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Concerned -- please help
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tom63130 Offline

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Posts: 8
Joined: Jul 2015

Machine: Respironics REMstar Pro
Mask Type: Nasal mask
Mask Make & Model: Nuance Pro
Humidifier: Respironics System One
CPAP Pressure: 7
CPAP Software: SleepyHead

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Sex: Male
Location: St. Louis, Missouri

Post: #1
Concerned -- please help
Last night was my first night on a CPAP machine (aside from a sleep study last month). My AHI was 9.3 -- thought it should be lower. From the SleepyHead software, got my graph, which is attached. (CPAP pressure is 7.)

Any assessments that anyone can share? I sure thought my numbers would look better.

Thanks in advance,
Tom


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07-28-2015 09:13 AM
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AlanE Offline

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Machine: ResMed AirSense 10 Autoset
Mask Type: Nasal pillows
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Sex: Male
Location: Southwest Florida

Post: #2
RE: Concerned -- please help
Can you post a screen shot? In Sleepyhead (on a PC not sure about Mac), press F11, F12 then F11 to return to normal. If you have dual monitors, make sure Sleepyhead is on the display #1.



Using FlashAir W-03 SD card in machine. Access through wifi with FlashPAP or Sleep Master utilities.

I wanted to learn Binary so I enrolled in Binary 101. I seemed to have missed the first four courses. Big Grinnie
(This post was last modified: 07-28-2015 09:24 AM by AlanE.)
07-28-2015 09:23 AM
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AlanE Offline

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Posts: 1,496
Joined: Mar 2015

Machine: ResMed AirSense 10 Autoset
Mask Type: Nasal pillows
Mask Make & Model: P10 & Mirage Liberty backup
Humidifier: Built-in
CPAP Pressure: 10-14
CPAP Software: ResScan SleepyHead

Other Comments: ʕ•ᴥ•ʔ So Long, and Thanks for All the Fish

Sex: Male
Location: Southwest Florida

Post: #3
RE: Concerned -- please help
Also after that, stand by for a bunch of questions that will help us understand your current therapy.

and Welcome



Using FlashAir W-03 SD card in machine. Access through wifi with FlashPAP or Sleep Master utilities.

I wanted to learn Binary so I enrolled in Binary 101. I seemed to have missed the first four courses. Big Grinnie
07-28-2015 09:25 AM
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tom63130 Offline

Members

Posts: 8
Joined: Jul 2015

Machine: Respironics REMstar Pro
Mask Type: Nasal mask
Mask Make & Model: Nuance Pro
Humidifier: Respironics System One
CPAP Pressure: 7
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: St. Louis, Missouri

Post: #4
RE: Concerned -- please help
(07-28-2015 09:23 AM)AlanE Wrote:  Can you post a screen shot? In Sleepyhead (on a PC not sure about Mac), press F11, F12 then F11 to return to normal. If you have dual monitors, make sure Sleepyhead is on the display #1.

Sure -- see attached -- thanks!


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07-28-2015 09:36 AM
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OpalRose Offline

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Posts: 3,181
Joined: Nov 2014

Machine: PR System One REMstar Auto 560 with A Flex
Mask Type: Nasal pillows
Mask Make & Model: AirFit P10 For Her
Humidifier: REMStar heated humidifier with heated hose
CPAP Pressure: Auto Cpap 10-13 AFLEX 1
CPAP Software: SleepyHead EncoreBasic

Other Comments: Started CPAP Therapy October 23, 2014

Sex: Female
Location: Northeast Ohio, USA

Post: #5
RE: Concerned -- please help
tom63130,
Do you have your sleep study results that you can share with us; like a breakdown of your apnea events and your AHI?

Since you have a straight CPAP and not an Auto CPAP, it's just a little harder to see what your pressure needs might be. If you had an APAP, then we could suggest a pressure range and get a better idea from sleepyhead what is going on.

You've only been on CPAP one night, so it's something you should watch for a week or two. Most important is do you feel any better after one night?

OpalRose
07-28-2015 10:17 AM
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Sleeprider Online
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Posts: 3,381
Joined: Dec 2014

Machine: Resmed Aircurve 10 Vauto
Mask Type: Nasal pillows
Mask Make & Model: Resmed Airfit P10
Humidifier: Resmed Climateline
CPAP Pressure: Auto Bilevel 18/9, PS 3
CPAP Software: ResScan SleepyHead EncoreBasic

Other Comments:

Sex: Male
Location: Where they make Respironics

Post: #6
RE: Concerned -- please help
(07-28-2015 09:36 AM)tom63130 Wrote:  
(07-28-2015 09:23 AM)AlanE Wrote:  Can you post a screen shot? In Sleepyhead (on a PC not sure about Mac), press F11, F12 then F11 to return to normal. If you have dual monitors, make sure Sleepyhead is on the display #1.

