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First week with CPAP and questions
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lolewis Offline

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Post: #1
First week with CPAP and questions
I have been on therapy now for just over a week. Good nights and bad. If I wake up in the night, I can't get back to sleep until I take it off. The longest I have gone is 4 hrs. I know it can take awhile. This week I will have an overnight oximetry to see how my oxygen levels are as I had desaturated 139 times with an average of 91%.
Two years ago I was told I had Pulmonary arterial hypertension by a pulmonologist due to elevated pulmonary pressures and an isolated low diffusion capacity on pulmonary function tests. I had had a negative sleep study done as well. When I was sent to the specialist for this, he said there wasn't enough evidence to warrant further testing. Now that the sleep study is positive, I am wondering if everything could be directly related to my sleep apnea and the first study was wrong?? I have requested another appointment with the pulmonologist to discuss this.
My question is on my study it said " Apnea-5
obstructive-1
central-3
mixed-1
hypopnea-143

How come I was diagnosed with Obstructive sleep apnea and not central? Do most people also have some central apnea's?
07-21-2015 07:13 AM
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DeepBreathing Offline
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Post: #2
RE: First week with CPAP and questions
The diagnosis is made on the basis of the AHI - apnea hypopnea index - which includes all those 143 hypopneas as well as the few apneas. Hypopneas are a breathing reduction but not complete cessation. It's likely the lab saw evidence that your hypopneas were obstructive in nature. The AHI is the average of all events divided by the number of hours of sleep. So assuming you slept 8 hours, your AHI would be (1+3+1+143) / 8 = 18.5, which is moderate. (If you only slept four hours it would be 37, which is severe).

Don't worry too much about taking the mask off at first. We all do it, but (mostly) grow out of it. I'm afraid I can't comment on the pulmonary issues.

DeepBreathing
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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.
07-21-2015 07:20 AM
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GingerMan512 Offline

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Post: #3
RE: First week with CPAP and questions
I had a similar problem of waking up and then not being able to fall asleep with the mask on. To alleviate this I turned off ramp up mode, now whenever I turn it on I just get full pressure. Now I don't feel starved for air when I'm trying to fall asleep.
07-21-2015 03:26 PM
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lolewis Offline

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Post: #4
RE: First week with CPAP and questions
(07-21-2015 03:26 PM)GingerMan512 Wrote:  I had a similar problem of waking up and then not being able to fall asleep with the mask on. To alleviate this I turned off ramp up mode, now whenever I turn it on I just get full pressure. Now I don't feel starved for air when I'm trying to fall asleep.



Thanks for the advice. Not sure what "ramp mode" is but I will look at the machine tonight.
07-22-2015 06:07 AM
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lolewis Offline

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Post: #5
RE: First week with CPAP and questions
(07-21-2015 07:20 AM)DeepBreathing Wrote:  The diagnosis is made on the basis of the AHI - apnea hypopnea index - which includes all those 143 hypopneas as well as the few apneas. Hypopneas are a breathing reduction but not complete cessation. It's likely the lab saw evidence that your hypopneas were obstructive in nature. The AHI is the average of all events divided by the number of hours of sleep. So assuming you slept 8 hours, your AHI would be (1+3+1+143) / 8 = 18.5, which is moderate. (If you only slept four hours it would be 37, which is severe).

Don't worry too much about taking the mask off at first. We all do it, but (mostly) grow out of it. I'm afraid I can't comment on the pulmonary issues.

Thanks for the explanation. Pretty confusing stuff!!
07-22-2015 06:10 AM
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sleepybeaver Offline

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Post: #6
RE: First week with CPAP and questions
(07-21-2015 07:13 AM)lolewis Wrote:  I have been on therapy now for just over a week. Good nights and bad. If I wake up in the night, I can't get back to sleep until I take it off. The longest I have gone is 4 hrs. I know it can take awhile. This week I will have an overnight oximetry to see how my oxygen levels are as I had desaturated 139 times with an average of 91%.
Two years ago I was told I had Pulmonary arterial hypertension by a pulmonologist due to elevated pulmonary pressures and an isolated low diffusion capacity on pulmonary function tests. I had had a negative sleep study done as well. When I was sent to the specialist for this, he said there wasn't enough evidence to warrant further testing. Now that the sleep study is positive, I am wondering if everything could be directly related to my sleep apnea and the first study was wrong?? I have requested another appointment with the pulmonologist to discuss this.
My question is on my study it said " Apnea-5
obstructive-1
central-3
mixed-1
hypopnea-143

How come I was diagnosed with Obstructive sleep apnea and not central? Do most people also have some central apnea's?

