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Please offer advice
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PaulaO2 Offline
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Posts: 8,065
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: #41
RE: Please offer advice
Look at it this way: for who knows how long, your body and brain has been waking up many times a night due to the apnea events. Most weren't enough you were aware of them. They've gotten used to this sleep a bit, wake up, sleep a bit, wake up routine.

It will take time for your body and brain to realize there's a new normal.

Google "sleep hygiene" and read about that. The better your sleep hygiene is, the better it will be for the body and brain.

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.
01-02-2013 08:50 PM
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kayla Offline

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Posts: 39
Joined: Dec 2012

Machine: resmed s9 autoset
Mask Type: Full face mask
Mask Make & Model: quattro
Humidifier: H5i
CPAP Pressure: 14-19?
CPAP Software: SleepyHead Other Software

Other Comments: I am grateful for the wonderful peopleon this board!

Sex: Female
Location: Canada

Post: #42
RE: Please offer advice
ok here are stats I got ....I wake up a lot and it says low usage but got machine in march last yr took a long time to comply and it wakes me up every 4 hours so av is 4 hrs I think-
ahi-.70
.ca-0.02
oa-0.31
.va-.025.h-0.15
I cant even be sure if this is all me as the machine was used who knows if they erased it or not but i think its me,I just cant keep it on for a long time,,,my sleep is so fragmented ....they said i may need bipap I dont know -not even sure what it all means but posting it ...and carrying on
01-02-2013 08:53 PM
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zonk Offline

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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: #43
RE: Please offer advice
(01-02-2013 08:53 PM)kayla Wrote:  ok here are stats I got ....I wake up a lot and it says low usage but got machine in march last yr took a long time to comply and it wakes me up every 4 hours so av is 4 hrs I think-
ahi-.70
.ca-0.02
oa-0.31
.va-.025.h-0.15
I cant even be sure if this is all me as the machine was used who knows if they erased it or not but i think its me,I just cant keep it on for a long time,,,my sleep is so fragmented ....they said i may need bipap I dont know -not even sure what it all means but posting it ...and carrying on
you've to do a bit of detective work to find out the source of your fragmented sleep .. leaks, uncomfortable mask (wrong size or type), meds, pain, lumpy mattress, humidity too much or too little, etc..
frequents wake-ups can prevent you getting into deeper sleep which you need to feel well rested
data is meaningless till you get sleep quality sorted out and sleeping right thru the night
01-02-2013 09:13 PM
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PaulaO2 Offline
Wiki Editor
Moderators

Posts: 8,065
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: #44
RE: Please offer advice
Where did you get those numbers? From the screen or from a software program? Is it just one night or the average over time?

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.
01-03-2013 02:36 PM
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JJJ Offline

Advisory Members

Posts: 751
Joined: Apr 2012

Machine: ResMed S9 Autoset
Mask Type: Nasal mask
Mask Make & Model: Most recent: Wisp, Pilairo, Mirage Vista
Humidifier: ResMed S9 Autoset
CPAP Pressure: 17-20
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: USA 97217

Post: #45
RE: Please offer advice
(01-03-2013 02:36 PM)PaulaO2 Wrote:  Where did you get those numbers? From the screen or from a software program? Is it just one night or the average over time?

Kayla is now using SleepyHead. She just hasn't updated her profile yet.
01-03-2013 03:23 PM
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vsheline Online

Advisory Members

Posts: 1,908
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: #46
RE: Please offer advice
(01-02-2013 01:38 AM)kayla Wrote:  Channel Min Med 95% Max
PressurePressure (cmH20)
Avg: 16.81 14.00 18.48 19.72 20.00
EPAPExpiratory Pressure (cmH20)
Avg: 13.81 11.00 15.48 16.72 17.00
Minute Vent.Minute Ventilation (L/min)
Avg: 6.32 0.00 6.12 8.12 30.25
Resp. RateRespiratory Rate (breaths/min)
Avg: 16.68 8.40 16.80 18.60 28.20
Flow LimitFlow Limit Graph (0-1)
Avg: 0.09 0.00 0.11 0.41 0.89
LeaksLeak Rate (L/min)
Avg: 0.92 0.00 2.40 8.40 50.40
SnoreSnore (unknown)
Avg: 0.08 0.00 0.06 0.52 1.10
Insp TimeInspiratory Time (seconds)
Avg: 1.70 0.18 1.64 2.00 6.14
Exp TimeExpiratory Time (seconds)
Avg: 1.86 0.10 1.84 2.25 4.70
Tidal VolumeTidal Volume (ml)
Avg: 376.23 9.92 360.00 580.00 1818.80

