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First two days of CPAP data - any advice?
#11
I guess it depends on your doc and where you are on where you are prescribed a machine. Where I am a sleep study of AHI over 5 and you go on cpap, no questions asked. Covered by medicare. Even a bit lower if you have some other contributing factors.

I was 15 with rapid O2 desats to 62 with about every OA and slow recovery so I was diagnosed moderate to severe.

But I know several with AHI of 5 to 6 prescribed auto machines out of the same sleep lab i was in.

2 nights dont tell you much. But Im in the switch the machine over to auto mode probably 6 to 11 range
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#12
(03-06-2015, 10:39 PM)quiescence at last Wrote: [just because you can doesn't mean you should.]
.

I wholeheartedly agree. We drive a new car gently for the first 1500 miles. So why should we let our APAP rip and burn the tires from day 1.
Started APAP 4-20, Closed range to 7.5-14, then straight 8.0 w/ Aflex 3
RDI always below 1. But sleep much much better at straight pressure.
Started on F10, Tried Quattro Air successfully. Finally settled on P10.
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#13
(03-07-2015, 12:32 AM)AshSF Wrote:
(03-06-2015, 10:39 PM)quiescence at last Wrote: [just because you can doesn't mean you should.]
.

I wholeheartedly agree. We drive a new car gently for the first 1500 miles. So why should we let our APAP rip and burn the tires from day 1.

We have as many opinions around here as we have folks that will offer them. All any of us can do is offer our best guess at what may be best in a given set of circumstances.

For me, when they gave me my machine the only thing they told me was that "It is your machine now, we won't take it back." My brain responded by thinking: "my machine, my cute little body, my apnea's --- Not going to fool with someone else's idea of a good time without investigating it on my own. Took me a solid 2 or 3 nights to figure out how to live with it, then the rest of forever making sure I won't ever have to live without it..

There's a reason we have auto-titrating machines, so for me and mine, I'm going to use the technology. I'll send a pm to the doc to keep him up to date if I feel I need to. It's called "patient empowerment."


P.S. On rereading all this stuff, I see where the OP is using an EPR of 3. I use 3, but I would not be able to do that if my set pressure was at 7. I'll modify my gentleness suggestion by adding I would set the EPR to 2, so that my exhale is at least 5.

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#14
Day 3 was a mixed result . . .I ended up taking my mask off to get up to adjust the fan in the room and fell back to sleep without it. Woke up today feeling completely terrible, but my CPAP data show that for the 2 hours I had it on, my AHI was 2.29.

Of course, now you guys have me worried that I don't actually have sleep apnea, or that at the very least I should be non-symptomatic. My symptom history suggests that I've been suffering from some kind of sleep disorder for a long time, and I'm almost certainly that the doctor's office said "mild to moderate sleep apnea" . . .begs the question, if not sleep apnea, what is causing all of my problems? I guess time will tell.
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#15
(03-07-2015, 08:08 AM)kupalooza Wrote: Day 3 was a mixed result . . .I ended up taking my mask off to get up to adjust the fan in the room and fell back to sleep without it. Woke up today feeling completely terrible, but my CPAP data show that for the 2 hours I had it on, my AHI was 2.29.

Of course, now you guys have me worried that I don't actually have sleep apnea, or that at the very least I should be non-symptomatic. My symptom history suggests that I've been suffering from some kind of sleep disorder for a long time, and I'm almost certainly that the doctor's office said "mild to moderate sleep apnea" . . .begs the question, if not sleep apnea, what is causing all of my problems? I guess time will tell.

kupalooza,
There is no doubt that you are going to feel terrible if you don't use your CPAP!

Yes, it is harder for some than others. If you have to get up, don't take your mask off...just unhook the mask hose from the hose on the CPAP.
It was hard for me too at first, so I would take my machine out to living room and read for an hour or so while hooked up to machine. This may help you to adapt faster.

I'm almost positive that if you didn't have sleep apnea, you wouldn't have been given a script for machine.

Take the advise given to you on pressure settings, but I would not leave it set at
4 and 20. Also, the EPR is an exhalation relief feature. It won't even work if set
at 4. At least set the minimum to 7 and pressure relief at 2 for now and try to use it more than 2 hours.
Sleep-well
OpalRose




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#16
(03-07-2015, 08:08 AM)kupalooza Wrote: Of course, now you guys have me worried that I don't actually have sleep apnea, or that at the very least I should be non-symptomatic. My symptom history suggests that I've been suffering from some kind of sleep disorder for a long time, and I'm almost certainly that the doctor's office said "mild to moderate sleep apnea" . . .begs the question, if not sleep apnea, what is causing all of my problems? I guess time will tell.

I guess I missed that part. Why would you feel we think you do not have sleep apnea? Clearly you do. Mild, medium, well-done --- it's all the same. You do need treatment and you are doing the right things to get there. Continue investigating and working to see what works for you. You'll be asymptomatic with treatment alright, but not without it.
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#17
(03-07-2015, 08:08 AM)kupalooza Wrote: Day 3 was a mixed result . . .I ended up taking my mask off to get up to adjust the fan in the room and fell back to sleep without it. Woke up today feeling completely terrible, but my CPAP data show that for the 2 hours I had it on, my AHI was 2.29.

Data from the first two days showed most of your events were central (Clear Airway) apneas.

The obstructive apneas and hypopneas were both low.

Raising the pressure only helps avoid obstructive events, which are not high.

Raising the pressure could worsen the number of central apneas and could be harmful.

I suggest staying with the doctors prescription for a couple weeks unless the therapy is too uncomfortable to bear, such as if the doctor had prescribed APAP with "way too wide" of a pressure range, leading to slight feelings of suffocation when pressure is too low, or excessive and painful air-swallowing when pressure is too high.

Your doctor has prescribed a fixed pressure of 7 and knows things we don't know.

Before changing any settings, I suggest getting copies of the full diagnostic sleep report and of the full titration sleep report.

The full reports include data. What events happened during diagnostic session (without CPAP treatment)? During the titration, what events occurred for each pressure and in each sleep stage? Lots of important info in those reports.

You have a right to have copies of the full reports with all data, for your own records.

Take care,
--- Vaughn


Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
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#18
Checking in . . .

My last two days have looked pretty good. AHIs of 1.08 and 2.25, almost all entirely clear airway events. One struggle that I am having is with sleep duration - my body just seems to say it's done with CPAP after about 5.5 hours at the most and wakes me up, although I still feel fatigued and find myself falling back to sleep after I take off my mask. It leaves me feeling with a kinda-refreshed-but-not-quite-there type of feeling, lots of yawning, and then of course if I fall back to sleep sans mask I feel terrible.

Will this get better with time? I assume it is generally good practice to get up to the recommended 7-9 hours of sleep and my body certainly feels like it could use it.
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#19
if you really feel like you're done after 5.5 hours, get up, wander around, sip some water. In less than a half hour you'll probably feel like you could go back to sleep, and then don your mask and continue the night.

I think most of us have this experience of waking and feeling fairly done, and sometimes don't gain fully conscious state. It is hard to choose and control in that state. Nodding off has similar circumstances for us.

keep it up. you are doing great!

QAL
Dedicated to QALity sleep.
You'll note I am listed as an Advisory Member. I am honored to be listed as such. See the fine print - Advisory Members as a group provide advice and suggestions to Apnea Board administrators and staff concerning Apnea Board operation and administrative policies. Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
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