First night with my "own" machine

Howdy . . . I'm a newbie to CPAP and to this forum. Thanks for being there for folks like me!

I was diagnosed with OSA a few weeks ago (AHI 14.7) using a home study because my insurance wouldn't pay for the clinical study. Yesterday I got my brand-spanking-new PR REMStar Auto A-flex w/ humidifier and heated tube, plus a ResMed AirFit N10 For Her.

I'm tired. Really tired. More-tired-than-when-I-sleep-with-OSA, except I like the idea of breathing.

My therapy hours last night said 7.36, but I didn't actually sleep for more than 3.5 hours. (I know because it was well after 3:00 am when I finally fell asleep.) My AHI was 4.5. 90% pressure was 7.0.

I had tried a nasal mask during the diagnostic period, but the pillows worked best for me. (The nasal mask made me feel like Bane from "The Dark Knight Rises.") I'm just not sure I have the right pillow mask yet. It's really light, but I still feel like it's mashing my nose. I woke up today with a headache, huge grooves by my eyebrows and a pug nose. I also noticed that I had rainout (washout?) at first. Not sure why that happened because I have a heated tube; perhaps it's because I had the air conditioning on?

Anyway, I just wanted to make my first post and hopefully get convinced that this will eventually work -- I will eventually find the right mask or make the one I've got work for me; I won't get rained out anymore; I will actually sleep; I'll actually wake up feeling better than with OSA. Thanks for any info/advice you can give!

Welcome to the club!

The machine you have selected in your profile is a 550 machine, one generation back.
Is it possible that you have the 560 instead?
After taking the humidifier chamber out, turn your machine over and look at the model number.
Here is what the label looks like on my 750P machine but mostly they look the same. The serial number is blacked out.

In the upper left corner it says "REF 750P." That's the model number. Yours should say 550 or 560.

Either one of these is a full data machine and you should be able to track your own treatment using software generally available, either SleepyHead or Encore.

Welcome to the forum.

If you have the heated hose PR System One Auto CPAP machine you have the 560 model...look on the bottom of the blower to confirm.
If so this would be the correct choice in equipment menu
for the machine PR System One 60 Series Auto CPAP
and for the humidifier PR System One 60 Series Heated tube humidifier with heated tube
If you will correct this in your profile it will help avoid confusion later.

For the Rain out issues...with the heated hose...what is your temperature setting (choices 1 through 5) and what is your humidity setting (choices 1 through 3). The answers to those questions would maybe open up some ideas for reducing the condensation.
Don't know about settings or how to get to them? Get the provider/clinical menu so you can get into the clinical setup menu. When using the heated hose the only option without going into the clinical setup menu is for the temperature control.
You can request the manual here
http://www.apneaboard.com/adjust-cpap-p ... tup-manual
Just make sure you request the PR System One 60 Series Auto CPAP with AFlex

Sounds like you have the straps way too tight on the mask. Have you watched the fitting videos for the AirFit N10?
If not you can go to cpap.com and look in the masks for that mask and fitting videos are included in the product description. Common mistake that newbies make with any mask...trying to get the perfect seal with too much tension on the straps.

Thanks so much for your replies, JDS74 and Pugsy!! It's true: I do have the 560. Now I need to figure out how to change that info in my profile.

Last night I started with different temp and humidity settings (can't remember what they were) but, after the rainout, changed them to: humidity level 2 and tube temperature 4. Things seemed to get better after that, though there is still some condensation in the tube.

Pugsy, I will definitely check out the fitting videos for the mask. Hadn't considered it because I assumed it was "one size fits all." Thank you!

Your mask in your profile points to the P10 nasal pillow mask (I didn't think to look closer since you said

ResMed AirFit N10

My bad for not looking closer and reading better.

Yes...the P10 headgear is indeed one size fits all and it sounds like you experienced what a lot of us experienced when first using the P10...that headgear can be a bit too snug. I am using the P10 right now and have been since Jan and it took me about 3 or 4 days for the headgear to either stretch out a bit or me to just get better used to it. I think it was the headgear stretching though. Now it is almost too loose.

You might try routing the hose up over your head if you can. I just wind it round the back of my bed pillow and down to my face...the long hose just lays on the mattress and the mask hose comes down from the top of my head.
This helps reduce the short hose tension pulling on the headgear.
Another alternative might be some sort of hose management system that keeps the hose up in the air. You can buy them or make your own. See this thread for ideas for DIY projects.
viewtopic.php?t=10640

Condensation in the nasal pillows themselves can be a bit tough to eliminate if it is mainly from the moisture in our own exhaled breath that condenses. If the problem persists and can't be remedied with another increase in air temperature of the heated hose we might have to look for additional options but normally more warm air will fix it.

