New here with questions

[thefer]

Hi

I have been dealing with migraine headaches for the last couple years. I had to start preventative medications and stop working. I saw a neurologist who decided to refer me to a sleep study because I also had problems with getting up 7-8 times a night as well as taking multiple naps during the day. I had the sleep study in January. It was found that I had mild obstructive sleep apnea and had a reading of an AHI of 5.3. I had a combination of RERA, hypopnea, obstructive and central apnea. I had a lot of hypopnea events. I was sent back to do a titration study and they got me up to a pressure of 8 cm. My AHI numbers were 1.44 hr. I picked up a machine and started using it. I am happy to say that I no longer have headaches and I am only up 1-2 times a night (same time every night 1-3 am). Two months later, the machine didn’t record the AHI. So, we switch machines two weeks ago. I was told to use sleepmapper to download the information from the card. When I discovered this message board, I download the sleepyhead program as well.

I have some questions that maybe someone can answer that I am trying to make sense of?

1. If my AHI during my sleep study was 5.3 and I was on a pressure of 8 cm and it was 1.44. Why is it at home, on the same pressure, my AHI is between 3.4 and 5 or even 6?

2. Between 1 and 3 am, I wake up and question if the machine is on or if I am getting air. Sometimes, I wake up gasping or putting my finger in my nose piece to see if it is working. It feels like I am not getting enough air. When I look on sleepyhead, I found around 18 events (mostly hypopnea). My dr wants to keep my AHI numbers under 5. It is under 5 daily but in that 2-3 hour period, it is in the double digits (10-12). I did drop off my card so that they could download it since I am on the new machine for 2 weeks that record the AHI. They will only get the daily average. Not what sleepyhead is seeing.

Any suggestions? I told the nurse that they need to up the pressure because it feels like I am not getting enough air. I am renting the machine so I can’t adjust it or change the prescription. I am hoping my dr will change it. What should I do? I am going on two months with this same pressure.

thanks
Jennifer[/u]

[me50]

I have no clue why you wake up every night at the same time with a lot of events happening during that time. I ask if this happened before you started using the machine and can only suggest that you think back to see if anything traumatic happened to you or someone you know during that time.

I would also suggest that you elevate the head of your bed and that may help you some. Is it only between 1 and 3 AM that you feel like you aren't getting enough air?

I know nothing about the machine you are using. Is your machine an auto (meaning that you can put in a lower and upper pressure range so that if you need higher pressure during your sleep, the machine will adjust accordingly)? If it is an auto, then try using it on auto maybe set the pressure from 7 to 12 and watch it in sleepyhead for a week (don't make any other changes or you won't know what is helping or not helping).

Others will hopefully come along with better suggestions that I have given. I am kind of at a loss but thought I would try and help you.

[trish6hundred]

Hi thefer,
WELCOME! to the forum.!
Do you know if you are using what is called the "ramp" feature? If so, you can either turn it off, or, if you still want to use ramp, you can turn it back to a shorter time. Ramp can run anywhere from 5 to 45 minutes.
The ramp will start you at a pressure of 4 and "ramp" up to your titrated pressure and sometimes, when the ramp is used, people feel like they aren't getting enough air; you are, but it may not feel like you are and some people opt to just turn it off for that reason.
Hang in there for more suggestions and answers to your questions and much success to you as you continue your CPAP therapy.

[DariaVader]

Hi

I have been dealing with migraine headaches for the last couple years. I had to start preventative medications and stop working. I saw a neurologist who decided to refer me to a sleep study because I also had problems with getting up 7-8 times a night as well as taking multiple naps during the day. I had the sleep study in January. It was found that I had mild obstructive sleep apnea and had a reading of an AHI of 5.3. I had a combination of RERA, hypopnea, obstructive and central apnea. I had a lot of hypopnea events. I was sent back to do a titration study and they got me up to a pressure of 8 cm. My AHI numbers were 1.44 hr. I picked up a machine and started using it. I am happy to say that I no longer have headaches and I am only up 1-2 times a night (same time every night 1-3 am). Two months later, the machine didn’t record the AHI. So, we switch machines two weeks ago. I was told to use sleepmapper to download the information from the card. When I discovered this message board, I download the sleepyhead program as well.

