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Newly diagnosed and could use advice
#1
Rainbow 
Newly diagnosed and could use advice
Hey there,

Kinda new to this world and wanted to share my experience with my CPAP and ask a couple questions. Thank you so so so much for your help and support.

I was diagnosed with moderate sleep apnea about 6 months ago. I was actually excited because I've struggled with depression and anxiety my entire life and thought this could help. Anyways, I was told I should see some indication of feeling better within a week, but I only felt worse. According to the myair app I was getting a full night of sleep but I still felt like sh*t. This happened with a full face mask and a nasal pillow. I gave up but want to try again.

1) Do I have to replace my mask, tubes, etc.?

2) How long should I give it before giving up?

3) Are there optimal pressure settings I should try? Or humidifier settings? Anything I should play with to experiment?

4) Is it possible that CPAP machines just won't work for me?

5) Is there a way that I can measure the quality of my sleep to know if the CPAP is making a difference? Like something that measures REM and deep sleep?

That's all I got for now. Again thanks so much.
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#2
RE: Newly diagnosed and could use advice
G'day tstiefler3. Welcome to Apnea Board.

Judging from the tone of your post, it seems you're not getting any support from your doctor or respiratory therapist. That's not unusual, and it's the main reason that forums like Apnea Board exist. Hopefully we'll be able to help you take control and get some real benefit from your machine. But first we need some data to work with. Apnea therapy is all about the numbers, and once the numbers are under control we can work on how you feel.

So, the first thing we need is a copy of your sleep study. Please erase any personally identifying information (full name, address, phone number, Medicare number etc) and post the report here. We need to see the full report including charts and tables, not just the written summary. Also if you have a prescription please post that as well.

Next we need to know how well your machine is currently working. For this we use software called OSCAR.

Get OSCAR: https://www.sleepfiles.com/OSCAR/

OSCAR help: http://www.apneaboard.com/wiki/index.php...OSCAR_Help

How to organise and post OSCAR charts: http://www.apneaboard.com/wiki/index.php...ganization

Turning now to your questions:

1) Do I have to replace my mask, tubes, etc.? It's too early to say - let's see the OSCAR data and we'll be able to give you more detailed advice.

2) How long should I give it before giving up? Never give up. If you really do have apnea then CPAP is the gold standard treatment. Apnea is an insidious disease which creeps up on your body ad is associated with all sorts of nasty things including diabetes, heart conditions, poor mental health, and death through falling asleep at the wheel.

3) Are there optimal pressure settings I should try? Or humidifier settings? Anything I should play with to experiment? Your prescription should have given you some good starting pressures. Once we see the Oscar data we'll be able to help you optimise them.

4) Is it possible that CPAP machines just won't work for me? Yes, it's possible. It's also possible you were misdiagnosed or you have other conditions alongside the apnea. So that's why we need to see the sleep study report.

5) Is there a way that I can measure the quality of my sleep to know if the CPAP is making a difference? Like something that measures REM and deep sleep? Again, Oscar will give us a very detailed view of your breathing and (from the breath patterns) a bit of indication of your sleep stages. Some of the better class smart watches can give an indication and there is a gadget called Dreem Headband which does a mini-EEG while you sleep. You could invest in one or all of these, but I suggest you stick with what you've got and see how things develop.

Best regards, and good luck!
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#3
RE: Newly diagnosed and could use advice
Wow I can't thank you enough for all your support. Seriously. Much much much appreciated. 

I attached my sleep study report. It was an at home sleep test which I'm still a little bit dubious of. But apparently they are just as accurate according to my doc.


I have resmed my air. I'm guessing that isn't good enough? If that's the case I'll buy an sd card and get back to you.

