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Long time CPAP user looking for some feedback
#1
Hi All,

I've been using CPAP for about 2,5y now and luckily I never had any big issue using it. I started with a nasal mask and then changed to a nasal pillows mask that was lighter and less intrusive during my sleep. I use the Airfit P10 and love it how simple and light it is, the only issue that I have with it is the head gear that gets loose very fast and I have to replace it every 6 to 8 months. For this particular reason I'm thinking in changing to the Swift FX, that is similar, but the head gear seems to be more better.

Since I started with the CPAP, I only changed the settings on the machine one time, from min. pressure 7.5 to 8.5 and that was it. It is basically how the sleeping clinic set it up for me. 

Lately I've been feeling tired during the day and because of that I decided to do a little bit more research and found this forum. Wow, I've learned so much already and regret not finding it before. Better late than never I guess.

I used to look at the data on the machine and on the DreamMapper, which is very limited. After reading the threads here, I downloaded Sleepyhead and was very surprised with the amount of information that the software can show you. I didn't know that I had so many different events during the night and still have a lot to learn.

I attached my charts from last night and if you guys can give me any feedback it would be great. I booked an appointment with the clinic that I bought my machine from, but I remember when I first got the machine that I didn't get much information from then and I'm not very hopeful now.

Thank you in advance! Smile


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#2
I am the least experienced person here, even though I've used cpap for over 25 years.

There are incredibly experienced people with wonder full knowledge. They really care. I do too!

I'm confident you will get the help you need and your experience will improve.
DaveL
Old Hoser Compliant for 25+ years
iMac computer/SleepyHead
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#3
Has your AHI been lower at this pressure, and with this mask?

It's about 3....(if that was my score and I asked for help, my old sleep doc would have said I was compliant at 3. I would have wondered what I could do to get it down lower! ) My DME has provided great care. How is yours?

I hope the caring knowledgable people here reach out soon.
DaveL
Old Hoser Compliant for 25+ years
iMac computer/SleepyHead
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#4
AHI of 5 is what the medical community considers treated.  
Could you post a couple of 2-minute charts.  This will show us the waveform of your flow and possibly indicate issues.

My guess is that you are tossing and turning thru the night, see how your flow chart is very spikey? and your events are very loosely clustered.  This may indicate that you may benefit from the use of a loose fitting soft cervical collar ( You are looking for a comfortable fit 2-inches larger than the circumference of your neck and just tall enough to support the jaw when your head falls out of alignment (measure your neck from collarbone to jaw and subtract 1".) or the anti-snoring collar (no back).

A minor increase (.5) in your minimum may or may not help
New to Apnea? Helpful tips to ensure success
Mask Primer
Dealing with a DME
Download SleepyHead
Organize Charts
Attaching Charts

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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#5
(10-13-2018, 09:34 AM)DaveL Wrote: Has your AHI been lower at this pressure, and with this mask?

It's about 3....(if that was my score and I asked for help, my old sleep doc would have said I was compliant at 3. I would have wondered what I could do to get it down lower! ) My DME has provided great care. How is yours?

I hope the caring knowledgable people here reach out soon.

Thanks for the support!  Thanks

I was looking at the statistics in SleepyHead and noticed that my AHI was never lower at this pressure and with this mask. It used to be worst when I had min set to 7.5 and I used the nasal mask, the average was around 4.91.

My DME has not provided a lot of support. They sold me the machine, had a automated follow up after six months and that was it. I have an appointment on the 24th, so lets see what they say now after 2 years.

Already got some great feedback here, the support from this forum is great!
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#6
(10-13-2018, 09:58 AM)bonjour Wrote: AHI of 5 is what the medical community considers treated.  
Could you post a couple of 2-minute charts.  This will show us the waveform of your flow and possibly indicate issues.

My guess is that you are tossing and turning thru the night, see how your flow chart is very spikey? and your events are very loosely clustered.  This may indicate that you may benefit from the use of a loose fitting soft cervical collar ( You are looking for a comfortable fit 2-inches larger than the circumference of your neck and just tall enough to support the jaw when your head falls out of alignment (measure your neck from collarbone to jaw and subtract 1".) or the anti-snoring collar (no back).

A minor increase (.5) in your minimum may or may not help

Thank you!

I attached one 2-minute chart where I had no events and a couple when I had events.

