Sierra

It will take some time to get used to the mask and the machine. My first night using a CPAP was awful. With respect to the dry mouth are you using a DreamWear nasal or nasal pillow mask, or the full face? If using the nasal type, and you open your mouth in the night, air can leak out, and give you a dry mouth. If using the full face that should not happen.

Do you have a heated hose, and have you put the humidity control in auto? A heated hose, humidity control in auto, and a temperature of 27 deg is usually very comfortable. I have not been able to tolerate a full face mask, but for the limited time I used it, I must mouth breathe and I do seem to get a bit of a dry mouth compared to the nasal pillow mask I normally use (ResMed P10).

I have read some reviews on the DreamWear mask where the air flow goes through the tubes up around your face to a tee connection on top of your head. Some complain that the mask is noisy. That said, I have a friend that uses the DreamWear Nasal Pillow mask and likes it. Give it some time before you make a change.

When you get SleepyHead working, let us know what pressures you are getting, or better still post a Daily screenshot. Depending on your pressures and whether or not you are opening your mouth, there may be better masks to try...

There are a couple of other options. Your data is as portable as your SD card. If you can convince someone with a computer to install SleepyHead you could take your data to the computer. On the ResMed AirSense 10 AutoSet, the data is available wirelessly to your machine provider. They should have software similar to SleepyHead to look at your results.

I tried to use SleepyHead with a brand new F&P SleepStyle machine. It would not work. I believe SleepyHead supports the Icon model though.

In that discussion forum I found this comment:

"After installing SleepyHead , you will find in C:\Program Files (x86) \sleepyhead two executables. One of them is SleepyHead-BrokenGL.exe That is the one you need, please make a shortcut to it..."

I checked and sure enough I have a BrokenGL version of the executable in the Program Files (x86) directory. It must create the two files when your download and run the single executable file. Sounds like you have to manually link a startup shortcut to that BrokenGL version of the file.

Yes, you can get a much more detailed report out of SleepyHead. You need a PC or Mac, and a SD card reader. After you install the software you can take the SD card out of the ResMed and transfer the data to SleepyHead. It should help you identify opportunities to see if the pressure can be adjusted. I will post a screen shot below as an example of what you will see. You can download SleepyHead at this link. It is freeware. And here is a link to a basic manual. Depending on your model of SPO2 monitor you may be able to display that data too. Click on the Oximeter link on the main SleepyHead page for more info.

Are you using the EPR feature? If so you may be able to gain a maximum mask pressure reduction by simply turning it off. Both myself and my wife use EPR at 3 but only during the ramp period.

Here is a screen shot from my wife's ResMed S9. She runs a pressure a little higher than mine, and close to what you have. She objects to the higher pressure so it is limited by the maximum pressure setting. Her values are min 12.8 and max of 14.4. This is not quite enough to totally control the flow limitations, but she dislikes having it higher, and over the longer term averages an AHI of about 1. She is currently using a F&P Brevida nasal pillow mask. It generally works well, but she does get some significant leaks during the night for short periods of time. I suspect from what I can hear that she dislodges it out of place to cause the leak.

I have downloaded the Windows 10 version from the link below, and it works fine for me on a couple of machines running Windows 10.

SleepyHead Download

Here are some basic instructions which may have some help.

SleepyHead Basic Instructions

This is a discussion forum for the software, but it is not very active.

SleepyHead Discussion Forum

What machine do you have? The software supports most ResMed and Phillips models.

I read an article at CBC on line about a University professor in Nova Scotia that is also a pharmacist. He (or more likely his grad students) has developed a website to provide resources to address insomnia and getting a good night's sleep without or with minimal medication. His view is that too many sleep aid medications are used, and they in turn are causing falls in seniors which cost the healthcare system a lot of money. He promotes the use of CBTi, or cognitive behavioural therapy for insomnia. It is a very good website, and I have gotten quite a bit out of it. There are a number of tools to evaluate your sleeping beliefs and habits. Check out the CBTi tab in particular. Here is the link:

Sleepwell

The author of SleepyHead is Mark Watkins. The link below is to a SleepyHead forum where he participates, but has not made a comment for 5 months or so. He indicates he is taking a break from development work. I see others have suggested an Android version. In any case you could make a suggestion there.

SleepyHead Discussion Group

Another user reported something similar a while back. Have a look at that thread.

What is your minimum pressure set at? It should display briefly on the machine when you turn it on each night. The minimum and maximum will be displayed in the top right. The current pressure which should initially be the ramp start pressure will show in the middle of the circle, if you are using the ramp. The reason I ask is that out of the box the machine will have a minimum of 4 cm. Some people, like me find that pressure too low and it feels kind of like suffocating. That said, you should feel that way each night on start up too, if the minimum pressure is too low. Something to discuss with your provider.

I use the same machine and also use some free software called SleepyHead. You can view your detailed machine data with this software including the actual pressure delivered during the night. It certainly would tell you what is going on with pressure. The detailed data of all your nights so far with the machine will be stored on the SD card, so it would be a matter of downloading and installing the software, then transferring the data from the SD card with a card reader to your computer. That would let you look back and see what happened to your pressure on the nights so far. Assuming it verifies what you are experiencing it would be good evidence to give your provider to get a new replacement machine.

SleepyHead Download

SleepyHead Basics

One simple thing to check too is your power cord connections. This summer I had bought my wife a new power supply for her CPAP. It worked OK for about 4 nights and then it started to shut off in the middle of the night, many times causing symptoms like you report. It turned out to be a faulty plug on the new power supply. It was a molded connection and the wire or solder joint inside the plug must have been bad. If you wiggled it a certain way you could make the machine stop and start. I gave my supplier a copy of the SleepyHead report showing what it was doing, and they immediately sent me a new one.

