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New Sleep Study
#11
Happy Birthday!

Am late to the party, but I was switched to a BI-PAP from a CPAP due to the high pressure causing me leaks, and hissing problems through my lips. While my pressure has gone down some after my surgeries, am still on the only BI-PAP I've ever been on (second machine in around 12+ years). The big secret is the setting of the lower pressure (EPAP-the pressure when not inhaling), from what I've read, the (IPAP) inhale pressure is mostly for comfort, mine bounces between 6 and 7.

I recently put mine in auto mode (which allows it to raise the pressures, but not below the base EPAP and IPAP), and besides sleeping a bit better, it raised my numbers by 1.3

Many people are not put on BI-PAP because they say it's hard to get used to the changing pressure. But for me it actually helps me to go to sleep, like counting or such, so I really like it, and not having to exhale through a high pressure is a real plus in my book. I don't know if I follow the machine or it follows me, but I sort of get lost in it and fall asleep.
*I* am not a DOCTOR or any type of Health Care Professional. My thoughts/suggestions/ideas are strictly only my opinions.

"Only two defining forces have ever offered to die for you. Jesus Christ and the American Soldier. One died for your Soul, the other for your Freedom."
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#12
(10-09-2013, 09:36 PM)me50 Wrote: I would really love to see if my AHI's have gone down due to being on CPAP treatment for over 2 years. Yea, I know that I still have apnea but I would just love to see if the treatment has improved numbers any. It is just a curiosity thing, I know.

Hi me50,

Because your obstructive apnea is so severe (requiring 20 cmH2O) I think it important to insist on an Auto bi-level machine rather than a non-auto bi-level, so that your pressure will not need to be fixed at a very high level all the time, and so the machine can automatically adapt to future changes in medications or weight or sleep position or whatever.

I think the PRS1 BiPAP Auto is more advanced than the ResMed VPAP Auto, because I think on the PRS1 BiPAP Auto the Pressure Support can be set to a range and can automatically adjust (gradually, over many breaths, not breath-by-breath) the amount of Pressure Support it uses, but on the ResMed VPAP Auto the Pressure Support can only be adjusted manually. (Pressure Support is the amount by which the IPAP pressure is boosted above the EPAP pressure.)

PAP therapy can treat the symptoms and protect our health from being ruined by sleep apnea, but, in general, one would not expect that treatment for 2 years would (in itself) in any way lessen the need for PAP treatment.

Because your AutoSet raises the pressure up to nearly 20 cmH2O most nights, you can trust you definitely still need PAP therapy.


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.
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#13
(10-13-2013, 06:36 AM)vsheline Wrote:
(10-09-2013, 09:36 PM)me50 Wrote: I would really love to see if my AHI's have gone down due to being on CPAP treatment for over 2 years. Yea, I know that I still have apnea but I would just love to see if the treatment has improved numbers any. It is just a curiosity thing, I know.

Hi me50,

Because your obstructive apnea is so severe (requiring 20 cmH2O) I think it important to insist on an Auto bi-level machine rather than a non-auto bi-level, so that your pressure will not need to be fixed at a very high level all the time, and so the machine can automatically adapt to future changes in medications or weight or sleep position or whatever.

I think the PRS1 BiPAP Auto is more advanced than the ResMed VPAP Auto, because I think on the PRS1 BiPAP Auto the Pressure Support can be set to a range and can automatically adjust (gradually, over many breaths, not breath-by-breath) the amount of Pressure Support it uses, but on the ResMed VPAP Auto the Pressure Support can only be adjusted manually. (Pressure Support is the amount by which the IPAP pressure is boosted above the EPAP pressure.)

PAP therapy can treat the symptoms and protect our health from being ruined by sleep apnea, but, in general, one would not expect that treatment for 2 years would (in itself) in any way lessen the need for PAP treatment.

Because your AutoSet raises the pressure up to nearly 20 cmH2O most nights, you can trust you definitely still need PAP therapy.


Take care,
--- Vaughn

This is my point. I think I need more than regular CPAP therapy but the sleep study I had Friday night was a bust....well, actually, it was the sleep therapist that was a bust and that made the sleep study a waste of my time and money. I will say this, I slept most of the day and night Saturday and woke up Saturday morning and Sunday morning with a headache and just felt like crap all day Saturday. I honestly believe it is because the pressure during the sleep study was too low. I don't have enough energy to tell the details of the sleep study right now. Sleeping all day and night on Saturday was not the way I wanted to spend my birthday!!
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#14
I meant sleep tech not Therapist
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#15
Hi me50,
I'm sorry to hear that your sleepstudy was such a bust.
Oh by the way, happy birthday.
trish6hundred
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#16
I had a rough time during my new sleep study. It took me forever to fall asleep so I would read a little in my book hoping it would help me fall asleep. The tech told me to quit reading my book and I would fall asleep faster. I quit reading my book and would lay there awake.

during my first sleep study, according to the doc's office staff, there were several lower pressures that I had 0 events but when they raised the pressure, I had more so they kept trying higher pressures and told me my pressure needed to be at 12.

while I don't know the results of my new sleep study yet (doc is out of town this week and it takes 5 days for the report to be completed), they stopped my pressure at 16 and didn't go higher to see if I had more events like they did in the first test (this per the sleep tech). I was not tried on BIPAP at all.