Machine Settings
Pr. ReliefPressure Relief EPR x3


second one eRLIER IN DEC-

Statistics
Channel Min Med 95% Max
PressurePressure (cmH20)
Avg: 15.91 14.00 17.54 19.56 19.92
EPAPExpiratory Pressure (cmH20)
Avg: 12.91 11.00 14.54 16.56 16.92
Minute Vent.Minute Ventilation (L/min)
Avg: 6.91 3.25 6.88 9.12 24.38
Resp. RateRespiratory Rate (breaths/min)
Avg: 16.76 10.00 16.80 19.20 24.60
Flow LimitFlow Limit Graph (0-1)
Avg: 0.07 0.00 0.10 0.27 0.79
LeaksLeak Rate (L/min)
Avg: 0.74 0.00 14.40 129.48 144.00
SnoreSnore (unknown)
Avg: 0.06 0.00 0.06 0.40 1.40
Tidal VolumeTidal Volume (ml)
Avg: 407.71 200.00 400.00 640.00 1240.00

Machine Settings
Pr. ReliefPressure Relief EPR x3

(01-02-2013 09:13 PM)zonk Wrote:  
(01-02-2013 08:53 PM)kayla Wrote:  ok here are stats I got ....
ahi-.70
.ca-0.02
oa-0.31
.va-.025
.h-0.15
I cant even be sure if this is all me as the machine was used who knows if they erased it or not but i think its me,I just cant keep it on for a long time,,,my sleep is so fragmented ....they said i may need bipap I dont know -not even sure what it all means but posting it ...and carrying on

you've to do a bit of detective work to find out the source of your fragmented sleep .. leaks, uncomfortable mask (wrong size or type), meds, pain, lumpy mattress, humidity too much or too little, etc..
frequents wake-ups can prevent you getting into deeper sleep which you need to feel well rested
data is meaningless till you get sleep quality sorted out and sleeping right thru the night

Hi Kayla,

What Zonk said. You will need to do some detective work to find what will allow you to sleep without waking up so often throughout the night.

1. If you are sleeping with your head "down" so your chin is near your chest, this could be raising how much pressure you need. Try to sleep on your side with neck and head positioned so the angle of your neck is fairly normal, using a pillow which does not hold your head too high or low. Position your head on your pillow with neck and throat relaxed while paying attention to whether your airway is getting constricted by your head position. (It is easiest to tell at normal room pressure before machine is turned on.) Improving your head and neck positions might lower your 95% pressure and therefore might lower how much air gets forced into your stomach, which has been a major problem for you.

Some observations about your data:

2. Your EPAP minimum pressure setting of 14 looks reasonable because your minimum EPAP (14) is not lower than about 4 cmH2O below your median pressures (18.48 and 17.54). In fact, it might help to raise the minimum to maybe 16 because this could help you keep the mask adjusted for no leaks, which might lower your 95% pressure and therefore might lower how much air gets forced into your stomach. (Yes, in this case raising the minimum pressure may lower how much air gets forced into your stomach.)

3. Your 95% pressures (19.72 and 19.56) are too high compared to your max (20). This is why you need to try to reduce these numbers. This can be done by optimizing your sleeping position (as discussed in comment 1) and by eliminating leaks, because leaks can cause machine to raise the pressure.

Your Leak numbers show fairly good average and median numbers but 95% leak numbers (8.40 and 129.48) very high on one of the two nights, and the max leak numbers are too high on both nights.

If SmartStart (auto start/stop) is enabled, I suggest turning it off in the Clinician settings menu, so we will know it is not the cause of the very high max leak numbers.

Your high 95% leak number shows you need to work on your mask fit. I suggest searching for posts on how to eliminate mask leaks. (There are many many postings on this hugely major topic.)

When Leak is very high this will use up all the water in your humidifier very quickly (which can cause discomfort and wake you up), can cause machine to raise the pressure too high (causing air to be swallowed), and can also wake you up by blowing on your face.

Hang in there. Take good care of yourself and don't give up.
--- 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: 01-13-2013 04:45 PM by vsheline.)
01-13-2013 04:39 PM
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kayla Offline

Preferred Members

Posts: 39
Joined: Dec 2012

Machine: resmed s9 autoset
Mask Type: Full face mask
Mask Make & Model: quattro
Humidifier: H5i
CPAP Pressure: 14-19?
CPAP Software: SleepyHead Other Software

Other Comments: I am grateful for the wonderful peopleon this board!

