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[CPAP] New & Confused
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apibrgr Offline

Members

Posts: 18
Joined: Nov 2013

Machine: REMstar Auto A-Flex
Mask Type: Nasal pillows
Mask Make & Model: ResMed Swift FX for her
Humidifier: Philips Respironics System One Heated Humidifier
CPAP Pressure: 20cm-4cm (?)
CPAP Software: Other Software

Other Comments: I am not sure what "XZero" means, but it is on one of the deilvery tickets for the equipment

Sex: Female
Location:

Post: #1
New & Confused
Hello,
I am totally new to this & somewhat confused about the whole sleep apnea thing, so I would welcome some advice.
I am told I have mild sleep apnea, so I just started last night with a CPAP. I had so much trouble trying to figure out what pressure to put it on to be comfortable or even effective. My Dr. Rx recommended "between 4 and 20". I tried 4, then 5, then 3. This went on for a while, til I was just exhausted & finally got to sleep at 4 setting. I woke up this morning, no kidding, so completely exhausted; almost dizzy, like a hangover. I took the mask off (I'd had it on for probably 7-8 hours) & I slept for another hour, comfortably.
Does anyone know how I am supposed to know/determine what to set the thing on so that I wake up with that legendary "refreshed & energetic feeling" everyone tells me about? I've never really been sleepy during the day until using this machine, but I'm told that because of my sleep study results, if I don't use it, I could die during the middle of the night. That, & I'm also told that it will help with losing weight (is that true...anyone?)
One more issue: I am told (per the sleep study) that I do not get the REM sleep that I am supposed to. I thought, but I'm checking this forum in case someone knows, that you would not dream if you were not in REM. I dream all the time, very vividly, every night, so I'm wondering if I'm being given the wrong information.
Thanx!
11-12-2013 05:34 PM
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zonk Offline

Advisory Members

Posts: 7,908
Joined: Feb 2012

Machine: A10 AutoSet
Mask Type: Nasal mask
Mask Make & Model: Activa LT
Humidifier: Integrated /ClimateLineAir
CPAP Pressure: 9/13
CPAP Software: ResScan

Other Comments: CPAP since Nov 2010

Sex: Male
Location: Australia

Post: #2
RE: New & Confused
(11-12-2013 05:34 PM)apibrgr Wrote:  I had so much trouble trying to figure out what pressure to put it on to be comfortable or even effective. My Dr. Rx recommended "between 4 and 20".
Hi apibrgr, welcome to the forum
Please fill your user profile so we know what machine are you talking about.
Do you have copies of your sleep study reports, the sleep report recommend pressure setting
11-12-2013 05:55 PM
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PaulaO2 Offline
Wiki Editor
Moderators

Posts: 8,062
Joined: Feb 2012

Machine: S9 Autoset
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: H5i
CPAP Pressure: 14-20
CPAP Software: SleepyHead

Other Comments: Ehlers-Danlos Syndrome, Hypermobility Type; chronic sarcasm

Sex: Undisclosed
Location: western NC, USA

Post: #3
RE: New & Confused
Okay, first off, what exactly where you changing? The 4, 5, and 3 sound more like you were changing the humidifier settings rather than the pressure as to change that, you have to get into the clinician menu part of the machine and even then, it doesn't go below 4.

You must have what they call an "auto" PAP (also known as autoPAP or APAP) which means it has a range it is set to operate between, a minimum and a maximum. Your doctor has it set to what we call "wide open": the lowest it can go and the highest it can go. This is typical for a new user. After a month or so, the doctor will narrow that range based on what the data says. What an APAP does is start at the minimum then increase as your throat collapses. It increases as needed up to the maximum as it attempts to keep the airway open.

Look at your machine. Does it have any words on it? Like Respironics or Resmed?

What I suggest is sitting up with the mask and machine on during the day. Wear it while watching television, reading, whatever. Get used to the sensations of it. Then when you go to bed, put it on, get comfortable with it, and just relax and try to go to sleep. I know, sounds easy, right? It may not be at first but with time, it will be!

Quote:but I'm told that because of my sleep study results, if I don't use it, I could die during the middle of the night.

