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Help and Advice please
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Eurika Offline

Preferred Members

Posts: 92
Joined: Nov 2014

Machine: Airsense10 Autoset
Mask Type: Nasal pillows
Mask Make & Model: P10 & Nuance Gel
Humidifier: Intergrated
CPAP Pressure: 5 to 11.4
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Male
Location: Singapore

Post: #1
Help and Advice please
Hi
I've been using the Airsense 10 Auto for a week, and my sleep has certainly improved. The sleep study I did shows that I am in the moderate band 37 AHI
However I have to 'self medicate' as there are no proper sleep clinics where I live.
My question is, how do I go about taking a step by step approach to narrowing the pressures from 4 : 20 to a lower split, and should this give me better AHI figures?
My current AHI has been hovering around 3.71 but I'm told that I should get down too lower figures. I'm using Sleepyhead to monitor my daily results at present.

Should I simply increase the minimum pressure a little every night, say by 0.4 to see the results or is there more to it than that.

Thanks in anticipation of your help.

Best
D

Failure is NOT an option.
11-08-2014 10:51 PM
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Lambsydoats Offline

Preferred Members-2

Posts: 117
Joined: Oct 2014

Machine: ResMed AirSense 10 AutoSet for Her
Mask Type: Nasal pillows
Mask Make & Model: ResMed AirFit ™ P10 Nasal Pillow
Humidifier: AirSense 10 AutoSet for Her-integrated
CPAP Pressure: 8
CPAP Software: SleepyHead

Other Comments: Initially: AHI=52; 2nd: AHI=18; CPAP 11-10-14; as of 8-18-15: AHI consistently under 5.0

Sex: Female
Location: Southwest Michigan, USA

Post: #2
RE: Help and Advice please
Hi, Eurika, and welcome!

I, too, am new to this board. Although I don't have any specific answers for you, if I've learned anything, I've learned that our sleep is nothing to mess around with. Probably few people on here would venture to give you advice on "self medicating," as it takes someone with a great deal of specialized training to know what to prescribe.

The best of success as you work to get your AHIs down to zero!

Lamb

To all, to each, a fair good-night,
And pleasing dreams, and slumbers light.
Scott—Marmion. L’Envoy. To the Reader.

Diagnosed with OSA September 2014
AHI=18
Lowest SpO2: 79%
11-08-2014 11:21 PM
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PaytonA Offline
Wiki Editor
Monitors

Posts: 3,005
Joined: Dec 2013

Machine: ResMed S9 VPAP Auto
Mask Type: Full face mask
Mask Make & Model: Resmed Mirage Quattro
Humidifier: H5i(distilled-top up)
CPAP Pressure: VAuto MinE14.0 MaxI 20.6 PS4.0
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Male
Location: Orange County,California

Post: #3
RE: Help and Advice please
If you are using Sleepyhead to monitor your night by night sleep performance, you should be able to give us some of your recent statistics for Pressure, AHI, and Leaks so that we might know a little more about where you stand. Then some members might be able to make some suggestions.

Yes it is much better not to leave your pressure set at 4-20. The range needs to be narrowed down to ensure optimum treatment but one must know where you have been in order to make reasonable suggestions.

Best Regards,

PaytonA
11-08-2014 11:53 PM
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vsheline Offline

Advisory Members

Posts: 1,907
Joined: Jul 2012

Machine: S9 VPAP Adapt (USA Model# 36007, not better 36037 or 36067)
Mask Type: Full face mask
Mask Make & Model: F10 or SimPlus w/ 2Liners. MirageQuatro & Gecko gel pad
Humidifier: H5i
CPAP Pressure: 15 EPAP, PS 5-10
CPAP Software: ResScan

Other Comments: Marfan Syndrome, chronic bradycardia, occasional Cheyne-Stokes Respiration

Sex: Male
Location: California, USA

Post: #4
RE: Help and Advice please
(11-08-2014 10:51 PM)Eurika Wrote:  The sleep study I did shows that I am in the moderate band 37 AHI

Sleep Apnea, if untreated, is horrible. So I think your previously untreated AHI of 37 was in the severely horrible band. (Mildly horrible is 5-15, moderately horrible is 15-30, and severely horrible is 30+.)

(11-08-2014 10:51 PM)Eurika Wrote:  My question is, how do I go about taking a step by step approach to narrowing the pressures from 4 : 20 to a lower split, and should this give me better AHI figures?
My current AHI has been hovering around 3.71 but I'm told that I should get down too lower figures. I'm using Sleepyhead to monitor my daily results at present.

Should I simply increase the minimum pressure a little every night, say by 0.4 to see the results or is there more to it than that.

Hi Eurika,

I have 5 suggestions. These suggestions assume you have had no major problems and mainly want to try to optimize your AHI and sleep quality. If you have had particular problems, please mention them.

