I have a Remstar Pro CPAP with C-Flex.  I have been on CPAP nearly 5 months-I am maybe 40-50 % better.  All my symptoms have returned, along with typical side effects like most people here.  Within the past 2-3 months, I have moved to a much lower elevation, and I consistently lost about one pound per week without effort.  Then, I stopped losing weight, I have even gained about 2 pounds back, along with awful fatigue and that oxygen-sleep deprived feeling, frequent awakenings, headaches, peeing.

I have returned to my sleep practitioner (have never seen a sleep doctor) Does not show concern-thinks most of the classic sleep apnea manifestations I am having are 'not related to sleep apnea.'  Thinks some are related to ineffective therapy having to do with my mask.  My smart card shows I am having leaks, but I am not getting a clear explanation.  I am meticulously 100% compliant.  The practitioner said to me "you do not have centrals-the study showed you did not have them."  I noticed my report did indicate I had a few.  Stated that patient needs to lose 20 pounds to require pressure adjustment.  States altitude has little or no effect on pressure settings.

In doing some research, I learned that the sleep lab I deal with shows no accreditation.  My 'sleep practitioner shows a total of <3 years experience in the nursing/practitioner field-total.  

I contacted my DME and spoke with a rep that serves a larger city in the state, I talked with my PCP office, and private parties with extensive knowledge in the medical field/sleep apnea.  I just learned that the acceptable procedure during initial set-up is for a patient to be properly fitted and given a choice of several masks.  I understand that a properly fitting mask is critical.  I was not given any choices.  I was not measured.

I contacted my RT many times from the start about my mask and headgear.  The last encounter, he cussed me out, stated in profane language he did not care what anyone said-he is doing his job.  He then called back to apologize.  He has one mask for me to try.

I am sitting here trying to feel alive each day, trying to pull myself through this mess.  

I am trying to decide if I can travel a 4-5 hour round trip to get to an accredited real sleep doctor, be able to afford the extra cost, and find the energy to do so.  I know I must do something, because I have heard it is so much better than this!   WHAT IS MY TRUE AHI? COULD I BE HAVING CENTRALS, AND HOW DO I GET THE RIGHT MASK?   WHEN AM I GOING TO FEEL ALIVE CONSISTENTLY? Lantern4life

It are you trying to use a full face mask with a beard?  If it is a REMstar Pro 2 C-Flex, it has automatic altitude adjustment (probaly up to 8,000 feet); what altitude were you coming from and going to?

Um. . . I don't have a beard-I am from Venus! I do use a full face mask Fisher-Paykel 431.  I have tried adjusting the headgear many times over.  If I make it looser, it leaks like a sieve.  If I tighten it, it leaves a pressure ulcer and a red ring around my face.  I have been batting an ulcer to my nose for almost 5 months.  The only thing that keeps it from getting clear down to the bone is 100% lanolin.  I apply it in the morning, then wash my face well at night.  The chronic presure ulceration is beginning to leave a scar.

I moved from about 7000 feet down to about 3,000.  Lantern4life

Your DME guy sounds like the one I deal with.  He once gave me a mask without trying it out with the machine, and I was at   a 20! I took it home and it blew right off of my face.  Then he acted put out when I asked him to order another Quattro for me.  Have you tried the mack's silicone ear plug trick to get it to seal ?  I don't know if it would work with the 431, but what I do is make sure there are no leaks around my eyes, then adjust the bottom for the best fit I can. Then I apply a rolled out and flattened plug to the bottom 1/3 of the mask.  This works well to keep the mask from slipping off of my little chin when I'm sleeping. I also adjust the top part really lose,  this keeps it from slipping upward, so I don't wake up with the mask around my mouth . I'm sure others who use the 431  can chime in with ideas , it would be a shame for you to spend all of that time and energy just to get a mask that fits, if that's your problem.  Virginia


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Resmed elite , 17, mirage quattro ff . 25 + years of untreated OSA

IMHO, You SHOULD have your choice for the mask.  You are the one buying it (even if your insurance covers it, you pay for your insurance one way or another)  Can you go to the DME?  Go in and try on masks.  Or, go online, look at all the masks, by looking at them see if you can figure out the ones that appear would drive you nuts...and eliminate them.  Then call the DME and tell them the ones you want to try.  If they do not stock the one you DO want to purchase...have them order it for you.

Though your smart card is showing leaks...how is the AHI?...And what ARE the leaks?  Are they in the accepatable range for your mask?

