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Noobe still needs your input
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Sedona79 Offline

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Posts: 11
Joined: Nov 2012

Machine: Icon Premo
Mask Type: Nasal pillows
Mask Make & Model: Swift FX
Humidifier: F&P
CPAP Pressure: 9
CPAP Software: Not using software

Other Comments:

Sex: Undisclosed
Location:

Post: #1
Ohmy Noobe still needs your input
Have been using the CPAP for almost 3 months and have 100% compliance (even through a very nasty head cold) - hurray! However have not altogether resolved the Apnea. I still have variability in the AHI score from night to night. I seem to score between 4 and about 10. The original AHI was 42 so a drastic improvement however I am now at the fine tuning stage.

What I have done to date:
- Removed the Senseawake feature of the machine - it kept decreasing pressure and I would revert to apnea mode. Made biggest difference in score (the AHI score variability was between 4 a 35+ with it on).
- Removed ramp-up feature. I fall asleep quickly and I would enter Apnea mode until machine reached full pressure setting. Made a moderate difference in the AHI score (improvement).
- Adjusted humidifier setting. Made a slight difference in AHI score (fine-tunning). Still experimenting with this one. Too little humidity and score goes up. I pretty much maxed-out the humidifier - it's like a Turkish bath in my lungs. There is a sweet-spot and I keep chasing it (like a dog with a bone). I find it gets confusing between the humidity number and the boost value (supposedly temperature boost). I am currently at 7 (max) and double (2) boost on my ICON machine. If I increase to triple boost my AHI goes up.

What I have not tried yet:
- I suppose I could back up the humidity a few notches and increase boost... ANY suggestions, anecdotal stories or words of encouragement are welcome. Think I might need to go back to a regimented approach and play again with the settings and allow more time between tests - this CPAP thing is not easy!
- I have not yet increased pressure settings. I am at 9 cm currently (per initial set-up), I could try increasing to 10 to see what happens.
- Have not tried different masks or chin strap to control the slight mouth breathing I do.

Any other ideas or suggestions that can help me to reduce the AHI below 5 and keep it in the 0 to 5 range are greatly appreciated.

Cheers,
Sedona
01-06-2013 02:39 PM
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zonk Offline

Advisory Members

Posts: 7,908
Joined: Feb 2012

Machine: A10 AutoSet
Mask Type: Nasal mask
Mask Make & Model: Activa LT
Humidifier: Integrated /ClimateLineAir
CPAP Pressure: 9/13
CPAP Software: ResScan

Other Comments: CPAP since Nov 2010

Sex: Male
Location: Australia

Post: #2
RE: Noobe still needs your input
(01-06-2013 02:39 PM)Sedona79 Wrote:  Any other ideas or suggestions that can help me to reduce the AHI below 5 and keep it in the 0 to 5 range are greatly appreciated.

Cheers,
Sedona
followup with the sleep doc

you need the software to see whats going
infosmart software available from Supplier #26 at $89

SleepyHead software is free, does works with the Icon and some said likes better than infosmart
01-06-2013 03:40 PM
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Sedona79 Offline

Members

Posts: 11
Joined: Nov 2012

Machine: Icon Premo
Mask Type: Nasal pillows
Mask Make & Model: Swift FX
Humidifier: F&P
CPAP Pressure: 9
CPAP Software: Not using software

Other Comments:

Sex: Undisclosed
Location:

Post: #3
RE: Noobe still needs your input
Quote:followup with the sleep doc

you need the software to see whats going
infosmart software available from Supplier #26 at $89

SleepyHead software is free, does works with the Icon and some said likes better than infosmart

Zonk - thank you for all your advice! Very much appreciated!

I downloaded the SleepyHead software but for some reason it does not import the data from my USB stick (can't find it???). Any assistance on how to import the Icon data into SleepyHead greatly appreciated.

