Post Reply 
APNEA Out of Control
Author Message
FrankNichols Offline

Advisory Members

Posts: 714
Joined: Mar 2016

Machine: AirSense 10 Autoset
Mask Type: Full face mask
Mask Make & Model: Resmed F10 and/or P10
Humidifier: Builtin
CPAP Pressure: 17-19
CPAP Software: ResScan SleepyHead Other Software

Other Comments: I've figured out how to get my AHI down to 5, I quit sleeping!

Sex: Male
Location: Live Oak, Florida

Post: #21
RE: APNEA Out of Control
(03-28-2016 02:47 PM)Mike208 Wrote:  I failed CPAP basically because I could not breath. I was unable to stay asleep for long periods, fought the machine to breathe, felt like I was suffocating...etc.. I was miserable. I have a feeling BiPAP won't be much better. The reason I say that is because I have tiny nasal passages and a very small throat. I think this has something to do with failing CPAP.

Don't be so sure about BiPAP. In my titration study they tried both with me, and the BiPAP was awesome! It was very easy to breath, in fact it was very nice. Sadly, My doctor liked the results in CPAP mode better for me, so that is my first machine. But, it is doesn't work for me, I know I will enjoy the BiPAP latter if I have to upgrade to it.

You mileage my vary of course, but wait and see, if you haven't used BiPAP and have problems breathing with CPAP, it can make a big difference.

I am not a Medical professional and I don't play one on the internet.
Started CPAP Therapy April 5, 2016
I'd Rather Be Sleeping
03-28-2016 02:59 PM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
robysue Offline
Wiki Editor
Advisory Members

Posts: 1,247
Joined: Oct 2013

Machine: PR Dreamstation BiPAP Auto
Mask Type: Nasal pillows
Mask Make & Model: Swift FX
Humidifier: PR Dreamstation humidfier
CPAP Pressure: min EPAP = 4; max IPAP = 9;
CPAP Software: SleepyHead EncoreBasic EncorePro

Other Comments: Papping since September 2010

Sex: Female
Location: Buffalo, NY

Post: #22
RE: APNEA Out of Control
(03-28-2016 11:46 AM)Mike208 Wrote:  They have sent me home twice now with a sleep test machine. This is a small unit that you place on your forehead with a nasal cannula. You lay on your back, push a button and wait for it to initialize and tell you you can sleep. He looked up the latest results and it showed the AHI's at 23. I realize that's still high. He says I actually slept 6.5 hours. You would think I wouldn't feel so bad if I was getting at least that much sleep. My question is how reliable are these take home tests?

It's got to be reliable enough to have satisfied the FDA if it's being used to diagnose a medical condition or evaluate the efficacy of the prescribed therapy for a diagnosed medical condition. If you recall the maker of the sleep testing device, a quick Google search might tell us exactly what kinds of data it collects. That would go a long way in answering the question of about the accuracy of the device.

At any rate, it sounds like the forehead unit has a device to measure EEG data and the nasal cannula is used to measure the rate the air is flowing into and out of your lungs. There may also be some kind of device in the forehead unit for measuring movement as well.

That's enough data to figure out whether each detected breathing irregularity has a high probability of being a sleep disordered breathing event because the EEG data and/or movement indicates there's a high probability of you being asleep.

In other words, there's no reason to believe the home sleep test machine is wildly inaccurate. If it says the AHI with the oral device is 23, my guess is that means there's virtually a 100% chance that your AHI with the oral device is on the high side of 15 and most likely is between 20 and 26. Which is still way too high.

As for why the dentist is claiming the oral appliance is doing its job: What was your diagnostic AHI? Oral appliance therapy is often considered "successful" if the treated AHI is less than half the diagnostic AHI. So if your diagnostic AHI was in the neighborhood of 50 or more, then an AHI = 23 with an oral appliance would be considered "successful" by many dentists and oral appliance manufacturers.

You might want to ask the dentist specifically what he means by "successfully treated OSA".

