
It will help lessen the need for the Afrin. Save the Afrin for emergency minimal use at bedtime only and then only the tiniest amount you can get relief with.
Oral decongestants also offer relief if you can take them. In general...treat the cold symptoms just like you would if you didn't need a cpap machine.

Let's confirm that you have a 60 series machine before we go sending you off to get the heated hose...
So look on the bottom of the blower unit for 3 digit model number...probably will have DS or REF in front of the 3 digits.
What is that 3 digit number?

Your DME machine supplier should have the heated hose conversion kit but if they don't or won't get it...you can get one for $75 online. More on that later but if you had one now it would allow for more customization of the amount of humidity delivered and thus be potentially more comfortable now with your cold symptoms and later in general.

Cpap.com online store hosts this forum. It's rare that I see their prices be beat and I always use them if they have something I need. Great people to do business with
https://www.cpap.com/productpage/pr-hea ... e-kit.html

Even without the heated hose...there is another option available on your machine that will deliver a bit more added moisture than what you are getting now...it also will warm the air a little more which might be more comfortable....if your bedroom is cold and your nose is cold...we might want to do that.

Nasal irrigation w/saline a few hours before bed might help. Commercially there is NeilMed which sells a package that includes either a bottle or netipot with premeasured saline packets.

If you already have a netipot or bottle that is appropriate, a DIY recipe for saline is 1 c distilled water (heated) to which you can add 1/4 teaspoon salt (non-iodized) + 1/4 teaspoon baking soda. Irrigate when temperature is comfortably warm. (By irrigate, I mean introduce the solution into one nostril with the head slightly tilted, until it comes out of the other nostril.)

Doing this nightly (at first) helps with congestion. I did it nightly for a while, then every other night, then once a week, etc. If I have congestion issues, I start again. It can be especially beneficial during a cold since it will keep sinuses clean and discourage bacteria; people who irrigate regularly rarely have sinus infections.

Distilled water is recommended for safety. In some areas of the country a certain amoeba can occasionally be found in water or pipes that you don't want to squirt up your nose. I like to err on the side of caution. Boiling tap water is an option, but distilled water is so cheap, why risk it?

I always avoided the use of saline sprays, preferring oral decongestants. Over time they just stopped working well for me (nasal sprays are really not good). So, this year I tried the saline spray everyone is into, I faithfully hit it twice a day every day I had a cold, and now when needed or every day for normal congestion. The saline spray I am convinced made by colds take less time to beat, and definitely beat back the congestion to breathable levels. Try the saline spray several times a day (I used some in pressure cans that blew through my nasal passages that worked real well), as it really does help - even more than decongestants like the spray you are using as they can cause a "rebound".

bavinck wrote:I always avoided the use of saline sprays, preferring oral decongestants. Over time they just stopped working well for me (nasal sprays are really not good). So, this year I tried the saline spray everyone is into, I faithfully hit it twice a day every day I had a cold, and now when needed or every day for normal congestion. The saline spray I am convinced made by colds take less time to beat, and definitely beat back the congestion to breathable levels. Try the saline spray several times a day (I used some in pressure cans that blew through my nasal passages that worked real well), as it really does help - even more than decongestants like the spray you are using as they can cause a "rebound".

There was no mention of saline sprays. Randy was talking about saline nasal irrigation.

LSAT wrote:

bavinck wrote:I always avoided the use of saline sprays, preferring oral decongestants. Over time they just stopped working well for me (nasal sprays are really not good). So, this year I tried the saline spray everyone is into, I faithfully hit it twice a day every day I had a cold, and now when needed or every day for normal congestion. The saline spray I am convinced made by colds take less time to beat, and definitely beat back the congestion to breathable levels. Try the saline spray several times a day (I used some in pressure cans that blew through my nasal passages that worked real well), as it really does help - even more than decongestants like the spray you are using as they can cause a "rebound".

There was no mention of saline sprays. Randy was talking about saline nasal irrigation.

That's what I meant by "saline spray". Thanks for clarifying.

We should differentiate between "saline spray" and "nasal irrigation," as it's NOT the same thing.

Saline sprays come in a bottle with a nasal applicator, and will spray a fine mist up the nose. In most cases, these sprays will moisturize but do not necessarily leak out the nose. Some of the ones that come in pressurized cans will drip out, but will still not put a large quantity of water up the nose.

Nasal irrigation is flushing a large amount of saline up the nose with either a squeeze bottle or a netipot until the solution travels through the sinus and exits through the opposite nostril, or through the mouth if the head is bent backwards. It is a deep cleaning of the nose and sinuses, not simply a moisturizing exercise as with the saline sprays.

Huh, I didn't realize the distinction - thanks. I will try out one of the irrigation methods and see how it works. Thanks for seeking clarity.