Sierra

Masks are the most difficult component of CPAP treatment to get right. I would try and make an arrangement with your sleep clinic to first get their advice, and second have the opportunity to try different masks if the first on does not work out. Some like the Dreamwear mask, but you never know for sure until you try it. Do you know what pressure is expected to be needed? Some masks handle more pressure better than other ones...

If you have a ResMed machine there is another option to get a little more information. If you hold the Home key (near the bottom) down and at the same time hold down the round set knob for about 5 seconds, it wills switch into the Clinical Menu. Then when you rotate the Set knob you can scroll down to a menu item called "Essentials". The default position is "On", but if you press the round knob and go into it you can set it to "Plus". Then exit out to the User Menu with the Home key. With Essentials set to Plus you will get a more detailed Sleep Report from the User Menu. Near the bottom you can select the time interval, and then get a breakdown of the type of AHI events you are having. It is not nearly as informative as SleepyHead, but it is better than nothing. The key is determining how much of the AHI is central apnea.

It did not happen to me in exactly that way. My AHI at diagnosis was about 37. It was mostly obstructive apnea but there was a small component that was central apnea. What happened to me on CPAP treatment was that the obstructive apnea went way down, but unfortunately the central apnea increased. CPAP pressure treats obstructive apnea because the pressure opens the airway. With central apnea the airway is already open, but the person simply stops breathing. The reasons for stopping breathing are complex, but the increased pressure can upset the oxygen and carbon dioxide balance that regulates breathing automatically. The upset can increase the frequency of central apnea. In about 3/4 of people that have this treatment onset of central apnea, the increase goes away in 6-8 weeks. It unfortunately did not for me.

So, the first thing you need to know is the breakdown of the apnea AHI you are now having. What portion is obstructive apnea, what is central apnea, and how much is hypopnea. You may be able to get that from your machine. What make and model do you have? However the best way to get more information is to display your data in a software called SleepyHead or OSCAR. You need a PC or Mac with a SD card reader, and a machine that is compatible with this software. Most ResMed and DreamStation machines are compatible.

The solution is most likely to be a reduction in pressure to a trade off point where obstructive apnea is not too high, and central apnea is not too high either. Also when you find that pressure, you may be better off with a single fixed pressure, rather than an auto range of pressure. However finding the ideal pressure is easier with the machine in auto. Using SleepyHead you can tell when obstructive events are happening, and when central events are happening and what the pressure is at each event.

Hope that helps some,

Have you tried mouth taping?

Mouth taping is the easiest way to ensure breathing through your nose at night. Works well. It does not prevent sleep apnea though.

I am not aware of any significant changes in the firmware of the A10. There is a setting in the Clinical Menu that slows the response of the machine to events. It apparently was not on some of the original machines. Not sure if it was an over the air firmware update, or if at some point the newer machines came with it. I have never tried using it.

On the more simple side, have you been replacing your air filter regularly? That might account for some loss of maximum flow.

I have only been using mine for just over a year now, but have not noticed any changes. My wife is at about 4 year on her ResMed S9 model and seems to be having no issues with it.

The best way to monitor what the machine is doing is to download SleepyHead or OSCAR and use the software to monitor the results in detail. You will be able to see when you are having events and evaluate to some degree if the machine is behaving properly in response to the events.

Hope that helps some

Having the CPAP interfere with the quality of your sleep is a real issue. The machine and especially the mask did disturb my sleep and as I said, it took months to get used to it. I have made many changes in the setup of my machine and I think I am on mask #6. I have switched pillows, changed the pillow case to a satin pillow protector, used at least 3 different chin straps, and now on method #2 of mouth taping to keep my mouth shut during the night. I have also gone from a wide pressure range in Auto mode to a single pressure in CPAP mode. We have even gone to a king sized bed from a queen size!

The mask, the pressure setting, the ramp method, the mask type, the headgear, the pillowcase, the pillow stuffing, etc... all can be part of the problem or eventually part of the solution.

OSCAR or SleepyHead will help you understand a lot better what is going on during the night. It will also give you a good idea whether or not your machine is well set up.

I have not used that particular mask. I tried the F20 but could not make it seal so gave up on it. I use the P10 mask combined with the Swift FX headgear. With either mask I do not disconnect the hose at the mask, and I am not even sure I can with the P10. I just disconnect it at the connection to the main hose. If I need to get up in the night to use the washroom, I just flip the attached hose over my shoulder and leave the mask on my face.

I guess that might be a workaround, but it does the trick for me...

10 days is not a long time to get used to wearing a CPAP. It took me months to get a restful sleep with the mask on. I was diagnosed with an AHI of 37, and did not feel any apparent great burst of energy from using a CPAP. I think some of the benefits get a little overstated. However, I have stopped snoring, and I more often than not sleep through the night without getting up. My target is to get 7-8 hours of quality sleep.

My thoughts would be to stick with it, and it will get better for you. Do you know what your breakdown of AHI events are that make up your current 3.5? If they are mainly obstructive, there may be opportunity to reduce the AHI a little further. My wife was diagnosed around 80 and now can routinely get under 1 for AHI. I however have mostly central apnea for residual and 3.5 is a good score for me. CPAP does not work well in reducing central apnea.