I have some questions that maybe someone can answer that I am trying to make sense of?

1. If my AHI during my sleep study was 5.3 and I was on a pressure of 8 cm and it was 1.44. Why is it at home, on the same pressure, my AHI is between 3.4 and 5 or even 6?

2. Between 1 and 3 am, I wake up and question if the machine is on or if I am getting air. Sometimes, I wake up gasping or putting my finger in my nose piece to see if it is working. It feels like I am not getting enough air. When I look on sleepyhead, I found around 18 events (mostly hypopnea). My dr wants to keep my AHI numbers under 5. It is under 5 daily but in that 2-3 hour period, it is in the double digits (10-12). I did drop off my card so that they could download it since I am on the new machine for 2 weeks that record the AHI. They will only get the daily average. Not what sleepyhead is seeing.

Any suggestions? I told the nurse that they need to up the pressure because it feels like I am not getting enough air. I am renting the machine so I can’t adjust it or change the prescription. I am hoping my dr will change it. What should I do? I am going on two months with this same pressure.

thanks
Jennifer[/u]

In the split study perhaps you did not hit a spot of REM (the most likely reason for your higher periodic AHI, and therefore a higher average...)

look at the flow limitations. Do they increase during the higher incident times? look at the respiration rate - it should be fast during REM periods.

You should go into REM 3 to 4 times a night I think - but people with apnea sometimes don't - especially if they have had a long time disturbance. My REM is changing and I am beginning to finally feel more rested after 6 months. RERA won't contribute to AHI, but will increase REM disturbance, cause headache, and many of the other symptoms of apnea and should be alleviated by CPAP therapy

I think there is a good chance that you do need a higher setting - If you are using a loaner, you should look through archangels docs and decide what you want (hint: auto with data) You should get a machine that reports on RERA.


Would be very helpful to know what the study breakdown was, and whether some of your current AHI is CA as well.

[retired_guy]

I have some questions that maybe someone can answer that I am trying to make sense of?

1. If my AHI during my sleep study was 5.3 and I was on a pressure of 8 cm and it was 1.44. Why is it at home, on the same pressure, my AHI is between 3.4 and 5 or even 6?

Hi Jennifer. There are so many variables between what was going on in the hospital setting and what is going on in your home that comparing the two results is not really useful. What we do want to focus on is how well your therapy is working for your at home.

No headaches? That's a biggy.

Your AHI is still a bit high though so it would seem to make sense to increase the pressure to 9 to see how you do. Then monitor with Sleepyhead & let us know the results. Of particular interest, more than just "AHI," is how many events and what type are you seeing? How many OA's, vs CA's, vs Hypop's. Also what is your pressure doing? Not so much the maximum overnight, but the averages, and the 95% value.

2. Between 1 and 3 am, I wake up and question if the machine is on or if I am getting air. Sometimes, I wake up gasping or putting my finger in my nose piece to see if it is working. It feels like I am not getting enough air. When I look on sleepyhead, I found around 18 events (mostly hypopnea). My dr wants to keep my AHI numbers under 5. It is under 5 daily but in that 2-3 hour period, it is in the double digits (10-12). I did drop off my card so that they could download it since I am on the new machine for 2 weeks that record the AHI. They will only get the daily average. Not what sleepyhead is seeing.

Any suggestions? I told the nurse that they need to up the pressure because it feels like I am not getting enough air. I am renting the machine so I can’t adjust it or change the prescription. I am hoping my dr will change it. What should I do? I am going on two months with this same pressure.

thanks
Jennifer[/u]

This sounds to me like you may be rolling over on your back and your head is not elevated well. Often in order to comfortably sleep on your back you will need a bit higher pressure. So again, I think a little higher pressure may be the answer for you.