Looking at the statistics on SleepyHead I noticed that my average pressure is around 8.8-8.9, so I think you are right, it might help this minor increase of .5. 

One thing that SleepHead showed me and I didn't know is that somehow I changed the "Pressure Relief" to A-Flex x2 to A-Flex x1, and according to the data I had a better AHI average (2.37 x 2.9) with the x2. I'll check it to see what it is the difference between these two settings that I don't even know how I changed.

I was looking into options to rent a newer machine, like the Airsense 10 Autoset, to see if I feel better, but I'll wait until my appointment with the DME.


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#7
Do you have a backup machine?  If not I would definitely look to get a new machine.

Towards that, I will state that many here prefer the ResMed machines, of which I would suggest either the Autoset or the Autoset for her models.  In general, the ResMed has a faster response to events.  Also, EPR is easier to work with than flex.  We have successfully utilized EPR for therapeutic purposes where we would use flex only for comfort.

The difference between an AHI of 2.37 and 2.9 is not significant and would generally be considered daily variations.

When you have AHIs in the range that yours are the numbers stop being significant.  What matters most here is how you feel.  You stated "to see if I feel better". So I ask How do you feel?
New to Apnea? Helpful tips to ensure success
Mask Primer
Dealing with a DME
Download SleepyHead
Organize Charts
Attaching Charts

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
I would increase minimum pressure by 0.5 cm to 9.0 to address some of the hypopnea snores and flow limits. Your options are kind of limited with the Philips machine due to the way the algorithm works slowly to treat events other than OA. That put me in line with Bonjour's suggestion that an Airsense 10 Autoset would probably deliver AHI less than one effortlessly. This is because the Resmed machine is much faster and proactive in treating the kinds of events you have, and the EPR feature actually works like bilevel therapy and is useful in treating H and FL. It's obvious looking at the close uo charts you posted that the Philips incorrectly reports your inspiration and expiration times, and this is pretty typical of Flex. What Flex setting are you using? Reducing it or turning it off may improve your results.
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#9
(10-13-2018, 10:04 PM)bonjour Wrote: Do you have a backup machine?  If not I would definitely look to get a new machine.

Towards that, I will state that many here prefer the ResMed machines, of which I would suggest either the Autoset or the Autoset for her models.  In general, the ResMed has a faster response to events.  Also, EPR is easier to work with than flex.  We have successfully utilized EPR for therapeutic purposes where we would use flex only for comfort.

The difference between an AHI of 2.37 and 2.9 is not significant and would generally be considered daily variations.

When you have AHIs in the range that yours are the numbers stop being significant.  What matters most here is how you feel.  You stated "to see if I feel better". So I ask How do you feel?

I don't have a backup machine, might be a good idea to get one.

I've been feeling pretty tired lately, thats what triggered me start searching about the CPAP again and my doctor suggested the same thing.

I changed the flex yesterday to 2 and didn't notice any difference. I'll change the min pressure today to 9 and see how it goes.

I'll definitely look into buying a ResMed machine, I found a good price for it in a online store that I found on the list of suppliers of the forum. I have to check with my insurance first how much they will cover.
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#10
(Yesterday, 08:47 AM)Sleeprider Wrote: I would increase minimum pressure by 0.5 cm to 9.0 to address some of the hypopnea snores and flow limits.  Your options are kind of limited with the Philips machine due to the way the algorithm works slowly to treat events other than OA.  That put me in line with Bonjour's suggestion that an Airsense 10 Autoset would probably deliver AHI less than one effortlessly.  This is because the Resmed machine is much faster and proactive in treating the kinds of events you have, and the EPR feature actually works like bilevel therapy and is useful in treating H and FL.  It's obvious looking at the close uo charts you posted that the Philips incorrectly reports your inspiration and expiration times, and this is pretty typical of Flex.  What Flex setting are you using?  Reducing it or turning it off may improve your results.

Thank you! I'm increasing the minimum pressure today to see how it goes. I was using A-Flex 1 until yesterday, tried 2 and didn't make any difference. I'll try turning it off today.

I'll check with my insurance tomorrow how much coverage I have to change my machine now and if I can buy directly online or if I need to use a DME. Hopefully I can buy online, since the difference in price here in Canada is around $1500 more if I buy it with an DME.
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