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What model of ResMed machine do you have DeterminedChocolateDog? I suspect it is an older model like an S8 or earlier. Just google some pictures to work it out. That would be useful to know.
Also, you can get a short, solid plastic bit of tubing, about 2 inches long, which could go between your hose and the humidifier chamber. It looks like this
https://www.google.com.au/imgres?imgurl=http%3A%2F%2Fwww.patientsleepsupplies.com%2Fimages%2FT%2Faghc150_small.jpg&imgrefurl=http%3A%2F%2Fwww.patientsleepsupplies.com%2FAdapters-and-connectors%2F&docid=CI-JsaIVwYTjrM&tbnid=WEctHuZ5Jhi0OM%3A&vet=10ahUKEwjhkabnv4vWAhVLyrwKHVl1BikQMwh5KEkwSQ..i&w=200&h=200&client=firefox-b&bih=1078&biw=1704&q=CPAP%20connector&ved=0ahUKEwjhkabnv4vWAhVLyrwKHVl1BikQMwh5KEkwSQ&iact=mrc&uact=8
That should prevent your hose from being damaged. There are several other things look a little different but will do the same job.
Have you had a look at an Amara View? It is usually where I'd go for someone who has issues with mask fit over the bridge of the nose. The Simplus is not bad in that area too (although not as good as the Amara View). Also, it is possible to use BiPAP with a nasal mask, even intranasal. Some of my patients do just fine that way. You could give it a try.
For rain out, the 2 things you can do are turn your heated tube temp up and turn your humidifier down. There is a limit to how much moisture the air will hold, so will have to turn your humidifier down until the rain out stops. Before you do that, turning your heated tube up should help prevent the rain out.
I noticed you have a minimum pressure of 10 cmH2O. That it a a little high for most people, so I was wondering if there is a reason it's set so high? If you're comfortable with it then it really doesn't matter. Also, you have EPR on 3. Is there a reason for this? If you feel OK with it off, then I'd leave it off unless there is a reason you have it on. It can cause problems (see a previous post of mine about EPR for details).
You may note I corrected my previous entry fro m"7-" to "70". Typing is not my strongest suit.
I couldn't really say what a typical level of usage for a 70 year old is because it's so individual. The reason I say that 5.5 hours/night is "pretty good" is that I have seen so many people of that age do a lot worse. Older people can be, somewhat unsurprisingly, more challenging to get used to therapy. 5.5 hours/night should be enough for her to receive some benefit to her health. If she remained at that level, overall I'd still call it a win. Hopefully she will gradually get more used to it over time. This can take many months for some people (just look at this site for some examples). Be encouraged that you are doing a good job so far. The best thing you can do is focus the areas she is struggling with and do your best to address them. Because every person is different there is no one magical cure-all for CPAP compliance (again, see the rest of this site). It's also worth remembering that, all other factors aside, your biological need for sleep decreases with time. At 70 it is probably something like 7 hours per night roughly speaking, possibly less.
For the vast majority, once properly set, a fixed pressure machine doesn't need to be adjusted for years, so there should be no unnecessary visits to the doctor or anywhere else. Your perception of your sleep, combined with data from your machine, should be enough to indicate if anything needs adjusting. Having said that, if you prefer auto and understand all that involves, then by all means use one. Where I come from, the difference in price is more like $2000, which is something most people can't afford to waste. And visits to the doctor are generally free. My concern is that people know what they are spending their money on, that is all. The best thing is whatever works best for you.
Unfortunately, this is not unusual for people with high pressure. What model of FFM do you have? There are several good ones, and one of the best things you could do is to try a different model to see if it fits you better, which would then mean the straps don't need to be so tight. Also remember that a bit of leak is not the end of the world.
I think you must have misunderstood. I said that CPAP USUALLY relieves oedema because it does, but that doesn't mean that it can't be causing it in your case. Your situation may be unusual but that doesn't mean that CPAP is not causing your problem. I certainly have no interest in shutting down discussion. If you learn anything more about what is happening please let us know because I'm sure there are plenty of people, not least of all myself, who would be interested in hearing about it.
I totally agree (in case that didn't come across in my previous post).
Not in my experience. Usually the doctor prescribes the pressure and leaves the rest of the details up to the supplier. It can take weeks or months of trial and error before finding out whether and auto may be called for. Suppliers are always keen to use an auto whenever they can get away with it because they make more money from the sale. Most doctors don't really know much detail about how various machines and modes work - that's what we techs are for. Also, retailers and, in many cases, doctors only get their information about CPAP machines and how they work from the manufacturers, and the manufacturers just tell them it always works fine with no problems because they want to sell more expensive units. I know this sounds a bit cynical, but unfortunately I see these things happen all too often. One of the reasons I post on this site is in the hope that, by better educating patients, more people will get the best and most appropriate treatment rather than being sold a machine that costs 3 times as much when they don't need it.
A good question. APAP (or Auto as we often call it) doe not treat your OSA any better than fixed pressure CPAP. In fact, because it has to see obstruction before it can respond to it and increase the pressure, it can be slightly worse (although for most people it's just fine). Also, it can be fooled by some things into increasing your pressure way more than necessary. If you have twitchy legs, for example, your auto will think that this is obstruction and increase your pressure, but because it doesn't stop the legs twitching it will keep on increasing the pressure until it maxes out. So for this and other reasons auto doesn't work for everyone, but it is fine for most. The benefit of an auto is that it keeps the pressure as low as possible for as long as possible. This can make it more comfortable in some cases. That is all well and good, but an auto costs about 2 - 3 times as much as fixed pressure CPAP, which is a lot of money for a possible slight increase in comfort. Of the thousands of patients I treat every year, maybe 1 or 2 will actually need auto to tolerate CPAP. The rest all manage just fine with normal CPAP (all of which have ramps, humidifiers and other features to help). So use an auto by all means if you think it's helpful and worth it, just bear in mind that you'll be paying a LOT more for that increased comfort, and that most people don't need it. If possible, see if you can try for yourself before purchase. Or possibly rent before buying if that's not too expensive (although rental can often be ludicrously expensive in an effort to force you into a purchase).
