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[Diagnosis] Brand spanking new to CPAP
#1
Brand spanking new to CPAP
    I am 3 days in with my CPAP. Diagnosed in 2011 - tried CPAP - gave up after 3 months of trying to sleep with the mask.  Now, its getting serious at 59 yrs old - new blood pressure issues, weight issues and related complications. So, I am committed to making it work. My questions - I dont know how to read and interpret the Sleepyhead metrics.  What do they mean in layman terms and what are the important items to focus on..??  Can someone give me a primer or point to a good wiki to digest..??
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#2
RE: Brand spanking new to CPAP
Welcome to the forum. You are using a Philips Respironics Dreamstation Auto CPAP in fixed pressure mode at 14-cm. Your well-constructed Sleepyhead chart shows that you have a moderate level of leak all night. This might be improved with adjustments to your current mask or a better fitting mask of a different size or model. The large number of VS2 events on your chart may be snores, or could be vibrations being picked up by the CPAP sensors from "mask farts" and other insignificant issues. The only snores that really count are the ones in the VS row. I would recommend turning off the event flags for VS2.

Once all the VS2 clutter is removed we can see your AHI is distributed between obstructive apnea (breathing stops at least 10 seconds) and hypopnea (respiratory flow decreased at least 50% more than 10 seconds). The duration of the events can be viewed in the Events tab above the date. We can observe that OA and H events tend to occur together in several clusters, for example from 02:50 to 02:15, 03:00 to 03:20 and less severe at 04:50 to 05:50. The clustering of events might point to obstructive positional apnea. Positional apnea is described in the wiki Optimizing Therapy http://www.apneaboard.com/wiki/index.php...onal_Apnea Also check out the Flow Limitation wiki http://www.apneaboard.com/wiki/index.php...Limitation and the Mask Primer in my signature links http://www.apneaboard.com/wiki/index.php...ask_Primer

Your results are okay for starting out, but we hope to see improvements in AHI and comfort as you move forward. Resolving the mask fit and leaks is a high priority, and we may want to put your machine in Auto mode with a range of 10.0 to 16.0 pressure to see if that resolves the obstructive apnea and hypopnea, or perhaps evaluate the use of a soft cervical collar. Good luck and welcome. Ask any questions you have as there are a lot of really knowledgeable members here.
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#3
RE: Brand spanking new to CPAP
Welcome to the forum.

Not bad, decent numbers and a good set of charts.
I do suggest to disable VS2 because we don't use it and it provides a good deal of clutter.

Your doctor will be happy with your numbers because you are under 5 AHI, here we like to do better.

To better help you turn off the ramp and are you using Flex? If so at what value.  

Assuming you are running in CPAP mode because someone somewhere said to without providing a reason I would like you to try APAP mode with a range from 10 to 20, to see what your APAP wants to do (Auto-titrating) I guarantee that we will change those values.

Two questions How do you feel?  I mean specifically regarding sleepiness, fogginess, be specific about why you are restarting CPAP.  What is it about your sleep.
What were your mask problems before, are you having them now?

The important stats for you are OA, Obstructive Apnea, and Hypopnea, as these are the bulk of your events.  Typically we treat OA by increasing your pressure, specifically your exhale or EPAP pressure (the green line on your Pressure Chart). and we treat Hypopnea with your pressure, specifically your IPAP or inhale pressure.  Hypopnea with a CPAP is typically treated the same as OA.

The Auto Algorithms respond to OA, H Hypopnea, FL Flow Limits increasing pressure in response to an increase in these items.

Read the Success Link in my signature, it will lead you to a wealth of information.

Ask Questions, make the questions then repost your charts and we will help you go from there.

Fred


Once again SR
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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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#4
RE: Brand spanking new to CPAP
Fred 

Thank you (and others) for taking the time to review and advise. I hope to return the favors to others as I gain wisdom on this board.

I will disable the VS2 to eliminate clutter. 

Are you saying that I should not use the "ramp" feature..??  Why..?? My understanding was that the ramp feature allows you to get off to sleep before the heavy pressure of 16 kicks in.   