Sure -- see attached -- thanks!

It's only one night, but it appears your pressure is too low and you are not getting adequate treatment of events that normally respond to pressure, particularly OA and H. The conservative approach is to give it time, but an overall AHI of about 10 is unacceptable. I think you need to increase pressure 1.0 cm at a time and see if it clears things up. If you have the Auto IQ mode on your machine, I would strongly recommend you use the machine to titrate a new pressure in auto mode.

For future graphs, put the graphs in order of Events, Flow, Pressure, Snores as described here: https://sleep.tnet.com/reference/tips/imgur

______________________________________________
Organize your SleepyHead Data
Post your SleepyHead Data from Imgur
Robysue's Beginner's Guide to Sleepyhead
(This post was last modified: 07-28-2015 11:49 AM by Sleeprider.)
07-28-2015 11:46 AM
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AndyB Offline

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Posts: 72
Joined: May 2015

Machine: ResMed AirSense 10 Autoset with RERA
Mask Type: Full face mask
Mask Make & Model: F&P Simplus, ResMed AirFit F10; PR Amara View
Humidifier: ResMed integrated heated
CPAP Pressure: 10.4-13.0
CPAP Software: SleepyHead

Other Comments: Diagnosed May 2015; EPR @ 1cmH2O; Ramp off; ResMed Climateline heated hose

Sex: Male
Location: SE Wisconsin

Post: #7
RE: Concerned -- please help
I'm sure you will get many helpful responses from experienced members of the forum, so I hesitate to chime in since I have only 7 weeks of CPAP therapy under my belt. However, I will plunge in and offer my 2 cents since I recently had a reaction like yours after my first few nights of therapy.

One night -- and especially your very first night -- is too little data to be meaningful. My first night using a CPAP I had an AHI of 15.22. I was extremely concerned by that because I had expected great results after my sleep study (severe sleep apnea, titrated to 11cmH2O, so pressure on my CPAP was set to 6-11 cmH2O). The next 2 nights were better, but hardly great: AHIs of 8.41 and 8.65. Then the next 6 nights were a roller-coaster: AHIs ranging from under 3 to over 10. Needless to say, I was not a happy guy.

Things have settled down now, 7 weeks into therapy. After two weeks I upped my pressure to 8-13 cmH2O, turned off EPR and Ramp, and most nights my AHI is under 5. Not fabulous, but technically treated. I'm still fiddling with masks (what a treat that is), and tonight I'm going to increase my pressure slightly, to 8.4-13.4 cmH2O, since I seem consistently to be at the top of my pressure range and I still have hyponeas. My CAs are also higher than I'd like, but my sleep doctor -- who is reputed to be a top sleep doc in my area -- told me not to worry about CAs that occur in the transition times of first falling asleep, waking up to use the bathroom and then falling back asleep, and then waking up in the morning.

I have climbed back off the ledge, and can now appreciated that it will take some time to adjust to CPAP therapy. I don't think you should panic this early in your new adventure.

Good luck!
(This post was last modified: 07-28-2015 06:39 PM by AndyB.)
07-28-2015 06:32 PM
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trish6hundred Offline

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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: #8
RE: Concerned -- please help
Hi tom63130,
WELCOME! to the forum.!
Try not to worry, you've only been at this new way of sleeping one night, just keep on working with it and hang in there for more responses to your post.
Much success to you on your CPAP journey.

trish6hundred
07-28-2015 07:18 PM
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parkerdt Offline

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Machine: ResMed A10 AutoSet
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CPAP Software: SleepyHead

Other Comments: I alternate between WISP and fabric Nuance - like both!

Sex: Male
Location: Mebane, NC

Post: #9
RE: Concerned -- please help
Give it a week. My first week, I had some nights of 17+ AHI. Now, I average around 2.5 and the big numbers are outliers. Too many jump to treatment conclusions on a night's worth of data. I think that is the wrong approach. A week makes a trend, a night does not. My opinion, of course!

hang in there, and welcome!

