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Apnea and Pulmonary Hypertension
#1
i am a 70 year old male in relatively good shape and condition- I went for a sleep test back about 2 months ago and the results were moderate sleep apnea- -I suspect I have had it for a considerable period of time- I had a scheduled test 2 years ago which never happened because the tech never showed up at the center. Anyway, I finally decided to get tested again since I had a couple of events upon falling asleep in my chair watching tv- woke up and gasped for breath- scary, hence got tested. About a month ago I had an exercise stress test and in spite of very good results on about everything, there was a notation of moderate pulmonary hypertension. Since then I have had chest X-ray, v/q scan, ct angiogram of the chest, bnp blood test- all negative. My cardiologist is going to do another echo next week but his thought is that the cause of this is oxygen desaturation during sleep from apnea and mild asthma that I have had all my life- he feels this can be treated with CPAP.

My question deals with treating this with CPAP- I have been using an auto pap device for about 6 weeks and am wondering how long this will take to stabilize or even reduce  the pressure (if it can do either). Thanks!
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#2
Hi Haynbo,
WELCOME! to the forum.! Hang in there for answers to your question and good luck to you with your CPAP therapy.
trish6hundred
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#3
Generally, when it comes to CPAP and cardiology, CPAP halts or slows the progression of conditions.
It sounds like you had a good cardio workup -- and it's always good to have a cardio doc on-board with the application of CPAP.

You sound like you're in good shape at age 70. I'd concentrate on making CPAP a comfortable experience; and not worry the other stuff.

BTW -- Welcome to ApneaBoard. Lots to learn; and your experience can help others.

regards,

Mongo
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#4
Haynbo, based on your profile, your machine is set to the default pressure settings. I think you really want to look at optimiizing that pressure to prevent events and giving yourself the rest that makes a difference. Download the free SleepyHead software, and you can see if you're still having apnea and hypopnea events among other things. We can help you to get that machine into the sweet spot..it may say automatic, but it makes a difference to optimize. What is the AHI on your machine's INFO screen?

My signature has tutorials on how to organize Sleepyhead charts and post them to the forum. If you need help with installing or getting your data loaded up, just ask.
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#5
Mongo,

Thanks very much for your encouraging words- I have become fairly comfortable with the whole CPAP experience although I am not quite sure what I should be aiming for as far as the AHI number- I have been averaging about 5.0 with several readings in the 3's and a couple around 8 something. Anyway, thanks again!

Haynbo
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#6
With optimization, most people achieve from less than 1 to 3 AHI. You're a bit on the high side, but I'm sure it would quickly respond to a small increase in minimum pressure. If you look at your Info screen, what is the 90% pressure on a 1-day, 7-day and 30-day average?
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#7
It shows 9.5, 9.5 and 9.2- what does that tell you? I'm sorry but I am relatively new with all this and I can tell you I was not given much in terms of instructions other than just use the ful face mask. Thanks for your help!
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#8
(03-07-2017, 10:41 AM)Haynbo Wrote: It shows 9.5, 9.5 and 9.2- what does that tell you? I'm sorry but I am relatively new with all this and I can tell you I was not given much in terms of instructions other than just use the ful face mask. Thanks for your help!

Haynbo, welcome to the Apnea Board! The 90% pressure numbers can give an initial insight into where your settings are and where to make adjustments. My reaction would be to recommend you increase your minimum pressure setting to 7 and leave the maximum where it is for now until we can take a look at your daily charts. As Sleeprider suggested you will gain a wealth of knowledge once you download and start using sleepyhead. You can follow the links in his signature. Also you will want to click on the link at the top of the page "CPAP Setup Manuals" and request the clinicians manual for your particular machine. From best I can tell you appear to have a PR Dreamstation Auto CPAP but you should verify before requesting the manual. The manual will tell you how to make adjustments to you machine including the minimum pressure change I suggested. The reason for the change is the Dreamstations are not very aggressive in raising pressure in response to events and you want to try to get you minimum within 2 cm of your 90% number to increase is effectiveness. Once you post some daily charts we'll be able to see what other settings should be tweaked to help lower your AHI and get you feeling better.

Welcome
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#9
Haynbo,
Your minimum pressure of 4 is too low.  I'm wondering how you breathe with a full face mask and a low pressure of 4.  Do you feel somewhat "air starved?"

With a 90% pressure of 9.5,  I would move the minimum pressure to at least 6.5 or 7 until we can see your data.  I'm pretty sure we can bring your AHI down with a few
adjustments.   And you should feel better too. Smile

If you haven't done so, order the Clinicans manual for your machine:
http://www.apneaboard.com/adjust-cpap-pr...tup-manual
OpalRose
Apnea Board Moderator
www.ApneaBoard.com

How to Organize and Post ScreenShots

http://sleep.tnet.com/resources/sleepyhead/shorganize
https://sleep.tnet.com/reference/tips/imgur

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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#10
Thanks for your response-  I did change it yesterday to 6.5- I'll be anxious to see what that does. Thanks again!
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