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Advice re sleep doc appt today
#1
I have a question as I am meeting with my sleep doc in about 7 or so hours.

This is a quote from DeepBreathing from another thread that I want to reference...

QUOTE"When the machine detects an apnea, hypopnea (partial closure of the airway), snoring or flow limitation, it will raise the pressure to prevent a recurrence of the event. If another event happens, it will raise the pressure some more, up to the maximum. However, if no further events occur, it will gradually reduce the pressure again." END QUOTE

Based on the above, if I were using an Auto CPAP machine, would it not have raised my pressure from my current fixed 7.6 to hopefully prevent a recurrence of snoring?

I am wondering if I mention that I am still snoring at around 40% of what I used to in both frequency and loudness if that is usually a good reason for a sleep doc to increase or adjust pressure? My AHI's are consistently below 1, and I know that is all he will be looking at in the data my machine provides. I am also still waking up most days with varying degrees of REM headaches. Still foggy brain, difficulty doing simple math, memory problems. Still feel like napping some afternoons. Still having some frustrating dreams.

Based on previous conversations with him, I am certain he will be happy with the results and that will be that. But I am hoping based on my residual snoring, REM morning headaches and other still present symptoms that he will try adjusting my pressure.

Any advice on what I can say to him today that he may continue to tweak my settings or make changes as I have very little positive effects from CPAP therapy with the exception that I may be a bit less tired than before?
APNEABOARD - A great place to be if you're a hosehead!! Rolleyes

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EVERY ACCOMPLISHMENT BEGINS WITH THE DECISION TO TRY!
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#2
To me, there really is two parts to XPAP therapy. (1) What is the AHI with treatment and (2) how do you feel with treatment?

I'd bring the fact that you aren't feeling much better up with your doctor - while I'm not going to "suggest" changes, you could always try to slowly raise your pressure and see what happens.
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#3
I think Ramblingasian has hit the nail on the head. We obsess about the numbers but what's really important is whether you are getting refreshing sleep and overcoming all the symptoms of apnea. Hopefully you can impress on your doctor the need for a holistic view of your treatment.

In answer to your other question, yes an Autoset will raise the pressure to control snoring as it is often a precursor to an apnea event. Raising your fixed pressure a little might help.
DeepBreathing
Apnea Board Moderator
www.ApneaBoard.com


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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#4
[attachment=1892][attachment=1893]

Posted attachments of past 2 nights with particular attention to Leak Rate and Snore.

While wearing the P10's for the past month I have awoken several times to the sound of rushing air with the mask not on properly due to side sleeping. I was wearing the Swift FX's for my first month of therapy, but at that time had the S9 Escape so no data.

Looking at the previous week's data (not including last night) in both SleepyHead and ResScan, it shows what looks to be a fair bit of snoring reaching in SleepyHead volume level '5' whatever that translates to. Then just looking at last night's data in both programs, while wearing the Swift FX's, snoring was not very often and was only to a maximum volume level of '2'. Not sure if last night wearing the Swift FX and having far less snoring is a fluke, as I cannot look back to the first month.

So maybe snoring will not be as much of an issue or may even be eliminated by continued use of the Swift FX's? Hoping so as my doc may make his decision on CPAP pressure level and write the final script today.
APNEABOARD - A great place to be if you're a hosehead!! Rolleyes

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EVERY ACCOMPLISHMENT BEGINS WITH THE DECISION TO TRY!
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#5
Different masks do have different results so it's quite possible the FX is giving you less snoring. I'm not familiar with it so I can't say more than that. However I have found that with the Simplus FFM my AHI is consistently ~1.6 points higher than with the Quattro Air FFM. The Simplus is much more comfortable and less prone to leaks so I put up with the slightly higher AHI.

Quote: Hoping so as my doc may make his decision on CPAP pressure level and write the final script today.
At the end of the day it's your decision what pressure you choose to accept. I don't believe they have CPAP Police in Canada so if you feel the need to judiciously increase your pressure by a few points to see if you get a better result, then there's nobody stopping you. The days of Doctor as God are over (or should be).
DeepBreathing
Apnea Board Moderator
www.ApneaBoard.com


Bed

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#6
Cate, the advantage of an auto CPAP is that the minimum pressure can be set to deal with most obstructive events. It seems your CPAP pressure is very nearly optimized. What an APAP can do is have a higher maximum pressure so it responds to the snores and flow limitations when they occur.

In your graphs, the increased snore level is punctuated by a hypopnea. In APAP that event might have been headed off because the pressure would have been increased slightly.

Overall, you seem to have a very effective pressure and low incidence of AHI. It may well be less disruptive to your sleep to have a constant pressure. This is the trade-off with APAP, is that fluctuating pressures can be disruptive to some people.
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#7
(11-18-2015, 09:36 AM)Sleeprider Wrote: Cate, the advantage of an auto CPAP is that the minimum pressure can be set to deal with most obstructive events. It seems your CPAP pressure is very nearly optimized. What an APAP can do is have a higher maximum pressure so it responds to the snores and flow limitations when they occur.

In your graphs, the increased snore level is punctuated by a hypopnea. In APAP that event might have been headed off because the pressure would have been increased slightly.

Overall, you seem to have a very effective pressure and low incidence of AHI. It may well be less disruptive to your sleep to have a constant pressure. This is the trade-off with APAP, is that fluctuating pressures can be disruptive to some people.

Thanks for explaining that in non technical terms! It's clearer to me now. Trade off's either way.

DeepBreathing: No you are correct there are no CPAP police or insurance companies looking for compliance like in the US. Just the fact that I will have to go back into the doc for follow-ups. If he really only looks at the AHI I guess it won't matter what machine or in what mode.
APNEABOARD - A great place to be if you're a hosehead!! Rolleyes

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EVERY ACCOMPLISHMENT BEGINS WITH THE DECISION TO TRY!
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#8
OK so I came away from seeing the doc with another pressure increase. He says it should take care of the residual lesser snoring I've been having. If not next time he wants to try me on an Auto machine to see what's going on. I'm back to see him again in a month.

Hopefully 3rd time is the charm!
APNEABOARD - A great place to be if you're a hosehead!! Rolleyes

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EVERY ACCOMPLISHMENT BEGINS WITH THE DECISION TO TRY!
Reply
#9
here's hoping for good reports Smile
هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
Tongue Suck Technique for prevention of mouth breathing:
  • Place your tongue behind your front teeth on the roof of your mouth
  • let your tongue fill the space between the upper molars
  • gently suck to form a light vacuum
Practising during the day can help you to keep it at night

هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
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