First SleepyHead Report

This is a copy of the first full night sleeping with the APAP on 5/24. I was set at pressures of 5 to 20 and struggled going to sleep because I felt suffocated by the low pressure and this was even after I turned off the ramp. I did sleep all night with a couple of minor wake ups and adjusting the mask. The second night on 5/25 was horrible, I truly did feel starved for air and was awake most of the night.

Yesterday, Pugsy's suggested I increase the min pressure to between 6 and 7. *thanks Pugsy* I started off at 7, it felt really strange like I was having trouble exhaling so I quickly reduced it to 6.2 and this seemed to work. I awoke around 6am due to a thunder storm, had trouble falling back to sleep so I increased the pressure to 6.4. I finally feel back to sleep for a short while. I feel increasing the pressure made a big difference in the way I felt.

So.....how do my graphs look in comparison? And...why does the 5/26 graph end at 7:45am, I didn't get up until 9:00am







Taz

Are you using SleepyHead Windows 0.9.5 testing version?
Your pressure lines look a bit whacko like mine did with the 9.5 version.
We may need to get you a different version.

You graph actually goes past 7:48. Look at the little markers past the 7:48 mark.
Though it does seem to end shortly after 8:00. You might want to check the S9 to make sure that the clock on the machine is set correctly. The clock is in the clinical setup menu.

Hi Pugsy,

Please point me to the correct version of SleepyHead.

Thanks,

Taz

I think you probably have 0.9.5 SH version right now and your pressure lines look like mine did when I used it.
Mark fixed that bug in 0.9.6 testing version which hasn't been officially released yet because he was waiting to just polish it up and include an installer.
I have a pre release version without the installer. I just sent you a private message with a link to where you can get 9.6.
You can remove 9.5 if 9.6 works.

It's hard to evaluate your pressure line with it looking so broken up but I suspect that your settings are going to be just fine if you can get past that "air hunger" thing. While a minimum of 5 probably would get the job done technically...it can feel rather suffocating and it hurts nothing to use a little more minimum to get you past that suffocation feeling. Gotta get the sleep first and kinda hard to fall asleep when we are suffocating.

We may need to do a little trick with the leak line graph so you can evaluate leaks a little better...let's see what 9.6 reports look like. You can toggle the y axis of the leak graph (the vertical number line) by double clicking on the lower left corner on the 0.0 number. This lets the leak graph auto adjust so you can see the leak line better. It will make mountains out of mole hills but will allow you to see just how close you really get to 24 L/min which is where your large leak territory begins.

Hi Pugsy,

Thanks for the info. I did get SleepyHead 9.6 loaded and it seems to be working, OK. I slept a solid 5.5 hrs, last nite with no wake ups after a rough beginning of trying to adjust the mask. The nasal pillows are starting to really irritate my nose. Can you give me a brief run down on what these graphs are showing me. I think I've read so much information, I'm having a hard time sorting it all out.




Thanks,

Taz

Pugsy wrote: You can toggle the y axis of the leak graph (the vertical number line) by double clicking on the lower left corner on the 0.0 number.

fantastic, very nice indeed, thanks

Taz wrote:The nasal pillows are starting to really irritate my nose.

Make sure that top strap isn't too tight. Anything more than minor tenderness usually means improper fit...either wrong size nasal pillow or the straps are too tight.
Get some Lansinoh lanolin ointment (found in the baby aisle at Walmart) and use it liberally during the day and tiny bit at night.
It will help prevent further soreness and heal what has already happened.
Did you watch the fitting video?

Taz wrote:Can you give me a brief run down on what these graphs are showing me.

Leaks are below large leak territory...that's good.
AHI is nice and low...that's good.
Pressure line wants to roam around a bit especially in the wee hours of the morning which might be supine sleeping pressure needs increasing or REM stage sleep pressure needs increasing. Both are common to see happen.
If the pressure changes were disturbing your sleep we might want to limit the roaming range a bit. Some people it does and some people it doesn't.
All in all a really good report for a newbie and nothing screams out "fix me" at this time. Main thing is to just get used to sleeping with the alien being stuck on your face and blowing air up your nose.

Don't let those nasal pillows rub a raw spot...they shouldn't ever do that when properly fitted. Minor tenderness only just from the nostrils never having anything up against them. Anything above minor tenderness is unacceptable and means there's something wrong with the fitting somewhere. Most often the usual culprit...the top strap being too tight. If you look in the mirror with the mask on and the first thought through you mind is "piggy nose"...definitely the top strap is too tight.

Pugsy,

I've always thought I looked like a pig with that thing on my face.....I'll see if I can get it to look less piggy. My nose doesn't feel so bad during the day, it's just so uncomfortable when I'm trying to go to sleep. The edge of my left nostril really hurts and I keep pushing on the mask to find some comfortable position. My nose is really getting dry so I increased the temp on the humidifier, a little. I watched the mask video, again and will try to make some adjustments, tonight.

