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First few nights not looking so good?
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zonk Offline

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Post: #21
RE: First few nights not looking so good?
(12-04-2012 06:08 AM)ImReallyTired Wrote:  Actually I have the same question. I have no idea why my pressure is so high. I just looked again, over the past 13 days the median is around 12, max is 18, min is 5. It' pretty much all over the place. I'm assuming it's due to the mask leaks. I get a small leak, pressure goes up, leaks gets worse, pressure goes up again......
what the % of large leak? AHI is not accurate with large leak
have you had a followup with the sleep doc
if pressure all over the place and having problems with leaks as machine increase pressure than maybe consider set the machine on fixed pressure which might help you maintaining the mask on all night... titrated pressure is a good start
12-04-2012 02:48 PM
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ImReallyTired Offline

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Post: #22
RE: First few nights not looking so good?
I didn't sleep more than an hour during my 2nd sleep study so we never dialed the correct pressure for me. Instead, they gave me an APAP, left it set at 5-20, and said, 'we'll review the data in 6 weeks and see what's next'.

It's been 2 weeks, and I'm not waiting 4 more. If my new mask isn't in my mailbox when I get home tonight, then I'm going to reset my range to 8-15 or somewhere around there and see what I get.
12-04-2012 03:18 PM
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PaulaO2 Offline
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Post: #23
RE: First few nights not looking so good?
You may want to give it just a little more time. Your body and brain has some catching up to do, some adjusting, and all that jazz. Just like with many medications, it can take a while before you see any results.

But ultimately, your health care is up to you. If you do changes, they have to be done slowly and you have to gather data over more than just a few nights.

PaulaO2
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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.
12-04-2012 04:28 PM
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Ugly Offline

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Post: #24
RE: First few nights not looking so good?
(11-26-2012 08:55 AM)Sleepster Wrote:  
(11-25-2012 11:22 PM)Ugly Wrote:  I'm new to this auto CPAP stuff myself and I regard it as quite amazing. It's regularly adjusting my pressure to a level higher than the "experts" had determined. No wonder it's been hell.

I hope you realize that auto CPAP's do not always set themselves to the correct pressure. They usually require manual adjustments.

I probably didn't always realize that, but after three weeks with one I learned that there certainly was no "standard" pressure for me. However it also explained why the default setting of 8 for me wasn't helping. The numbers ranged from 8.4 to 11.2 so it seems 8 was certainly not correct. Keeping a running total the average so far was 10.44 cmH2O. I sent my results to my otolaryngologist but I never got a response. I'll offer up my findings to my respiratory therapist when I return the S8 Auto model to her tomorrow morning. And if I get no support from anyone, at least I have the ability to change the pressure myself. Thanks to Apnea Board for showing me how to take matters into my own hands.
12-04-2012 04:50 PM
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ImReallyTired Offline

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Post: #25
RE: First few nights not looking so good?
Maybe I'm misunderstanding how all this is supposed to work. For example when I look at these graphs (mine from last night), shouldn't my pressure be increasing in response to the obstructive apneas? It's like this pretty much all night, the pressure increases in response to a vibratory snore event, but very rarely in response to the OA's.

[Image: graph1.png]

Am I misunderstanding something?
12-04-2012 05:43 PM
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JJJ Offline

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Post: #26
RE: First few nights not looking so good?
(12-04-2012 05:43 PM)ImReallyTired Wrote:  Maybe I'm misunderstanding how all this is supposed to work. For example when I look at these graphs (mine from last night), shouldn't my pressure be increasing in response to the obstructive apneas? It's like this pretty much all night, the pressure increases in response to a vibratory snore event, but very rarely in response to the OA's.
Am I misunderstanding something?

I have the same issue. My PRS1 is not responding fast enough.

In your case, part of the problem might be that your pressure range is too great. Maybe if you raised the minimum pressure it wouldn't have so far to go in order to overcome the event.
12-04-2012 05:54 PM
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Sleepster Offline
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Post: #27
RE: First few nights not looking so good?
(12-04-2012 05:43 PM)ImReallyTired Wrote:  Am I misunderstanding something?

I don't believe it'll respond that fast. The time window of the graph you posted is just a bit over one minute!

Let's get back to basics here. You have your APAP set wide open because they were unable to titrate you at the sleep lab. You are experiencing leaks. You sent your data to your doctor but he didn't respond. Let's see if it's time to take matters into our own hands here.

What is your 95% pressure?

What is your percent time in large leak?

I would tend to agree with you that if you can't get your leaks under control it's time to lower that upper end of your pressure range and see if we can get the leaks under control. At that point we can start getting some reliable AHI numbers and see if the pressure range needs tweaking.

I would recommend that you mention all this to your RT and see what they say. They'll probably recommend that the doctor change the pressure range, so maybe it's a good idea to wait and see what they say before you make any adjustments yourself.

Sleepster
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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.
12-04-2012 09:57 PM
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ImReallyTired Offline

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Post: #28
RE: First few nights not looking so good?
You're only seeing 1 minute in that graph, but, even if I go out 30 minutes, there's still no pressure adjustment until I snore.

Anyway, I got frustrated (go figure) and changed my pressure to 8-17. I had virtually 0 leaks last night, it was a decent night in that respect.

On the AHI side it still kinda sucked, 13.78. I realize it's only one night, but based on that, the leaks aren't my issue.

Maybe the question I should be asking is this, is it normal, 15 days in, to still have relatively high AHI's? Over the last couple weeks it's averaged 17.86 and I haven't had 1 night where I haven't woken up once every hour or 2.

Oh, my 95% pressure right now is 13.5 although last night's change may have skewed it, over the last 7 days it's 16.9. Not sure how to find the percentage of time in large leak.
12-05-2012 05:54 AM
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PaulaO2 Offline
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Post: #29
RE: First few nights not looking so good?
Yes, it is normal, or rather, not surprising. Your body and brain will take some time to adjust. And it is "only" 15 days. Give it time. I know it's a PITA but you're doing better than you were before CPAP. Sometimes it can take a while.

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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.
12-05-2012 01:12 PM
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ImReallyTired Offline

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Post: #30
RE: First few nights not looking so good?
Thanks. I will be sticking with it for sure, like you say, even if it's not great yet it's better than before. I just put my SD card in the mail today to my DME so maybe in a few days he'll weigh in too.
12-05-2012 04:12 PM
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