I can reach out to the Sleep Dr - but in Canada it seems like it takes weeks / months to get apppointments at the most inconvenient times. He'll probably suggest another wonderful stay at his clinic so he can charge the medical system... he's been as useful as t**** on a bull... all that to say I think I need to invest in the software.
01-06-2013 04:02 PM
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Dawei Offline

Preferred Members-2

Posts: 342
Joined: Feb 2012

Machine: ResMed S9 AutoSet
Mask Type: Other
Mask Make & Model: Respironics "FitLife"
Humidifier: H5i
CPAP Pressure: 10-20
CPAP Software: ResScan SleepyHead

Other Comments: Began CPAP in 2006; spent the first 6 years with a "brick"

Sex: Male
Location: Western North Carolina

Post: #4
RE: Noobe still needs your input
Sedona79-- I was just reading about your machine and see that it is a straight CPAP that delivers a constant pressure. First, I should say that my AHI also varies from night to night, but not quite to the range of variations that you're having. So, it seems that it's normal to see some variations.
Secondly, it seems to me that humidity/temp levels are not the primary factor in controlling apnea events; pressure is (assuming you have only obstructive apnea and nothing additional going on). With OSA, the correct pressure is a must to control events. You could increase pressure from 9 to 10, but the chances are just as good that you might not see any improvement as they are that you would. For example, if your currently correct pressure is 15, moving from 9 to 10 wouldn't show any change most likely.
So, consider how long ago that 9cm pressure was set, and was it the result of a sleep study, doctor's guess or a titration using an auto machine that you had access to earlier?
Keep in mind that a person's pressure needs to stop events can definitely change over time. Right now, it sounds like your current pressure may be off a little, but changing it arbitrarily should be done slowly and over enough time for results to be valid.
In looking at your current numbers, include mask leakage reports, since excessive leaking affects AHI reporting. I don't know if your machine has a max. leak rate above which AHI readings become unreliable, as ResMed machines do, but getting leaks down close to zero is an important goal.
01-06-2013 04:16 PM
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zonk Offline

Advisory Members

Posts: 7,908
Joined: Feb 2012

Machine: A10 AutoSet
Mask Type: Nasal mask
Mask Make & Model: Activa LT
Humidifier: Integrated /ClimateLineAir
CPAP Pressure: 9/13
CPAP Software: ResScan

Other Comments: CPAP since Nov 2010

Sex: Male
Location: Australia

Post: #5
RE: Noobe still needs your input
Hi Sedona
I don,t use SH or the Icon but seen elsewhere someone posting Icon data charts using SleepyHead
check you PM (private message) in few minutes to see the SH charts using the Icon

see post #6 for InfoSmart report and post #7 for the InfoSmart glossary
http://www.apneaboard.com/forums/Thread-...-Questions
01-06-2013 04:23 PM
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PaulaO2 Offline
Wiki Editor
Moderators

Posts: 8,057
Joined: Feb 2012

Machine: S9 Autoset
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: H5i
CPAP Pressure: 14-20
CPAP Software: SleepyHead

Other Comments: Ehlers-Danlos Syndrome, Hypermobility Type; chronic sarcasm

Sex: Undisclosed
Location: western NC, USA

Post: #6
RE: Noobe still needs your input
I don't think humidity matters in terms of causing or preventing events. I do feel that ramp can hurt more than it helps, especially if you fall asleep before it is done.

You can't go with just one night as a proof of something working or not. You need at least 7-10 days with the same settings to determine a trend. Each night is different since each day is different. Too many variables. So by gathering data over time, you can see trends. "I never went over 7 but never went below 4".

I don't think SleepyHead works with your machine. You have to buy the software. This is one of the reasons I think folks should avoid the Icon. You pay how much for a device then have to pay more just to view the data? Your own health data?

If you are still having events as high as 10, then you are not at the best pressure. Are the events obstructive or central? If obstructive, you could try to bump the pressure up by .5-1. Then leave it for 7-10 days or more.

Then again, if you've only been on it for 3 months, it is probably best you speak to your doctor. This early in your treatment, he/she needs to be in on it as much as you can tolerate.

PaulaO2
Apnea Board Moderator
www.ApneaBoard.com


Breathe deeply and count to zen.