Well, not exactly. Having sleep apnea is a systemic thing. Yes, it is a sleep thing, but it effects the entire body. Because it robs the body of oxygen, every cell of the body is deprived of it for however long you are asleep. Organs that especially depend on it, such as the heart, work even harder and can develop a plethora of problems. But, just because you were diagnosed now doesn't mean your chances of death suddenly increased. It just means you now know about it and can do something about it. And that something is using the CPAP.

Quote:That, & I'm also told that it will help with losing weight (is that true...anyone?)

Yes and no. It depends. If you are obese and if you have a lot of fat around your neck, yes, losing weight will help. Will it "cure" you? Maybe. Maybe not. It depends on the reasons you have sleep apnea. I am assuming you have obstructive sleep apnea (OSA). OSA happens when the tissues in the throat (the muscles, the tongue, the fat) relax in our sleep and collapse together, closing the airway. The more narrow the airway was to begin with, the more fat gravity has to work with, etcetera, all this combines to create the various causes of OSA. There are surgeries. Some work, some do not. Again, depends on the cause.

Quote:One more issue: I am told (per the sleep study) that I do not get the REM sleep that I am supposed to. I thought, but I'm checking this forum in case someone knows, that you would not dream if you were not in REM. I dream all the time, very vividly, every night, so I'm wondering if I'm being given the wrong information.

I think we dream outside of REM sleep. And I think folks with sleep apnea have really awesome dreams because we are not deeply asleep. Prior to getting the CPAP, I could manipulate my dreams. I could stop, rewind, fast forward, change color, characters, all sorts of stuff! It was really fun! Then I got the CPAP and that changed. And then for about a month or more, my brain said "Pay back time!" and I had some really, really freaky dreams. Wow.

PaulaO2
Apnea Board Moderator
www.ApneaBoard.com


Breathe deeply and count to zen.

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.
11-12-2013 06:08 PM
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trish6hundred Offline

Advisory Members

Posts: 6,430
Joined: May 2012

Machine: Resmed S9 AutoSet for Her
Mask Type: Full face mask
Mask Make & Model: Fisher & Paykel Simplus
Humidifier: H5i Heated Humidifier
CPAP Pressure: 10 - 7-20 Cm H2O
CPAP Software: Not using software

Other Comments: I started CPAP in 2008. Totally blind since birth.

Sex: Female
Location: Missouri, USA

Post: #4
RE: New & Confused
Hi apibrgr,
WELCOME! to the forum.!
What Paula said.
CPAP therapy can take some getting used to but just stick with it, it does get better.

trish6hundred
11-12-2013 07:06 PM
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apibrgr Offline

Members

Posts: 18
Joined: Nov 2013

Machine: REMstar Auto A-Flex
Mask Type: Nasal pillows
Mask Make & Model: ResMed Swift FX for her
Humidifier: Philips Respironics System One Heated Humidifier
CPAP Pressure: 20cm-4cm (?)
CPAP Software: Other Software

Other Comments: I am not sure what "XZero" means, but it is on one of the deilvery tickets for the equipment

Sex: Female
Location:

Post: #5
RE: New & Confused
(11-12-2013 06:08 PM)PaulaO2 Wrote:  Okay, first off, what exactly where you changing? The 4, 5, and 3 sound more like you were changing the humidifier settings rather than the pressure as to change that, you have to get into the clinician menu part of the machine and even then, it doesn't go below 4.

You must have what they call an "auto" PAP (also known as autoPAP or APAP) which means it has a range it is set to operate between, a minimum and a maximum. Your doctor has it set to what we call "wide open": the lowest it can go and the highest it can go. This is typical for a new user. After a month or so, the doctor will narrow that range based on what the data says. What an APAP does is start at the minimum then increase as your throat collapses. It increases as needed up to the maximum as it attempts to keep the airway open.

Look at your machine. Does it have any words on it? Like Respironics or Resmed?

What I suggest is sitting up with the mask and machine on during the day. Wear it while watching television, reading, whatever. Get used to the sensations of it. Then when you go to bed, put it on, get comfortable with it, and just relax and try to go to sleep. I know, sounds easy, right? It may not be at first but with time, it will be!

