Sierra

I use a nasal pillow mask and find it keeps my nose clear.

Using water with minerals in it is not going to be harmful to you as the water essentially gets distilled by the humidifier. Only pure water vapour goes with the air to your lungs. However, it is not good for your humidifier in the CPAP. Minerals will build up and will have to be removed using vinegar. You should be using distilled water, demineralized water, or reverse osmosis purified water.

This said when we travel and have no access to distilled, demineralized, or RO water, we just use tap water. Up to a couple of weeks does not result in too much mineral build up in the humidifier. When you do this, you should throw the remaining water in the humidifier each morning. That will get rid of most of the minerals.

I have not done much research on the stages of sleep. But, perhaps a stimulant suppresses the REM stage of sleep, so it may not be counter intuitive.

@RayRBD has posted a link to what looks like a very useful resources site for RBD. They are looking for volunteers for a study, but seem only to be located in the US, and Montreal in Canada.

Yes, I am surprised that regulators allow the use of ozone cleaners for CPAP use. Without a doubt it is an effective way to sterilize the CPAP, hoses, and mask. However, it is a significant risk to the longevity of the materials. Ozone is a naturally occurring form of oxygen. Before during or after a thunderstorm it can be smelled in the air. Lightning can cause it to form and linger at levels high enough to be detected by the nose. But, on the more positive side, ozone is very reactive and does not last long. It is commonly used in bottled water to kill any bacteria which may form. Unlike tap water which will have a residual chlorine or chloramine to kill bacteria, distilled water or bottled water will not have anything in it, unless ozone is added. That is my pet peave with bottled water. The plastic containers are another contributor to our plastic pollution problem. And, bottled water is almost always activated carbon filtered to take out the chlorine and chloramine which leaves it vulnerable to bacteria contamination and growth. Some, but not all bottled water is treated with ozone to overcome this problem.

I am not so convinced that these ozone cleaners like SoClean are a health hazard to people, but they certainly can be to your CPAP equipment.

BUG is correct. Your owners manual would be a good starting point. I use pure vinegar on my mask and hose first, followed by some Dawn dishwashing detergent, and then finally a rinse to drip dry. If your machine has a prewarm feature that will remove any remaining moisture. I try to wash the parts in the morning and let it drip dry all day before using it again. The vinegar is good at removing any mineral deposits and will also act as a disinfectant if pure. I would avoid using an ozone cleaner like SoClean. The ozone can damage the machine and void the warranty. UV probably does no harm. I was negligent on replacing my inlet air filter and it got pretty dirty. I have set a reminder to replace it every 3 months. Depending on what I see, I may extend that to 6 months.

I have not tried a mask like this one, but have thought that the nasal pillow version of it may be worth a try. I believe BUG has tried this mask or a similar one and had some issues with it. I will leave it to BUG to cover them.

The masks I have tried in order are:

ResMed AirFit P10 Nasal Pillow - It works very well for me, is comfortable, quiet, and when the headgear is working the leaks are reasonable. However the headgear is a pain to keep adjusted and the straps keep slipping.

ResMed AirFit F20 Full Face - It is well made with substantial headgear, but I could not make it seal with any reasonable amount of headgear tension. Probably only used it 2-3 nights and gave up on it. It is in the spare parts box.

ResMed Quattro Full Face - My son uses this one and he gave me a spare mask. I hated it for the same reasons as the F20, but the Quattro was worse. Did not make it through one full night of sleep.

F&P Brevida Nasal Pillow - This has a better headgear than the P10 but the nasal housing is much larger in size and not as comfortable when sleeping on my side. It also irritated my nose between the nostrils. I gave it to my wife who was using a ResMed Mirage FX Nasal Mask. It had to be adjusted very tight to make it seal and she was annoyed by the marks the mask and straps were leaving on her face in the morning. She loves the Brevida and gets almost zero leakage with it.

ResMed Swift FX Nasal Pillow - I basically bought this mask for the much better headgear and a nasal pillow design similarity to the P10. It was fine except for the vents. Unlike the P10 model which has a diffuser vent on each side of the nasal chamber, the Swift has angled straight through holes. The velocity of the air coming out those vents is like standing behind a jet engine. I could not find any position when sleeping where the air velocity would not be constantly waking me up.

Sierra FX-10 Hybrid - This mask I made by fitting the Swift headgear to the P10 Nasal housing. From my post, at this link, it looks like I have been using it for 3 years now. I've replaced the silicone nasal pillow cushion once, and that is it other than periodically replacing the 3M tape that holds the splice together. I love the mask. Works great and is quiet.

For the life of me I don't understand why ResMed does not put the Swift headgear on the P10 mask. That would be a winner.

I know you have been having issues with RBD for some time. I hope this treatment works for you. On a quick look at the Mayo Clinic site, it certainly seems to have a long list of potential interactions.

Actually I have zero concern that my ResMed AirSense 10 AutoSet is not reporting AHI properly. And with AHI averaging under 1.0 I really have no room for improvement. I sleep just fine if I avoid naps during the day and don't try to sleep more than 8 hours at night. If I get to the point where I cannot maintain AHI under 5, with centrals being the dominant type, then I will consider an ASV. I am currently no where near to that point.

If you were diagnosed with a CA index of >53 then you are dealing with a very different situation. A sleep test is done with no treatment pressure, so treatment pressure is obviously not that cause of your central apnea. An ASV would be an obvious choice.

If I was to wish for a technical improvement to my ResMed APAP it would be the ability to distinguish between obstructive hypopnea and central hypopnea. Some in lab polysomnography tests can do this, but I am not aware of any APAPs that can do it. Currently the ResMed APAP responds to OA and hypopnea events with a pressure increase. CA events are correctly not responded to. The ideal auto treatment would be to only respond to OA and obstructive hypopnea with a pressure increase, while providing no pressure increase to CA and central hypopnea. I suspect that this is technically very hard to do, so they are not doing it. The flow pulsing technique they use is probably not suitable for a hypopnea situation and only works in a no flow situation.

I suspect this is a very personal thing like a pillow. My preference for a bed covering is something light, warm, and a cool room (64 F or a bit less). We are currently using a silk comforter.

For sleep issues I have found this site at the link below helpful. It advocates CBTi over a medication solution. In particular I have found the tips for the hygiene of sleep helpful. The site was started by a university pharmacy professor that was concerned about the number of hip injuries due to falls in elderly people using sleeping pills.

MySleepwell