Questions about SleepyHead?
See my Guide to SleepyHead
03-28-2016 03:06 PM
Find all posts by this user Post Reply Quote this message in a reply
robysue Offline
Wiki Editor
Advisory Members

Posts: 1,247
Joined: Oct 2013

Machine: PR Dreamstation BiPAP Auto
Mask Type: Nasal pillows
Mask Make & Model: Swift FX
Humidifier: PR Dreamstation humidfier
CPAP Pressure: min EPAP = 4; max IPAP = 9;
CPAP Software: SleepyHead EncoreBasic EncorePro

Other Comments: Papping since September 2010

Sex: Female
Location: Buffalo, NY

Post: #23
RE: APNEA Out of Control
(03-28-2016 02:47 PM)Mike208 Wrote:  I failed CPAP basically because I could not breath.

Could not breathe in what sense? Did you find it uncomfortable to inhale with the machine on when you were awake and that's what made you uncomfortable? Or did you find it difficult to exhale fully when you were awake and that's what made you uncomfortable? Or did your nose get very clogged up as soon as you put the mask on and you couldn't breathe because of the congestion?

It's important to know what you mean by "can't breathe" since all of the above problems are routinely described as "I can't breathe with the machine". They all have solutions, but the solutions are different. And the solution to "I can't inhale comfortably" is likely to make the "I can't exhale comfortably" worse, and vice versa.

Quote:I was unable to stay asleep for long periods, fought the machine to breathe, felt like I was suffocating...etc.. I was miserable.

When you say you felt like you were suffocating, do you mean you could not inhale comfortably because there was not enough air coming in through the mask?

Or do you mean you felt like you were suffocating because you could not exhale completely and it felt as though too much air was being forced down your airway?

Or do you mean your nose clogged up to the point where you could neither inhale nor exhale because of severe nasal congestion?

Quote:I have a feeling BiPAP won't be much better. The reason I say that is because I have tiny nasal passages and a very small throat. I think this has something to do with failing CPAP.
I have a very small upper airway. I failed CPAP and APAP (or I should say CPAP and APAP failed ME) because of severe aerophagia problems which lead to severe insomnia problems. On CPAP and APAP I also could not comfortably exhale even at reasonably low pressures and even with exhalation relief turned on at the maximum setting. In short I was miserable with CPAP and APAP.

BiPAP was much, much more comfortable. I could comfortably exhale on BiPAP. The aerophagia was much, much less on BiPAP. It still took months of hard work, however, to rein in the out-of-control insomnia that was triggered by my difficulties with plain CPAP and APAP.

Questions about SleepyHead?
See my Guide to SleepyHead
03-28-2016 03:18 PM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
Mike208 Offline

Preferred Members

Posts: 35
Joined: Mar 2016

Machine: AirSense 10 Autoset
Mask Type: Full face mask
Mask Make & Model: Resmed Airfit 10
Humidifier: unsure
CPAP Pressure: Supposed to be 10
CPAP Software: Not using software

Other Comments:

Sex: Male
Location: South Carolina

Post: #24
RE: APNEA Out of Control
(03-28-2016 02:59 PM)FrankNichols Wrote:  
(03-28-2016 02:47 PM)Mike208 Wrote:  I failed CPAP basically because I could not breath. I was unable to stay asleep for long periods, fought the machine to breathe, felt like I was suffocating...etc.. I was miserable. I have a feeling BiPAP won't be much better. The reason I say that is because I have tiny nasal passages and a very small throat. I think this has something to do with failing CPAP.

Don't be so sure about BiPAP. In my titration study they tried both with me, and the BiPAP was awesome! It was very easy to breath, in fact it was very nice. Sadly, My doctor liked the results in CPAP mode better for me, so that is my first machine. But, it is doesn't work for me, I know I will enjoy the BiPAP latter if I have to upgrade to it.

You mileage my vary of course, but wait and see, if you haven't used BiPAP and have problems breathing with CPAP, it can make a big difference.