I always fall asleep on my right side and usually wake up on that side, too but my husband confirms that I do sleep on my back, at times. No, the increase in pressures did not bother me, I slept very soundly with no wake ups, last night.

I'm already looking at other masks. I've ordered a Air Fit P10 Nasal pillows and when I return to my DME, in a couple of weeks, I'm going to exchange this Swift FX Pillows and get them to fit me for a full face mask. I know I'm going to need a full face mask when my allergies & sinus issues flare up, it's just a matter of time. Any suggestions on a full face mask? I have very dry eyes and need one that will blow little or no air in my eyes?

oh, oh..almost forgot...would you please PM me a link to the ResScan software.

Thanks for all of your help.

Taz

"really hurts" means something is not right with the fit. Either nasal pillow size or the straps.
Try the next larger size in the nasal pillow. Maybe the inner cone is getting pulled into the nostril a little too easily. They shouldn't go "in" the nostril but just the tiny tip of the cone. If the rim of the pillow is getting pulled into the nostril it hurts.
Next large size might help but I still suspect the straps. People just seem to tighten those suckers too tight. I can slip my entire hand easily under the top strap of the Swift FX.

You may like the AirFit P10 better though. Let's see what happens with it.

I can't help with the FFM thing. I have never ever used one beyond a one night trial with the Innomed Hybrid. I can't stand anything on my nose and the lower straps on all the FFmask create hell and havoc with my cervical spine...so I don't even own one and have no desire to own one and I managed to get through the occasional cold just fine with my nasal pillow mask.
Even if I did have one that I thought was "good" it wouldn't necessarily mean it would work for you anyway. Mask preferences are just so personal and individual. You might be surprised though...many people find that the humidity and direct air using nasal pillows actually helps keep those nasal passages open better when allergies or cold symptoms pop up.

With the way FFmasks fit on the nose and potential for leaking into the eyes...if I were you I would look at the Innomed Hybrid...it uses nasal pillows and the interface for the mouth. That way no chance of anything blowing into your eyes.
ResMed has a similar mask called the Liberty. The down side to the Liberty is you don't get multiple sizes of the oral interface...you have to decide ahead of time which size is most likely the best. The Innomed/Respcare Hybrid comes with 3 sizes of oral interface so you can play with the different sizes.

Taz wrote:My nose is really getting dry so I increased the temp on the humidifier, a little.

With the S9 and the Climateline hose that increasing in temperature does nothing to increase the humidity. It actually could make the dryness worse if warmer air tends to dry out the nasal mucosa.
The S9 ClimateLine default setting is for automatic humidity delivery at 80% no matter what the temperature.
There is a manual setting available though...you could change it to a setting of 5 or 6 for humidity delivery and have the temperature control also separate. The default from factory when ClimateLine hose is attached is for automatic 80% humidity delivery. To change it to a manual control you would need to go into the clinical setup menu. I don't know if a setting of 5 or 6 will give you more than 80% though...they never tell us what those settings give in terms of %.
80% is the default because that is most likely what the majority of the population would be comfortable with.
When I use my S9..that's what I use but when I use my PR S1 I like to get 90% so I set it to level 3 for humidity.
I did try the manual S9 Climateline settings...5 and 6 but I couldn't tell that they gave me any more than 80% automatic setting gave me...so now I just use the automatic setting. YMMV though. Trial and error comes with cpap use.

Get some Simply Saline (or similar product) and use it at bedtime. It will help hydrate the nasal mucosa and prevent dryness and won't hurt anything no matter what setting you use. Also use it first thing in the AM.

I like that you were able to display your Sleepyhead data chart. Can you explain how you got the graphic of Sleepyhead on the forum? I tried the "Img" button and tried to put my jpg between the code for images but couldn't figure out how to get it to work.

Nashpap wrote:I like that you were able to display your Sleepyhead data chart. Can you explain how you got the graphic of Sleepyhead on the forum? I tried the "Img" button and tried to put my jpg between the code for images but couldn't figure out how to get it to work.

Hi Nashpap,

I brought my SleepyHead capture over from Photobucket, posted it in the message area, highlighted it and clicked on Img. I failed the first couple of times because I kept forgetting to "highlight" it before I clicked on Img. I hope that helps.

Taz

Pugsy wrote:"really hurts" means something is not right with the fit. Either nasal pillow size or the straps.
Try the next larger size in the nasal pillow. Maybe the inner cone is getting pulled into the nostril a little too easily. They shouldn't go "in" the nostril but just the tiny tip of the cone. If the rim of the pillow is getting pulled into the nostril it hurts.
Next large size might help but I still suspect the straps. People just seem to tighten those suckers too tight. I can slip my entire hand easily under the top strap of the Swift FX.

You may like the AirFit P10 better though. Let's see what happens with it.

I can't help with the FFM thing. I have never ever used one beyond a one night trial with the Innomed Hybrid. I can't stand anything on my nose and the lower straps on all the FFmask create hell and havoc with my cervical spine...so I don't even own one and have no desire to own one and I managed to get through the occasional cold just fine with my nasal pillow mask.
Even if I did have one that I thought was "good" it wouldn't necessarily mean it would work for you anyway. Mask preferences are just so personal and individual. You might be surprised though...many people find that the humidity and direct air using nasal pillows actually helps keep those nasal passages open better when allergies or cold symptoms pop up.

