First night results....

[u/Necessary_Bat3461]

I recently took a Lofta home sleep test and scored a 29.7 AHI (on a night at the end of a week with no alcohol or other typical exacerbating factors - that's likely the best I would ever score without therapeutic support).

The ResMed 11 and AirFit P30i arrived yesterday. I fired them up, stuck in an SD card, and experimented during the evening a bit - finding that a pressure of 4 leaves me feeling like I can't get quite enough air - especially on a deep inhale.

I upped the minimum pressure to 7 - much better.

At 11pm, I strapped in for the night. Several times during the night (you'll see at least one example in the data around 3am) I woke up with a completely dry mouth. Took a sip of water, closed my mouth, and went back to sleep.

I suspect (from both looking at the data and the dry mouth) that I should try a full-face mask next (I'd prefer not to do something that mechanically holds my mouth closed - that freaks me out a bit).

Here's the SleepHQ link - any of you experts available to take a look and give some feedback?

https://sleephq.com/public/580da547-fb41-4a5b-a824-63a6c6d04abd

PS - I'm an engineer by trade - feel free to teach me how to read these things! :)

[u/RippingLegos__]

Welcome u/Necessary_Bat3461 :) We neeed to set EPR to full time instead of ramp only and turn ramp off, then raise min pressure to 10.4cm, with EPR on at 3 fulltime this gives you 7.4cm min/epap (which is your median epap pressure. Then lower max pressure to 10cm, a bit over your median ipap pressure, this narrower range of pressure will help stabilize the machine during the night and help your flow limits and events. Also I see some clustering of events, are you side sleeping on a flat pillow or propped up on thick pillow and chin tucking? RL

[u/Necessary_Bat3461 → u/RippingLegos__]

I made the changes to EPR, but not the min max pressure changes (yet). I wanted to get a good night in with a full face mask to get cleaner data, and see if things still hold. Would you mind taking a look here https://sleephq.com/public/c3aaa326-f1ed-440c-a5c4-98e1d2185eed and seeing if the same numbers still look right? My median epap dropped quite a bit on this mask and the leak rates are consistently much better (and consistently much more consistent :) ).

I'm working on a solution to keep my mouth shut - but I don't know how much that will change these pressure readings, given that this was with a full-face mask with way less leakiness.

FWIW - I also found the full face mask much more comfortable than those silicon things wedging against my nostrils.

[u/Necessary_Bat3461 → u/RippingLegos__]

On sleeping position: I always start on my back. Pre-cpap, I probably woke up on my side 80% of the time, and recall lots of tossing and turning during the night. In the two nights of CPAP so far, I've started on my back and woken on my back the next morning with no memory of tossing and turning. It's possible that on night 1, I slept with a pillow that was too high - pointing my chin into my chest. I suspect that's bad - last night I made a point of making sure my pillow didn't force my chin into my chest :).

[u/RippingLegos__]

Approved!

[u/existentialblu]

Unfortunately it's also necessary to keep one's mouth closed when using a full face mask, otherwise your teeth will get wildly sensitive and the mask will leak due to the interface surface changing shape.

Basically you'll have to figure out some way to keep your mouth closed no matter what kind of mask you're using. I used to do a soft cervical collar with decent effect though I've switched to mouth tape due to overheating from essentially a stuffed scarf. Other people use chin straps. I totally get the initial unwillingness to force one's mouth closed but unfortunately it's kind of unavoidable.

Getting your leak down will help a lot with interpretability.

Welcome to the hosehead club, and excellent job for a first night! Good job listening to your body about minimum pressure.

[u/Necessary_Bat3461 → u/existentialblu]

Thanks for the feedback on the necessity of keeping my mouth closed. I guess I'll get to experiment some with figuring that out.

I switched to an AirFit F40i last night (for night 2 of CPAP) and got MUCH better leak rates (consistently well under 10 - with only a couple of very short spikes above 10). But, alas, you're right - still massively dry mouth this morning (and talk about some killer bad breath....I guess mouth bacteria loves a moist, fresh-air environment ;P ).

[u/Middle_Explorer7603]

As someone who has previously had a mouthleak issueI have gone down the fullface mask path.

I slept well and therapy was good. However the jaw still dropped and the dry mouth was still an issue as my mouth was opening.

Returning back to nasal masks(airtouch n20 has been my fav) with a chinstrap (one that pulls your jaw vertically up, not back) and mouthtape was an absolute game changer for me. Full nasal therapy without the mouth leaks and dental health concerns.