Hi Lolewis....what machine are you using and mask...what pressures are you running, what are your other settings, humidity, ramp time if any, EPR....why are you taking the mask off, do you fell like you can't breath, are you doing in your sleep...thanks

It's exactly like that. . . . only totally different. . . . Sleep-well
07-22-2015 06:40 AM
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DeepBreathing Offline
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Machine: Resmed S9 VPAP Adapt
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CPAP Pressure: EPAP: 9 - 15 PS: 3 - 10
CPAP Software: ResScan SleepyHead

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Location: Perth, Western Australia

Post: #7
RE: First week with CPAP and questions
(07-22-2015 06:07 AM)lolewis Wrote:  Thanks for the advice. Not sure what "ramp mode" is but I will look at the machine tonight.

Ramp mode starts your machine at a very low pressure and gradually ramps up to operating pressure. The idea is that you should be asleep before the pressure gets high enough to be annoying. Some machines set the ramp time to 45 minutes default, which is way too long. Most start at a pressure of 4 cm H2O, and a lot of people find they don't get enough air at that pressure.

So the idea is to turn it off if you don't need it. Otherwise set it for the shortest period which is comfortable for you, and at a comfortable starting pressure.

If you let us know your machine details, somebody will be able to advise on how to set it on your machine.

DeepBreathing
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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.
07-22-2015 06:57 AM
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lolewis Offline

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Post: #8
RE: First week with CPAP and questions
(07-22-2015 06:40 AM)sleepybeaver Wrote:  
(07-21-2015 07:13 AM)lolewis Wrote:  I have been on therapy now for just over a week. Good nights and bad. If I wake up in the night, I can't get back to sleep until I take it off. The longest I have gone is 4 hrs. I know it can take awhile. This week I will have an overnight oximetry to see how my oxygen levels are as I had desaturated 139 times with an average of 91%.
Two years ago I was told I had Pulmonary arterial hypertension by a pulmonologist due to elevated pulmonary pressures and an isolated low diffusion capacity on pulmonary function tests. I had had a negative sleep study done as well. When I was sent to the specialist for this, he said there wasn't enough evidence to warrant further testing. Now that the sleep study is positive, I am wondering if everything could be directly related to my sleep apnea and the first study was wrong?? I have requested another appointment with the pulmonologist to discuss this.
My question is on my study it said " Apnea-5
obstructive-1
central-3
mixed-1
hypopnea-143

How come I was diagnosed with Obstructive sleep apnea and not central? Do most people also have some central apnea's?

Hi Lolewis....what machine are you using and mask...what pressures are you running, what are your other settings, humidity, ramp time if any, EPR....why are you taking the mask off, do you fell like you can't breath, are you doing in your sleep...thanks

I am not sure of the machine. I am at work right now but it is only a trial one. I know the Respiratory Therapist increased the pressure last week and I find it harder to adjust. I had told her that I couldn't get back to sleep and she said it was because the pressure was higher at that point. She showed me a button to push that would reduce the pressure but I still can't seem to fall back asleep. I have the humidity at level 3. I use the nasal pillows(I think that is what it is called). I am sure there is a level of anxiety associated with this as I am an RN at a hospital and need my sleep!
07-22-2015 08:58 AM
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Exhale Offline

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Post: #9
RE: First week with CPAP and questions
Hello lolewis
I have been using my cpap since February and I still hate it and cannot get use to it. I was away for a few days (CPAP free) and my husband stayed home. He said he slept better without me there. So last night I used CPAP and after 3.5 hours he couldn't take it anymore, neither could I. My AHI is very low, typically under 1 or zero with CPAP. So my apnea is almost normal but my oxygen level dropped to 81 during the first sleep test. I think if they could just give me oxygen it would be better for me. I try and get answers from the doctors but it seems that they are taught one way and are sticking to it. I just can't imagine using and wearing his thing every night for the rest of my life, possibly ruining my marriage (will be 30 years in 2017).
I hope it works out for you. Mostly everyone I see on this forum has adjusted.

"Life is not measured by the number of breaths we take,
but by the moments that take our breath away.
"
Hillary Cooper
07-24-2015 08:36 AM
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lolewis Offline

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Post: #10
RE: First week with CPAP and questions
I was on my Pulmonologists cancellation list so I managed to get in to see him yesterday which is great as usually it takes 3 to 6 monthes! Since he was the one who diagnosed me with pulmonary arterial hypertension I asked him if sleep apnea may have been the cause. He said that my apnea would have to be severe and I would typically weigh much more in order for it to be the cause. He looked back at my sleep study from two years ago and said if he had been the one to have read it, he would have recommended CPAP back then as the report was not much different than the one just done! It had been read by a doctor from another city and no one questioned his diagnosis of it being normal.
He suggested I go for a polysomnography but I said if it wouldn't change anything, why would I bother? is there any benefit to it that I am not thinking about?
07-24-2015 08:39 AM
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