My first three suggestions are all the same: get the software running on any old cheap clunker of a computer bought at a garage sale for $10, if you need a computer. A giveaway (worthless) Windows XP machine would probably be adequate to run both ResScan and SleepyHead. I suggest at least scanning the major thread for ResScan and also the major thread for SleepHead. (I use pretty much only ResScan, but many prefer SH.)

The 4th suggestion (when not working on getting the software running) is to look at your machine's sleep data on its LCD display. (You have the Clinician set-up manual, right? It will explain how to navigate around the LCD screens.)

In particular, I suggest looking at the statistics for the median (50 percentile) pressure, the 95 percentile pressure, and the max pressure, and to gradually raise the Min Pressure setting up to about 1 to 3 lower than the 95 percentile pressure. (Some may suggest gradually raising the pressure to 4 or 5 lower than the 95% pressure, and then staying there for a while.)

Stated precisely, the 95% pressure is the pressure you were at or below at least 95% of the night. It is also the pressure you were at or above at least 5% of the night.

The 5th suggestion would be to consider whether there is any reason for you to lower the Max Pressure setting. Experiencing any of the following may be good reasons to lower the Max Pressure, at least temporarily. (There may be other good reasons, too.)

1. Pain in chest or lungs. Or, unable to comfortably inhale fully after getting up and no longer using the machine.
2. Uncomfortable and bothersome amount of aerophagia (swallowed air)
3. Increase or start of tinnitus (ringing or noise in the ear)
4. Increase or start of Hearing Loss
5. Increase or start of dizziness or vertigo
6. Increase or start of eye infections, or worsening of high intraocular pressure or glaucoma

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.
(This post was last modified: 11-10-2014 12:00 AM by vsheline.)
11-09-2014 12:05 AM
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Eurika Offline

Preferred Members

Posts: 92
Joined: Nov 2014

Machine: Airsense10 Autoset
Mask Type: Nasal pillows
Mask Make & Model: P10 & Nuance Gel
Humidifier: Intergrated
CPAP Pressure: 5 to 11.4
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Male
Location: Singapore

Post: #5
RE: Help and Advice please
Thanks Vaughn and all for your response.
I have none of the last 4 on your 5th suggestion. I am happy to upload my data via pm, I have 7 days worth on sleepyhead and it will show where I have fiddled with the pressures. Just let me know what to do and I'll send the relevant data file. I am using it on Mac Osx but can get it onto windows by using the virtual machine if that would be required.
Hi Lambsydoats I would take professional advice if it was available here in Singapore, but that is not the case so I have to go it alone with the help of this forum.
You made me smile with your name, lambsydoats and doesydoats andlilambseativy akidlyeativytoo wouldn't you? That was the little rhyme my dear depart4d grandmother taught me as a wee bairn and I'm sixty now! Oh the simple pleasures

Failure is NOT an option.
11-09-2014 12:20 AM
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Gabby Offline

Preferred Members-2

Posts: 664
Joined: Dec 2013

Machine: ResMed AirSense 10 AutoSet For Her
Mask Type: Nasal pillows
Mask Make & Model: Philips Nuance Nasal Mask
Humidifier: ResMed AirSense 10 For Her
CPAP Pressure: 8-14
CPAP Software: SleepyHead

Other Comments:

Sex: Female
Location: Sunshine Coast, Qld., Australia.

Post: #6
RE: Help and Advice please
Welcome Eurika!
I would like to say if you have no other help available to you, you will not go wrong with the valuable advice offered to you on this forum.
If there is anything to learn about sleep apnea, here is the place to learn it.
I definitely agree with closing your numbers in, there is no need to have such a wide gap.
Once you download SleepyHead and know what you are looking at you will be on your way, alongside the good people here.

Wishing you the best of luck.

Sleep Tight...
Gabby
(This post was last modified: 11-09-2014 12:35 AM by Gabby.)
11-09-2014 12:34 AM
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PaulaO2 Offline
Wiki Editor
Moderators

Posts: 8,062
Joined: Feb 2012

Machine: S9 Autoset
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: H5i
CPAP Pressure: 14-20
CPAP Software: SleepyHead

Other Comments: Ehlers-Danlos Syndrome, Hypermobility Type; chronic sarcasm

Sex: Undisclosed
Location: western NC, USA

Post: #7
RE: Help and Advice please
Changes are made gradually. You want to watch for trends, first. Let the machine do its thing. Gather data for as long as possible. I suggest for you, at least two weeks. The reason for the long wait is no two nights are the say. Neither are no two days. You want to go through a good cycle of what your days and nights are like so the machine has time to experience them.

And like Vaughn said, the pressure you want to look for is the 95 (or 90) %. That's going to be about where the maximum will be.

