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[CPAP]  Adjustment
#1

Hello, I have 45 years OLD, and a week ago I was diagnosed (AOS) severe apnea (44.2/h).

I took 4 days with the C-PAP with a pressure of 8 cm. and apneas continue approx. 11 to 20, according SleppyHead.

How long do I need to adjust the system (C-PAP)?

Sorry for my English, the translator of google makes the task.

A greeting and thanks to all
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#2
Bienvenido! Your obstructive apnea rate is still too high at 11-20. You should increase pressure from 8.0 to 9.0 and observe the changes over several days. You should see the AHI decrease. Additional adjustments can be considered based on the results.

Good to see you are using Sleepyhead. Your questions here are always welcome and after you have 4 posts, you will be able to post charts from Sleepyhead. Buena suerte.
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#3
(10-28-2016, 10:46 AM)Sleeprider Wrote: Bienvenido! Your obstructive apnea rate is still too high at 11-20. You should increase pressure from 8.0 to 9.0 and observe the changes over several days. You should see the AHI decrease. Additional adjustments can be considered based on the results.

Good to see you are using Sleepyhead. Your questions here are always welcome and after you have 4 posts, you will be able to post charts from Sleepyhead. Buena suerte.


Thanks for your quick reply.
But I'm worried.



    First Day
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#4
Well, ignore what I said about increasing pressure. You may have CPAP induced complex apnea, and a pressure increase is NOT what you need. Your events are central apnea and hypopnea. Did you have central apnea in your sleep test?
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#5
If I have to study polisomnografia.

Central 32 (4.7h)
Obstructiva 45 (6.6h)
Mixta 10 (1.5h)
Hipopneas 214 (31.4h)
Apneas + Hipoapneas 301 (44.2h)

So I'm concerned, the graph shows central apneas and non obstructive ...

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#6
I assume you will have an appointment with your doctor soon. You need to tell him about this complex apnea. The correct treatment is an "Adaptive Servo Ventilator" like the Resmed Aircurve 10 ASV or Philips Auto SV Advanced. These machines detect when you stop breathing, and supply a higher inhalation pressure to maintain your breathing volume and rate. CPAP will not likely work.

You should call your doctor and obtain advise and a prescription for ASV therapy. About 15% of apnea patients can develop complex or mixed apnea. You had equal central and obstructive apnea, as well as mixed apnea and many hypopnea in your study. The result you are having on CPAP is not unexpected. You need a different machine, however, your current results are much better than your sleep study. Continue to use the machine at current settings until you can talk to the doctor.
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#7
(10-28-2016, 12:11 PM)Sleeprider Wrote: I assume you will have an appointment with your doctor soon. You need to tell him about this complex apnea. The correct treatment is an "Adaptive Servo Ventilator" like the Resmed Aircurve 10 ASV or Philips Auto SV Advanced. These machines detect when you stop breathing, and supply a higher inhalation pressure to maintain your breathing volume and rate. CPAP will not likely work.

You should call your doctor and obtain advise and a prescription for ASV therapy. About 15% of apnea patients can develop complex or mixed apnea. You had equal central and obstructive apnea, as well as mixed apnea and many hypopnea in your study. The result you are having on CPAP is not unexpected. You need a different machine, however, your current results are much better than your sleep study. Continue to use the machine at current settings until you can talk to the doctor.

Perfect, it is clear. Thanks
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#8
While you are worried, you have only been on the CPAP for 4 days. You have already decreased the AHI to 25% of where you started. Yes, still too high, but it takes time to get used to the machine and to find the settings you need. You may need to go to BiPap, or BiPap ASV (given the centrals that you exhibit).

A couple of questions - 1) What altitude is Bogotá at? 8.500 ft. ?? - the machines do work on a pressure differential, but I do not know if there are additional considerations that need to be made. 2) I had trouble reading the Sleepyhead chart you posted, but are you sure that your machine pressure is set at 8 cm H2O? I couldn't make it out clearly - but it looked lower than that.

I have been on PAP for over ten years, and still need to adjust settings every once and a while. Do not be discouraged. Instead of thinking that you have so much further to improve, think of how much better it is already! Incidentally, the improvements now become harder to achieve, but keep at it. Good Luck !
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#9
(10-28-2016, 12:40 PM)robertbuckley Wrote: While you are worried, you have only been on the CPAP for 4 days. You have already decreased the AHI to 25% of where you started. Yes, still too high, but it takes time to get used to the machine and to find the settings you need. You may need to go to BiPap, or BiPap ASV (given the centrals that you exhibit).

A couple of questions - 1) What altitude is Bogotá at? 8.500 ft. ?? - the machines do work on a pressure differential, but I do not know if there are additional considerations that need to be made. 2) I had trouble reading the Sleepyhead chart you posted, but are you sure that your machine pressure is set at 8 cm H2O? I couldn't make it out clearly - but it looked lower than that.

I have been on PAP for over ten years, and still need to adjust settings every once and a while. Do not be discouraged. Instead of thinking that you have so much further to improve, think of how much better it is already! Incidentally, the improvements now become harder to achieve, but keep at it. Good Luck !

Bogota height of 2600 meters. Thank you very much for your help and your words of encouragement, but understand that from now until the end of my days, I have connected a machine every night, I generated some sadness ... I'm not used to, I had never hurt anything, and now everything goes wrong ...
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#10
You are in good company with the need to use a machine at night. Nothing to be sad about. It is normal after some time, and it makes life a lot easier to use it.

I was last in Bogota in 1978 when El Edificio Avianca burned. I was an exchange student at the time and lived south of the city Calle 111. I loved the countryside around Bogota, even if the names were a challenge. I actually got to fly into El Choco on a plane owned by a gold mining firm. Amazing experience in la selva for a week. I was pretty young at the time, and learned about Aguardiente for the first time.
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