I believe that I am using Flex as I can feel the difference on the exhale.  I will check on the value tonight.  I will try the APAP with the suggested range.  Prior to CPAP, I have always felt fatigue but have been able to successfully fight it off with no real problems.  But, in last year - I have taken naps in my office (in my chair) out of necessity and have fallen asleep at long traffic lights more than once in the evenings on way home from work.  I tend to toss and turn duirng the night and the mask hinders that normal way (for me) of sleeping.   Never able to be stationery during sleep.  Now, excess sleepiness, my blood pressure is high (last 3 years), my cholesterol is high, weight is high (last 3 years)- all things that happen with age and which may be caused or exacerbated by apnea. At 51 I had choices - and I chose not to sleep with a mask on my face.  At 59, my choices are slim to none on this issue.  Oh yea - the entire house shakes when I snore.  I wake myself up with my snoring and when we are sitting still (couch, plane or car) - I can close my eyes and be dreaming in 20 seconds or less.        

This is a new task in my life and my life is full of them. I am a practicing trial lawyer and dont have much room on my plate for new things. BUT, this sleep apnea issue has become a focus and I am determined to get it under control to restore balance in my health and lifestyle.
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#5
RE: Brand spanking new to CPAP
No ramp is in part a test to see if it is an issue for you (it's not an issue for me even when my pressures were 20/25) and because it takes away from therapeutic time by not being at an effective pressure.
Both SR and I have the same goal, slightly different settings, and the intention is to change them to something that will more suit you after 1 night.  It will take a little while to dial you in but your comfort will be an important issue especially since you failed previously.

The symptoms you stated are very important to track. Why, first they will help us to optimize your treatment, and second they are a strong list of symptioms to present your case to your doctor should you need a more capable advanced machine.

Fred
New to Apnea? Helpful tips to ensure success
Mask Primer
Dealing with a DME
Download SleepyHead
Organize Charts
Attaching Charts

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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#6
RE: Brand spanking new to CPAP
All,

I eliminated VS2 to reduce clutter. I made some adjustments on my APAP - switched to Flex 1 and set for automatic 10-20.  Having mask leak issues (more than the night before) and will likely have to try another mask.  As I slept, it felt like my mask would pull away from my face as pressure adjusted and then would allow air to escape on certain areas.  Nose bridge was sore this morning - maybe too tight..??


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#7
RE: Brand spanking new to CPAP
Other than leaks this looks great. Let's talk about your mask. Do you know that a full face mask is needed, or were you told that? A nasal pillows mask like the Resmed Airfit P10 is a much smaller interface that moves with you and seals much easier because it only needs to contact the outside nares around your nostrils. The pillows are not "prongs" and do not insert into your nose. For many of us, the "blast" of air-pressure opens nasal passages and sinuses enabling nasal breathing. It takes some people time to adjust to keeping their mouth closed at night, and to be certain, some people cannot use nasal therapy.

Fred showed up here with a clunker on his face and his huge beard, and I was pretty amazed he actually got something resembling a seal. He was eventually persuaded to to try the nasal pillows, and has been a believer ever since. We like to say resistance is futile. If you succeed in nasal therapy, you will never go back.

Tom
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#8
RE: Brand spanking new to CPAP
Tom, 

I was originally given the Respironics Amara View (M) but had troubles getting it to stay in place and avoiding leaks.  Used it the first 2 nights. So, I moved on to the F20 because of my mouth breathing issue.  Maybe, I should try the Respironics again. I was told (DME) that I needed full face because of the high pressure prescription (16).
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#9
RE: Brand spanking new to CPAP
(01-24-2019, 10:11 AM)bhouston350 Wrote: I was told (DME) that I needed full face because of the high pressure prescription (16).

B*** S***
I use P10 Pillows and I'm in that neighborhood every night.  Even used them at 21/25 CM on my VAuto.  No problem
New to Apnea? Helpful tips to ensure success
Mask Primer
Dealing with a DME
Download SleepyHead
Organize Charts
Attaching Charts

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
RE: Brand spanking new to CPAP
(01-24-2019, 10:11 AM)bhouston350 Wrote: Tom, 

I was originally given the Respironics Amara View (M) but had troubles getting it to stay in place and avoiding leaks.  Used it the first 2 nights. So, I moved on to the F20 because of my mouth breathing issue.  Maybe, I should try the Respironics again. I was told (DME) that I needed full face because of the high pressure prescription (16).

Let me just say, the Amara View is a world away from the Airfit P10 in comfort, quiet and leak prevention. Your current situation sucks, so I'd say, give it a shot.  Agree with Fred the usual DME claim you need FFM is B.S.
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