Sorry, I didn't realize I had a response. I go see the sleep doc in the morning about the bipap. I don't mean to sound so negative but this is really frustrating. I am willing to give it a try and I really do hope that it works. The dental appliance has cut the apnea down 70% but I still feel lousy a lot of the time. What's really aggravating is the dentist seems peeved at me. He says the appliance is working and I should be feeling better. He hasn't said it but he makes me feel as though he thinks this is the cure. It isn't.
04-06-2016 05:17 PM
Find all posts by this user Post Reply Quote this message in a reply
robysue Offline
Wiki Editor
Advisory Members

Posts: 1,247
Joined: Oct 2013

Machine: PR Dreamstation BiPAP Auto
Mask Type: Nasal pillows
Mask Make & Model: Swift FX
Humidifier: PR Dreamstation humidfier
CPAP Pressure: min EPAP = 4; max IPAP = 9;
CPAP Software: SleepyHead EncoreBasic EncorePro

Other Comments: Papping since September 2010

Sex: Female
Location: Buffalo, NY

Post: #25
RE: APNEA Out of Control
(03-28-2016 02:47 PM)Mike208 Wrote:  I failed CPAP basically because I could not breath. I was unable to stay asleep for long periods, fought the machine to breathe, felt like I was suffocating...etc.. I was miserable.
Felt like you were suffocating because there was too much air coming in through the mask for you to exhale comfortably?

Or felt like you were suffocating because there was not enough air coming in through the mask for you inhale comfortably?

BiPAP will help if the problem was that you could not comfortably exhale. Starting at a higher minimum pressure will help if the problem was that you could not inhale comfortably.

Questions about SleepyHead?
See my Guide to SleepyHead
04-06-2016 08:13 PM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
Mike208 Offline

Preferred Members

Posts: 35
Joined: Mar 2016

Machine: AirSense 10 Autoset
Mask Type: Full face mask
Mask Make & Model: Resmed Airfit 10
Humidifier: unsure
CPAP Pressure: Supposed to be 10
CPAP Software: Not using software

Other Comments:

Sex: Male
Location: South Carolina

Post: #26
RE: APNEA Out of Control
(04-06-2016 08:13 PM)robysue Wrote:  
(03-28-2016 02:47 PM)Mike208 Wrote:  I failed CPAP basically because I could not breath. I was unable to stay asleep for long periods, fought the machine to breathe, felt like I was suffocating...etc.. I was miserable.
Felt like you were suffocating because there was too much air coming in through the mask for you to exhale comfortably?

Or felt like you were suffocating because there was not enough air coming in through the mask for you inhale comfortably?

BiPAP will help if the problem was that you could not comfortably exhale. Starting at a higher minimum pressure will help if the problem was that you could not inhale comfortably.


I think it was the high pressure that was the problem. I recall things being fine until later when the machine ramped up to the higher pressures.
04-07-2016 05:23 AM
Find all posts by this user Post Reply Quote this message in a reply
tmoody Offline

Advisory Members

Posts: 175
Joined: Mar 2016

Machine: PR System 1 BPAP AutoSV
Mask Type: Nasal pillows
Mask Make & Model: Swift FX nose pillows
Humidifier: PR System 1 attached
CPAP Pressure: 8-25
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Philadelphia

Post: #27
RE: APNEA Out of Control
(04-06-2016 05:17 PM)Mike208 Wrote:  What's really aggravating is the dentist seems peeved at me. He says the appliance is working and I should be feeling better. He hasn't said it but he makes me feel as though he thinks this is the cure. It isn't.

Yes, that would be beyond annoying.

You, and your dentist, need to understand that "how you feel" is only a small part of the story. When I was diagnosed with sleep apnea, nine years ago, I felt fine. I was never sleepy during the day, had no headaches, didn't fall asleep early in the evening. But my AHI was 42, and probably had been high for years, if not decades. The only reason I went for a sleep study was because my wife said I'd stop breathing during the night.

I eventually developed complex apnea, and even with CPAP or APAP treatment my AHI was typically around 15. I didn't feel especially bad. I'd gotten used to it. Now, on an ASV machine, when I get a low AHI number like 1.x, I do notice an improvement, but it's not dramatic.