Quote:but I'm told that because of my sleep study results, if I don't use it, I could die during the middle of the night.

Well, not exactly. Having sleep apnea is a systemic thing. Yes, it is a sleep thing, but it effects the entire body. Because it robs the body of oxygen, every cell of the body is deprived of it for however long you are asleep. Organs that especially depend on it, such as the heart, work even harder and can develop a plethora of problems. But, just because you were diagnosed now doesn't mean your chances of death suddenly increased. It just means you now know about it and can do something about it. And that something is using the CPAP.

Quote:That, & I'm also told that it will help with losing weight (is that true...anyone?)

Yes and no. It depends. If you are obese and if you have a lot of fat around your neck, yes, losing weight will help. Will it "cure" you? Maybe. Maybe not. It depends on the reasons you have sleep apnea. I am assuming you have obstructive sleep apnea (OSA). OSA happens when the tissues in the throat (the muscles, the tongue, the fat) relax in our sleep and collapse together, closing the airway. The more narrow the airway was to begin with, the more fat gravity has to work with, etcetera, all this combines to create the various causes of OSA. There are surgeries. Some work, some do not. Again, depends on the cause.

Quote:One more issue: I am told (per the sleep study) that I do not get the REM sleep that I am supposed to. I thought, but I'm checking this forum in case someone knows, that you would not dream if you were not in REM. I dream all the time, very vividly, every night, so I'm wondering if I'm being given the wrong information.

I think we dream outside of REM sleep. And I think folks with sleep apnea have really awesome dreams because we are not deeply asleep. Prior to getting the CPAP, I could manipulate my dreams. I could stop, rewind, fast forward, change color, characters, all sorts of stuff! It was really fun! Then I got the CPAP and that changed. And then for about a month or more, my brain said "Pay back time!" and I had some really, really freaky dreams. Wow.

what exactly where you changing?
OK..now I see what you are talking about re the dial. Somehow, I thought that I was responsible for setting the pressure and that was the way it was done. Now I understand that the dial is for the humidifier. "got it" on that one! Thanx!
11-12-2013 09:53 PM
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Tez62 Offline

Monitors

Posts: 837
Joined: Feb 2013

Machine: Resmed S9 Autoset
Mask Type: Full face mask
Mask Make & Model: Resmed Mirage Quattro
Humidifier: Resmed
CPAP Pressure: 5-15
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Melbourne, Australia

Post: #6
RE: New & Confused
apibrgr, welcome, if someone has set the pressure settings for you from 4-20 leave them until you get a couple of weeks of usable data. The high of 20 may be able to come down where you have a margin of about 10, like 4-14. You are saying you are using 'other software' not sure what that is, if you use Sleepyhead software you will be able to seeing how you are going each minute of the night and see what your AHI and leaks are during the night. You will also be able to see your pressures and whether you need to have the pressure that high, but you do need a couple of weeks of data, good luck with it.
11-12-2013 10:20 PM
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apibrgr Offline

Members

Posts: 18
Joined: Nov 2013

Machine: REMstar Auto A-Flex
Mask Type: Nasal pillows
Mask Make & Model: ResMed Swift FX for her
Humidifier: Philips Respironics System One Heated Humidifier
CPAP Pressure: 20cm-4cm (?)
CPAP Software: Other Software

Other Comments: I am not sure what "XZero" means, but it is on one of the deilvery tickets for the equipment

Sex: Female
Location:

