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HI! New to Forum and CPAP...have questions
#1
Hi Everyone,

Bill here!

I have been suspicious that I had sleep apnea for years. After discovering that I had cancer earlier this year, I decided to deep dive into my health and get everything fixed. I'm having surgery for my cancer in mid-July. My surgeon suggested that if I thought I had sleep apnea, I should get it checked out an on therapy before the surgery so I would recover better.

My sleep Doc was referred to me by my PCP. I don't require referrals, however, this guy does a great job of getting me to competent specialty docs.

When I went to the sleep doc, he suspected that I have severe OSA and ordered a sleep study. The study was supposed to be a 2 night study/titration. however, the sleep tech woke me up about 2 hours into the study and said there was no question as to the severity of my condition and that she wanted to get the CPAP going ASAP.

The results came out at AHI=47 without CPAP, 4.6 with.
I have a deviated septum and sinus issues so I am a mouth breather

So, this is where things get interesting....Since the surgery time is getting closer and the surgeon wants me on therapy at least 3 weeks before the surgery, the sleep doc had me come in immediately to review the results and recommend the the therapy. I show up at the office and they tell me that I didn't have an appointment that day. The staff was nice enough but it took a few minutes to realize they had made a mistake in where they registered my appointment in their system. Their computer system was down and they had they did could not access my study. Instead of waiting for things to restore, they sent me home. Later in the day, they called and said due to the closeness to the surgery, they were not going to have me come back in. They would just go ahead and submit my prescription to a DME to cut down on the time to get going on therapy.

Four days go by and I hadn't heard from the DME co. So, I called them and they hadn't received the rx yet from the doc. I told the DME co that I was concerned because I had not had a conversation with the doc to discuss mask and machine options...or even know what they were ordering.

The DME co (AME) was very helpful. They also nagged the doc's office and got the rx in. They told me I had chosen a quatro FX mask when I had not made a decision on any mask. It turned out that the quatro fx was the mask they used in the study so they put it down as though I chose it. Fortunately, the rx said that patient was to receive mask of choice and the machine was to be autoset with humidifier.

Through a lot of research, I had settled in my mind that I wanted the ResMed S9. The DME said they did not carry the A10 and that I could have the S9. I got a call back from the late in the day before they were to come with everything and they said they got the A10 Autoset in...and did I want that instead. I said "sure"!

So, the tech that came was fine and she brought the AirFit full face mask. She said I could change the mask within 30 days if I wanted to so I went with that. I was told not to play with the settings unless the doc ok'd any changes.(I was thinking bwahhahaha...u just DON'T know me now do ya).

The machine was set to constant pressure of 10, ramp up of 15min starting at 4, ERP is on and at 3.

First night - AHI = 12.5, RERA=.07 (yes, this model checks RERA and it's not a for her model) Felt really good the next day and even skipped morning coffee. Lots of issues getting used to the mask. I know now I had it too night.

Second Night - AHI = 9.6 RERA=.01 0 Felt like crap the following day with huge brain fog. Decided I didn't like the ramp feature and after reading about ERP decided to turn it off the next night

Third Night - AHI=4.4 RERA=.06 no ramp or ERP. Felt great! Immediate results. Felt like running a marathon.

Fourth Night (which is last night)= AHI=8,4, RERA=4.2 ERP=1 - Feel like total crap today. One thing about last night...I started with CPAP before bed and felt like I would be going to the bathroom soon so I disconnected. Before I got up to go, I fell asleep. Didn't get the mask on until 3 hours later when I woke up to go. I think the high RERA result has to do with the mask being off for quite awhile.

My sleep doc's office is slow with responding to questions so here are a few ?s that I have.

1. Shouldn't I be getting better scores for AHI or does that take awhile.
2. I am going back to ERP to off tonight. Should I also try to put the machine on AUTO mode vs. constant?

I would appreciate any comments or suggestions based on this post.

Bill
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#2
(06-19-2015, 01:42 PM)masbirdies Wrote: Fourth Night: I started with CPAP before bed and felt like I would be going to the bathroom soon so I disconnected. Before I got up to go, I fell asleep. Didn't get the mask on until 3 hours later when I woke up to go. I think the high RERA result has to do with the mask being off for quite awhile.

First, Welcome

You are turning the CPAP off when you get up, aren't you?

(06-19-2015, 01:42 PM)masbirdies Wrote: 1. Shouldn't I be getting better scores for AHI or does that take awhile.
2. I am going back to ERP to off tonight. Should I also try to put the machine on AUTO mode vs. constant?

