Sierra

Welcome to the forum.

I have tried 5 different masks and like the ResMed AirFit P10 nasal pillow mask the best. The second best was the F&P Brevida nasal pillow, but I have now used the P10 for about 6 months and will probably stick with it. I also use the Breathewear Halo chin strap, and even tape my mouth shut with 1" medical paper tape to ensure I do not lose air out of my mouth when I am asleep. While this is a bit of a pain, I find it overall more effective and comfortable than the FFM which always seemed to be leaking somewhere.

As far as fit goes, these nasal pillow masks usually do not have a sizing chart, but instead they supply different sized inserts (fit pack) when you buy the first mask. About all you can do is try the different sizes in the fit pack and see which size works best for you. In the P10 I found the medium sealed better but I think went too far into my nostrils and irritated my nose. The large sits more on my nose, and while it leaks a little more, it is still OK, and I now have no irritation from it. The Brevida mask comes with two sizes in the fit pack, a large and a small. In this brand the large worked better, but still caused irritation, so I switched back to the P10.

Hope that helps some,

It sounds like you are well on your way to success with CPAP treatment.

I can't think of what may be causing the issue. You would need to talk to the doctor who has adjusted it to see what could be done. As for not using it, I guess that will have to be a decision for you to make. I'm not a medical professional, but I see you were diagnosed with an AHI of 45 and are still getting an AHI in the 15 range. Not using the machine which is helping you some is a risk, but you can be sure there are many people not using a machine and suffering from apnea.

Welcome to the forum. One thing for sure is that wearing a CPAP mask does take some getting used to. It is an irritant and can cause a lighter sleep until you make peace with it. So my main advice would be to hang in there and it will most likely get better.

There are some issues with the machine and the mask that you may want to look into. I find that using a higher minimum pressure and preventing the machine from running up and down in pressure all night is more comfortable to me. Mask leaks can be an irritant, and if you can't eliminate them without using too much tension in the straps, it may be time to consider a different more comfortable mask. I have found that nasal pillow masks are the most comfortable to me, but they don't suit everyone. These are things to discuss with your sleep technician, unless you want to dig into it deeper yourself. If you want to see what the machine is doing during the night I would suggest downloading the free SleepyHead program. It uses the data from the SD card in your machine. A PC or Mac with a card reader is needed to use it. With the software you may be able to see what the machine is doing when you are waking up and whether or not something can be changed.

Last I stumbled on a website which was developed by a pharmacist and university professor. The purpose of the site is to help people with insomnia without using drugs. I have found the various tools on the site helpful in improving my sleep. One of my main learnings from the site was to reduce the amount of time I was trying to sleep, and to eliminate to the extent possible, naps during the day. And, if I have a poor sleep one night I don't try to make up for it by having a nap, or trying to sleep more the next night. I try to sleep the same every night. In any case here is a link to the site.

Sleepwell

OK, that is not so serious. I suppose the mask may be contributing to the issue. The general idea is to use the least strap tension possible but still get a seal. My preference is the nasal pillow type as it make much less contact with the face.

I hear what you say, but let me respond with this. Of all the places I go, the one I fear the most when it comes to infections and disease, it is the hospitals. You probably know that when someone is going to be admitted to a hospital they do a questionnaire. One of the big questions is when you were in a hospital last. If it has been within the last year or so, all the red flags go up and you have to be tested for the superbugs. Why? Because the superbugs live in the hospitals despite all the disinfection precautions. If you have spent time in a hospital you are an infection risk.

So, yes I understand why hospitals have to be so careful, but despite being careful they are a hotbed for infections. I don't share that same concern with my CPAP that never leaves my personal care. I don't find the cleaning to be onerous or time consuming. The only bugs that my machine has are the same bugs that I already have. If a machine is going to be recycled the manufacturer provides detailed instructions on how to sterilize the machine for use by another person. Not necessary for repeated use by the same person. You do not catch a cold from yourself.

First of all I am not a medical professional, so take this advice as such. I suffer from apnea including central apnea and am also a diabetic. To my knowledge macular edema is a condition more associated with diabetes, high blood pressure, and the issues they can cause with blood vessels in the eye. Any chance you have diabetes? If so you should be seeing a retina specialist, and regardless you should be seeing one if you have macular edema. If diabetic one of the common treatments is to lower blood pressure with an ACE inhibitior like Ramapril. I would not expect it is caused or aggravated by CPAP treatment. Macular edema is normally diagnosed by looking at a grid with a dot in the middle, one eye at a time. When parts of the grid are dark or not visible then you have it.

Now if you are just talking about "goop" in the eye, often called "sleep" in the eye, that blurs your vision when you wake up that is totally different. Again not probably caused by the CPAP unless leaks blow into your eye. It may be aggravated by a sinus infection or the like. I doubt that it could be caused by a mask. I wear a minimal contact nasal pillow mask and suffer to some degree from the goop in the eye issue.

OK, I understand better. I have to say that based on your one sleep test results that is not real likely that apnea is a major cause of your waking up. And I also have to caution you that there is always some discomfort with wearing an apnea mask. The therapy has to reduce apnea enough that it offsets the increase in discomfort with the mask.

I would also say that doing a sleep study is not a fun event. I did mine at home and had control of a lot of things that you did not. I would say I got almost no sleep, but they told me I got probably 3 hours. All of that considered I think my assessment with an AHI of 34 or so was probably accurate.

My thoughts are that unless you have other serious issues like heart disease or lung issues, an at home sleep study is probably just as good as an in lab test. You have control of much more of the event, and are likely to get more sleep in that can be used to make an assessment.

This all said don't underestimate the value of an in home sleep trial with a CPAP. Just make sure it is an automatic one that collects data on everything that happens.

Just my thoughts as having gone through the process. Not a medical professional!

I understand from your first post that you have a new DreamStation Auto BiPAP. That machine supports transfer of data to SleepyHead. My suggestion would be to download SleepyHead and then with the data that will exist on your SD card, go back and look at what was happening with the medium sized mask and then see what has changed. I recall I posted links to SleepyHead and a basic instruction manual to your first post. If you can post a screenshot from before and after here I can make a lot better comments. It is hard to guess without seeing what the machine is actually doing.

Higher pressure can increase CA frequency. Higher pressure support can increase it, or in some cases decrease it, if set properly. The starting point would be to observe when the CA events are occurring relative to pressure support and pressure.

I understand you are between health care plans. Is your plan to wait until you have another health care plan in effect before you go ahead with a CPAP? The reason I ask is that based on the study you have had you may or may not need a basic CPAP. I can't imagine how you would ever need a BiPAP type machine. There is not much point in spending a bunch of your own money to determine exactly what type of machine you need and what pressure it should be set at. Those tests will cost two or three times more than the machine itself would cost. The difference between a basic CPAP and an Auto CPAP is about $80. The Auto machine essentially eliminates the need for a titration test to determine your set pressure. It finds the right pressure for you.

I guess what I am suggesting is that there are different routes to take depending on who is paying...