Post: #7
RE: New & Confused
Thank you, Paula02. I think I now understand that the button I was changing is not the pressure, but the humidifier. Somehow, I misunderstood the instructions and thought that I was the one who set the pressure. Now "I get it" re that part.
About the obesity: I am overweight & I'm successfully working my way down the scale, but I've been told my metabolism is extremely slow. I have lost 8 pounds in the last month, but it is a struggle even though I work out & eat way better than I did. I'm not obese, but my BMI is 27.3 & I was told that I could never "lose" the CPAP until at least I lost 40 pounds (I'm 5'6", and need to get down to 131 if I want to improve my sleep). I'm definitely "goal oriented" now!
My sleep study - Diagnostic Polysomnography (which was at home) report says that one of the 2 nights, "Apnea events were id'd as a 10 or more 2nd period of at least 80% reduced airflow. Hypopneas events were id'd as a 10 or more 2nd period of at least 30% reduced airflow and a 4 or more % drop in oxygen saturation. Obstructive apnea events show an effort to breathe, central events show no effort to breathe. The recording was for 7 hours and 8 minutes. I had 20 apneas, there are 14 obstructive, 0 (0%) unclassified, 4 central and 2 mixed apneas; and 51 hyponeas for a combined apnea-hypopnea index of 10 respiratory events per hour. My average oxygen saturation was 93%, and the lowest saturation was 81%. There were 23 min (5%) minutes below 90% saturation. There were 9 min (2%) minutes below 88% saturation. My pulse rate had a minimum heart rate of 62 beats/min., a max heart rate of 99 beats/min and an average heart rate of 75 beats/min. The 'overall impression': Night 2 of 2: This is an abnormal study with mild obstructive sleep apnea on the second sleep night."
So, there it is. Once I was told all this, which I still do not understand what it all means, it took about a week to get the CPAP to get started. I was so freaked out and scared that I spent that week sitting up to sleep & getting next to no sleep at all. I was afraid to lay my head down.
The recommendation on the report was Auto-PAP with pressure between 4 & 20 with a mask of my choice.
So, anything you can tell me to shed more wisdom on my condition would be appreciated.
11-12-2013 10:23 PM
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Tez62 Offline

Monitors

Posts: 837
Joined: Feb 2013

Machine: Resmed S9 Autoset
Mask Type: Full face mask
Mask Make & Model: Resmed Mirage Quattro
Humidifier: Resmed
CPAP Pressure: 5-15
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Melbourne, Australia

Post: #8
RE: New & Confused
apibrgr, it looks like you had 71 apnea in total over a 7 hour period or 10 per hour, this equates to mild sleep apnea. Normal people stop breathing between 0-5 times an hour, 5-15 is mild, 15-30 is moderate and 30+ servere. Yours would be mild with an AHI (Apnea Hypoapnea Index) of 10, what you want to do using your CPAP is to have it consistently below 5 and the lower the better. You can see that figure on the screen or by using software as I mentioned before. Just try to take in what you can, you will learn everything you need to over time by reading posts on here and asking questions. This is a long journey and you have just started. Make sure you keep a positive attitude and be patient.
11-12-2013 10:34 PM
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apibrgr Offline

Members

Posts: 18
Joined: Nov 2013

Machine: REMstar Auto A-Flex
Mask Type: Nasal pillows
Mask Make & Model: ResMed Swift FX for her
Humidifier: Philips Respironics System One Heated Humidifier
CPAP Pressure: 20cm-4cm (?)
CPAP Software: Other Software

Other Comments: I am not sure what "XZero" means, but it is on one of the deilvery tickets for the equipment

Sex: Female
Location:

Post: #9
RE: New & Confused
Thank you, Tez62 (and everyone else who has replied.) I don't know what kind of software & I'm not sure how to find out. There is a modem on the machine. I am going to work on getting more familiar with it tonight. The weirdest thing about the whole first night experience is that I was totally exhausted the next morning. Nothing refreshing about it. It was a real disappointment.
11-12-2013 10:35 PM
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Tez62 Offline

Monitors

Posts: 837
Joined: Feb 2013

Machine: Resmed S9 Autoset
Mask Type: Full face mask
Mask Make & Model: Resmed Mirage Quattro
Humidifier: Resmed
CPAP Pressure: 5-15
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Melbourne, Australia

Post: #10
RE: New & Confused
You can get the software from this site, you will need a card reader unless your PC has a built in one, they are the ones used for digital camera's.
Then download the software and import the data, we can talk you through the process.

There are also youtube videos on how read the data, give it a try but get the machine right first, some peopl have really good nights the first night and others have problems, just relax and be patient.

http://sourceforge.net/projects/sleepyhead
11-13-2013 12:12 AM
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