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First Night
#1
ResMed S9Autoset

Not to bad for a first night. AHI 8.1, with a happy face leak rate. Worse than I hoped but better than expected.

I'll run software tonight and get details and see where things really are. RT set machine up in auto mode and I already know the sleep test showed a cpap pressure of 15cm was the best for me. I'm betting the auto mode let the pressure get too low.

Thoughts?
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#2
(04-18-2012, 07:42 AM)Abearir Wrote: ResMed S9Autoset

Not to bad for a first night. AHI 8.1, with a happy face leak rate. Worse than I hoped but better than expected.

I'll run software tonight and get details and see where things really are. RT set machine up in auto mode and I already know the sleep test showed a cpap pressure of 15cm was the best for me. I'm betting the auto mode let the pressure get too low.

Thoughts?

If the machine is in, as you describe, auto mode, it will have a range of pressures (eg, 13-17), rather than a single number (15, in your profile) which simply indicates straight cpap. Do you know which is which, in your case, and if in auto, what the range is? And I wouldn't get too wed to the idea that the sleep test provided the ultimate and best number for you. In most situations, it would likely be merely the best guess resulting from a one-time test under difficult sleeping conditions. The autoset can help you and your doc determine if the number shown in the sleep test is actually the best.

Breathing keeps you alive. And PAP helps keep you breathing!
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#3
If it's set in auto mode, you started off low... how low is the question. :-) It takes a bit for the machine to push up the pressure, so if your events were all during periods where the pressure was low, the next step would likely be to move the low setting up a cm at a time - consult with your RT on that, and be sure to give it a few nights in between changes so you can see what it actually does. One nights data really isn't enough - there are many things that affect your AHI, including just plain getting used to CPAP.

What range has he got the machine set at?

For myself, if the titration said 15, I'd probably look for a range around 11-17 to bracket the 15, and leave it there for a week or so to see where the machine actually averages out to. *That is just my opinion, don't go doing it without checking with your RT. :-)
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#4
There's not much to tell from the first night- escept kudos for getting through the "first night" withour horrors. The AHI is a little high, but I think it takes a month or two for our bodies to really adjust to and get the full benefit from the machine. Try to be patient and wait at least two weeks to get to learn the machine and for it to learn you before making changes. In the beginning to involve your doctor in any decisions you make. If he/she asked you to return in a month or two or three make that appointment. Good luck and thanks for joining the forum.
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#5
Thanks all,

Yes the RT set the machine too low in my opinion. They set it in auto 4-15cm. I bumped it to 6-15 for the first night to see how it would go. I'm going to check the 95th and see what it was. I'll likely set the minimum close to that unless I find it ill advised to do so.

As far as my Dr is concerned.....Lets just say I'm looking for a new one. Three weeks out from the sleep study and they couldn't be bothered to do my follow up to write the script. (I had to demand the study in the first place).

So I had the sleep center forward the study to my cardiologist who wrote the script. He was not impresssed either as I have suddenly developed a cardiac condition which he feels was caused by my apnea. I have O2 sats at night as low as 72% and a pulse in the low 30's, AHI's in the high 90's.....so........ here I am.

Regards
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#6
(04-18-2012, 08:57 AM)Abearir Wrote: Thanks all,

Yes the RT set the machine too low in my opinion. They set it in auto 4-15cm. I bumped it to 6-15 for the first night to see how it would go. I'm going to check the 95th and see what it was. I'll likely set the minimum close to that unless I find it ill advised to do so.

As far as my Dr is concerned.....Lets just say I'm looking for a new one. Three weeks out from the sleep study and they couldn't be bothered to do my follow up to write the script. (I had to demand the study in the first place).

So I had the sleep center forward the study to my cardiologist who wrote the script. He was not impresssed either as I have suddenly developed a cardiac condition which he feels was caused by my apnea. I have O2 sats at night as low as 72% and a pulse in the low 30's, AHI's in the high 90's.....so........ here I am.

Regards

Sounds low to me, too - but again, work with your RT on this.

Check out your 95th percentile, and ask your RT why he topped it out at 15 - mine did something similar, before my titration study. He set my machine at a range of 10 - 18, for me to use for a couple weeks to see if they could get a good value off it, before my titration study (which was booked *months* out from my initial study, hence starting me off with an APAP machine). After 2 weeks we were seeing a 95th percentile value of ... 18. "Well, thats probably going to be your number..." I pointed out that if the top end is set to 18, and 95% of the time I'm at 18... how do we know that my number isn't actually 19?

"Oh. Yeah, good point...I'll change the range to 12 to 20 for a week or so...."

Sure enough, my 95th went up to 18.5 with highs in the 19 -20 range...

Wow, just though about it, thing have really changed...my 95th is running about 16 for the last few months.

With your O2 sats, etc, your might also want to look into the pulse oximeters that folks like Paula have mentioned here, looks like there's excellent data to be had, there, and the numbers can be imported into ResScan, too.

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#7
(04-18-2012, 09:09 AM)CHanlon Wrote: With your O2 sats, etc, your might also want to look into the pulse oximeters that folks like Paula have mentioned here, looks like there's excellent data to be had, there, and the numbers can be imported into ResScan, too.

good advice. with bad numbers there's also the chance that you need o2 with the cpap. you won't know that unless you check it. a good cheap overnite recording pulse oximeter can be had for $80 including shipping. in the product review section i did a review of one model and dreamcatcher did another.
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#8
I'm just curious to know how you feel today after going from an AHI in the high 90's down to 8.1 last night?
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#9
Abearir, a rather common range setting based on a PSG single pressure finding is 2 below and 3 above. In your case, if the initial best single pressure was 15, that would be 13-18. But that should be checked with your cardiologist or RT, if only to get approval for changing. And at the upper pressures (mine is 10-20) during the night, I find mask leak to be a significant issue. On the charts, AHI is acceptable when leak is OK, but otherwise...not so good. You might look for that when checking your data.
Breathing keeps you alive. And PAP helps keep you breathing!
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#10
(04-18-2012, 09:50 AM)shutterbug sue Wrote: I'm just curious to know how you feel today after going from an AHI in the high 90's down to 8.1 last night?

Actually not bad at all. Not exactly refreshed, but not dragging like usual either. During my titration, I was at 3.4 AHI and felt as good with 4 hours as I do now with 6.4hours...

I'll go out on a limb and say I'll tweak a setting or two and be close to that number for tomorrow.

Hopefully

PS

The low O2 sats were recorded PRE Titration.... 92%+ during cpap.
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