Newbie Tweaks?

[ceecee]

Hi all,

I'm a new entrant to the world of Darth Vader wanabees, I have only been using this machine for a few days (ResMed S9) and I have just a few questions about using it. The machine starts off at quite a low pace, and I can normally get off to sleep, however after a couple of hours I usually wake up with the machine blasting out air and causing the mask to leak around my nose and into my eyes. The only way I can rectify this is by tightening the mask quite a bit but this makes it uncomfortable, I then find I cant get back off to sleep with the mask on so leave it off, obviously defeating the object of treatment! I also suffer from extreme dry mouth, but the clinic has said they will give me a humidifier to help with this. I've read all the success stories and it seems that perseverance is the key, and I will persevere but can anyone offer any other advice?

Thanks in advance and may the forks be with you all

[Alleycat]

Hi ceecee
Well done for perservering so far. It can take some getting used to. Which mask are you using? It may be that you need some help getting the fit right or may.need a different type of mask. If you stop and restart your machine when you wake it should reset to the lower pressure. I can't recall if there is a specific ramp button on the s9 you can use instead. Are you on an auto or fixed pressure? Humidification should help with the dryness.
Hope you are starting to feel more comfortable soon.

[Tigers Fan]

Hi ceecee

Is the machine yours permanently or on loan for a week so that your NHS clinic can assess what CPAP pressure you need?

If the latter, just switch off and on again each time it wakes you. A real pain but persevere so that the clinic can get as much info as possible - and try hard not to die of exhaustion in the meantime!

Sounds like you are the recipient of yet another wide-open APAP - one left to operate betwen the upper and lower limits the machine is designed to handle, never mind what a human being can withstand!

If it is yours privately or a permanent machine from the NHS, you need either to get your clinic to reduce its operating range (a little either side of your 95% pressure) or, if they won't do that, you can learn to do it yourself - many of us do. It's very simple.

The only way I know to adjust your mask to withstand full 20cm pressure is to tighten the straps at 20cm - and that is very uncomfortable at lower pressures, as you have discovered.

TF

[Richard]

Hi Ceecee,

Living with CPAP is a lot like learning to ride a bike: it's no good reading a book about it, you learn from doing it. You fall off, you find out why you fell off and you get back on again, determined it won't happen again.

It's no good tightening the straps to stop the leaking: it's very painful and unnecessary. If it's a full-face mask you're using, you need a 'gasket' between your face and the mask, and the Remzzzs face-mask liners that are available from this site will do the job for you. You might also try Isopel barrier cream smeared around the nose and forehead, which is good for preventing abrasions and helps keep the mask in place.

This should help.

May the knaves and forks be with you, too.

Richard

[ceecee]

newbie tweaks

Hi All,

Thanks for your responses, as I reply bleary eyed once more please excuse any typos (3.45am). Alleycat, I have settled on a Resmed Mirage Quattro FX full face mask after using nasal pillows and a Liberty Full face, ( I cant seem to get on with things up my nostrils, they end up being slung across the room, if you know what I mean) . the unit is Autoset, but as Tigers Fan says the unit is wide open with min being 4cm and max 20cm. I have been just switching on and off, this tends to leave me extremely tired though as after about the third time I cant get back off with the mask on, and usually fall asleep downstairs on sofa. Tigers Fan, the unit is on permanent loan to me and I have learned how to make minor adjustments on the unit, and may try this out next. Richard thanks for this advice, would this gasket fit onto a Mirage mask? I shall give the Isopel a go.

Again thanks all for taking the time to respond, heres to seeing a lot less of the "Dark Side" of the day.

[symmit]

Hi and welcome.

The problem way cpap works is that it is constant pressure, not constant flow. So if there's leak it will drive the fan harder to try and get back to pressure.

Although some here have "issues" with having an APAP fully open (4-20) it's acceptable if not ideal, but what you need to do is adjust your mask so it seals at a higher pressure.

I'm not recommending you change any settings on your machine, but if you can find out how to make it run at 10-15 for a few minutes and adjust your mask straps for that pressure, then set it back to how the clinic have set it for you, you'll have fewer issues. Or just sit with it running for an hour while you're awake, but bear in mind it may never get off 4 if you're airway isn't constricted while awake.

When you speak to your clinic tell them you have an issue with it increasing too much then they may up the minimum pressure (they probably will if they read the data from the machine anyway) - a wide open machine reacts to apnoea events,one that's got some base pressure in can help prevent them.

Good luck - stick with it!

[Tigers Fan]

Hi ceecee

Are the minor adjustments you have learned to make in the Patients' or Clinicians' Menu?

From the Clinicians' Menu, I adjusted my APAP to have Pmin set at 2cm below my 90% pressure and Pmax 1cm above. The raised Pmin stops a lot/most/nearly all of apnoeas happening in the first place and there is still a little 'room' for the APAP to operate as it is designed by increasing pressure to Pmax. The reduced Pmax means that the machine may not cope with all apnoeas - but it is not blowing a 20 cm gale for nearly everyone, either.

It really is a trial and error thing so you creep up on your optimum pressure settings - wehich may well change next week or month, anyway. I use 0.5 cm change each four days as a rule of thumb - to allow my body to adjust.

In fact, I kept making the operating band ever narrower until I finished up converting my APAP to CPAP, which, I discovered, suits me better. I believe most people prefer APAP.

If there is not yet a RemZzzs specifically for the Quattro FX, my guess is that one for a Quattro will do, just a little less stretching will be needed.

TF