Hello Guest, Welcome to Apnea Board !
As a guest, you are limited to certain areas of the board and there are some features you can't use.
To post a message, you must create a free account using a valid email address.

or Create an Account


New Posts   Today's Posts

First Night on Therapy -- CA worries
#31
RE: First Night on Therapy -- CA worries
So...Andy, how is the facemask working in connection with your leaks, and apnea since your using a facemask?
Post Reply Post Reply
#32
RE: First Night on Therapy -- CA worries
I believe that things will work out for this OP. Otherwise, he may need to go ASV, whatever. In any event, I am surprised that as a newbie he is able to sustain sleep on the machine for such relatively long periods of time.

How does OP feel the next day? Does OP feel like he has had a good night's rest?

I think it's important that he gets his AHI down to <1.0, eventually. He may also be experiencing a sleep debt.

If his optimal pressure is 11, perhaps he should increase his minimum APAP pressure to no less than 9 or 10 if he sleeps on his side.

Agree that Andy should reduce EPR to '1', or '0' if he can handle it.
Post Reply Post Reply
#33
RE: First Night on Therapy -- CA worries
Here's an update, after 14 nights of therapy:

I've left pressure at 7-11 for the last 13 nights, but turned off all EPR starting 6/20.

I've tried multiple masks: the nasal masks rubbed the bridge of my nose raw, even trying to keep them relatively loose. The full face mask was cumbersome and no more effective than the nasal masks. The pillows mask is comfortable and easy to use. I am not a mouth breather, but when asleep my mouth will occasionally fall slightly open, so one night (6/18) I tried a mouthguard (ugh) and for the last 5 nights (6/21 to 6/25) I've used surgical tape to hold my lips together (not a great long-term solution).

My AHI numbers are better than my sleep study results (AHI 41, all OSAs and Hypopneas), but it's clear my body and brain are still wrestling with this new experience, as my AHI numbers are mostly over 5, and more than a few are in the 8-10 range. I now have almost no OSAs, relatively few Hyponeas, but numerous CAs.

Link to my SleepyHead stats: http://screencast.com/t/i58p99PCN

I'm pondering whether to fiddle with the pressure, perhaps increasing the range from 7-11 to 7.6-11.6 (my APAP changes pressure settings in .2cmH2) increments). The alternative is to leave pressure alone for a while longer, and give my body and brain some more time to adjust to this new adventure in sleeping.

The good news is I don't snore anymore, and I feel better when I wake up and during the day (never felt awful, but was often a little tired).

Thanks again everyone for your support and great information.

Andy

Post Reply Post Reply
#34
RE: First Night on Therapy -- CA worries
Hard to see in the overview when you are getting your events. Can you post a Daily? What I can see is that you are bumping up against your max pressure setting. If it were me, I would bump the max up to 15. Since it is in APAP it will only go that high if it needs it and adjust it lower later if necessary.
Using FlashAir W-03 SD card in machine. You can download your data 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

Stick it to the man, Download OSCAR and take back control of your data!

Thanks Ian. Like I didn't have enough Honey-Do projects to tackle. Mornincoffee
Post Reply Post Reply
#35
RE: First Night on Therapy -- CA worries
Here are screenshots of a couple of different time periods from last night -- the first is approximately 60-90 min into the evening, and the second is the last 30 min of sleep in the morning, when I woke on and off before turning the APAP off.

http://screencast.com/t/a8zJt6UZ0

http://screencast.com/t/0TFvC6RO

And, lastly, here's a shot of the entire night:

http://screencast.com/t/KIWsCzYxfkk
Post Reply Post Reply
#36
RE: First Night on Therapy -- CA worries
Andy, your results suggest mild complex apnea that is most likely caused by your CPAP pressure. Increasing pressure would likely increase events, and decreasing pressure could allow more OA and H events. It is borderlike whether you might be a candidate for ASV therapy which would initiate a breath when you don't. About 15% of apnea patients develop CPAP induced complex apnea.

This is really a discussion you need to have with your doctor. Read this article for some background. http://www.hindawi.com/journals/sd/2014/798487/

I hope this helps. Lots of other resources are out there to explain this condition, but your next step needs to be a discussion with your professional.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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.
Post Reply Post Reply
#37
RE: First Night on Therapy -- CA worries
Sleeprider,

That makes sense. I think I will stick with my current settings and see what things look like in 3 more weeks, when I have a follow-up with my primary care physician. By then I should have a meaningful amount of data, which I can share with him via SleepyHead reports.

And thanks for the link to the article -- much appreciated!

Thank you
Post Reply Post Reply
#38
RE: First Night on Therapy -- CA worries
I think the last paragraph of section 5.1 of that article may point to your best interim approach:

"When none of the previously discussed PAP therapies or respiratory assist devices are well tolerated, using lower pressures by allowing some obstruction to persist (permissive flow limitation) may be successful in some patients [11]"

Basically, reducing pressure to the threshold of OA, may reduce CA. You appear to meet the criteria for ASV treatment with an AHI over 5.0 consisting of predominately CA events. Good luck!
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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.
Post Reply Post Reply
#39
RE: First Night on Therapy -- CA worries
Yes, i just read the article and noted that -- very interesting! It appears that increasing my current pressure settings could prove counter-productive.

I have much to think about, and to discuss with my doctor.

Thanks again for this very informative information.
Post Reply Post Reply
#40
RE: First Night on Therapy -- CA worries
(06-26-2015, 01:11 PM)AndyB Wrote: Sleeprider,

That makes sense. I think I will stick with my current settings and see what things look like in 3 more weeks, when I have a follow-up with my primary care physician. By then I should have a meaningful amount of data, which I can share with him via SleepyHead reports.

And thanks for the link to the article -- much appreciated!

Thank you

Unless your PCP is board-certified in sleep medicine or has some kind of specialized knowledge, I would not place all the much credibility on what he has to say. This is not a simple case scenario- it may be beyond his level of expertise.

Post Reply Post Reply


Possibly Related Threads...
Thread Author Replies Views Last Post
  WW4B Therapy thread WW4B 49 4,062 Yesterday, 04:31 PM
Last Post: WW4B
  Therapy Help - Possible UARS - REM jkossis 8 157 Yesterday, 02:09 PM
Last Post: Sleeprider
  [CPAP] Therapy help rekaviv 9 253 Yesterday, 11:22 AM
Last Post: rekaviv
  IanD - Therapy Thread IanD 28 2,264 03-26-2024, 08:18 PM
Last Post: IanD
  MrIvanDrago - CPAP|Bi-PAP Therapy Journey MrIvanDrago 67 3,350 03-26-2024, 01:22 PM
Last Post: MrIvanDrago
  Marcin's Therapy Thread marcinpiskala 20 957 03-23-2024, 04:38 PM
Last Post: Sleeprider
  Jakespeare65 - Therapy Help jakespeare65 26 808 03-22-2024, 12:55 PM
Last Post: jakespeare65


New Posts   Today's Posts


About Apnea Board

Apnea Board is an educational web site designed to empower Sleep Apnea patients.