The point is: The reason why AHI=23 isn't good enough is about the wear and tear on your whole body, not just how you feel. We all need restorative sleep, and we don't get enough of it if we're constantly almost waking up to breathe. Your dentist should understand this, and it sounds like he's being defensive about his own work. That doesn't help you at all.
04-07-2016 09:48 AM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
Mike208 Offline

Preferred Members

Posts: 35
Joined: Mar 2016

Machine: AirSense 10 Autoset
Mask Type: Full face mask
Mask Make & Model: Resmed Airfit 10
Humidifier: unsure
CPAP Pressure: Supposed to be 10
CPAP Software: Not using software

Other Comments:

Sex: Male
Location: South Carolina

Post: #28
RE: APNEA Out of Control
(04-07-2016 09:48 AM)tmoody Wrote:  
(04-06-2016 05:17 PM)Mike208 Wrote:  What's really aggravating is the dentist seems peeved at me. He says the appliance is working and I should be feeling better. He hasn't said it but he makes me feel as though he thinks this is the cure. It isn't.

Yes, that would be beyond annoying.

You, and your dentist, need to understand that "how you feel" is only a small part of the story. When I was diagnosed with sleep apnea, nine years ago, I felt fine. I was never sleepy during the day, had no headaches, didn't fall asleep early in the evening. But my AHI was 42, and probably had been high for years, if not decades. The only reason I went for a sleep study was because my wife said I'd stop breathing during the night.

I eventually developed complex apnea, and even with CPAP or APAP treatment my AHI was typically around 15. I didn't feel especially bad. I'd gotten used to it. Now, on an ASV machine, when I get a low AHI number like 1.x, I do notice an improvement, but it's not dramatic.

The point is: The reason why AHI=23 isn't good enough is about the wear and tear on your whole body, not just how you feel. We all need restorative sleep, and we don't get enough of it if we're constantly almost waking up to breathe. Your dentist should understand this, and it sounds like he's being defensive about his own work. That doesn't help you at all.


I had a similar situation. I didn't feel bad either. I went to an out of town wedding and shared a room with another of the wedding party. They told me I snored and appeared to stop breathing. And then my father died and I shared a room with my sister. She said the same things.

It seems to me that if the dentist has been trained in the treatment of Apnea he would be more understanding. He seems to think the appliance is the cure and it isn't. My research has already told me the device is not meant for Apnea of my severity. I knew that going in. But I had failed CPAP and the surgeon in Charleston was hesitant to perform any surgery due to the shape of my palate, the narrowness of my nasal passages, and the small throat. We thought it was worth a try. I understand that the apnea is taking its toll on my entire body. AHI's of 23 are still very high and need to be brought down. The people at the sleep center know this as well. They don't consider the apnea being treated very well at this point.

Saw the sleep doc this morning. He said insurance will not approve the bilevel just because I failed cpap. He said he's been through this before and they require a damn good reason as to why it is needed, like copd, emphysema, or some other serious affliction. You would think my situation would be good enough but it is not. He knows I have only Medicare and does not want me to get stuck paying for the machine.

He agreed that the dental appliance is just not good enough. It's better than nothing but not enough. He said the dentist is only seeing things from the appliance side and not considering the big picture and that aggravates him. So, he is ordering another sleep study to see where we can go from here. He said he has no problem trying the bilevel to see if there is an improvement and we can show a need for it.
04-07-2016 12:53 PM
Find all posts by this user Post Reply Quote this message in a reply
tmoody Offline

Advisory Members

Posts: 175
Joined: Mar 2016

Machine: PR System 1 BPAP AutoSV
Mask Type: Nasal pillows
Mask Make & Model: Swift FX nose pillows
Humidifier: PR System 1 attached
CPAP Pressure: 8-25
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Philadelphia

Post: #29
RE: APNEA Out of Control
(04-07-2016 12:53 PM)Mike208 Wrote:  AHI's of 23 are still very high and need to be brought down. The people at the sleep center know this as well. They don't consider the apnea being treated very well at this point.

Exactly. If you didn't have the history you have, and your first study showed AHI=23, you'd automatically be a candidate for CPAP therapy, no questions asked. Nobody can look at that number and say, "No treatment needed."

Quote:Saw the sleep doc this morning. He said insurance will not approve the bilevel just because I failed cpap. He said he's been through this before and they require a damn good reason as to why it is needed, like copd, emphysema, or some other serious affliction.