Dave
07-28-2015 07:26 PM
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tom63130 Offline

Members

Posts: 8
Joined: Jul 2015

Machine: Respironics REMstar Pro
Mask Type: Nasal mask
Mask Make & Model: Nuance Pro
Humidifier: Respironics System One
CPAP Pressure: 7
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: St. Louis, Missouri

Post: #10
RE: Concerned -- please help
(07-28-2015 10:17 AM)OpalRose Wrote:  tom63130,
Do you have your sleep study results that you can share with us; like a breakdown of your apnea events and your AHI?

Since you have a straight CPAP and not an Auto CPAP, it's just a little harder to see what your pressure needs might be. If you had an APAP, then we could suggest a pressure range and get a better idea from sleepyhead what is going on.

You've only been on CPAP one night, so it's something you should watch for a week or two. Most important is do you feel any better after one night?
OpalRose, thank you for the reply. I really didn't feel any better today, and if anything, felt a little worse than normal. I just keep having to remind myself that it's only been one night and that adjustments can be made to make things better.

(07-28-2015 11:46 AM)Sleeprider Wrote:  It's only one night, but it appears your pressure is too low and you are not getting adequate treatment of events that normally respond to pressure, particularly OA and H. The conservative approach is to give it time, but an overall AHI of about 10 is unacceptable. I think you need to increase pressure 1.0 cm at a time and see if it clears things up. If you have the Auto IQ mode on your machine, I would strongly recommend you use the machine to titrate a new pressure in auto mode.

For future graphs, put the graphs in order of Events, Flow, Pressure, Snores as described here:
Thanks Sleeprider. I might try a pressure of 8.0 cm tonight. I don't think my machine has an Auto IQ mode, from having reviewed the manual and also played with the settings on my "Respironics PRO C-Flex+". Thanks for your tip on posting the graphs to the sleep.tnet.com site and then linking to them. Also, a question: I'm in learning mode about a number of the terms such as OA and H. Can you refer me to a good place to learn more of what they are?

(07-28-2015 06:32 PM)AndyB Wrote:  I'm sure you will get many helpful responses from experienced members of the forum, so I hesitate to chime in since I have only 7 weeks of CPAP therapy under my belt. However, I will plunge in and offer my 2 cents since I recently had a reaction like yours after my first few nights of therapy.

One night -- and especially your very first night -- is too little data to be meaningful. My first night using a CPAP I had an AHI of 15.22. I was extremely concerned by that because I had expected great results after my sleep study (severe sleep apnea, titrated to 11cmH2O, so pressure on my CPAP was set to 6-11 cmH2O). The next 2 nights were better, but hardly great: AHIs of 8.41 and 8.65. Then the next 6 nights were a roller-coaster: AHIs ranging from under 3 to over 10. Needless to say, I was not a happy guy.

Things have settled down now, 7 weeks into therapy. After two weeks I upped my pressure to 8-13 cmH2O, turned off EPR and Ramp, and most nights my AHI is under 5. Not fabulous, but technically treated. I'm still fiddling with masks (what a treat that is), and tonight I'm going to increase my pressure slightly, to 8.4-13.4 cmH2O, since I seem consistently to be at the top of my pressure range and I still have hyponeas. My CAs are also higher than I'd like, but my sleep doctor -- who is reputed to be a top sleep doc in my area -- told me not to worry about CAs that occur in the transition times of first falling asleep, waking up to use the bathroom and then falling back asleep, and then waking up in the morning.

I have climbed back off the ledge, and can now appreciated that it will take some time to adjust to CPAP therapy. I don't think you should panic this early in your new adventure.

Good luck!
Thanks AndyB! Good information/insight in here, although I am overwhelmed with the terminology. Where I can learn what CAs are? (Similar to the question I asked Sleeprider above about OA and H... I'm struggling to understand and need some sort of primer.) Thanks again.

(07-28-2015 07:18 PM)trish6hundred Wrote:  Hi tom63130,
WELCOME! to the forum.!
Try not to worry, you've only been at this new way of sleeping one night, just keep on working with it and hang in there for more responses to your post.
Much success to you on your CPAP journey.
Thanks trish6hundred!

(07-28-2015 07:26 PM)parkerdt Wrote:  Give it a week. My first week, I had some nights of 17+ AHI. Now, I average around 2.5 and the big numbers are outliers. Too many jump to treatment conclusions on a night's worth of data. I think that is the wrong approach. A week makes a trend, a night does not. My opinion, of course!

hang in there, and welcome!

Dave
Thanks Dave! I see merit in the approach of not changing anything until there is some sort of trend. Going to give this some serious consideration.
(This post was last modified: 07-28-2015 07:47 PM by tom63130.)
07-28-2015 07:45 PM
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