Sierra

Well 2.7 is acceptable. The normal goal is to be under 5 for AHI. The good news is that 11 cm for pressure is relatively low, and it should make the CPAP and mask easier to get used to.

I have not heard of these companies. The two main manufacturers are ResMed and Phillips Respironics. They both make good machines. I have a preference for the ResMed AirSense 10 AutoSet For Her machine, but others will work well too. Getting a mask that fits and you can get used to is the harder part. I hope they have some arrangement that you can try different masks to see what works for you?

I press them fairly firmly together when I put the 1" paper tape on. No overlap though.

Also, if you are male shaving before putting the tape on helps. And it seems to help to do a thorough face wash before taping too.

Some people (like my wife) can get away with minimal tape and that encourages them enough to keep their mouth shut during the night. Some claim they can train themselves to keep their mouth closed by keeping their tongue at the top of their mouth behind their top front teeth. Neither worked real well for me. The chin strap and a horizontal 1" wide strip of the Nexcare Gentle Paper tape usually does the trick. However I found the chin strap uncomfortable to wear.

So my current method is to continue using the 1" wide paper tape, as I find that the most moisture resistant. But to give it additional staying power without using a chin strap I cover that with a second layer of MeFix tape that is 10 cm wide. I cut a piece that is about 6 cm, or 2.5" long. I find the MeFix tape to be more flexible and with a bit stronger adhesive. I tried the MeFix tape alone, but I found it was not moisture resistant enough and came loose. The combination of the two, with the paper tape on first does work well for me. I have been able to abandon using the chin strap.

My understanding is that they do allow some water to be carried with you for a CPAP. However, I am not sure how much. You would be best to check with your airline for clarification as to what you can bring on board. If you have checked luggage you could bring some that way.

How long are you staying? We typically go to a smaller area of Mexico for a couple of weeks in the winter, and they do not have distilled or demineralized water readily available. So my wife and I just use the bottled water at the resort. Each day I shake up the reservoir that has the remaining water for the night and throw it out. This prevents any significant mineral build up. When we get back I thoroughly clean the reservoir with pure vinegar to remove any remaining minerals. In Canada in this situation I would just use tap water, and clean with vinegar when we get home.

It sounds simple, but it is not a real easy thing to do. First I would suggest reading this ResMed Battery Guide document. It gives you an idea of what size a battery you need in amp hours. However there are many complications. First is that ResMed runs their equipment on 24 volts instead of 12 volts. For that reason you need to use your standard power supply and plug that into an inverter, which is in turn powered by a battery. That is the least efficient method, but potentially the most reliable. We use a 5th wheel travel trailer and both myself and my wife use a CPAP. When we are plugged in to AC there is no problem. But when off the grid we need to run off the 12 volt DC. An inverter works but if you push it too hard the cooling fan will come on during the night and make a lot of noise. Assuming it is for short term use the best thing you can do is change the settings on your machine so it does not use the humidifier and does not use the heated hose. This greatly reduces the current draw. When off the grid I have a 70 watt solar panel that I use to recharge the 12 volt batteries in the trailer. To recover from each night, I bought the DC to DC converters that ResMed sells and are described in that document, and are claimed to be more efficient. The one for my AirSense 10 seems to work well. However, the one for my wife's S9 does not. Unless she turns off the heated hose and humidifier it trips out repeatedly during the night. I am on converter #3 from ResMed and the problem still exists.

The next issue is the battery to take on a plane. You can look up in the tables in that document what size a battery you need, but it is significant. A motorcycle battery might work, but it is not really designed for deep cycle, and I really doubt they would let you take it on a plane. They are probably going to be looking for something that is from ResMed and considered to be medical equipment, and even then if it is Lithium Ion, alarm bells are going to go off. In short I am not sure how you could get something to use on the plane. Your machine is a specialized unit and an ordinary CPAP is not going to work. There are very portable version of a CPAP that have an included battery, like the Z1 auto or possibly now the Z2 auto. Those you are likely to get on a plane and survive for the length of a flight. But they are basic APAP machines, not ASV machines.

So in summary, off the grid, but not on a plane, a deep cycle 12 volt battery will work, with a 12 volt DC to 24 volt DC converter, or with an inverter. A 70 to 100 watt solar panel should recharge it on most days if you shut off the humidifier and heated hose. A larger battery than the minimum size recommended in that document will give you more reserve.

Hope that helps some,

My suggestion would be to download SleepyHead and look at your detailed data which should all be captured on the SD card in your machine. Further development of SleepyHead has been shut down, but the current download should work fine with your machine. You need a PC or a Mac and a SD card reader to use SleepyHead.

SleepyHead will let you see every event during the night, when it happened, and at what pressure it happened at. This is very useful in determining if your pressure settings are optimized for you. If you want to post a screen shot here of a typical daily report I and others can comment. With an Auto CPAP you are essentially doing a titration test every night. The machine has no way of telling whether your are in REM sleep or not, but I suspect that is not the issue.

Here is an example of what a Daily Report looks like in SleepyHead. There are many other variable tracked, but I find these to be the more important/useful ones.

The heated hose may make the humidifier more effective. And warmer!

Do you have a heated hose and humidifier? I have both with the hose temperature set at 27 deg C or about 81 F. I never feel cold unless the vent air from the mask blows on my arm.

I can't comment on the DreamWear masks as I have not tried them personally. I do use the P10 with the Swift headgear, and find no problem sleeping on my back or either side. I route the hose to the center of the bed, down the middle of the bed, and then back up to my face. I locate the heated hose to mask hose connector right at my waist with the hose under the covers. I find this routing keeps the hose out of my way and I don't end up with my arm over the hose. It takes a little adjustment from time to time in the night, but it seems I have gotten used to doing it without waking up.

The only issues I have been having with this arrangement is that I occasionally pull the mask hose out of the heated hose socket, and the back strap sometimes slips up. I have now put a wrap of packaging tape on the mask hose part to make it fit tighter. Has worked so far. I am still working on a solution for the back strap slipping. Thinking of gluing on a layer of non slip rubber mat to see if that helps.

As far as fit to the face goes, we are all different, and I suspect the ideal fit is as unique as we are. The good news for you is that your pressure is quite low and that makes things a lot easier. Try getting your mask to seal at 20 cm and you will see what I mean.

Unfortunately BiLevels are not always effective on central apnea, and may not be any better than an APAP. The first line of treatment with centrals is to keep pressure as low as possible, as more pressure usually results in more central. The second line is to try breathing support with a higher differential between inhale and exhale. That appears to be what the doctor is now trying. But, it can be difficult to achieve. In any case I would suggest you go back to your doctor to see what adjustments are possible.