See if you can stretch out the headgear a little before trying to wear it again. If you can't you might want to consider a mask with the headgear allowing for more adjusting. The Swift FX nasal pillow might be a good alternative.
Also consider trying the next size up in the P 10 nasal pillow. I found that using the XSmall caused more nasal soreness than the Small and I have always been able to wear the XSmall in any other nasal pillow mask without issues.

The one size fits all headgear issue with the P10....a few people couldn't deal with it so abandoned it but those of us who managed to get the headgear a little looser have been quite happy with the mask. It all depends on just how tight it is on you. For me it wasn't horribly tight but I did have a sore nose for a few days but it never gave me piggy nose. If your head is fairly large then the headgear may not stretch enough to fit you comfortably.
Piggy nose is unwanted and shouldn't happen with any nasal pillow mask.

Pugsy,

Sorry for writing N10 instead of P10 in my first post. Guess you know what sleep deprivation does to a person's memory . . . I am barely functioning today!

Great idea about stretching the headgear. As a result, I've got it strapped over a really large teddy bear's head at the moment! Hope that helps some.

I'll try this mask for a week or so before going back to Apria and asking for another. The other option the guy suggested was the mask below -- do you have any experience with it?

http://www.cpapxchange.com/nuance-nuanc ... onics.html

(BTW, I probably don't need a hose cover if I've got a heated hose, right?)

Thanks --

No, you probably don't need a hose cover with the heated hose. Not at this point anyway. The heated hose does a great job except maybe when condensation is happening only in the nasal pillows from a combination of the moisture in our exhaled breath and the ambient bedroom temperature. Been down that road myself lots of times before the heated hose was even available and even after I got the heated hose. Mainly for me it's in the wintertime because I like a cold bedroom and lots of humidity. Conditions that are ripe for condensation. If it becomes too much of a problem that the heated hose can't handle and you don't want to use the hose cover (or it doesn't help) there's always Padacheek nasal pillow barrel cozies available ...but they don't work well on the P10 due to vent holes but do work well on other nasal pillows.
http://www.padacheek.com/PACSwiftII_Barrel_cozy.html
You might take a stroll through her website just to see what comfort options are out there.
Before the heated hose...the barrel cozy was the best money I have ever spent on any cpap accessory. When I first started therapy we didn't have all these heated hose options and rain out was a common day PITA thing to deal with.

The Respironics Nuance...yes, I have experience with it and in fact I have one. I typically try all the new nasal pillow masks if they look remotely interesting to me and the Nuance was no different. It was a keeper for me meaning I liked it well enough to keep it and not return it for my money back. There are a couple of others that are ahead of it in terms of my own personal preference but that doesn't mean much. Mask preferences are highly personal anyway.
It's a good mask to try and very similar in how it fits to the Swift FX nasal pillow mask that I mentioned.
There's no one perfect mask out there that is going to suit everyone's needs. They all have pros and cons...the P10 even has a few cons but the pros outweigh the cons in my book. The thing is some people's pros might be another person's cons. I have this thing about really preferring the least amount of "stuff" on my face and head as possible...the trade off for minimal "stuff" is often stability but it is worth it for me.
The Nuance was before the Tap Pap (no headgear at all) and the P10 in terms of when I tried it...so it was in second place after the Swift FX until the Tap Pap and P10 came out and now everything has got shuffled about in terms of my preferences. Right now I can't decide if I like the P10 or the Tap Pap the best. It's a close race. I can successfully use pretty much all nasal pillow masks...I just prefer some more so than others....but the Optilife is at the bottom of the list. I hated the headgear with it and wouldn't ever want to try it again. The headgear is a bit much on the face and head for someone who prefers nothing.

If your DME will let you keep the P10 by all means try the Nuance. DMEs can let you keep masks if they just would.
If they make you return a mask just to try another mask then think carefully unless the mask simply is not working well. Sometimes what you trade for ends up being worse than the first one. Use whatever mask allowance policy is available to you while you can if you feel the least little bit of need. Mask manufacturers actually allow 30 days per mask but DMEs often make their own rules that we have to live with.

Good to know that both of the nasal pillows I am considering are "good" systems . . . but I realize it will be trial and error. Agreed -- I'll try to get the Nuance if I can keep the P10 too.

The DME rep said something about swapping the masks within 30 days, but he didn't say anything about whether I could keep the P10. He didn't let me try anything else on in the office. Thank goodness I had tried a nasal mask previously and knew that I preferred the pillows.

Thanks for the Pad A Cheek website. Great resource!!!