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Newbie need advice please
#1
Hi everyone,
I just found this wonderful forum this morning and since then have been searching and reading. Seems like a great source of valuable information.
I'm 33 y.o,250lb, 6.1 male, I started having this episodes of waking up short of breath, gasping for air with my heart racing and anxiety as a result. It started about a year ago but only happened occasionally, then started happening more and more frequently until I literally could not sleep all night. I know I need/should get a sleep study and definitely going to do so, but it may be a few weeks until I can do it. Meanwhile I bought a CPAP machine and planning on using it to see if it helps. Can you recommend pressure settings to me? I was thinking to start on the low side, 9 0r 10 and go from there. Definitely going to buy a pulse ox with an alarm to help me find out if my o2 saturation level drops. I am not even sure if my apneic episodes are obstructive or central in nature but hope it is obstructive rather than central. Any advices would be appreciated.
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#2
Hello - not wishing to rain on your hopes and wishes, honest. All I know is what I have read above. As a guy that has *BOTH* OSA, and, heart issues created by OSA - we/you do not know if these are 'panic attacks', 'heart events', or what at this point. Do you have a regular doctor? When was your last exam? Last blood work? Have you seen, or considered seeing a heart Doctor? If it's heart-related, catching it *before* a heart 'attack', is much nicer.

The problem whether thinking you my have apnea, and not knowing if it's obstructive or central or mixed (or, something else), is the machine you have is only good for one possible type. If your issue is central apnea, you *can* actually make it worse with pressure.

*IF* you had an 'APAP' (auto-CPAP), and it was data-capable, and if you had the (free) software to read the data, a person could leave the settings wide open for a few nights and then pull the data and get some basic thoughts and direction to go. Otherwise, your thoughts of setting the pressure to 9-10 and trying it, may actually (depending on what your issue(s) actually are) create a bigger problem, or possibly do harm.

Please do not be frustrated by my reply~! And, please know that others will be replying to you shortly.

It wasn't until *after* my sleep studies, and CPAP, and lots of testing inc heart cath, holter monitor, stress test that it was learned that I had; self-bypassed one artery, had a major 'heart event' sometime in my past that killed over 20% of my heart, and, was in really, really bad heart health. Am not saying that this is your issue, just giving you an idea of what the range may be. So, sooner rather than later, eh?
*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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#3
You'll get widespread agreement in this forum that you're condition is undiagnosed, and potentially life threatening. The only valid approach is to go seek medical professional help immediately. But, if you are not - right now - at the emergency room, set the machine up either wide open 4-20, or set it at straight 4 cm and go take a 2 hour nap - right now. Tell us the readings you get for AHI from the machine screen, today, as soon as you are awake.
Dedicated to QALity sleep.
You'll note I am listed as an Advisory Member. I am honored to be listed as such. See the fine print - Advisory Members as a group provide advice and suggestions to Apnea Board administrators and staff concerning Apnea Board operation and administrative policies. 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.
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#4
Hi ramstein,
WELCOME! to the forum.!
Hang in there for more suggestions and much success to you as you start CPAP therapy.
trish6hundred
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#5
(01-04-2015, 01:46 AM)ramstein Wrote: I started having this episodes of waking up short of breath, gasping for air with my heart racing and anxiety as a result. It started about a year ago but only happened occasionally, then started happening more and more frequently until I literally could not sleep all night.

Hi ramstein, welcome to Apnea Board!

Your symptoms certainly may be caused by simple OSA (obstructive sleep apnea). On the other hand, it would be safest to wait until you have the recording Pulse Oximeter with settable alarm before trying to self-treat.

If your CPAP machine is able to differentiate between (meaning "report") central versus obstructive apneas (such as the Philips Respironics System One DS450 or DS460 REMstar Pro machine), that would be good. Also, if it is both data-capable and an auto-titrating machine (an APAP machine, such as the PRS1 DS550 or DS560 REMstar Auto), that would make everything easier, too.

(01-04-2015, 01:46 AM)ramstein Wrote: I know I need/should get a sleep study and definitely going to do so, but it may be a few weeks until I can do it. Meanwhile I bought a CPAP machine and planning on using it to see if it helps. Can you recommend pressure settings to me? I was thinking to start on the low side, 9 0r 10 and go from there. Definitely going to buy a pulse ox with an alarm to help me find out if my o2 saturation level drops. I am not even sure if my apneic episodes are obstructive or central in nature but hope it is obstructive rather than central. Any advices would be appreciated.

As already suggested, safest to start with as low a pressure as you can tolerate, such as perhaps 4 cm H2O, and then look at the data using SleepyHead program.

Or, if using an APAP machine, Min Pressure of 4 cm H2O and Max Pressure slightly higher, such as 5 or 6, and then look at the data using SleepyHead program.

When beginning CPAP therapy it may at first be uncomfortable to breathe out against the pressure. This is normal and usually goes away within a few days or weeks. But if it ever feels like it takes a little too much effort to breathe in easily, giving you a very slight feeling of suffocation, raising the Pressure a little would likely help correct that and make everything more comfortable.

