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[Diagnosis] Another Newbie Seeking Help
#1
Another Newbie Seeking Help
Hello all. My name is Mike. I found this forum yesterday as someone linked it on the Sleep Apnea subreddit and from all I've read so far, I'm very happy to have made my way here.

I am hoping to get some help with fine tuning my Apap settings.

Some background: I was diagnosed in May of last year with sleep apnea and an AHI of 12.2. This is something that I believe I've had for years and doctors just never suggested it as being a possibility to explain the snoring, brain fog, and daytime exhaustion that I'd been dealing with. But finally, after lots of waiting and dealing with different companies, I was set up with my Philips Dreamstation in August of last year. With the exception of a few days the first couple weeks, I've been using it religiously every day since. 

My problem is that while my snoring has subsided thanks to the Apap, I am still exhausted and my memory is pretty much running at 50%.

I just learned last week that I was able to get to the menu to adjust settings myself on my machine and I'm hoping you all can help me make things better.

My initial prescription was set for Min. Pressure of 5 and Max of 20. So far the changes I've made are bumping the min pressure up to 6.5 and last night I turned off Ramp. According to OSCAR my AHI is down below 1, which is great, but I'm still hopeful there is more than can be changed to get me feeling myself again. Its been a very long time.

I've taken screenshots of my data from last night and attached them. Please let me know if any others are needed.

Thanks so much for anyone that can offer some help or feedback with this.

Mike


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#2
RE: Another Newbie Seeking Help
The Dreamstation is slow to react to events because of that you need to increase the low number, I would increase it by 1 to 7.5. The top number 20 can stay where it is. You have a good leak chart, nothing there to do. Take a couple nights and post again with how you feel and the Oscar charts. I can not see if you are using the ramp. If you are turn it off, you don't need it. While it is on you are not getting therapy.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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#3
RE: Another Newbie Seeking Help
Not bad Mike, actually pretty d* good.

We only need the first chart, if we need more we will ask for it.
With these numbers we don't chase the numbers, but how you feel becomes very important. It is important that you bee critical in your descriptions. "I feel fine" is a bad answer. It will take time to overcome years of apnea.

I would like you to really note how you feel, then increase pressure by 1 to 7.5 for a bit, at least 3 nights, then ask yourself critically which is better 6.5 or 7.5? This is searching for the comfort factor. Note that 8 cmw is a common pressure. Personally I cannot tolerate pressures of 10 and lower.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter

Download OSCAR
New to Apnea? Helpful tips to ensure success
Soft Cervical Collar
Mask Primer
Dealing with a DME
Organize Charts
Optimizing Therapy
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#4
RE: Another Newbie Seeking Help
(08-27-2020, 10:38 AM)Jdmeg693 Wrote: Hello all. My name is Mike. I found this forum yesterday as someone linked it on the Sleep Apnea subreddit and from all I've read so far, I'm very happy to have made my way here.

I am hoping to get some help with fine tuning my Apap settings.

Some background: I was diagnosed in May of last year with sleep apnea and an AHI of 12.2. This is something that I believe I've had for years and doctors just never suggested it as being a possibility to explain the snoring, brain fog, and daytime exhaustion that I'd been dealing with. But finally, after lots of waiting and dealing with different companies, I was set up with my Philips Dreamstation in August of last year. With the exception of a few days the first couple weeks, I've been using it religiously every day since. 

My problem is that while my snoring has subsided thanks to the Apap, I am still exhausted and my memory is pretty much running at 50%.

I just learned last week that I was able to get to the menu to adjust settings myself on my machine and I'm hoping you all can help me make things better.

My initial prescription was set for Min. Pressure of 5 and Max of 20. So far the changes I've made are bumping the min pressure up to 6.5 and last night I turned off Ramp. According to OSCAR my AHI is down below 1, which is great, but I'm still hopeful there is more than can be changed to get me feeling myself again. Its been a very long time.

I've taken screenshots of my data from last night and attached them. Please let me know if any others are needed.

Thanks so much for anyone that can offer some help or feedback with this.