The first step is to start a sleep journal. You want to keep track of the changes you make and when you made them. When you get ready for bed, write down what kind of day you had. Work, play, stress, beers with friends, argument with idiot brother in law, headache, new medication, etc). Also note any changes to the mask or hose or sleeping situation (sleeping on the couch because of what you said to the idiot brother in law). In the morning, jot down how you slept, how you feel, did you dream, do you remember them, and whatever else you feel is important to you. This way, when you look at the data later, and you see a big increase (or decrease) in the AHI, you can look back and see "That was the day we worked on the deck" "that was the night with the new medication".

Once you have gotten the data for 2 weeks, you'll get a better idea of where you are with it. If you see that you rarely if ever hit a max of 17, then go ahead and drop that maximum number to 17. Then look at the median. That number will have a wider range because the machine likes to use the lowest pressure possible so it may be harder for you to decide what to use. If it is a wide range, pick the middle. So say if it ranges between 6 and 10, pick 8.

Now you have a range of 8 and 17. With that narrowed, now you can get a better picture of just what your true range will be. Your 95% will be much more accurate. Keep looking at the data. At this point, you can start tweaking more, although remember, a single night is not something to base a change on. Too many things go into how good or bad we sleep! You are looking for trends and ranges. You won't hit the same pressure every night. You'll fall within a range that fits you, your life, and your sleep patterns.

Here's a resource for you:
http://www.apneaboard.com/adjust-cpap-pr...re-on-cpap

PaulaO2
Apnea Board Moderator
www.ApneaBoard.com


Breathe deeply and count to zen.

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.
11-09-2014 12:37 AM
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zonk Offline

Advisory Members

Posts: 7,908
Joined: Feb 2012

Machine: A10 AutoSet
Mask Type: Nasal mask
Mask Make & Model: Activa LT
Humidifier: Integrated /ClimateLineAir
CPAP Pressure: 9/13
CPAP Software: ResScan

Other Comments: CPAP since Nov 2010

Sex: Male
Location: Australia

Post: #8
RE: Help and Advice please
(11-08-2014 10:51 PM)Eurika Wrote:  My question is, how do I go about taking a step by step approach to narrowing the pressures from 4 : 20 to a lower split, and should this give me better AHI figures?
The machine comes in default setting 4-20, where "CPAP Pressure: 6" comes from? as showing in your profile
11-09-2014 12:53 AM
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vsheline Offline

Advisory Members

Posts: 1,907
Joined: Jul 2012

Machine: S9 VPAP Adapt (USA Model# 36007, not better 36037 or 36067)
Mask Type: Full face mask
Mask Make & Model: F10 or SimPlus w/ 2Liners. MirageQuatro & Gecko gel pad
Humidifier: H5i
CPAP Pressure: 15 EPAP, PS 5-10
CPAP Software: ResScan

Other Comments: Marfan Syndrome, chronic bradycardia, occasional Cheyne-Stokes Respiration

Sex: Male
Location: California, USA

Post: #9
RE: Help and Advice please
(11-09-2014 12:20 AM)Eurika Wrote:  I have none of the last 4 on your 5th suggestion. I am happy to upload my data via pm, I have 7 days worth on sleepyhead and it will show where I have fiddled with the pressures. Just let me know what to do and I'll send the relevant data file. I am using it on Mac Osx but can get it onto windows by using the virtual machine if that would be required.

Hi Eurika,

Sorry, I expanded the list to 6 items. Have you any of the (now) six?

If not, keep on the lookout for these, although I think it is far more common for prescription medications (especially antibiotics) to cause inner ear problems than for CPAP pressures to cause inner ear problems.

Regarding how to post attachments or images, here is a link to the HOW TO help page:

http://www.apneaboard.com/forums/Thread-...4#pid65514

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.
(This post was last modified: 11-09-2014 01:31 AM by vsheline.)
11-09-2014 12:56 AM
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Eurika Offline

Preferred Members

Posts: 92
Joined: Nov 2014

Machine: Airsense10 Autoset
Mask Type: Nasal pillows
Mask Make & Model: P10 & Nuance Gel
Humidifier: Intergrated
CPAP Pressure: 5 to 11.4
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Male
Location: Singapore

Post: #10
RE: Help and Advice please
Hi and many thanks guys, I don't have any of the 6 thank goodness. Sorry about the 6 in the profile Zonk, I'm not sure where that came from but I've amended to unsure. I also take sleep medication and anti depressants every night, which I guess is relevant, but with the CPAP I'm hoping to wean off the sleep meds. On the plus side I stopped smoking 50 cigs a day about 3 weeks ago, in fact even though my wife smokes I haven't touched one for 3 weeks and have no intention of starting again, Im not going through the trauma of being addicted to nicotine ever again. Life starts at 60!!

Failure is NOT an option.
11-09-2014 03:22 AM
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