Recommendations on what to look for when buying a machine:
http://www.apneaboard.com/wiki/index.php...ne_Choices

Be sure to request the Clinician Guide (set-up manual) for your machine:
http://www.apneaboard.com/forums/Thread-...d=30#pid30

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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#6
Im going out on a limb here but. My OSA was called panic attacks 20 years ago when I would wake out of dead sleep with skyrocketing BP, as in bust blood vessels in my eyes and cheeks and ambulance ride to the ER accompanied by gasping for air sky high HR and ER thinking i was having a heart attack every time until the next morning. This went on every week or two on the road for over a year. Then went on about once a month or for the next 19 yrs after my CDL was taken due to the same thing.


DO NOT fall for its a panic attack. I knew it wasnt then and told them so but I didnt know what it was. Nobody ever brought up SA and I knew nothing about it though it is what was going on.

Years later after the damage was done I get sent for a sleep study by a nurse prac of all things after having been in ERs and hospitals all over the lower 48 and guess what??? Tests sent numerous times to Mayo Clinic and also tested for everything under the sun except SA.

SA was the cause.

Ill also go out on a limb and say setting at 4cm will only suffocate you worse. 6 is probably the min youll be able to tolerate.

Get a home or lab study ASAP but in the meantime doing what your saying Id be going on the machine till I could. low pressure and hopefully a full data capable auto machine start out capping the max pressure at 9 and see what happens.

Im not a doc but waking up like that sounds awfully familiar.
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#7
yeah - I picked 4 as a start for first cpap ever, because (1) the initiate actually can breathe quite well (until they get used to higher pressures [read as reliant]) and (2) there are no EPR issues usually until 6 and above - usually causing a reaction to the initiate, and (3) trying to get the closest approximation to "untreated" as possible for the one nap. It looks like OP is not doing that, though. So, he may have checked in at the ER, or is gonna just play this one out independent of our "help".

If he has OSA, he is likely to land at a start pressure of 6 or more. I hope he is ok.
Dedicated to QALity sleep.
You'll note I am listed as an Advisory Member. I am honored to be listed as such. See the fine print - Advisory Members as a group provide advice and suggestions to Apnea Board administrators and staff concerning Apnea Board operation and administrative policies. 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.
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#8
(01-05-2015, 12:30 AM)quiescence at last Wrote: yeah - I picked 4 as a start for first cpap ever, because (1) the initiate actually can breathe quite well (until they get used to higher pressures [read as reliant]) and (2) there are no EPR issues usually until 6 and above - usually causing a reaction to the initiate, and (3) trying to get the closest approximation to "untreated" as possible for the one nap. It looks like OP is not doing that, though. So, he may have checked in at the ER, or is gonna just play this one out independent of our "help".

If he has OSA, he is likely to land at a start pressure of 6 or more. I hope he is ok.

NO, I did not go to ER, but did make an appointment with a doctor this Friday. Due to my new insurance I have to have a referral and a new PCP. Both my sister and her husband are Nurse Practitioners and I am an RNBSN so even though I have not worked with apnea patients a lot, my experience in healthcare helps a little.
I started CPAP 2 nights ago, set it at 4 and got 12 AHI, next day I bumped it up to 8 and got 2.2 AHI and actually feel like I had some sleep(I was starting to go crazy). I have been reading and researching quite a bit that's why I did not post right away. Thank you for all replies.
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#9
(01-05-2015, 01:10 PM)ramstein Wrote:
(01-05-2015, 12:30 AM)quiescence at last Wrote: yeah - I picked 4 as a start for first cpap ever, because (1) the initiate actually can breathe quite well (until they get used to higher pressures [read as reliant]) and (2) there are no EPR issues usually until 6 and above - usually causing a reaction to the initiate, and (3) trying to get the closest approximation to "untreated" as possible for the one nap. It looks like OP is not doing that, though. So, he may have checked in at the ER, or is gonna just play this one out independent of our "help".

If he has OSA, he is likely to land at a start pressure of 6 or more. I hope he is ok.

NO, I did not go to ER, but did make an appointment with a doctor this Friday. Due to my new insurance I have to have a referral and a new PCP. Both my sister and her husband are Nurse Practitioners and I am an RNBSN so even though I have not worked with apnea patients a lot, my experience in healthcare helps a little.
I started CPAP 2 nights ago, set it at 4 and got 12 AHI, next day I bumped it up to 8 and got 2.2 AHI and actually feel like I had some sleep(I was starting to go crazy). I have been reading and researching quite a bit that's why I did not post right away. Thank you for all replies.

did you look at the events with Sleepyhead? It would be good to know if they were OSA or CA...
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#10
sounds like OP got excellent results. nice to get some real sleep, eh?
Dedicated to QALity sleep.
You'll note I am listed as an Advisory Member. I am honored to be listed as such. See the fine print - Advisory Members as a group provide advice and suggestions to Apnea Board administrators and staff concerning Apnea Board operation and administrative policies. 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.
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