Hope that helps some,

A post from Ace copied and pasted here:

"Sierra, I am a 52 year old man that was diagnosed with obstructive apnea. I also have astma, but not central apnea. I use the RESMED airsense 10 since one year approximately. The healthcare detected high blood pressure cause of apnea. And since I got the apap treatment the blood pressure has gone down. But now when I went through a 24 hour test I've noticed that the blood pressure is high during awakening. I've also noticed that I can wake up a couple of times catching my breath........ when I'm half awake, so to speak, it's almost like I have central apnea. This is quite scary, when you find yourself not even atempting to breathe. What sleeptech is writing is not to be taken lightly. The industry itself will never bring up matters like this. Obviously they want to develop their products to be as good as possible to be competitive and sell more. But during development there will be issues like this. And these "issues" can actually cost lives(!) Now to my point. I've tried with decreasing the EPR-level from the preset level 3 to 2, 1 and finally the last weeks turning it off. When the EPR turned off completely, I've noticed a very big difference. I breathe much better and sleeps better. My natural brething (respiratory effort) is normal again. If the EPR-funtion (Expiratory Pressure Relief) affects and increases the CO² levels creating central apnea we should never even consider trying out the EPR(!) As sleeptech mentioned: "should be avoided in almost every instance." Concering CO²-levels and central apnea: "I have recorded evidence of this happening." "Where I work, we only ever allow our patients to use EPR or C-Flex if they have had a sleep study with it and we can verify that it is not causing any harm. Otherwise we do not use it at all. I can think of fewer than 5 people who have actually had some benefit from using EPR/C-Flex in all my years of being a sleep tech." Please take his warnings seriously. (For comfort, setting the ramp with EPR is of no harm obviously.)"

My reply to your post:

Based on my personal experience when I awaken during the night short of air, I believe I have had an apnea. It could be either central or obstructive. I unfortunately suffer from more central apnea events than obstructive, and increased pressure is of no benefit in reducing central events.

I have also adjusted EPR from none to 3 on numerous occasions. As I said in my post, it has had no repeatable impact on my frequency of central apnea. But also as I said I can get the same apnea normalization with less maximum mask pressure when EPR is turned off. On that part I agree with Sleeptech. It has some negative impacts but I would suggest it is in mask pressure not any impact on central apnea frequency.

With respect to impact on oxygen and CO2 levels I think you have to put it in perspective. We are talking about a pressure increase of 3 cm of water. Yes, that means more oxygen will go into the lungs, but the question is whether or not 3 cm is significant. I won't bore you with the math, but if you do it the atmospheric air pressure when the weather changes from a low pressure formation to a high pressure formation, the pressure in CPAP units changes by about 35 cm of water. That is a factor more than 10 times higher than turning EPR on or off at a setting of 3 cm. My conclusion is that 3 cm is not significant in the scheme of things. Also remember that standard atmospheric pressure is about 1030 cm of water in absolute units. A change of 3 divided by 1030 results in a very small percentage change.

You mentioned that you gained some benefit by turning EPR off. Again without going through my previous post again, I think that is quite possible in that depending on how your machine is set up turning EPR off may reduce the frequency of obstructive apnea. Have you quantified what your before and after central and obstructive apnea frequency was? I find one needs to document at least a month's worth of data to determine what the change had been.

Another thing to consider is that one of the treatments for higher than 5 AHI due to central apnea is to use a BiPAP machine. A BiPAP really only differs from an APAP in that it can use an EPR of higher than 3 cm. Yes it is called pressure support but it is really the same thing -- a split in the IPAP and EPAP pressures. And central apnea is actually treated by using a higher than 3 cm split in the pressures. Some question the effectiveness of it, but it is done. I know because I suffer from central apnea and I have investigated all options to deal with it including a BiPAP and an ASV machine.

So I will say again that I agree with Sleeptech in that there are some downsides to using EPR for someone who is mainly suffering from obstructive apnea, but causing central apnea is not a very likely one. It certainly has not been my personal observation although I wish it was. I don't think you will find credible sources elsewhere that suggest it causes central apnea either. If there are, I have missed them. If you have them, then I certainly would be interested in looking at them.

I am 68 years old and have mixed sleep apnea (obstructive and central). I am also Type 2 diabetic. But, I am not a doctor and cannot provide you with any kind of diagnosis. That said I have suffered from time to time from some of the same things you describe.

Getting dizzy when standing up is called orthostatic hypotension. I am aware of it as it is a symptom of diabetic neurophathy, and that I have to be observant of. It can also be caused by low blood pressure and many other conditions. It can be a side effect of blood pressure medications. Headaches, waking up to pee several times a night, and night sweats are symptoms of diabetes and high or low blood sugar. I have experienced them personally. Blood sugar variations can cause similar symptoms that you describe like feeling dizzy or drunk. My suggestion is to be sure to ask your doctor to test you for diabetes if that has not already been done. You are a little old to have juvenile type 1 diabetes, and not old enough to be a typical type 2, but in my opinion as a diabetic, you have enough symptoms to be tested. There are three tests for diabetes and ideally you want them all done. One is an overnight fasting blood glucose test, another is the oral glucose tolerance test (OGTT), and the last is the AIC test which estimates blood glucose over the last three months. All can be done in one lab visit. Having all three tests done is much more conclusive than relying on one single test.

Like diabetes you are not a likely candidate for sleep apnea based on your age and weight. However getting a sleep study test done is a good idea. It should be quite revealing as to whether or not apnea could be an issue.

Hope that helps some...