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Newbie CPAP User - suggestions?
#1
Newbie CPAP User - suggestions?
Hi all -

First of all, thanks so much for the wealth of information here. I was led here by a news article that talked about how open-source was changing CPAP, and as a guy that lives in source code all day long, that intrigued me.

I've had apnea and snoring for years, but weight gain, increasing blood pressure, and fatigue finally got me to get a CPAP machine. Last night was my first night at home wearing a mask. Woke up feeling better than usual.

I am starting with an off-the-machine AHI of 60.1, with oxygen getting as low as 78%.

I ended up with a Dreamstation CPAP Auto and humidifier, something I knew to ask for because of the supported Sleepyhead models, and an AirTouch full-face mask. I need full-face for certain, as I mouth-breathe at night.

I haven't changed any of the settings that the DME set.

I'm attaching a screenshot of the first night's results. Can anyone offer any suggestions or advice? There's a lot to absorb here all at once.

Thanks in advance!


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#2
RE: Newbie CPAP User - suggestions?
Welcome to the forum.

A couple of questions.  Is there a reason that you are in CPAP / Fixed mode?  
What did your Sleep Study say, in detail please?

Based on this chart we have 2 approaches.
1. stay in CPAP mode.  increase your pressure by 1 cmw
2. switch to APAP / Auto Mode.  This means to set your min pressure to 10 and your Max pressure to 15.  Note: I do not know why you are on CPAP, if your doctor knows something that I do nor (very likely) it is possible that your AHI will get worse.  Whether it gets better or worse we will know much more about how your machine reacts with your apnea and adjustments can be made from there.

in either case, the follow up is to review and adjust as appropriate.

My choice, in general, would be to use Auto mode.
That said there are definitely circumstances where I recommend CPAP mode.

See the CPAP Setup link at the top of the page and get the manual for your machine.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
OSCAR

Download OSCAR
New to Apnea? Helpful tips to ensure success
Mask Primer
Dealing with a DME
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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#3
RE: Newbie CPAP User - suggestions?
The report that I got said:

Respiratory Summary:
278 apneas for an index of 42.1;
119 hypoapneas for an index of 18;
An apnea/hypopnea index of 60.2;

Oxygenation Summary:
Average oxygen saturation was 93%;
Lowest oxygen saturation was 76%;
31 minutes total with a saturation less than 88%;

Cardiac Summary:
Minimum pulse rate was 54bpm;
Max pulse rate was 113bpm;
Average pulse rate was 70bpm;

There is no mention of CPAP vs APAP. The doctor's prescription mentioned a setting of 12.3, but my machine is set to 12. The next nearest setting seems to be 12.5. I mentioned APAP to my doctor, but he seemed pretty set on CPAP.
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#4
RE: Newbie CPAP User - suggestions?
That is all summary data which unfortunately frequently does not tell the whole story.  Do you have the full report? the one with the charts and the different pressures and results and also mentions mixed/complex apnea?  

What brand and model of machine do you have?
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
OSCAR

Download OSCAR
New to Apnea? Helpful tips to ensure success
Mask Primer
Dealing with a DME
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
RE: Newbie CPAP User - suggestions?
See if you can trade your machine for a ResMed AutoSet, you can use it in CPAP mode if you must, but it is the best machine you can have since it will be with you for 5+ years when it will be replaced.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
OSCAR

Download OSCAR
New to Apnea? Helpful tips to ensure success
Mask Primer
Dealing with a DME
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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#6
RE: Newbie CPAP User - suggestions?
Unfortunately, that's all the stuff I have - I didn't know to ask for the rest. I'll have to ask.

I do recall "complex apnea" from something I read, but that's as substantive as I can get right now.

The machine itself is a Phillips Dreamstation Auto CPAP, firmware version 1.1.7. I've been able to get into the clinician menu, but I didn't change anything there, just looked around.
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#7
RE: Newbie CPAP User - suggestions?
You are in better shape than I thought you were in, you have an APAP.
Download SleepyHead v 1.1.0 from the top of the page, you will need an SD card and a reader for you PC if it doesn't have one built in.

Read the Organize link in my signature. That states which graphs to include, and to turn off the pie chart and the calendar so we can see your settings.

That said how do you feel, or rather, enable Flex at 2 and then state how you feel, how comfortable is your breathing.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
OSCAR

Download OSCAR
New to Apnea? Helpful tips to ensure success
Mask Primer
Dealing with a DME
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
RE: Newbie CPAP User - suggestions?
I've adjusted the menu as your link suggested, here's a new screenshot.

I felt pretty good this morning, other than dry mouth (my humidifier ran out, it's very dry in my house). FYI, humidifier is set to 3. I don't recall any trouble breathing.

Still a little foggy, but I probably have a lot of sleep deficit to make up. I recall waking up once because the strap was irritating my neck, but then I also woke up half an hour early without an alarm, for no reason other than I think I was done sleeping. So, that's probably a good sign.


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#9
RE: Newbie CPAP User - suggestions?
So how would you like to proceed?
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
OSCAR

Download OSCAR
New to Apnea? Helpful tips to ensure success
Mask Primer
Dealing with a DME
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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#10
RE: Newbie CPAP User - suggestions?
well, i'm here for suggestions! Wink

I'm certainly open to gradual changes in the settings, such as flex. I will note that my prescription was specifically for 12.3, so maybe bumping the pressure to 12.5 might be in order.

I also notice that I had the most sleep interruption not long after I went to bed - and I will further note that I sleep on my back, due to reflux/gerd.
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