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How do you know you're getting better?
#1
Before my home sleep study, I didn't realize I had a problem. I was tired a lot, groggy in the mornings, yawning all day. I thought it was just short sleep (going to bed late-ish but still getting up early for work). Then my fiance told me that I'd begun snoring a lot and he was also witnessing me skipping breaths.

On my study night, my AHI was 6.5, so I was diagnosed with mild sleep apnea. Oxygen desat went as low as 85%, though I don't know for how long.

Now, after two weeks of APAP therapy, average AHI is around 2.6. I also still show a lot of snore events and flow limitations. I *think* I have more daytime energy but am not sure. Some days I'm still yawning a lot, and I nearly dozed off during a seminar this weekend. Other days, not a yawn, and I'm not fading as quickly in the evenings.

But is that enough? Is the 2.6 AHI with lots of snores/FLs acceptable or do I need to work it down even lower? Do I need to be using an oximeter to see what's going on there? How do you know when you're out of the woods?
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#2
You can control snores and flow limitations by raising start pressure.

Are you downloading your SD card to Sleepyhead? If you can, look for your 95% pressure reading, and max pressure reading, and let us know what it is.

We can better advise you if you can let us know those numbers. In the meantime, order the Clinicians manual, see top of page. This will help you learn about your machine and how to change pressures and other settings.

As far as your question on "getting better", you are the best judge of that in how do you feel.
Your AHI is coming down, but as I said, flow limation and snores can be lessened by raising start pressure.




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#3
(02-16-2016, 10:19 AM)OpalRose Wrote: You can control snores and flow limitations by raising start pressure.

Are you downloading your SD card to Sleepyhead? If you can, look for your 95% pressure reading, and max pressure reading, and let us know what it is.

We can better advise you if you can let us know those numbers. In the meantime, order the Clinicians manual, see top of page. This will help you learn about your machine and how to change pressures and other settings.

As far as your question on "getting better", you are the best judge of that in how do you feel.
Your AHI is coming down, but as I said, flow limation and snores can be lessened by raising start pressure.

Thank you! Yes, I download my data every morning, and I've got the Clinician's manual already and have altered settings based on advice here a few days ago (it was 4-20, now I've got it set 8-12). Here's a screenshot from last night.



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#4
That looks okay. A little better than your previous results and considerably less flow limitation. I'd keep those pressures for a while, and maybe experiment with a Flex setting of 1.0. you will get the same pressure relief with a lower Flex setting, but the transition speed is faster, and that might help at the end of your exhale.
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#5
The PR APAP responds to vibratory snores and will raise pressure anticipating an apnea event.
It doesn't respond to VS2. I don't think VS2 are really snores, but the machine picking up small vibrations.

I don't see anything to be concerned over, but I think your pressure should start closer to your medium pressure number or 2 to 3cm below your 95% number. Watch for a week and make small changes. It's hard to gauge progress if too many changes are made.
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#6
Thanks so much!
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#7
(02-16-2016, 10:08 AM)Winterfrost Wrote: How do you know when you're out of the woods?

For me it was a gradual process, not an event. There is a psychological factor for some of us. As our condition worsened over the years we adapted to it and gradually abandoned sleeping as a refreshment. Now, as a dedicated CPAPer I have some days when I wake up refreshed, and on those days I know I'm out of the woods. Plus, lots of other things improved too, all signs of remarkable improvement. As far as a time frame goes, that's different for different people, so all we can do is optimize our treatment and try to enjoy life. Without these machines we'd be in the much worse situation that our parents, grandparents, etcetera, had to endure.

Presumably you're using the machine every time you sleep, all the time you're sleeping. That's more important than anything else as nothing else you do will work if you're not doing that. Secondly, check your leak graph in SleepyHead. If you see stretches of time where the leak rate is up and staying up that's a sign that you may be mouth-leaking. The remedy is a chin strap, and if that doesn't work, a full face mask. If your leaks aren't under control the machine can't keep your airway from restricting and collapsing and could result in snores and flow limitations.

Once you get those two things under control you can really fine tune things by adjusting the pressure levels.

Hopefully the machine itself is not a bother to you. Sometimes the pressure in the face, the hose getting tangled, the mask pushing on the pillow, and the swallowing of air, can interfere with sleep. Thankfully we humans seem to have a marvelous way of adapting to these things and after a while they stop bothering us as much.
Sleepster
Apnea Board Moderator
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#8
Even if the CPAP merely prevents you from getting worse, this is better than before. Most people will feel significantly better in from a few days to a few months. This depends on many factors - how sick you are at the start of therapy, how long you've suffered from untreated apnea, how old you are, and so on.

In my case once they finally had the treatment dialed in properly the first thing I noticed was that I was no longer getting weaker and feeling older and older, as I was before. That alone was a success.
Then after a few months I noticed that things had changed for the better - I was doing things without thinking about it that were a struggle before. No longer needed my walking stick. I walk up the stairs to the second floor instead of dragging myself up by the bannisters. Lots of other small things.

Ed Seedhouse
VA7SDH

I am neither a Doctor, nor any other kind of medical professional.

Actually you know, it is what it isn't.
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#9
I'm somewhat of a banister-dragger (tri-level home, so lots of that!), so that will be a milestone to watch for! :-)
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#10
Winterfrost. Your machine has auto trial mode.
Good way to find your sweet spots pressure wise would be to set your machine to auto trial mode , min 8 max 20. Set number of days for auto trial to run at 2 weeks.
At the end of 14 days the machine will switch to cpap ck mode using your 90% pressure the machine found over that 14 days.
At that point just set machine back to auto mode , set your min 1 or 2 cm below that 90% pressure or at it if you are comfortable with it, and max about 4 cm higher.
Youll have a very accurate treatment range that way.
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