With the way FFmasks fit on the nose and potential for leaking into the eyes...if I were you I would look at the Innomed Hybrid...it uses nasal pillows and the interface for the mouth. That way no chance of anything blowing into your eyes.
ResMed has a similar mask called the Liberty. The down side to the Liberty is you don't get multiple sizes of the oral interface...you have to decide ahead of time which size is most likely the best. The Innomed/Respcare Hybrid comes with 3 sizes of oral interface so you can play with the different sizes.

Taz wrote:My nose is really getting dry so I increased the temp on the humidifier, a little.

With the S9 and the Climateline hose that increasing in temperature does nothing to increase the humidity. It actually could make the dryness worse if warmer air tends to dry out the nasal mucosa.
The S9 ClimateLine default setting is for automatic humidity delivery at 80% no matter what the temperature.
There is a manual setting available though...you could change it to a setting of 5 or 6 for humidity delivery and have the temperature control also separate. The default from factory when ClimateLine hose is attached is for automatic 80% humidity delivery. To change it to a manual control you would need to go into the clinical setup menu. I don't know if a setting of 5 or 6 will give you more than 80% though...they never tell us what those settings give in terms of %.
80% is the default because that is most likely what the majority of the population would be comfortable with.
When I use my S9..that's what I use but when I use my PR S1 I like to get 90% so I set it to level 3 for humidity.
I did try the manual S9 Climateline settings...5 and 6 but I couldn't tell that they gave me any more than 80% automatic setting gave me...so now I just use the automatic setting. YMMV though. Trial and error comes with cpap use.

Get some Simply Saline (or similar product) and use it at bedtime. It will help hydrate the nasal mucosa and prevent dryness and won't hurt anything no matter what setting you use. Also use it first thing in the AM.

Hi Pugsy,

You were right!!!....the top strap on my mask was too tight. Also, you may be right on the nasal pillow size, too. I've always felt they went too far into my nostrils however after a 30 second fitting from the DME tech, she declared it a perfect fit. I'm going to try the next larger size and just see if it makes a difference.

I increased the temp on my humidifier, last night and it did seem to dry my nose out even more....you were right about that, too!!! I do have Simply Saline but have only used it, at night....I will begin using it every morning, too. I've been looking at masks at cpap.com and I was considering the Innomed Hybrid however the patient reviews are so mixed, it seems people love it or hate it but I may try it. I mentioned to the DME tech about my issue with chronic dry eyes and she discouraged me from even considering a FFM. She said about the same thing you have, that the humidity & air from the CPAP may actually help with my sinus issues. Maybe I need to take a "wait & see" approach and stop trying to solve problems that haven't occurred, yet. In the past, my husband has accused me of taking the "prepare for the worst & hope for the best" philosophy to a whole new level.

Taz

Taz wrote:Maybe I need to take a "wait & see" approach and stop trying to solve problems that haven't occurred, yet.

Let's see ...I say "cross that bridge if and when we come to it" or "let's not go buying trouble unless we have to"

Work on the known issues right now...worry about other issues if and when they crop up or at your leisure later.
It's enough to just adjust to having the alien plastered on your face blowing air up your nose.

When I first started therapy I thought I just HAD to have a full face mask for those times I might not be able to breathe through my nose because everyone here told me that I would die a thousand deaths if I didn't have one. So I researched the full face masks and lower straps (bad neck that those lower straps really mess with the neck) and came up with the Hybrid mask as being a possible alternative. What a disaster. I was new to therapy and shouldn't have been even trying it at that point as I didn't have a clue what I was doing and I didn't need it at that point anyway. Horrible night's sleep...worst case of aerophagia I have ever had and I rarely have aerophagia. It wasn't the mask...it was me that was the problem. I was trying to fix problems before they ever happened and didn't really have a clue what I was doing anyway. I used it one night. I could use it if I HAD to but it was delegated for emergency use only.

You know what happened the first time I caught a cold? I was able to breathe well enough with the aid of oral meds and simple saline and a tiny cheater bit of Afrin that I could start out the night with my nasal pillows and I cranked up the humidifier to deliver max moisture and that actually helped clear up the congestion even more. Ended up waking up breathing better than while I was awake. Slept okay...or about as okay as anyone does when they have a cold.
I didn't die a thousand deaths because I didn't have a full face mask.
Never used the Hybrid again and ended up giving it away....never bought another full face mask and don't really intend to.
Now I am lucky....allergy congestion hasn't really ever been much of an issue for me. Simple saline and/or a bit of Flonase usually takes care of it for me.

If you want to prepare for problems that might pop up later...wait till you get some experience under your belt and deal with just adjusting in general right now. Try the P10 and see how it does. You don't have to have a solution for every potential problem immediately.