Sex: Female
Location: Canada

Post: #47
RE: Please offer advice
(01-13-2013 04:39 PM)vsheline Wrote:  Hi Kayla,

What Zonk said. You will need to do some detective work to find what will allow you to sleep without waking up so often throughout the night.

1. If you are sleeping with your head "down" so your chin is near your chest, this could be raising how much pressure you need. Try to sleep on your side with neck and head positioned so the angle of your neck is fairly normal, using a pillow which does not hold your head too high or low. Position your head on your pillow with neck and throat relaxed while paying attention to whether your airway is getting constricted by your head position. (It is easiest to tell at normal room pressure before machine is turned on.) Improving your head and neck positions might lower your 95% pressure and therefore might lower how much air gets forced into your stomach, which has been a major problem for you.

Some observations about your data:

2. Your EPAP minimum pressure setting of 14 looks reasonable because your minimum EPAP (14) is not lower than about 4 cmH2O below your median pressures (18.48 and 17.54). In fact, it might help to raise the minimum to maybe 16 because this could help you keep the mask adjusted for no leaks, which might lower your 95% pressure and therefore might lower how much air gets forced into your stomach. (Yes, in this case raising the minimum pressure may lower how much air gets forced into your stomach.)

3. Your 95% pressures (19.72 and 19.56) are too high compared to your max (20). This is why you need to try to reduce these numbers. This can be done by optimizing your sleeping position (as discussed in comment 1) and by eliminating leaks, because leaks can cause machine to raise the pressure.

Your Leak numbers show fairly good average and median numbers but 95% leak numbers (8.40 and 129.48) very high on one of the two nights, and the max leak numbers are too high on both nights.

If SmartStart (auto start/stop) is enabled, I suggest turning it off in the Clinician settings menu, so we will know it is not the cause of the very high max leak numbers.

Your high 95% leak number shows you need to work on your mask fit. I suggest searching for posts on how to eliminate mask leaks. (There are many many postings on this hugely major topic.)

When Leak is very high this will use up all the water in your humidifier very quickly (which can cause discomfort and wake you up), can cause machine to raise the pressure too high (causing air to be swallowed), and can also wake you up by blowing on your face.

Hang in there. Take good care of yourself and don't give up.
--- Vaughn

Hi and thanks for responding,
I am using sleepyhead,but do not understand it.Nor canI figure out how to change my profile.
-and yes I am keeping my head in a tucked in position I have a c-pap pillow and guess I could use it.it is uncomfortable.
--can hear the leaks in my mask and they wake me up...
-I actually almost make the mask so tight it wont leak,and it hurts.
i tried a smaller quattro mask and that was kinda awful.
-The people lent me a bipap machine as they said it was easier to breath out and its true but -mY MOUTH IS SO DRY IN IT AND I CANT KEEP THE HUMIDIFER FULL FOR LONGER THAN 2 HRS.-
-I am at my wits end ,and am using my resmed,but I am awake all night and day.
-I am trying to find someone here to help me,cause Honestly I dont understand all of this.I am not stupid,but i am very tired,and still afraid to go to sleep.
-do I use the bipa? or the C-pap?
I have been quite ill latley and my stomache ,I have to tell you its bad.
-I have other health problems but this should not be too hard to figure out.
-have I contracted something form my machine? no one told me to clean it or how,now I have,maybe I just have a flu.
as for masks i have chinstrap ,and nose mask but cannot seem to keep my mouth closed.
I have never been this frustrated in my life.
I will change my sleep position,and I use a humidifier in my room,latley the water in my machine seems to last longer ...
In all honesy I am a little lost.
a lot lost.
But not giving up
Thank you so much for your help,very kind,and I will look at the mask leak solutions on this board,if anyone knows whter I should use bi-pap or cpap,please let me know,I wake up less w bi pap-easier to breath and I am still wondering should i change my pressure on my own? I could do it but I still dont really understand the manuel.
I feel embarrassed to post this,but also grateful for your ideas.
kayla

(kayla, I cleaned up your post to remove the over-sized quoted text.- Moderator)
01-13-2013 11:11 PM
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PaulaO2 Offline
Wiki Editor
Moderators

Posts: 8,065
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: #48
RE: Please offer advice
Quote:I am using sleepyhead,but do not understand it.Nor canI figure out how to change my profile.

This thread discusses the User Control Panel:
http://www.apneaboard.com/forums/Thread-...trol-Panel
This post within that thread discusses updating your profile:
http://www.apneaboard.com/forums/Thread-...13#pid4713

You can read how to work with SleepyHead by going here:
http://sourceforge.net/apps/mediawiki/sl...sers_Guide

To ensure your questions are being answered, start another thread for your Sleepyhead questions and we'll try to help.

