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Hi, I'm new and two weeks into therapy
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Huesito Offline

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Posts: 62
Joined: Dec 2015

Machine: DeVilbiss IntelliPAP
Mask Type: Full face mask
Mask Make & Model: Resmed Quattro Air
Humidifier: built-in
CPAP Pressure: 6-12
CPAP Software: Other Software

Other Comments:

Sex: Male
Location: New Jersey, USA

Post: #1
Hi, I'm new and two weeks into therapy
Hi everybody.

I've been mostly reading up while getting setup, and I thought it was time to register and thank everyone for the great amount of information and to share my experience so far.

A bit of background: I'm in my early 40's, 6 feet tall, never had any notable health issues until about two months ago. I smoke since I was 19, and switched to ecigs about 4 years ago. About a year ago I started to snore heavily, also coupled with weight gain (I was already fat at 220lbs, went up to 235).

A couple months ago I had an episode of Hypoglycemia, coupled with severe fatigue. I'm self employed, have no insurance, but worked on medical systems for years so after a brief stop at the hospital, I checked with a doc friend of mine. Blood test showed pre-diabetic state, but doc said we caught it on time (plus I have no family history of beetus, which was a plus), put me on a diet and some meds (lost 20lbs in the last 2 months), and with my sugar back on track, the other remaining issue was the severe fatigue...

So we did a home sleep study, and it came back with severe sleep apnea.

Total recording time: 355 mins
Total Hyponeas: 75
Total Apneas: 210
Average Apnea secs: 33
RDI(AHI) 4%: 48%
RDI(AHI): 52.0

Study recommends CPAP therapy with a starting pressure of 8cm H2O

After much reading here and having to pay for everything out of pocket, i visited a local CPAP shop here with prescription in hand from my doc. I bought a DeVilbiss IntelliPAP auto, with the detachable humidifier. Doc said to start at 4-8 and go from there. I tried a few masks (I do breathe from my mouth sometimes, so I went for full face) and the Resmed Quattro Air was very comfortable.

I bought the IntelliPAP because it was priced right for my budget, it's small and the smart codes can get me data I can track daily. And if eventually I want to get niftier with it, I can optionally get a data module to hook into sleepyhead.

First week went great. AHI was 5 or less for all days except one (7.5). I generally felt less fatigued and more in focus. Last week I traveled down south to Texas for the holidays and since I've been here, I noticed that both 90th and 95th percentile were at the max (8) and the pressure plateau crept up to 12%-15%. So two nights ago I moved the pressure range to 4-10. Last night my AHI was 5, the 90/95 percentile were 9.0 and 9.5 respectively and the plateau just 4%.

I was tired very fatigued the last couple of days though, which coincided with a severe change in temperatures too (not sure if it's related).

That said, I'm sticking with it. The machine reports no leaks and I have zero problems sleeping with the mask. I'm putting 7-8 hours of sleep and I'm hoping to start seeing better results in a few weeks.

Thanks again for all the info here, for peeps on a budget like me it's invaluable. I'll be happy to donate when I get back home and I'll post updates in this thread.
12-28-2015 08:23 PM
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OpalRose Offline

Monitors

Posts: 3,180
Joined: Nov 2014

Machine: PR System One REMstar Auto 560 with A Flex
Mask Type: Nasal pillows
Mask Make & Model: AirFit P10 For Her
Humidifier: REMStar heated humidifier with heated hose
CPAP Pressure: Auto Cpap 10-13 AFLEX 1
CPAP Software: SleepyHead EncoreBasic

Other Comments: Started CPAP Therapy October 23, 2014

Sex: Female
Location: Northeast Ohio, USA

Post: #2
RE: Hi, I'm new and two weeks into therapy
Welcome to Apnea Board Huesito,
Your start pressure of 4 is too low, especially if you were titrated at 8.
Your start pressure should be slightly under your 90% pressure.

Based on your numbers above, you probably would do better with a pressure range of around 8-12.

If you make changes, try to stick with it for a couple weeks to see how you do.
Would like to see your AHI <5, but most important is how you feel.