1. That is a big variable. It took me close to 7 months. . . Some sooner, some never.

2. You could try auto, I would suggest a low limit of about 8cm, so you won't feel like you're suffocating. The upper limit can be 20cm. The machine (usually) won't go higher than needed.

Good Luck! Sleep-well
______________________
Useful Links -or- When All Else Fails:
Posting SleepyHead Charts in 5 Easy Steps
Robysue's Beginner's Guide to Sleepyhead
Apnea Helpful Tips
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#3
(06-19-2015, 02:14 PM)sgearhart Wrote: First, Welcome

You are turning the CPAP off when you get up, aren't you?

(06-19-2015, 01:42 PM)masbirdies Wrote: 1. Shouldn't I be getting better scores for AHI or does that take awhile.
2. I am going back to ERP to off tonight. Should I also try to put the machine on AUTO mode vs. constant?

1. That is a big variable. It took me close to 7 months. . . Some sooner, some never.

2. You could try auto, I would suggest a low limit of about 8cm, so you won't feel like you're suffocating. The upper limit can be 20cm. The machine (usually) won't go higher than needed.

Good Luck! Sleep-well

Thanks for the welcome!

No, I'm not turning the machine off. the hose disconnects from the front of the mask. I was told to just disconnect if I have to get up. The machine auto turns off if I'm not breathing into it.

It took you 7 months to what?
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#4
I would suggest you get sleepyhead or resscan and download your sleep info and take a look at what is going on when you are sleeping so you can give us info to better help you
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#5
Whats the leak rates, median, 95th percentile, maximum
You can get the figures from either ResScan or SleepyHead, profile shows you,re using both
The machine sleep report display 95th percentile but you need "Essentials" set to "Plus" in the clinical menu

I second the idea of trying "AutoSet" mode, something like 8-12, and see what pan out

The machine score events whether you're awake or asleep, awake events don't count
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#6
Hi masbirdies,
WELCOME! to the forum.!
I hope your cancer surgery goes well and much success to you with your CPAP therapy.
Hang in there for more answers to your questions.
trish6hundred
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#7
(06-19-2015, 03:42 PM)zonk Wrote: Whats the leak rates, median, 95th percentile, maximum
You can get the figures from either ResScan or SleepyHead, profile shows you,re using both
The machine sleep report display 95th percentile but you need "Essentials" set to "Plus" in the clinical menu

I second the idea of trying "AutoSet" mode, something like 8-12, and see what pan out

The machine score events whether you're awake or asleep, awake events don't count

I have ResScan.... Here's what you asked for: (average over 4 days)
Median - 1.2
95%tile - 22.8
Max - 29.4
AHI-9.0
RERA-.07
Apnea Index - 7.3 OSA-3.8, CA-3.5
Hypopnea - 1.8



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#8
Leak below the red line in ResScan (24 L/m) is acceptable
95th percentile means leak was at or below 22.8 L/m for 95% of the night

AHI is 50% obstructive events and 50% central events
The AutoSet in AutoSet mode increase pressure only in response to snoring, flow limitation, and apnea obstructive

I think, talk your doctor given your coming surgery
Good luck with the surgery
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#9
1-With my PR at least when I stop the machine to go the head SleepyHead reports each segment individually and therefore give me a record of how many times I was up. I don't remember accurately otherwise.
2-If your surgeon wants you on the machine so you can heal a little the do it for heaven sake. Go raise hell with the people that are failing to serve you efficiently! I mean you are having surgery, the surgeon wants you on cpap ASAP and someone is riding the sit n spin?
Sheesh!
I use my PAP machine nightly and I feel great!
Updated: Philips Respironics System One (60 Series)
RemStar BiPAP Auto with Bi-FlexModel 760P -
Rise Time x3 Fixed Bi-Level EPAP 9.0 IPAP 11.5 (cmH2O)
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#10
[quote='zonk' pid='118491' dateline='1434756664']
Leak below the red line in ResScan (24 L/m) is acceptable
95th percentile means leak was at or below 22.8 L/m for 95% of the night

AHI is 50% obstructive events and 50% central events
The AutoSet in AutoSet mode increase pressure only in response to snoring, flow limitation, and apnea obstructive

I think, talk your doctor given your coming surgery
Good luck with the surgery
[quote]

Care to give me a layman terms on that analysis? What's it say to you? The surgery is non related to the sleep issues...other than an assist to recovery.

Thanks!
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