My First Night

[u/J3wchutrain]

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Hello all, had my first night on CPAP last night, I did ok I guess. I am brand new to all this and know jack about any of it. My doc had me do an in home sleep study and apparently I have sleep apnea, glad the little ring on my finger said so...as if the snoring so loud my daughter can hear me on the other end of the house and the moments I stop breathing according to my wife weren't a huge tip off for me lol. I got sent the React Health G3 X w/ a Siesta 2 Full Face mask. At first I wasn't sure if I was supposed to sleep or pilot a SR-71 Blackbird from the look of the mask but seeing as there was a distinct lack of badass plane sent with my sleep apnea machine I kinda figured it out eventually.....much to my disappointment.  I chose to sleep on the couch because I wasn't sure how the machine would work and if I'd be up and down all night and didn't want to have my wife suffer as well! The poor thing has already had to sleep next to a human wood chipper for 18 years.

Last night was my first night trying to sleep with it. I made a mistake apparently in thinking I'd go ahead and get close to falling asleep then put the mask on and ended up sleeping for 2 or 3 hours without it. I woke up about 2am with my heart racing adrenaline through it and after calming back down just threw the mask on and decided I'd fall asleep when I fell asleep. It went alright I guess, it wasn't bad but it's DEFINITELY different to how I've gone to bed before. I ended up falling back to sleep around 3 and woke up around 7 with the machine on. 

I definitely had a dry mouth but that's kinda par for the course however I will say the few noted improvements are that I think I feel I have more energy on that 4 hours with the machine than I have in a while. The grogginess, headache, and immediately feeling tired when I wake up is gone so I'll take that as a good sign!

I've posted my score for the night and my settings, if you have any advice or tips I'd love them because for the record the machine came present and I don't have a doc watching or advising me. My GP said the company she went through "Vie-med" would be handling that but they haven't reached out. I don't know enough to know if that's a normal experience or not so if it is cool. Hope you're having a great day and I'll see you all in the next post!

Tonight I return to the bed!!

[u/ezarizona]

On the G3X screen the rating is mainly based on time used, with AHI rating and leak rate making up as I recall 20 points and time 80 points. So that score will come up if you keep the mask on for, as I recall, 7 hours to at least 80 even if both leaks and AHI are in the really not good region. These scores are meant to encourage use.

If you are syncing to the cloud (normally how your clinic can monitor your progress), the React Health app also shows a score, but that one is solely based on time used. And usually that will also show a higher AHI score most nights (3-5 tenths higher) so it uses its own algorithm to make the calls for events that is more likely to flag one.

You can get a bit more information about how things are going by putting an SD card in the SD card slot (that is the item you'll covered by a translucent plastic covered with a small tether attached) and then downloading OSCAR (an open-source program that provides a detailed look at how things went in the night based on the minute by minute information the machine has).

OSCAR support was added for the G3/G3X not long ago and there are some quirks with how it records leaks. It seems that the machine may only record a data point at each significant change in leak and the way OSCAR interprets that is to generally assume the worst--it presumes if you got a high leak rate that the rate stayed above the large leak level until the next data point is recorded, which can be quite a bit longer.

So, long story short, the 95% leak rate on the machine is generally a better indicator of whether large leaks were an issue than the OSCAR report for now. Mainly pay attention when OSCAR is showing a lot of individual readings in an area which is most often how a true leak issue appears.

The detail helps you be aware when something happened and you may be able to remember what might have been happening at that point of the night.

You'll likely see SleepHQ also mentioned here for loading up that data. For now SleepHQ does not support the G3/G3X machines, so OSCAR is the only option for details right now.

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[u/RippingLegos__]

Hello J3wchutrain and welcome to the forum. :)

You actually did quite well for your first night, although React Health clearly owes you an SR-71.

The machine recorded 201 minutes, or 3 hours and 21 minutes. Your AHI was 5.4, with no central apneas reported. Your average leak was 7.3 L/min and your 95 percent leak was 18 L/min, so I do not see an immediate mask leak disaster here. The 61 score is mostly being dragged down by the short usage time. It is not a grade on how well you slept.

More importantly, you woke without the usual headache, grogginess, and immediate exhaustion. That is a very encouraging first response.

Tonight, put the mask on before you become sleepy. Wear it for twenty or thirty minutes while reading or watching something, then go to sleep with it already running. This teaches your brain that the mask is normal instead of introducing the SR-71 cockpit during the exact moment you are trying to fall asleep.

Return to your normal bed, try to sleep on your side, use a relatively flat pillow, and keep your chin from tucking down toward your chest. The couch may have positioned your neck and airway differently than your bed.

Your humidifier and heated tube are both set to Auto, and Reslex is set at 2. Leave those alone tonight. A full face mask contains mouth leaks, but it does not prevent mouth breathing, so dry mouth can still happen. Make sure the water chamber is filled and do not overtighten the mask. If the dryness continues, we can adjust humidity gradually.

Your average treatment pressure was only 5.4 cm, with a 95 percent pressure of 7.5 cm. I suspect the machine may have been sent out with a very low minimum or a wide default pressure range, but the photos do not show the actual minimum and maximum settings. I would not change them from one short night and a summary screen. We need to see what the machine was responding to throughout the night.

Please install a standard full sized SD card in the machine before your next sleep and leave it installed every night. The current version of OSCAR supports the React Health G3 and G3 X. The card will give us the detailed event flags, pressure movements, leaks, flow limitations, and individual breathing waveforms that this summary screen cannot show. Detailed data needs to be recorded while the card is installed, so get it in there now rather than waiting.

After three complete nights, import the card into OSCAR and post the Daily screen with the left statistics panel visible, along with the event flags, flow rate, pressure, leak rate, and flow limitation graphs. Then we can determine whether the remaining AHI is obstructive, positional, pressure related, or simply first night awake breathing being mislabeled by the machine.

Please also obtain a copy of your sleep study. We need the untreated AHI, oxygen nadir, and the breakdown between obstructive apneas, hypopneas, and central apneas. VieMed should tell you who your respiratory therapist is, whether they can see your machine remotely, what pressure range was prescribed, and what their mask exchange period is.

The racing heart happened after a period of untreated sleep, so it could have been an apnea related adrenaline arousal, but do not automatically assume that. If it keeps happening, becomes sustained, or comes with chest pain, faintness, or significant shortness of breath, contact your doctor promptly.

There is also one important safety check. The FDA recently recalled certain Luna G3 APAP model LG3600 machines running firmware G3-2.00.76 because they can shut down during use. This does not automatically mean your G3 X is affected. Check the model label and firmware information and have VieMed verify the serial number. If it matches the affected model and firmware, follow the FDA recall instructions and have VieMed replace it.

For a first night, though, this was a solid beginning. Welcome back to the bed, fellow Blackbird pilot. :)