OpalRose
(This post was last modified: 12-28-2015 08:41 PM by OpalRose.)
12-28-2015 08:39 PM
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Huesito Offline

Preferred Members

Posts: 62
Joined: Dec 2015

Machine: DeVilbiss IntelliPAP
Mask Type: Full face mask
Mask Make & Model: Resmed Quattro Air
Humidifier: built-in
CPAP Pressure: 6-12
CPAP Software: Other Software

Other Comments:

Sex: Male
Location: New Jersey, USA

Post: #3
RE: Hi, I'm new and two weeks into therapy
Thank you very much for the suggestion. I will give it a shot and keep with it for two weeks at that setting to see how it goes. I'll keep the ramp up pressure at 4 in case I need it to fall asleep.
12-28-2015 08:50 PM
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trish6hundred Offline

Advisory Members

Posts: 6,449
Joined: May 2012

Machine: Resmed S9 AutoSet for Her
Mask Type: Full face mask
Mask Make & Model: Fisher & Paykel Simplus
Humidifier: H5i Heated Humidifier
CPAP Pressure: 10 - 7-20 Cm H2O
CPAP Software: Not using software

Other Comments: I started CPAP in 2008. Totally blind since birth.

Sex: Female
Location: Missouri, USA

Post: #4
RE: Hi, I'm new and two weeks into therapy
Hi Huesito,
WELCOME! to the forum.!
Much success to you with your CPAP therapy and hang in there for more responses to your post.

trish6hundred
12-28-2015 11:02 PM
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Huesito Offline

Preferred Members

Posts: 62
Joined: Dec 2015

Machine: DeVilbiss IntelliPAP
Mask Type: Full face mask
Mask Make & Model: Resmed Quattro Air
Humidifier: built-in
CPAP Pressure: 6-12
CPAP Software: Other Software

Other Comments:

Sex: Male
Location: New Jersey, USA

Post: #5
RE: Hi, I'm new and two weeks into therapy
Thank you trish, this is all new to me and once again the information here has been great!
12-28-2015 11:17 PM
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vsheline Online

Advisory Members

Posts: 1,908
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: #6
RE: Hi, I'm new and two weeks into therapy
(12-28-2015 08:50 PM)Huesito Wrote:  Thank you very much for the suggestion. I will give it a shot and keep with it for two weeks at that setting to see how it goes. I'll keep the ramp up pressure at 4 in case I need it to fall asleep.

Hi Huesito, welcome to Apnea Board.

Many patients don't like 4 as their start pressure for longer than perhaps the first night. The Start Pressure can/should be adjusted by the user to whatever is most comfortable.

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.
12-29-2015 01:57 AM
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cate1898 Offline

Advisory Members

Posts: 784
Joined: Aug 2015

Machine: PR System One 560BT Auto
Mask Type: Nasal pillows
Mask Make & Model: P10's/backup-DreamWear
Humidifier: PR attached
CPAP Pressure: 8.5 - 13. A-Flex 3
CPAP Software: SleepyHead

Other Comments: Began CPAP Therapy Sept. 11, 2015. Hx Hypertension, Post Graves Disease, chronic migraines.

Sex: Female
Location: Southern Ontario//SW Florida

Post: #7
RE: Hi, I'm new and two weeks into therapy
Welcome Huesito to the forum! Glad to see you are getting some helpful tips to improve your CPAP therapy!

APNEABOARD - A great place to be if you're a hosehead!! Rolleyes

-------------------------------------------------------------------------------------------------
EVERY ACCOMPLISHMENT BEGINS WITH THE DECISION TO TRY!
12-29-2015 07:35 AM
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Sleeprider Offline
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Posts: 3,369
Joined: Dec 2014

Machine: Resmed Aircurve 10 Vauto
Mask Type: Nasal pillows
Mask Make & Model: Resmed Airfit P10
Humidifier: Resmed Climateline
CPAP Pressure: Auto Bilevel 18/9, PS 3
CPAP Software: ResScan SleepyHead EncoreBasic

Other Comments:

Sex: Male
Location: Where they make Respironics

Post: #8
RE: Hi, I'm new and two weeks into therapy
Huesito, you've done well to investigate and take care of your medical issues in the absence of insurance coverage. Congrats on your persistence, and the support you received from your doctor. You should retain copies of your prescription and sleep study to increase your options. Be sure to shop your supplies like mask, headgear etc. Online suppliers are generally less expensive than DMEs that may include the services of a respiratory therapist, which you may or may not need. Most online suppliers will retain your prescription and you can make unlimited purchases without renewing the prescription. Call for the best prices, because posted prices online must comply with minimum advertised price (MAP) limitations stipulated by manufacturers. You may be quoted lower prices by phone.