Again, I can't thank you enough. Thanks


Attached Files
.pdf   282.201989.161134.1.pdf (Size: 943.01 KB / Downloads: 25)
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#4
RE: Newly diagnosed and could use advice
Sometimes it my take months to see good improvements. It takes time to repair the damage that was probably years in the making. Have patience good wwill come. If you are having trouble getting used to it , try wearing while you are awake wathing tv or somthing.
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#5
RE: Newly diagnosed and could use advice
You might want to remove the personal information in your sleep study attachment, e.g. name, DOB, phone, etc. Smile
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#6
RE: Newly diagnosed and could use advice
I'm definitely able to fall asleep. And im used to it. Which is great. I just want to be able to track if it's working accurately because I still don't feel well rested.

Also my apnea score was only 24 from an at home sleep test. Is that even that bad?
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#7
RE: Newly diagnosed and could use advice
(01-14-2020, 09:28 PM)tstiefler3 Wrote: Also my apnea score was only 24 from an at home sleep test. Is that even that bad?

Not if you like your night to be a series of 2.5 minute naps!!!
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#8
RE: Newly diagnosed and could use advice
"Only 24 AHI" is a moderate obstructive apnea and borderline severe. Your events were mostly hypopnea (17/hour) with the remainder being obstructive full apnea. You are being prescribed an auto titrating CPAP (Auto CPAP) with pressures set at 4 to 20. Please request a Resmed Airsense 10 Autoset which will reach therapeutic pressure faster. We can tell you already that you should set it up with a minimum pressure of 7.0 and use EPR (exhale pressure relief), which will help treat the hypopnea better than straight CPAP pressure. Very few people can tolerate the low 4.0 cm starting pressure, however the Resmed does rise quickly. If you accept a Philips Dreamstation you will have a much higher residual hypopnea rate because the machine does not raise and hold pressure as effectively, and does not provide the bilevel EPR pressure.
Sleeprider
Apnea Board Moderator
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#9
RE: Newly diagnosed and could use advice
(01-14-2020, 10:54 PM)Sleeprider Wrote: "Only 24 AHI" is a moderate obstructive apnea and borderline severe. Your events were mostly hypopnea (17/hour) with the remainder being obstructive full apnea.  You are being prescribed an auto titrating CPAP (Auto CPAP) with pressures set at 4 to 20.  Please request a Resmed Airsense 10 Autoset which will reach therapeutic pressure faster.  We can tell you already that you should set it up with a minimum pressure of 7.0 and use EPR (exhale pressure relief), which will help treat the hypopnea better than straight CPAP pressure.  Very few people can tolerate the low 4.0 cm starting pressure, however the Resmed does rise quickly.  If you accept a Philips Dreamstation you will have a much higher residual hypopnea rate because the machine does not raise and hold pressure as effectively, and does not provide the bilevel EPR pressure.

Thank you again for having a look. Just a few clarifying questions:

1) My machine is a Resmed Airsense 10 Autoset. So I'm all good there right?

2) Is there any way that I can set it up myself with the 7 min pressure and EPR? I'm in between insurance right now.

3) How long do I need to try the new pressure and EPR thing out before knowing if it's working?

4) You mention the Philips Dreamstation. Just to make sure I totally understand, that machine is worse for me? I should stick with my resmed?

5) Why didn't the doctor set it up that way to begin with? It's frustrating that they wouldn't.
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#10
RE: Newly diagnosed and could use advice
Quote:1) My machine is a Resmed Airsense 10 Autoset. So I'm all good there right?
Yes


Quote:2) Is there any way that I can set it up myself with the 7 min pressure and EPR? I'm in between insurance right now.
Holding in the home key and the knob at the same time for about 5 seconds takes you to the clinicians setting menu


Quote:3) How long do I need to try the new pressure and EPR thing out before knowing if it's working?
One night doesn't make a pattern. Two or three is better.

Quote:4) You mention the Philips Dreamstation. Just to make sure I totally understand, that machine is worse for me? I should stick with my resmed?

Yes..stick with the Resmed


Quote:5) Why didn't the doctor set it up that way to begin with? It's frustrating that they wouldn't.

Time and money. Most insurance and medicare say an AHI < 5 is good enough. 
It's kind of like physical therapy that ends once you can get from your bed to the bathroom and back.
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