Mike

Everyone is a bit different, this makes treating everyone a bit difficult, but not impossible.
My mate got a machine home just lately from a Hospital in Northern Ireland.  They just handed him a machine and told him "Sorry, but I am NOT allowed to set up the machine for you, take it home and use it, we will see you in a month to see how you are getting on with it".
Well, as you can imagine, he was a bit distraught and really didn't know what to do with it.  It was a ResMed Autosense10.
It was of course at factory settings 4 low and 20 high.  He tried to use it the first night and he couldn't use it at all, felt as if he was choking.
He phoned me next day for help (He did try phoning the hospital, but no joy)!
First question I asked was "What type of machine did they give you"?  = ResMed Autosense10.
Are you sure it is an Auto, look and see if it says Auto.  = Yes it does.
What pressure was you at before if you know?  - 14.
Ok, let's set it up for you as best I can without any data.

Told him how to go into Clinician's Menu.

Set low to 10 and left it at 20 high, try the pressure just now to see how it fells.  Fells fine.  Ok, any problems phone me back tomorrow.

Phone rings after a few days, machine is nice, it works fine.
(Q) = What about EPR?  Do I put it on or leave it off?  (A) = If you have been using it without it, leave it off, it drops the pressure when you breath out.
(Q) = How do I know how I am doing last night?  (A) = Told him how to see how many AHI he had the night before.
He phones back after a couple of days.

(Q) = My AHI is a bit high, I think?  It is 8 one night and 10 the following night.
(A) = There could be a few reasons for that, but you will need to download the software from [THIS SITE] to read how you are doing.
(Q) - I had a constant pressure of 14 on the last machine, I am used to a constant higher pressure, do you think it is a bit low at 10?
(A) = It might be just a bit low, but without data I can't really say! 
(Q + A)  = (You can try putting it up a little on the LOW pressure, but first what is the pressure it went up to during the night?
(A) = I think it said it went up to 15.
(Q) = How do you feel since you got the new machine?
(A) = I feel a bit more tired, a bit like I need more sleep.

Ok, just a trial without data (This was a few days ago) Let's put your low pressure up to 11.6 and just see what happens.  If you AHI stays high or gets worse let me know right away.  If it drops, talk to me in a week.  He only has this machine for a week, so he has to get his AHI/events down.

So far I have heard nothing from him, so they must have gone down.

So he needed a higher lower pressure than others.

If your pressure is a bit low at the low setting put it up a bit.  I tend to find I also can't stand low pressure.
At the start, you might think the pressure is a bit high, but trust me you get used to it quite fast.
The thing is, the bigger a pressure gap between LOW and HIGH pressure that your machine runs at every night the more chance that an event will happen.  If the gap is large, not only will an event have more chance of happening, but when the machine rises quickly in pressure it might disturb you in your sleep.  You might be aware of it or you might not, in any case, you will not be sleeping as well as you could be.
I have NOT looked at your charts, but most machines are set for to low for most people.
I can't stand a pressure lower than 10 and I find that is a bit low for me, I have my one set at 11 or slightly higher.
Most hospitals will set the low pressure here at 10 and leave the machine at 20.
I would start at that and see how things go.
Remember that no one is used to air being blown up their nose, so it does take a bit of getting used to.
You have to be of the mind that "This will work for me come hell or high water" and the chances are you will get there, but it takes a while to feel better and less tired.  Takes a while to get used to the machine, especially at higher pressures, but in the end it is worth its weight in gold.
There is nothing else that will come close to working so well as a CPAP/APAP machine.
If you have complications, there are more specialised machines, so don't give up.
I am NOT a doctor.  I try to help, but do not take what I say as medical advice.


Every journey, however large or small starts with the first step.

Sleep-well
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#5
RE: Another Newbie Seeking Help
Thanks so much for the replies everyone. 

I will try upping the pressure tonight to 7 then to 7.5 in a couple days.

I will admit that I tried my pressure at 7 one night last week and I thought my ears were going to explode so i took it back down to 6.5 immediately. Wild fire smoke has my allergies going crazy and the congestion isn't helping anything.

Will report back in a couple days.

Thanks again!
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