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New User with Problems
#1
New User with Problems
New user here and have only used CPAP now for 5 days and having a very difficult time.  Started with a nasal mask and just switched to full face and last night was awful even though the new mask is more comfortable.  The lowest AHI is 22 and all others are over 30.  This is the equipment I'm using:

ResMed AirSense 10 Autoset
Resmed AirTouch F20 Mask

Settings are all on auto with a pressure range of 8-20.  Once pressures go over 10, I start getting mask leaks unless the mask is very snug.  Is this normal?  There are times when I swear the machine is pulsating briefly with excess pressure that causes a brief mask blowout along with the CPAP machine getting loud.  When the pressures level off around 11, it is very hard to tolerate and I'm getting very little sleep.  I was taking Lunesta for a little over a month and I'm trying to stop which is likely aggravating the bad sleep.  When I take 2mg of Lunesta I feel like I slept fairly well, even with AHI over 30.

Any help is appreciated.  Right now my body feels like I'm stopping breathing and this CPAP doesn't seem to help.  I suspect it may be a defective unit because of the pressure surging but being new to this it's hard to say.

I installed Sleepyhead software and looked at the data but don't know how to interpret it.

Colin8
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#2
RE: New User with Problems
Do you know the results of your sleep study. You have a large amount of CA's which may mean you need a different type of machine. I am sure the experts will give you better advice. Again knowing the results of your sleep study would help and it is your right to have a copy.

Car54
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#3
RE: New User with Problems
G'day Colin8. Welcome to Apnea Board.

I agree with Car54 - we need to see your sleep study results. Your apneas are almost entirely central, which this machine can't treat. There are basically two types of apnea:

1. Obstructive, where the tissues of your upper airway (ie tongue, throat) collapse and mechanically obstruct the airway. This is the most common type and would be treated very nicely by your machine.

2. Central apnea. This is less common. It's caused by the brain failing to send a "breathe now" signal to the lungs. Without going into too much detail, it's often related to the amount of CO2 in your blood.

New users can get "pressure-induced" central apnea, where the pressure decreases the CO2, tricking the brain into thinking that it doesn't need to breathe. In most cases, this goes away after a while (weeks or months). However, if you already had central apnea before you started treatment, then it's unlikely the Autoset will do the job for you.

There is a problem in the American insurance procedures in that patients are often required to try a regular CPAP/APAP machine, then when that doesn't work they graduate to a bilevel, and when that doesn't work they eventually get the right machine which is an ASV. I suspect you are at the start of this process. ASV machines are expensive (like four or five times the cost of an Autoset) and they are also contraindicated for people with severe congestive heart failure. So the insurance companies don't like handing them out if they can avoid it.

Let's see the sleep study results, then we'll be able to give you more definite advice. But in the meantime you should probably start making appointments with your sleep doc, as this might turn out to be a lengthy process. The good news is that people with ASV machines almost always get spectacularly successful results.
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#4
RE: New User with Problems
I agree with above, but also realize that just starting CPAP therapy can also induce CA events, simply by blowing off the CO2 and it takes time for your body to adjust to this new therapy.  To be certain, your sleep study results are needed.

If you do need a different machine, you will most likely need to continue to try CPAP for a period of time, a month or two, with different settings.  After that, you would need a trial with BIPAP, before a more aggressive form of therapy, ASV, all of which require more sleep studies.
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#5
RE: New User with Problems
Welcome to Apnea Board Colin8,

I agree with the other postings, so let's start with the basics. Post your sleep study and script info, redacting or blacking out your personal identifiable info. Then, we suggest you get SleepyHead reporting application for free at the top of the screen. You will need an SD card to dedicate to your CPAP machine to record data and to transfer to SleepyHead via your PC's card reader.

All the above are important to give us the info so we can assist in optimizing your therapy. It does sound like what others have stated, you may not be on the correct machine. This data you need to provide will help us determine if this is the case. If in fact you have predominantly Central Apnea, I have first-hand knowledge what you should expect, as I had to go that path too. I am on a higher level device than what other apnea users typically are issued. The process is rather a pain, but the results are well worth it. But, let's not cross that bridge yet. Let us confirm that a standard CPAP is right or wrong first.

Work on getting SleepyHead working, get the SD card if you don't have one, and get hard copies of the PSG sleep study and the script. And for homework, see below in my signature the beginner guide. Read up on that as well. Thanks. Best to your success that will be gained via CPAP therapy.

Coffee
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#6
RE: New User with Problems
Thanks for the comments.  Last night was poor sleeep with AHi=39.55 but I actually felt like I was beginning to get used to the mask and breathing under pressure.
The only sleep study I've had was at home - report is attached along with the script.  I believe the equipment used for the home study is only capable of detecting obstructive apnea and not central.  I believe that this is just a start and I'm being steered down the path of least cost...

Thanks for any suggestions.
Colin8


Attached Files
.pdf   Sleep Study 1-18-18 CB HST Report.pdf (Size: 319.47 KB / Downloads: 38)
.pdf   CPAP RX.pdf (Size: 615.18 KB / Downloads: 35)
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#7
RE: New User with Problems
Dave,

Thanks for the reply.   I installed Sleepyhead software and imported data from the sd card.   My first post has 2 attachments which are screen shots from Sleepyhead software.  That much is working but I don't know how to interpret the data.

About an hour ago, I posted my sleep study and cpap prescription and am looking forward to comments from those who know about these things.

Colin8
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#8
RE: New User with Problems
Colin, you have complex apnea, and it's pretty severe. There is probably an 90% chance you will need a ASV machine which will provide pressure support to cause you to take a breath when you have central apnea, and will provide enough pressure to prevent obstructive apnea. You should really inform your doctor of these results and ask about a bilevel ASV titration study. This rarely just goes away, and pressure settings usually won't improve results enough.

You are using a minimum pressure of 8 and maximum of 12 with EPR at 2. The first thing to do is turn off EPR, and probably just try fixed pressure at 8.0. If that doesn't improve the complex apnea, you are headed to ASV.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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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#9
RE: New User with Problems
You're welcome. Sleeprider has the right idea. Tell your doc about complex apneas. As best you can, try to get the ResMed ASV, it just works awesome. If I can help with anything, pointers, suggestions, etc., feel free to shout out. Best to success.

Coffee
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#10
RE: New User with Problems
Hi Colin8,
WELCOME! to the forum.!
Good luck with CPAP therapy and getting the machine that will help serve you better..
Hang in there for more responses to your post.
trish6hundred
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