Sierra

I think you are correct in that the NHS does not provide machines for those in the mild category of sleep apnea (5-15). In that range, the dental appliance alternative might work for you. That would be something to check with your dentist, or ideally a dentist that specializes in apnea devices. They are likely to be more expensive than a CPAP machine though, and I am not sure NHS covers that either.

Masks are difficult to fit and select. Your best bet if it is a reasonable cost is to try masks from your provider if they will let you try before you buy. CPAP.com is one of the larger on line suppliers and many masks include return insurance if you don't like them. Within a type of mask you can list them in order of their sales activity. Top sellers at the top of the list. It gives you some idea what is popular and what is not. There are also many reviews by users.

The basic nasal pillow is the ResMed AirFit P10, and I believe also the most popular nasal pillow. The straps are poor on it though. Another one to consider in the nasal pillow type is the F&P Brevida. My wife uses it and likes it. The headgear/straps on it are better than the P10.

The snoring index seems extremely high in the home study. It makes you wonder how they measured it. The snore in the lab study seems more reasonable. In general CPAP pressure does reduce snoring.

Hydrogen peroxide will certainly do a good job of disinfection. However, it will not be as good as vinegar in removing any mineral deposits. The vinegar is acidic and dissolves any minerals left by the water. I have to admit that I cheat now and then and use tap water in the reservoir instead of demineralized, and that certainly leaves a mineral deposit. But even with demineralized water residue does tend to build up over time.

Thank you for posting. My wife has a S8. I will keep your fix in mind. If I still have one when her S8 starts to act up!

My thoughts are to keep expectations in check. I've worn glasses since I was about 10 years old or so. When I first get a new pair they are perfect, but slowly regress as time goes by. New pair is like seeing the light again. But, now as I get older, I know what to expect.

If we skip forward to CPAP, my expectations were low. In fact I was hoping I would get diagnosed with not having apnea. Not the case, so now I use one. Did I ever expect it would lower my blood pressure, lower my cholesterol, prevent heart disease, reverse my diabetes, and keep my pants from wearing, tearing, or sagging at the knees? No, I did not. It does reduce my apnea, or so my machine tells me. Better sleep? Perhaps slightly. I do sleep through the night now about 50-70% of the time. Never did before. Is it worth it. Probably. Was it easy? No, but I figured it out. Good thing my expectations were low...

Then I start to realize that I do not hear so well. In a restaurant I can't hear the conversation at the table. So then come the hearing aids. They are going to cure everything? Right? Well they don't. This time I expected more but got less. That is my current project -- lowering expectations to reality.

Next the vision issue comes back. I notice that I can see well with one eye, but not the other. Go for a check, and it is not a simple pair of a new prescription. The optometrist tells me I have a cataract. So, now we research IOL options. My vision is going to be made perfect again? I hope so, but I'm starting to learn. Lower those expectations again...

Bottom line. There is a price to getting older, and there is a benefit in keeping expectations in check! Age happens!

I don't think you need any of those special products. I just use vinegar at full strength. My normal process is to rinse the mask, hose, and humidifier reservoir with pure household vinegar first. Vinegar will remove any mineral deposits and acts as a disinfectant. Next I use a rinse of water and Dawn dishwashing detergent to get the vinegar smell out. Last is a rinse with water, then hang to dry. Best to do it first thing in the morning so the parts have all day to dry. Ideally should be done once a week, but I admit I let is slip a little longer than that at times...

I have CPAP mask wipes that came in my CPAP package but don't use them. I just got hearing aids and I may use the wipes on the hearing aids to use them up. I believe SoClean is unnecessary, and potentially a risk to damage the equipment. Plus with a CPAP, blood glucose meter, hearing aids, and a blood pressure meter, the last thing I need is another medical gadget to take up space!

Another factor I found increases my frequency of central apnea is using EPR. I originally used it at a setting of 3 when in Auto mode. I believe it increases the pressure in Auto mode and as a result increases CA's. Now I use it in AutoRamp only, and it shuts off when the ramp ends. I think that is one of the reasons I can now use the fixed pressure mode at a lower pressure.

I also take an ACE inhibitor (perindopril), but I don't suspect it is a problem.

One of the things you might want to think about is pressure. Over the months I reduced the maximum pressure and increased the minimum pressure until I only had about 1 cm difference. My theory based on a detailed review of the events recorded in SleepyHead is that the ResMed machine is chasing hypopnea events with more pressure. And, it is designed to do that, as it assumes a hypopnea event is caused by an obstructive flow restriction that does not go to a full obstructive apnea.

The problem is that the hypopnea event can also be caused by a reduced effort to breath, which is really central hypopnea. For these reasons I think it is of benefit to me to restrict the maximum pressure that the machine can go to, as increased pressure, at least in me, causes more central apnea. With this theory, I finally got to the point of trying a single fixed pressure (CPAP mode). It actually achieved a better AHI than even a narrow 1 cm pressure range in APAP mode. It does however takes long trial periods at different pressures to find the ideal. It would seem that one would just have to reduce pressure until obstructive apnea becomes a problem. I found it is not that simple. It seems even a single short obstructive apnea event can start a minute ventilation cycle which can result in multiple central apnea events. More pressure can cause centrals, and at some point less pressure can also cause centrals. So there is no sharp clear cut pressure which is obviously ideal. It just takes trial and error and a long time at a pressure to see how good or bad it is. As a check I also use total time in apnea as a measure. To me that is even more important than AHI.

I was running a pressure up to 15 cm in Auto mode, but now I use a single fixed pressure of 11 cm and get better results.

Hope that helps some,

Yes, that is helpful. Sounds similar to what I suffer from, although I typically get a fairly event free first half of the night. You may want to zoom in on that flurry of events strung together. They can be Cheyne Stokes Respiration, although if your machine is a ResMed it should flag it. DreamStation calls it periodic breathing. Sometimes medications can be a problem. I suspect my beta blocker for blood pressure increases my CA event frequency, and I convinced my doctor to half the dose.

But I think if the AHI averages under 5 it is not going to get much attention from a sleep doctor. If you can't stay under 5 and it is almost all CA then an ASV may be worth looking into. At least that is my plan. Stick with my AirSense 10 AutoSet for as long as I can, and then hopefully get a prescription for an ASV. The disturbing part of central apnea is that if it is not drug related, it most often indicates cardiovascular issues. And they should always be investigated and treated on their own merit.