I have continually asked for my data plot graph and have yet to receive it but the doc's office has it from my first sleep study. I have everything from my first sleep study but that.

So, after the sleep study, I slept 29.37 hours out of 48 hours. To me, that tells me the pressure was too low the night of the sleep study. I had a constant headache through Monday and even cancelled my MRI because of the headache.

On a happier note, last night, I kept the machine off when I put on my mask and then turned the machine on. I turned the machine off before I took my mask off.

The leak rate was 0.0 median; 1.2 at 95%; maximum 3.6. median pressure 12.4; 95% pressure 18.5; maximum pressure 19.8. AHI was higher than normal at 1.8 but still acceptable. .4 hypopnea; 1.4 obstructive. I would like to see my AHI's back to what it was before but won't complain if they are 1.8. I think each day they may go back down after I continue to practice keeping the machine off when I put my mask on and take my mask off. I also think some of the leaks come from when my headgear will come loose and I have to Velcro it back. I need a new headgear but am waiting until I choose a different mask.

During the new sleep study, she only tried one mask and then when it was over, she gave me another mask to put on and lay down with it for 15 minutes but that wasn't enough to determine whether it was going to work or not. She said it was a new mask (a gel mask but I don't know which one....I think the name started with an A).

I will spare all of you the rest of the details.

I do have a question though. Am I on the right track thinking that the reason I slept so much after the sleep study and had a constant headache until Monday that my pressure was too low during the sleep study? with my autoset at home, my pressure has been at the top limits 95% and maximum each night.

Thanks for your help.
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#17
thank you for the birthday wishes!
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#18
I'm thinking that simply 'change' could have been the cause for the poor sleep and the headache. Yes, of course too low a pressure could be the cause - but my bet is all the changes they made, different mask, different tension on the headgear, different/changing pressures during the night.

People are different, but most need time to adapt to changes, and if you go from a higher pressure to a lower pressure for *ONE* night, all that's going to do is mess you up. The real question is, would you sleep better and get better numbers if you were at the lower pressure for a week or three??
*I* am not a DOCTOR or any type of Health Care Professional. My thoughts/suggestions/ideas are strictly only my opinions.

"Only two defining forces have ever offered to die for you. Jesus Christ and the American Soldier. One died for your Soul, the other for your Freedom."
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#19
(10-15-2013, 11:08 AM)Peter_C Wrote: I'm thinking that simply 'change' could have been the cause for the poor sleep and the headache. Yes, of course too low a pressure could be the cause - but my bet is all the changes they made, different mask, different tension on the headgear, different/changing pressures during the night.

People are different, but most need time to adapt to changes, and if you go from a higher pressure to a lower pressure for *ONE* night, all that's going to do is mess you up. The real question is, would you sleep better and get better numbers if you were at the lower pressure for a week or three??

the sleep study was started at pressure of 12. Currently, my auto set is from 12 to 20. My first sleep study recommended my pressure to be set at 12. After my appointment with DME, I was going to set my machine to 16 to 20. My doc is out of town this week and I won't see him until Nov 4.

I have not ever had a headache like I did last weekend. The tech asked me if I woke up gasping and I said no which is true but I never wake up gasping in my life. The only reason I got my first sleep study is b/c I had an EKG that the doc was concerned about.

Thanks for your advice!!
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#20
Granted, my studies were done many years ago, but my understanding is that the 'tech' is supposed to be watching you - so why did the tech ask you that? You were asleep, and they were (supposed to be) watching you? Plus during all of mine, they were filmed, so they could (and did) show me jerking and heaving and even sitting bolt upright (without waking completely) several times during the night.

NOTE: I was told I had "life threatening OSA" - as my O2 dropped into the mid 60s many times, and my apnea count was really high (can't remember the exact number any longer, but above 80), and I never got to REM sleep - so for me, my AHIs being >10 is wonderful now~!

I am not saying coincidence, but headaches do just happen sometimes. And for me, pattern changes mess me up badly. I recently switched my BI-PAP from set numbers for EPAP and IPAP to the 'autoset' mode, and it's only been the last few nights that my numbers have even gotten back to my 'normal' - yet the only change is a one number increase during the night.

I agree completely that it sucks that the tech did not do as instructed and test you on BI-PAP, or at numbers higher than 16 - for those two reasons I feel it too was a waste of your time and $$$. But, I believe the idea is, to find the lowest pressure that makes you both stable, and gives you low numbers. To my knowledge, too high a pressure is just as bad as too low a pressure.

I can only assume that the 'autoset' algorithms do the job they are supposed to do. I don't know how they work, or truly how good they are compared to a knowledgeable tech and all the wires, etc can do. But I think that one value to the autoset is it's 'watching' you night after night after night - instead of a one session snap-shot - plus, the autoset (hopefully) can handle random changes (cold, stuffy nose, being really tired, etc)...
*I* am not a DOCTOR or any type of Health Care Professional. My thoughts/suggestions/ideas are strictly only my opinions.

"Only two defining forces have ever offered to die for you. Jesus Christ and the American Soldier. One died for your Soul, the other for your Freedom."
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