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.
01-06-2013 04:32 PM
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zonk Offline

Advisory Members

Posts: 7,908
Joined: Feb 2012

Machine: A10 AutoSet
Mask Type: Nasal mask
Mask Make & Model: Activa LT
Humidifier: Integrated /ClimateLineAir
CPAP Pressure: 9/13
CPAP Software: ResScan

Other Comments: CPAP since Nov 2010

Sex: Male
Location: Australia

Post: #7
RE: Noobe still needs your input
(01-06-2013 04:32 PM)PaulaO2 Wrote:  I don't think SleepyHead works with your machine.
Paula check your PM
01-06-2013 04:33 PM
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PaulaO2 Offline
Wiki Editor
Moderators

Posts: 8,057
Joined: Feb 2012

Machine: S9 Autoset
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: H5i
CPAP Pressure: 14-20
CPAP Software: SleepyHead

Other Comments: Ehlers-Danlos Syndrome, Hypermobility Type; chronic sarcasm

Sex: Undisclosed
Location: western NC, USA

Post: #8
RE: Noobe still needs your input
It does? Cool. I looked it up on Sourceforge and it said they were working on it.

PaulaO2
Apnea Board Moderator
www.ApneaBoard.com


Breathe deeply and count to zen.

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.
01-06-2013 04:36 PM
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vsheline Offline

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Posts: 1,907
Joined: Jul 2012

Machine: S9 VPAP Adapt (USA Model# 36007, not better 36037 or 36067)
Mask Type: Full face mask
Mask Make & Model: F10 or SimPlus w/ 2Liners. MirageQuatro & Gecko gel pad
Humidifier: H5i
CPAP Pressure: 15 EPAP, PS 5-10
CPAP Software: ResScan

Other Comments: Marfan Syndrome, chronic bradycardia, occasional Cheyne-Stokes Respiration

Sex: Male
Location: California, USA

Post: #9
RE: Noobe still needs your input
(01-06-2013 02:39 PM)Sedona79 Wrote:  Any other ideas or suggestions that can help me to reduce the AHI below 5 and keep it in the 0 to 5 range are greatly appreciated.

Hi Sedona79, welcome to the forum!

Keep in mind that Obstructive Sleep Apnea is usually highly positional and usually worse when on our back or when our lower jaw is pulled back instead of extended outward a little.

To stay off our back, many folks wear a teeshirt with pocket or sock sewn on back with tennis ball in it. I find the ball needs to be high up, between my neck and shoulder blades so it won't shift position and touch the bed and bother me when I'm sleeping on my side.

To hold the lower jaw in a forward (outward) position, some folks (not very many) wear a mouth guard. Dentists charge a small fortune for elaborate dental appliances for this purpose, but drug stores sell very inexpensive ones that often do the job adequately. If we use an automatically self-adjusting (APAP) machine, I think a mouth guard is definitely unneeded.

If you are unable to acquire an automatically pressure-adjusting (APAP) machine which is fully data-reporting, because our pressure needs vary with position and night-to-night, perhaps the best thing would be to request a home titration (for a week or a month) using an APAP machine which is fully data-reporting, including reporting of Obstructive Apnea events and Clear-airway Apnea events.

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.
(This post was last modified: 01-06-2013 05:38 PM by vsheline.)
01-06-2013 05:09 PM
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trish6hundred Offline

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Posts: 6,424
Joined: May 2012

Machine: Resmed S9 AutoSet for Her
Mask Type: Full face mask
Mask Make & Model: Fisher & Paykel Simplus
Humidifier: H5i Heated Humidifier
CPAP Pressure: 10 - 7-20 Cm H2O
CPAP Software: Not using software

Other Comments: I started CPAP in 2008. Totally blind since birth.

Sex: Female
Location: Missouri, USA

Post: #10
RE: Noobe still needs your input
Hi sedona79, It sounds like you are making quite a bit of progress with your therapy. You might turn your humidy back a notch or two and see if that helps.
Best of luck to you.

trish6hundred
01-06-2013 05:25 PM
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