Did the centrals show up in your diagnositc study or the titration study?

For some of us, we do not feel consistantly better with the fatigue part of it.  Your dr may be right, could be other things causing it.  Untreated SA often masks other conditions, only until you are being effectively treated for the SA do you realize it is not just the SA.  Do you have Fibromyalgia?  Do you have leg movements in the night (would show on your study).  How is your blood sugar?  How's your B12?  How's your nutrition?

I am so sorry to hear you are having so many problems...you are too sweet for this.


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CLICK HERE FOR MORE INFO~ http://tinyurl.com/69q52a

BiPAP Auto M 13/8 Mirage Nasal Swift. 20 years+ undx'd. RLS/PLMD, Hypersomnia & more.

Your machine wouldn't have a problem doing pressure compensation in that altitude range.  

It sounds like you have a major leak problem and need to try a new mask and/or to shave off part of your beard.  Have you tried using a nasal mask?

I don't use a full face mask, but I have heard from several people that full face masks and full beards are mutually exclusive.  I have a full beard and moustache and I use a nasal mask.  Every mask I have ever used (except for nasal pillows) has leaked where it goes over my moustache, and because of that I don't see how a full face mask could possibly work over a full beard.

Bearded one, you are confusing Lantern4life with someone else,  re-read her post- she's from Venus!  Unless she has a serious hormone problem, there is no beard !  Chalk it up to an apnea moment and have a good day, Virginia


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Resmed elite , 17, mirage quattro ff . 25 + years of untreated OSA

Oops, sorry.  I'll shut up now.

Way too funny...     Lantern4life...do you work for the circus/fair?  Are you the the Bearded Lady?


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CLICK HERE FOR MORE INFO~ http://tinyurl.com/69q52a

BiPAP Auto M 13/8 Mirage Nasal Swift. 20 years+ undx'd. RLS/PLMD, Hypersomnia & more.

lantern4life do you  have any close friends or family that could drive you or ride with you to a place that has got better facilities? If you can be taken care of and set up properly by a Board certified Sleep specialist and have a good DME to work with, it might take a few trips  initially, but after you get everything right you shouldn't have to make that trip so often.  I am sure it would be worth your time and trouble. Can you get your insurance to pay at these  other places? I personally think that maybe a new sleep study might be in order, one done by a Doctor that is certified in Sleep Apnea. and definitely a new mask that is fitted properly. I do wish you Luck


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White Beard with a White Beard
Resmed VPAP Adapt SV Enhanced, HumidAire 2i, ResLink with Model 8000 Flex sensor Pulse Oximeter, and ResScan 3.5 software. Respironic EverFlo OPI Oxygen Concentrator 3 lpm
EEP 9.0, min PS 6.0, max PS 16.0

I go 250 miles one way to my neurologist.  Whitebeard is right...per usual....once you do the initial stuff you will probably never need to see them...and if you do it will only be on occasion.  If you want to continue to order your filters and stuff from them...they can mail them...or you can use the local supplier for the small stuff.


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CLICK HERE FOR MORE INFO~ http://tinyurl.com/69q52a

BiPAP Auto M 13/8 Mirage Nasal Swift. 20 years+ undx'd. RLS/PLMD, Hypersomnia & more.

Thanks Mrs. Rip Van Winkle for the information.  I would need to go about 150-175 miles one way, but it sounds like it would be worth it.  Thanks White Beard. I unfortunately do not have anyone who can drive me.  My friends all work and are overloaded as it is, and I have no family that lives near me.  I can handle a few trips, although difficult.  I get really fatigued with long drives.  It usually takes me about 3 days to bounce back.  But, you are right-it would be worth my time and trouble if I can get the right care.  As far as I know, the insurance will cover another doctor, if I want to switch.  Thanks Lantern4life

L4L, a fitting mask is only part of the equation.  To date, a month and a half, I have tried 4 different masks.  Each one fit well, but only two are working out well while sleeping on my side because of pressure from the pillow.  Getting the Encore software also gives you a graph of the mask leak rates over the course of your sleep along with a graph of the obstructive apneas and hypopneas.  If you can't rely on your sleep doc, it may be worth purchasing.  Your DME should also be able to print out this data from your smart card.  If anything, it gives you peace of mind that your therapy is working, or not.


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REMStar Pro M w/ c-flex and heated humidifier
ResMed Swift LT nasal pillow
Encore View Software
12 cm H20, 13 cm H20
CPAP start date: June 4, 2008