That went well: CPAP, night 1

Don’t worry, I won’t blog every night of my CPAP use. But the first time is special, isn’t it? It went extraordinarily well, though there is still room for improvement — and, I expect to improve.

My insurance company sprang for what seems like about the best CPAP machine on the market: ResMed AirSense 10. (Online, I see it available for ~$750.) I don’t know if it is actually the best on the market, but it sure is nice. I was once worried I’d get a machine that was noisy. This one is silent, once the mask is on. Can’t hear it at all.

Other niceties: It’s smallish/lightish. It automatically adjusts pressure as needed. It can back off the pressure for exhale. I thought this would be obtrusive and wake me up. It’s so gentle, I didn’t notice it at all.

It can heat the tube so condensation doesn’t build. It’s got lots of customizable features for comfort (humidity, temperature, and the like). The menus are easy to use. It gives feedback, either on the device or via an app. Once a data card is plugged in, the user can get even more data. (You bet I will!)

I opted for a “nasal pillows” mask, as it has the smallest facial footprint and is most similar to Provent, with which I had already become comfortable. I believe I correctly surmised this would be the easiest transition. However, I was worried the silicone pillows would irritate my skin. Perhaps they would have, but as a precaution I applied some non-petroleum skin product before bed (this, because it’s what I have and use for my lips anyway [trumpet player]). I think that helped, and it certainly could not have hurt.

I was worried my nose would feel sore after hours of use (not the skin, but the structure). Didn’t happen. I was worried I’d get a headache from the pressure. Nope.

I wore the mask for 7 hours, starting at 9PM, a half hour before sleep, and ending at 4AM, after which I slept another hour without it. I took a quarter dose (2.5mg) of Ambien before bed, just to get me started. The machine tells me I needed 5.5 cmH2O of pressure. I’m not sure if that’s a max or average. Either way, it’s low, consistent with my mild case. That’s why Provent worked, and probably an oral appliance would too.

I had 0.1 apnea/hypopnea events per hour. Since I only used the thing for 7 hours, I’m not sure how it got this number. It implies I had less than one over the period of use. I think these should be quantized in integers, no? (Excuse me, but was that a half a snore I heard? Nonsense.) So, let’s call this zero, shall we?

There’s a bit of room for improvement. First, I want to use this Ambien-free, which I’m sure I will get to in a few days. Second, I want to use it for the full night, something like 10PM-6AM. It’s normal to need to remove it as one adjusts, but ideally one should ultimately leave it on the full night.

The bottom line here is that my original fear of CPAP machines was an evidence-free bias. One night in, I’m pretty happy. Perhaps I’ve got some awful stuff ahead of me — maybe my nose will get sore or I will never get fully used to the thing. But this is a good start and better than I’d dared to hope.

PS: It’s got to help that I want this therapy to work, and I’m highly motivated and informed. I am a light/fussy sleeper, so I could easily sabotage treatment by getting annoyed with everything that’s unusual. It would not take much for me to mind-game myself into insomnia. A good attitude goes a long way. #CognitiveBehavioralTherapy


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