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I was issued with my machine and started using it in September this year, I've just had my review, and it looks like I'm stuck with it for a while, I'm currently messing with a few different masks, I have the normal full face mask, which I'm iffy about, main use seems to be the Mirage FX nasal, but I'm having problems with the machine or mask, not sure yet, and I have just got the N20 nasal mask which has a truly awful head mounting arrangement, I think the part which goes over the nose is good, but the rest is like a bridle and no good if you like to sleep on your side.

My reason for coming on here is I am getting conflicting info from Resmed, and also my sleep clinic, which is in St James Hospital in Leeds, West Yorkshire. The problem I have is the machine ramps up the air pressure and this wakes me up so defeating the purpose, Resmed say this should not happen, the clinic says it is a response to the mask leaking, which if it was I'd accept, but once awoken I press the mask onto my face, but the pressure does not drop, I have to turn off the machine for a few minutes (go to loo) then fire it up again, then it's fine again, I noticed that when turned off in the morning that the machine carries on blowing at a reduced pressure for several hours, Resmed said this should not happen, I forgot to mention this at the clinic.

I'm unsure how to proceed so any advice will be welcome.

Cheers Kev.

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Welcome Kev.  It's no unusual to get different advice which can cause more confusion.

Firstly, I'd comment about the fact you've had both a full face mask and a nasal one.  If you're a mouth breather and you're using a nasal mask, this could be causing the machine to ramp up if air is escaping from your mouth.  If you are a mouth breather during sleep then you need to revert back to a full face mask or use a chin strap to keep your mouth closed.

St James' Hospital are very good, and Resmed are a reputable manufacturer, but still differing advice can be offered.  The clinic are correct in that mask leaks could be causing you to wake up, which coincides with the pressure raising due to the mask leak.  However, there are also people who get disturbed sleep without mask leaks, just when the pressure starts to raise to treat their apnoeas.  Auto pressures are not for everyone - sometimes people get better therapy on fixed CPAP pressures.

Resmed are correct that the machine shouldn't continue to blow for several hours, so I'd book in an appointment with your clinic to find out what's going on and to discuss whether you need a chin strap or use a full face one.  Once you're getting good therapy things will start to improve.

Thanks Kath, that all makes sense to me, well it will do when I've read it a few more times :) :)

During the day I breathe through my nose, so I assume the same at night, so I shall perhaps give the full face one another try for a few days, although I find it cumbersome to wear.

As for Auto, I'm sufficiently competent to change any of the Resmeds settings if need be,it has a warmer which I need to get to grips with, only had that a week, not getting quite as much dry mouth, but would I still get a dry mouth if it remained closed throughout the night?

CheersKev

Yes see how it goes Kev, as if you can nasal breathe at night with a nasal mask it's certainly healthier for us.  Unfortunately, I can't and need a full face mask.  If you've got the humidifier on and you're not opening your mouth you should find the dry mouth eases, although there are some medical conditions and some medications that can cause dry mouth as well.  If you're still struggling the Xylimelts are a great solution http://www.hope2sleep.co.uk/xylimelts-dry-mouth-discs.html



Kev Behr said:

Thanks Kath, that all makes sense to me, well it will do when I've read it a few more times :) :)

During the day I breathe through my nose, so I assume the same at night, so I shall perhaps give the full face one another try for a few days, although I find it cumbersome to wear.

As for Auto, I'm sufficiently competent to change any of the Resmeds settings if need be,it has a warmer which I need to get to grips with, only had that a week, not getting quite as much dry mouth, but would I still get a dry mouth if it remained closed throughout the night?

CheersKev

Hi Kev,

You didn't say what machine you have.

The ResMed machines have an Smart Start function that will run if you do not turn it off at the mains.

If the pressure rise affects your sleep, you can change it to a soft response which raises the pressure slower, but this will affect treatment slightly.  You might not notice though, but it might stop it waking you up.  It is in the Clinicians settings.

You can also disable Smart Start in there as well.  Not sure if you have an S9, but it uses much the same software, so in theory it should have the same settings.

The Airsense10 comes in a few forms, but some of the controls are still there.

The clinics do not like you adjusting the settings and they will know if you do, however, sometimes they will let you do it if you know what you are doing.  Turn Smart Start OFF and put it onto SOFT if the machine wakens you up when it rises in pressure.  It is also better if your low pressure is 90% of your needs, or taken nearer the pressure the machine gets up to.

It is easier if you can read your data yourself to know what is going on.  Sleepyhead is the best for this, but you do need to get used to it.  Be very careful if you do this not to delete your data, it is easy done.  Clinics also do not like you doing this, but if you want to see what is going on you have no option as the clinic will not show you.

Once you get used to it you can read the data and tweak the machine to give you the best treatment.

I just got a new machine and they didn't know what setting to set it at, so they set it at 10 and left it wide open and on APAP, they were supposed to set it on EPR, but only set it for the ramp time, then they said they would set it to ramp (I hate this) so I am glad they didn't do this either.  I said to them that I would adjust the machine later to a storm of protest.

I only see them every 5 years, so a lot can happen between times, so I want to keep an eye on things.

If it is an Airsense10 the manual has all the instructions in it, if you don't have the full manual you can download it:

http://www.resmed.com/assets/documents/product/airsense_10_autoset/...

If it is an S9 you have the manual is here: 

https://www.resmed.com/ja-jp/dam/documents/products/machine/s9-seri...

Both have the clinicians setup instructions in them and are freely available on the Internet.

If it is any other machine just google for the clinicians manual.

A climate line I am told will help a lot more with dryness.  I have not used one, but everyone I ave spoken to that used one has a great belief in them.  Even with a chin strap, air can escape through your lips and your mouth will dry out, plus, the chin straps stretch a bit and it is still possible to open your mouth with a chin strap on, try it, no matter how tight it is you can still open your mouth.

Hi, thanks, I don't think I breathe through my mouth much, but I'm asleep so who knows :) :) 

I have been through and changed a few setting (photos of original first of course) nothing seems to help me, it becomes very noisy when it ramps up even on the auto setting, it is ultra quiet where we live.

Thanks for the manual URL, always prefer the PDF to paper, easier to search for things.

Machine is the airsense 10 

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