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Help with New Cpap user
#1
Help with New Cpap user
I am a first time user of Auto-Cpap for the last month. I am very grateful to have found this site and all the information and help available!
I ordered a home test on myself not thinking that I had sleep apnea but more out of curiosity since my family says I snore a lot, and I wanted to be able tell my patients what it entailed. To my surprise I have moderate Sleep apnea with AHI 20.6 per hour. I was also concerned about the desats to 81%.
Note to self- do not order a test unless you want to deal with the results!! Thinking-about  
Here is the sleep report:
Clinical History
Rule out sleep apnea syndrome.

Report
This is an ambulatory Type III home sleep test (Alice PDx) performed for the evaluation of sleep-disordered breathing.  

Findings
The duration of the recording was 300.0 minutes.  During that time, the patient had 307 snoring episodes.  There were 103 apneas and hypopneas which were mostly obstructive in type with an average of 20.6 per hour (AHI 20.6).  These events ranged in duration from 10 to 43.0 seconds with a mean duration of 19.9 seconds.

There were a total of 88 desaturation events with the lowest SpO2 at 81% compared to an average value of 92% and with a desaturation index of 17.6.  Patient spent 5 minutes with SpO2 below 89%. The mean heart rate was 65.2, and the highest heart rate was 83.

Impression
Obstructive sleep apnea/hypopnea syndrome of a moderate degree.

Recommendations

  1. 1. Treatment of choice for this patient is Nasal CPAP.
  2. 2. Auto PAP 7 to 15 cm H2O at home would be appropriate in the absence of co-morbidities such as CHF, COPD, or neuromuscular disease, otherwise In Laboratory CPAP titration is needed.
  3. 3. Follow-up with Physician in 4 - 6 weeks from initiation of CPAP to download compliance data and make adjustments as needed.
  4. 4. Patient should be cautioned not to drive if sleepy and not to use alcohol or sedatives close to bedtime.
  5. 5. If applicable patient should participate in a weight loss program with medical supervision to bring BMI to below 30.

Electronically Signed By: 
Diplomate, American Board of Sleep Medicine 

Signed Date and Time:   Saturday, June 03, 2017  6:37 PM



I am doing this without insurance as my deductible is large. Before I found this site, I researched machines and decided to get Resmed AirSense 10 auto for her- so I accidentally bought a good machine. I am using the Dreamwear nasal mask and like it a lot. 

Initially, I followed the suggestions from the test report to set the range from 7-15.
During the first week, I would often awaken with the pressure at 12.5- 13.I was uncomfortable and it was too much for me to go back to sleep. I would turn the machine off and on again to start at 7 again... then would awaken later and have to repeat the cycle. 
The AHIs were between 5-6 with the CA 3-5 and OA 0.9 to 2. I did not feel good at all in the mornings. 

I found this site and read that CA can be lowered with lowering the pressure or after a time the body adapts in some people and the CA get lower.
  
The second week, I changed the pressure range 7- 11.6 and lowered the EPR to 1. Can't remember how I settled on 11.6.  I felt comfortable with this range and did not awaken due to the high pressure. I felt much better in the mornings and I won't sleep without the machine as it has made a big difference in how much better I feel. I am sleeping quite well now with these pressures.
The AHI are under 5. Most of the time between 3-4.5 with the OA 1.2 to 1.9 and the CA higher than OA.

I am wondering if I should give the CA more time to get lower or adjust the pressure?
I need to get to 4 posts to be able upload the sleepyhead for you to see any problems. 
Thank you for suggestions.
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#2
RE: Help with New Cpap user
If you use Imgur you can put a space in the address as a workaround as long as it's a sleepyhead chart or data pertaining to your treatment.

Dave
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#3
RE: Help with New Cpap user
Welcome to the forum. More data will be helpful. I suggest you download SleepyHead s0ftwarecfrom the link at the top of this page. See the links below for the user guide, and how to organize and post your data. If your machine was set with a minimum pressure of 7 it was going to 12.5-13 for a reason; in response to an apnea or flow limitation. I'm not suggesting you make any changes at this point but it will be helpful if you can share some SleepyHead data.
Download OSCAR

Organize Charts
Attaching Charts

Mask Primer
Soft Cervical Collar

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.

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#4
RE: Help with New Cpap user
It won't let me post - I added a couple spaces - please suggest how to do this better.
[url=http://imgur  .com/       Then I had the rest of the address but still can't post due to the 4 post requirement .
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#5
RE: Help with New Cpap user
Include the address as: "http:// imgur com/image address" Don't use the "Insert Link" option.
Crimson Nape
Apnea Board Moderator
www.ApneaBoard.com
___________________________________
Useful Links -or- When All Else Fails:
The Guide to Understanding OSCAR
OSCAR Chart Organization
Attaching Images and Files on Apnea Board
Apnea Helpful Tips

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.
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#6
RE: Help with New Cpap user
Here is another try.

http://  imgur.com/ 3PlJ1Sl.png

Well that did not work out. Perhaps now that I have 4 posts it will let me do it without the work around that I obviously have failed at!!
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#7
RE: Help with New Cpap user
Cotaka's Chart:

[Image: 3PlJ1Sl.png]
Crimson Nape
Apnea Board Moderator
www.ApneaBoard.com
___________________________________
Useful Links -or- When All Else Fails:
The Guide to Understanding OSCAR
OSCAR Chart Organization
Attaching Images and Files on Apnea Board
Apnea Helpful Tips

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.
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#8
RE: Help with New Cpap user
Edit:Removed image Crimson beat me to it. Smile
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#9
RE: Help with New Cpap user
Thank you for posting for me!!

I have another image - it won't let me post yet but I can include the link in this post.
http://imgur.com/J5xQ8a4
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#10
RE: Help with New Cpap user
As I see it, you have a choice. You can stay where you are till the CA subside, they are probably pressure induced. If you are able to, turning the EPR off could help a bit.

you can slowly raise the pressure, you are maxing out on your current setting, I would try 11 min 13 max and see the results.
http://www.apneaboard.com/resmed-airsens...setup-info
mask fit http://www.apneaboard.com/wiki/index.php...ask_Primer
For auto-cpap, from machine data or software. You can set the min pressure 1 or 2cm below 95%. Or clinicians commonly use the maximum or 95% pressure for fixed pressure CPAP, this can also be used for min pressure.
https://aasm.org/resources/practiceparam...rating.pdf
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