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Nicholas' progress thread
#1
Hi again, forum. Everyone has been super helpful to me from the beginning. This is a new thread to track my overall progress (a success story in the making)!

I feel I've come a long way since I started on CPAP for the first time roughly a month ago. My very first week, I think I felt even worse and slept even less than before I ever got on a machine. Thankfully, not any more; I'm sleeping much better. At first, although I could easily fall asleep on the machine, I found that once I woke up in the night (which I do several times to use the toilet), I couldn't fall BACK asleep with the CPAP on; I'd have to take the mask off in order to fall back asleep. Then, later I'd wake up slightly due to an event and re-don the mask.

Not so any more. Over the last month, I've gotten to where I easily fall back asleep with the mask on, which feels like a pretty big milestone (perhaps that adjustment was psychological). Consequently, my average time on the machine has gone from 2 or 3 hours up to above 6 hours. Seems like progress.

While on the machine, I sleep less restlessly. My wife has reported not only drastically reduced snoring but also drastically less tossing and turning - hooray.

Furthermore, I find myself dreaming more throughout the night - a good indicator that I may be getting more REM - another hooray.

I still have a long way to go. I still feel very tired in the morning and throughout the day - sometimes so tired I can barely function. Mental processing and concentration seem like a struggle. Hopefully all of that (and my metabolism and overall health) will start to show improvement as I continue to make adjustments and see improvements in my numbers.

I'm still getting up 3 or 4 times a night to go to the restroom (which, for most of my life, I thought was normal). I've been checked out by a urologist who could find no apparent issues with my prostate or urinary tract, and simple changes like "drinking less water in the afternoons" do not cause me to get up less at night. So, I'm guessing this problem is caused by the fact that I haven't been sleeping long enough for my body to produce enough vasopressin, a hormone that keeps the body from urinating at night. So, this is a major thing that'll hopefully improve as my sleeping improves with time.

And now to continue on with the thread I originally started in the technology forum. @sleeprider @opalrose: Last night I increased my minimum pressure from 7 to 9, and here are the results. I'd appreciate any feedback you may have after comparing this to the night before.

Now it's time to go educate myself on how to read and interpret all this data. Thanks, all.
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#2
Damn fine numbers Here's to ya! One of the really big things I noticed about a month into therapy is that when I wake it feels normal to on the machine and abnormal to be not on it. There are times when I cannot tell it I have it turned on or not. The pressure has become a comfort to me.
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#3
Hi Nicholas,
It’s great to hear that you’re
doing so well with CPAP therapy, thanks for sharing this, as it will help others continue on.
Keep up the good work.
trish6hundred
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#4
(05-29-2017, 05:14 PM)TASmart Wrote: Damn fine numbers Here's to ya!  One of the really big things I noticed about a month into therapy is that when I wake it feels normal to on the machine and abnormal to be not on it. There are times when I cannot tell it I have it turned on or not. The pressure has become a comfort to me.

Yeah, I get it. I'm already starting to notice that trying to sleep *without* the machine is more weird than trying to sleep *with* it. Thanks for complimenting my numbers, but what makes you say they're "damn fine?"
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#5
I see 6 3/4 hours and AHI of 2.2 with low CA and low RERA. No significant leaks. All look damn fine to me.
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#6
Keep up the good progress. It took me six months to feel a lot better. Another year and I feel better than in the last 20 years.

Sleep-well

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#7
you don't need to do a thing...

however, I would lift the minimum to 10, (closer to the median 10.4) to see if it helps with the OA count.

I would bring the max down to 15, but so it is still 1 or 2cm above the 95% you get for the night, because they say it works better with a tighter gap.
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#8
(05-29-2017, 03:34 PM)Nicholas Wrote: And now to continue on with the thread I originally started in the technology forum. @sleeprider @opalrose: Last night I increased my minimum pressure from 7 to 9, and here are the results. I'd appreciate any feedback you may have after comparing this to the night before.

Now it's time to go educate myself on how to read and interpret all this data. Thanks, all.

the pressure you have on exhale (shown as EPAP) makes the greatest impact on obstructive apnea (OA).  when comparing the 5/26 Fri EPR off to the 5/28 Sun EPR 2, there is little difference in your response to these two alternatives.  that is good, as either therapy can be chosen based on your comfort.

[min 7 with EPR off gives you EPAP min 7] and that nearly equals [min 9 EPR -2 giving you EPAP min 7].

looking at the median EPAP for both nights, one is 9.04, the other 8.40. this suggests you may be better served slightly increasing the start pressure.  That pressure which gives you an EPAP of 8.5 can be done by [min 10.5 EPR -2 for EPAP of 8.5] quite similar to the suggestion by ajack above.  If you liked the EPR off better, you would take that into consideration, and setting would be [min 8.5 EPR off for EPAP of 8.5].

of course, you could continue just as you are set now for several days to get an average.  most of us have learned that our scores vary, sometimes way more than you would guess.  I have seen suggestions that run from 3 to 4 days up to two weeks on a setting before deciding on new adjustments.

you are doing great so far, and I wish you well as you continue to retrieve much of the health you thought you'd never regain.

QAL
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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#9
Thanks, QAL and ajack for your suggestions. Also, here are last night's data with the same exact settings as the night before. As always, any feedback is appreciated.
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#10
I agree with ajack that a pressure of 10 makes more sense. You are nearly always above that pressure, so it won't affect your experience. As you can see on your most recent chart, when the pressure drops back at 23:00 you immediately have events that drive the pressure back up. Again, the line I would want to see is flow limitation, not mask pressure. I suspect you don't have enough FL to push your pressure up ahead of an OA event, thus you are one of the rare individuals that needs the higher minimum pressure on a Resmed Autoset.
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