Also, pay attention to your sleeping position. I'm very much in favor of being able to sleep on your back, but make sure the head of the bed is elevated some. Not just bigger fatter pillows, that actually makes the breathing channels worse as they tend to force the chin downwards towards your chest.

[Terry]

1. If my AHI during my sleep study was 5.3 and I was on a pressure of 8 cm and it was 1.44. Why is it at home, on the same pressure, my AHI is between 3.4 and 5 or even 6?

The required pressure changes a little during the night as you change position (roll over on your back), and also if you become more congested (not enough humidity?)

The pressure during your sleep study is probably a good guess, but not really meaningful on any given night. If you can get an auto machine, it will adjust as your needs change.

2. Between 1 and 3 am, I wake up and question if the machine is on or if I am getting air. Sometimes, I wake up gasping or putting my finger in my nose piece to see if it is working. It feels like I am not getting enough air. When I look on sleepyhead, I found around 18 events

. . .

Any suggestions? I told the nurse that they need to up the pressure because it feels like I am not getting enough air.

They should have no objection to raining the pressure, and that should fix a lot of the problems. 8cm is actually very low pressure, so it's not surprising you might need more.

[thefer]

Hi

Thanks for everyone's suggestions. I am a back sleeper. I rarely sleep on my side. I do use the humidifer and have it set at 3 because of living in a dry climate (AZ).

During one particular night this week, I had 4 CA's, 2 OA's and 29 Hypop's. During the hypop's, the pressure does go up.

The dr's office called me on Friday afternoon at 4:45 pm letting me know that a new order was sent over to the DME to increase the pressure on my machine and wanted me to get over there before 5 pm. Yep. That didn't happen. Will do it on Monday. I waited all day for that call and they called me at the end of the day and expected me to jump. Hopefully, that increase pressure will help me sleep through the night better.

Jennifer

[me50]

Hi

Thanks for everyone's suggestions. I am a back sleeper. I rarely sleep on my side. I do use the humidifer and have it set at 3 because of living in a dry climate (AZ).

During one particular night this week, I had 4 CA's, 2 OA's and 29 Hypop's. During the hypop's, the pressure does go up.

The dr's office called me on Friday afternoon at 4:45 pm letting me know that a new order was sent over to the DME to increase the pressure on my machine and wanted me to get over there before 5 pm. Yep. That didn't happen. Will do it on Monday. I waited all day for that call and they called me at the end of the day and expected me to jump. Hopefully, that increase pressure will help me sleep through the night better.

Jennifer

If you know what pressure your doc wants you to have, you can do it yourself. Also, did you know that you might also be able to set your humidifier temperature (I don't know about your machine but thought I would suggest that you can check on it to see if you can). I do understand a dry climate but this week had some rain.

[thefer]

hi

I went in today and they bumped me up to 10. Not sure what the temperature is set at It goes by numbers 1-5. The higher the number, the higher the humidty.. I am at a 3. I will add an extra pillow tonight to see if that helps. They also suggested that I try a chin strap because I may be opening my mouth during the night. The therapist said that it does sound like I am having problems during the deep sleep period so hopefully with the increase pressure, it will stop the problems.

[me50]

hi

I went in today and they bumped me up to 10. Not sure what the temperature is set at It goes by numbers 1-5. The higher the number, the higher the humidty.. I am at a 3. I will add an extra pillow tonight to see if that helps. They also suggested that I try a chin strap because I may be opening my mouth during the night. The therapist said that it does sound like I am having problems during the deep sleep period so hopefully with the increase pressure, it will stop the problems.

Glad they bumped your pressure up. Be careful adding additional pillows because if it pushes your head downward, that can close or partially close your airway. better to put a board under your headboard or if you don't have a head board, put a board under the feet of your bed frame.

let us know how the pressure change and the humidity change is working.