What's your blood pressure like?

Quote:He agreed that the dental appliance is just not good enough. It's better than nothing but not enough. He said the dentist is only seeing things from the appliance side and not considering the big picture and that aggravates him.

So it should. The dentist did what he could, got you some relief, but it just isn't enough. That's the bottom line, and since all treatment options haven't yet been exhausted, all parties should be on the same page about finding something that works (better). CPAP doesn't work for everyone, but some do get relief on BiPAP.

Quote:So, he is ordering another sleep study to see where we can go from here. He said he has no problem trying the bilevel to see if there is an improvement and we can show a need for it.

If they experiment with bilevel during the sleep study, as they should, and they are able to get a substantial reduction in your AHI, they have all the evidence the insurance company could ask for, and your current AHI demonstrates the need.
04-07-2016 01:11 PM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
Mike208 Offline

Preferred Members

Posts: 35
Joined: Mar 2016

Machine: AirSense 10 Autoset
Mask Type: Full face mask
Mask Make & Model: Resmed Airfit 10
Humidifier: unsure
CPAP Pressure: Supposed to be 10
CPAP Software: Not using software

Other Comments:

Sex: Male
Location: South Carolina

Post: #30
RE: APNEA Out of Control
(04-07-2016 01:11 PM)tmoody Wrote:  
(04-07-2016 12:53 PM)Mike208 Wrote:  AHI's of 23 are still very high and need to be brought down. The people at the sleep center know this as well. They don't consider the apnea being treated very well at this point.

Exactly. If you didn't have the history you have, and your first study showed AHI=23, you'd automatically be a candidate for CPAP therapy, no questions asked. Nobody can look at that number and say, "No treatment needed."

Quote:Saw the sleep doc this morning. He said insurance will not approve the bilevel just because I failed cpap. He said he's been through this before and they require a damn good reason as to why it is needed, like copd, emphysema, or some other serious affliction.

What's your blood pressure like?

Quote:He agreed that the dental appliance is just not good enough. It's better than nothing but not enough. He said the dentist is only seeing things from the appliance side and not considering the big picture and that aggravates him.

So it should. The dentist did what he could, got you some relief, but it just isn't enough. That's the bottom line, and since all treatment options haven't yet been exhausted, all parties should be on the same page about finding something that works (better). CPAP doesn't work for everyone, but some do get relief on BiPAP.

Quote:So, he is ordering another sleep study to see where we can go from here. He said he has no problem trying the bilevel to see if there is an improvement and we can show a need for it.

If they experiment with bilevel during the sleep study, as they should, and they are able to get a substantial reduction in your AHI, they have all the evidence the insurance company could ask for, and your current AHI demonstrates the need.


My BP has been pretty much controlled on meds but runs higher during the day when I'm active. I am hoping they do try the bilevel during the study. I would think that' the plan. Smile
04-07-2016 01:49 PM
Find all posts by this user Post Reply Quote this message in a reply
Post Reply 


Possibly Related Threads...
Thread: Author Replies: Views: Last Post
  Cleaning Climate-control tube on ResMed Air Sense 10 GL Bishop 18 11,366 11-07-2016 03:31 PM
Last Post: Jonesie
  RemStar Auto A-Flex: Control wheel fault? yossarian 2 262 09-08-2016 09:48 AM
Last Post: Sleeprider
  [CPAP] Control of breathing rate - me or machine? txpap 9 650 07-12-2016 07:25 AM
Last Post: txpap
  New Machine - Out of Control Events! HELP blehmier 6 808 06-06-2016 09:17 PM
Last Post: Sleeprider
Angry Rainout with Climate Control Air Curve! Kate 4 728 01-09-2016 08:03 PM
Last Post: trish6hundred
  [Equipment] Climate Control niammus 3 612 12-20-2015 06:48 PM
Last Post: niammus
  [CPAP] Calculator for ResMed S9 with humidifier and climate control hose on 12V battery nilsola 0 626 12-06-2015 10:17 AM
Last Post: nilsola

Forum Jump:

Who's Online (Complete List)