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cpapsistah
Unread post  Post subject: Newbie with suspicions about titration study  |  Posted: Wed Jan 03, 2018 2:21 pm

Joined: Sun Dec 24, 2017 10:20 am
Posts: 2
PAP Machine: Resmend Airsense 10 Auto
Humidifier: Resmed Heated Humidification
Pressure Setting: RX: CPAP, 5/EPR 1. Current trial APAP, 5/20, EPR 3

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First, I must say to Jason...Thank you for this forum and your channel. It is the only thing that has kept me sane as I embark on this now almost three week cpap journey. In the sleep lab my AHI was 28.4 so I didn't need arm twisting that I had sleep apnea and to go on cpap. I really want to be successful. My doctor sent to me to another place to get the cpap titration and this is where my threat ganglion went up (yes, I am a fan of Star Trek Discovery). The entire experience was sketchy. The tech seemed rushed and annoyed by my questions. Put me on a full face mask which I struggled with all night. About two hours before the study ended, he switched me to a Swift FX nasal pillow and the mouth breathing ensued. After it was over her sent me home with the masks (Airfit F10/small and FX nasal pillows) and threw in a Airfit N20. The Tech really appeared as if he had been asleep and ushered me out. The DME supplier comes by a week later and says I needed a pressure of 5 (which I knew was low) and brought a WISP. Not one of these people put a template to my face. Just eyeballed it. After the first three nights of alligator death rolling/mask throwing fits, I found you the youtube channel and forum. By now I am out of town with tfor the holiday. As I began to watch and learn, I printed templates and sure enough, each mask was the wrong dang size. And since I am a chronically congested, claustrophobic, side sleeping mouth breather (le sigh) I need a full face mask or help with the slack jaw. I ordered a larger nasal mask and chin strap. Ordered a century guard too. Meanwhile, I began to suspect the pressure was way too low. Struggling to breath each night. On top of that I was leaking like a deflated Macy's Thanksgiving balloon while trussed up like Hanibal Lechter with the mask way too tight. Armed with a little knowledge now, I call and ask for the titration report to be sent. I arrive home last night and really think something isn't right. The report basically states that the tech "stopped the pressure at 5 since I did well while in the supine position." One problemo. Of the 267.5 hours I was asleep, I spent zero, zilch, nada time in the supine position. All the apnea events were in the non-supine position. What in the what?! I have decided to take the APAP by the horns and put the machine on APAP, 5-20 pressure, EPR 3 (not sure if that is wise for a trial or should be lower), with heated humidity, with a full face mask (going to use the Airfit F20) which I will do for a week to see what is what before seeing my doctor, or perhaps seek a new doctor since he cosigned this report. Hopefully the CPAP police wont raid my apartment before the trial is over. Based on your experiences with your CPAP journey, does this sound reasonable or am I overthinking this (it wouldn't be the first time). Thanks for your time everyone. Jason...you rock.


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TheLankyLefty
Unread post  Post subject: Re: Newbie with suspicions about titration study  |  Posted: Wed Jan 03, 2018 11:02 pm
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Joined: Mon Aug 15, 2011 10:22 am
Posts: 4516
PAP Mask: Practically tried them all.
PAP Machine: Use Phillips Respironics System One APAP with Aflex for mask testing
Humidifier: None
Pressure Setting: When testing, I use APAP with a range of 5-10

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cpapsistah wrote:
Based on your experiences with your CPAP journey, does this sound reasonable or am I overthinking this (it wouldn't be the first time).
This is a great approach to take. I wouldn't keep it on those settings for longer than a couple weeks though. Check the airflow signal, leak values, and general pressure you "hang out at happily" in SleepyHead (hopefully you're using it or have downloaded it).

After a couple weeks you can try setting your pressure to a narrower range, or go with a static pressure where you seem to be happiest. What you're doing is what many sleep docs do in lieu of a titration night in a sleep lab. Most in lab titrations tend to be more complex, so what you are doing isn't anything out of the ordinary at all.

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cpapsistah
Unread post  Post subject: Re: Newbie with suspicions about titration study  |  Posted: Thu Jan 04, 2018 10:30 am

Joined: Sun Dec 24, 2017 10:20 am
Posts: 2
PAP Machine: Resmend Airsense 10 Auto
Humidifier: Resmed Heated Humidification
Pressure Setting: RX: CPAP, 5/EPR 1. Current trial APAP, 5/20, EPR 3

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Thank you for getting back to me so quickly. I appreciate it. Thanks to your forum and YouTube, I downloaded SleepyHead and have begun to use it and referring to your videos to learn more. Thanks again!


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CobaltSky
Unread post  Post subject: Re: Newbie with suspicions about titration study  |  Posted: Thu Jan 04, 2018 10:40 am

Joined: Thu Nov 16, 2017 1:32 pm
Posts: 43
Location: Peyton, CO
PAP Mask: Aitfit P10 or Dreamwear (with a headband over lips)
PAP Machine: ResMed Airsense 10 Autoset
Humidifier: Integrated but without climateline hose
Pressure Setting: 9-13

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I just tried an F20 (over my usual Airfit P10 pillows and headband over my mouth. AHI was good, but I had a large amount of leaks (from the chin area). What was happening to me is exactly what was happening in Jason's video: my jaw would relax and pull away from the bottom of the FFM. I ordered a boil and bite double mouth guard to keep my mandible in place yesterday. In the meantime, I switched back to my P10/headband method and hot 8 hours of AHI 0.0 last night!

So if that F20 does the same thing to you (I see you mentioned slack jaw), try the mouth guard or a different mask setup. Good Luck!


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audihere
Unread post  Post subject: Re: Newbie with suspicions about titration study  |  Posted: Fri Jan 05, 2018 3:10 pm

Joined: Tue May 10, 2016 2:54 pm
Posts: 69
PAP Mask: F10 Full Face
PAP Machine: Resmed Airsense 10 Autoset
Humidifier: Heated hose Resmed
Pressure Setting: 10-16

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I have good seal using F10, but tried the F20 and wasn't able to get as good of a seal on it so went back to F10. Just FYI.


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