I strongly agree with the previous comments that a pressure range of 4-8 is probably too low. I would set the minimum pressure for comfort so you don't feel air-starved, and let the machine automatically adjust pressure upwards as needed. There is no need to limit the upper pressure range at this time. After several weeks, I would set the minimum pressure at your average pressure, or at your 90% pressure minus 3 cmH2O. This usually results in the most responsive and comfortable treatment. Maximum pressure limits are generally not needed unless you have problems with comfort, air ingestion, central apnea or other issues. The machine only increases pressure to what is needed to eliminate flow limitations, snoring and other indicators of airway collapse. Good luck with your therapy, and well done so far.

______________________________________________
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12-29-2015 09:14 AM
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Huesito Offline

Preferred Members

Posts: 62
Joined: Dec 2015

Machine: DeVilbiss IntelliPAP
Mask Type: Full face mask
Mask Make & Model: Resmed Quattro Air
Humidifier: built-in
CPAP Pressure: 6-12
CPAP Software: Other Software

Other Comments:

Sex: Male
Location: New Jersey, USA

Post: #9
RE: Hi, I'm new and two weeks into therapy
First night on 8-12

AHI: 3.0
95th: 9.0
90th: 9.0
Plateau: 0%
High Leak Flow: 0%
NRI: 1.75
EPI: 3
While Breathing Hours: 8.1

Looking good. We'll see how I feel during the day. Thanks again for the suggestions and will keep on posting.
12-29-2015 09:18 AM
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Huesito Offline

Preferred Members

Posts: 62
Joined: Dec 2015

Machine: DeVilbiss IntelliPAP
Mask Type: Full face mask
Mask Make & Model: Resmed Quattro Air
Humidifier: built-in
CPAP Pressure: 6-12
CPAP Software: Other Software

Other Comments:

Sex: Male
Location: New Jersey, USA

Post: #10
RE: Hi, I'm new and two weeks into therapy
(12-29-2015 09:14 AM)Sleeprider Wrote:  Huesito, you've done well to investigate and take care of your medical issues in the absence of insurance coverage. Congrats on your persistence, and the support you received from your doctor. You should retain copies of your prescription and sleep study to increase your options. Be sure to shop your supplies like mask, headgear etc. Online suppliers are generally less expensive than DMEs that may include the services of a respiratory therapist, which you may or may not need. Most online suppliers will retain your prescription and you can make unlimited purchases without renewing the prescription. Call for the best prices, because posted prices online must comply with minimum advertised price (MAP) limitations stipulated by manufacturers. You may be quoted lower prices by phone.

I strongly agree with the previous comments that a pressure range of 4-8 is probably too low. I would set the minimum pressure for comfort so you don't feel air-starved, and let the machine automatically adjust pressure upwards as needed. There is no need to limit the upper pressure range at this time. After several weeks, I would set the minimum pressure at your average pressure, or at your 90% pressure minus 3 cmH2O. This usually results in the most responsive and comfortable treatment. Maximum pressure limits are generally not needed unless you have problems with comfort, air ingestion, central apnea or other issues. The machine only increases pressure to what is needed to eliminate flow limitations, snoring and other indicators of airway collapse. Good luck with your therapy, and well done so far.

Thanks! I'm gonna stick with 8-12 for a couple of weeks and see how it works out.

Basically the hospital bills set me back a bunch even though I was there less than 8 hours. I got a discount with the sleep study but I just didn't follow through with the DME or other docs, due to $$$ but also because I was going to go on this trip and was adamant to have a machine with me and the DME took forever to contact me.

I carry a copy of my sleep study and prescription with me on my cell. Apparently, at least the snoring, is all palate related.

I had zero problem sleeping with 8-12 last night. Just a couple of times I woke up with rainout (I'm still trying to get the hang of the humidifier settings) and also a very tiny leak near my nose when sleeping on the side which I quickly corrected readjusting the mask. The rest was smooth sailing.

We'll see how's the fatigue during the day.
12-29-2015 09:32 AM
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