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Newbie Nullus seeking advice
#1
Surprised 
Newbie Nullus seeking advice
Well, where do i even begin.

My girlfriend told me i started snoring extremely loud about 6 months after we started dating, ive gained about 35lbs being on an injury. One night she smacks me awake and tells me that i had stopped breathing for "30 seconds" so i emailed my doctor and they set me up with an at home sleep study. I used the WatchPAT with sp02 monitor.  Sleep like total garbage that night because the device was awkward with my finger being stuck straight out, then i got the phone call telling me that i had "severe obstructive sleep apnea" with a score of 42.3 AHI. i was told that i needed to come in and pick up a machine because it was harmful to my health to continue sleeping this way.. 

I was completely shocked, i will admit that a few years ago i had severe health anxiety and i had lots of tests done because i was always paranoid about family history. 
  • GI tests
  • a bunch of heart tests
  • CT scan of left Lymph node and upper respiratory
  • blood work
After all these tests nobody ever mentioned anything about this. some of these tests were even done under sleep.. and nothing was ever said about this. so the diagnosis had me in my feelings about all this. The first couple of weeks were very difficult, the kid wanted to know what i was wearing mask now to sleep.. finding a mask that fit was an absolute nightmare. my first mask was a full cover nose mask that i couldnt get to stop leaking. the second was a full face ResMed mask F30i that constantly leaked. and now ive settled on the N30i which still leaks but is the most comfortable to sleep with. I am finally starting to get used to it after using it every night for a few months now. 

The Doctors dont seem to be that helpful, my initial appointment to pick up the CPAP i didnt get to talk to the doctor - only his medical assistant who didnt know how to respond to any of the questions i had, she told me that a follow up phone call would be done in a month to check up. That follow up phone call with yet another assistant told me when i asked her about the doctors notes that "he would like to see a 15% reduction in body weight, at least. and that this could reduce or reverse the need for a cpap." and i asked if there was anything else and they said no.

second follow up i was told that because my sp02 dropped below 90 11% of the time i was sleeping that i would need to come in for another sleep study to measure my sp02 while on the CPAP because if it remains low ill need to be sent to my primary to be tested for COPD, lung disease heart disease etc.

Thats where i stand currently in treatment.

i will say that sometimes i feel like im breathing through a straw with my nasal mask on, my mouth does come open at times, i tried the tape thing but i just cant do it... so i have a chinstrap on order.

i wish i could get the mask to fit better, i feel like its either too lose. and it leaks, or its too tight and i feel like i cant breathe. i have done the fit and test plenty of times with the cpap and it passes the test when im trying it while awake and switching positions. but when im sleeping it usually finds its way to leak. ive also been having an issue with condensation build up in the tube and being woken up to a freight train sound and a wet nose with water in the pipe. lol

im a side sleeper usually. try to stay left side.

i am hoping that i can get some great advice to get me on the right path.

 Thanks


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#2
RE: Newbie Nullus seeking advice
Welcome to the board!  Your numbers sate excellent but I can see why you feel like “you are breathing through a straw. Your min is at 4 and that is the absolute lowest the machine can go and that is the pressure they would use on children. 

I would suggest you raise the min higher.  I would try 7 but if you still feel you need more move it up until you are comfortable with the amount of air. 

New settings

Min 7
EPR 3

See how that works and please post again tomorrow
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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#3
RE: Newbie Nullus seeking advice
i guess i should have said that because the mask fitting has been an issue sometimes the nasal pillow or portion slides up and blocks my nose. so ill have to pull the pillow down and re adjust it to open the flow back up.

oh i see, i read that wrong. thank you for the advice and the welcome!
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#4
RE: Newbie Nullus seeking advice
Welcome to the Apnea Board,

Try what Stacey has recommended. It's very typical to have the doc either be unavailable and unhelpful. Or both. So welcome to common Apnea patient un-treatment. Your 4-20 setting they slaved over for 1 second is also called machine default, as in what it comes at out of the box. Again common.

Circling back to the setting edit, try it a night and post a standard OSCAR Daily Details tab via F12. Answer the following with a critical but not generic answer "How do you feel?". This reflects how therapy is going as much or more than the numbers. Numbers are used to quantify how your feel, you fill in the rest by stating it.

Best to your 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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#5
RE: Newbie Nullus seeking advice
Thank you, I made the adjustments and put the mask on to try it out, the setting son the bottom reflect the changes but it still starts at 4.0 with three … doing the wave. Is this normal? And will it ramp to 7? Or should it start at 7?
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#6
RE: Newbie Nullus seeking advice
No, that's accurate and an expected action. 7 is your base inhale pressure with this setup with EPR 3. The math to illustrate, pressure Min 7 minus EPR 3 equals 4. That's why 4 still shows up.

EPR stands for exhale pressure relief, this is why it drops pressure on exhale, it's by design to make exhale easier, more comfortable. And it is a limited range pressure support as in what's going in the more expensive BPAP like the VAuto.
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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#7
RE: Newbie Nullus seeking advice
t this low of a pressure turn the ramp off.
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#8
RE: Newbie Nullus seeking advice
About the "rainout" -- a heated hose, if you can use one, or a hose cover might help.

I'm glad you're getting some attention for the O2 levels. You might consider getting a recording oximeter that is compatible with Oscar (click on Oximetry Wizard from the opening page to see the devices that would work.
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#9
RE: Newbie Nullus seeking advice
ok on an update was my girlfriends birthday last night and so we went out for dinner had a few drinks.

i changed the settings as suggested here.

Min 7

EPR 3


and turned RAMP off

took the mask off a couple times, fell asleep and woke up put it back on .. as you can see in the charts.

my Sp02 was pretty bad last nightim not sure if these events are happening while my mouth is open or not. ill try sleeping tonight with either hte full face mask, or the liptape and see if that helps prevent the dips in SP02


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#10
RE: Newbie Nullus seeking advice
(11-13-2021, 01:49 PM)Dormeo Wrote: About the "rainout" -- a heated hose, if you can use one, or a hose cover might help.

I'm glad you're getting some attention for the O2 levels.  You might consider getting a recording oximeter that is compatible with Oscar (click on Oximetry Wizard from the opening page to see the devices that would work.

i was looking at those but im not sure if they will stay on the finger unless people have a way of adding tape? 

ive also noticed that if you have an SP02 monitor on and you are laying in bed with your arm elevated above your heart like reading a book... sp02 levels drop. obviously im asleep when this is happening so im not sure if im doing that or not.
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