Quote:-and yes I am keeping my head in a tucked in position I have a c-pap pillow and guess I could use it.it is uncomfortable.

The head tuck method does not work for everyone. Another method is to raise the head of your bed. You can have someone put one or two boards under the feet of the headboard. Others put the boards between the mattress and the bed frame. As for the CPAP pillow, nearly everyone I have spoken to who has tried one, hates it. While you may have success with it, your money may be better spent elsewhere first.

Quote:--can hear the leaks in my mask and they wake me up...
-I actually almost make the mask so tight it wont leak,and it hurts.
i tried a smaller quattro mask and that was kinda awful.

Over-tightening the mask will cause more leaks, not fix them. Almost all masks now are designed to "float" on the face and tightening can break that seal. I believe the Quattro is one of these.

Quote:-The people lent me a bipap machine as they said it was easier to breath out and its true but -mY MOUTH IS SO DRY IN IT AND I CANT KEEP THE HUMIDIFER FULL FOR LONGER THAN 2 HRS.-

Just like over-tightening, too much humidity can be just as bad as too little.

You mention a chin strap. The strap should be tight enough that when you relax, your mouth does not fall open but not so tight you cannot chew. You do not want it so tight that you cannot force your mouth open should there be some sort of emergency.

Quote:-I am at my wits end ,and am using my resmed,but I am awake all night and day.
-I am trying to find someone here to help me,cause Honestly I dont understand all of this.I am not stupid,but i am very tired,and still afraid to go to sleep.
-do I use the bipa? or the C-pap?

There's no reason to be afraid to sleep. You were sleeping with undiagnosed sleep apnea for a long time, you'll be fine until you can figure this out. Honest. And the stress from that is not helping you to keep calm and work through these issues. I know it can be tough! You are not alone and we can help.

The bilevel PAP will not help with leaks. What it does is make the difference between inhale and exhale larger than 3 points. As an example, if your treatment pressure is 17, you breathe in at 17 and exhale is 13 or less, depending on the setting. Regular CPAPs do 1-3 points difference. In the example, if your EPR on your ResMed is set to 3, then your inhale is 17 and your exhale is 14. Bilevel PAPs are better for folks who have lung issues and cannot push against the pressure.

If you had to pick one problem as the highest priority that you need to figure out? What would it be? Let's start there and work our way down the list.

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.
01-14-2013 12:11 AM
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kayla Offline

Preferred Members

Posts: 39
Joined: Dec 2012

Machine: resmed s9 autoset
Mask Type: Full face mask
Mask Make & Model: quattro
Humidifier: H5i
CPAP Pressure: 14-19?
CPAP Software: SleepyHead Other Software

Other Comments: I am grateful for the wonderful peopleon this board!

Sex: Female
Location: Canada

Post: #49
RE: Please offer advice
(01-14-2013 12:11 AM)PaulaO2 Wrote:  
Quote:I am using sleepyhead,but do not understand it.Nor canI figure out how to change my profile.

This thread discusses the User Control Panel:
http://www.apneaboard.com/forums/Thread-...trol-Panel
This post within that thread discusses updating your profile:
http://www.apneaboard.com/forums/Thread-...13#pid4713

You can read how to work with SleepyHead by going here:
http://sourceforge.net/apps/mediawiki/sl...sers_Guide

To ensure your questions are being answered, start another thread for your Sleepyhead questions and we'll try to help.

[quote]-and yes I am keeping my head in a tucked in position I have a c-pap pillow and guess I could use it.it is uncomfortable.

The head tuck method does not work for everyone. Another method is to raise the head of your bed. You can have someone put one or two boards under the feet of the headboard. Others put the boards between the mattress and the bed frame. As for the CPAP pillow, nearly everyone I have spoken to who has tried one, hates it. While you may have success with it, your money may be better spent elsewhere first.

Quote:--can hear the leaks in my mask and they wake me up...
-I actually almost make the mask so tight it wont leak,and it hurts.
i tried a smaller quattro mask and that was kinda awful.

Over-tightening the mask will cause more leaks, not fix them. Almost all masks now are designed to "float" on the face and tightening can break that seal. I believe the Quattro is one of these.

Quote:-The people lent me a bipap machine as they said it was easier to breath out and its true but -mY MOUTH IS SO DRY IN IT AND I CANT KEEP THE HUMIDIFER FULL FOR LONGER THAN 2 HRS.-

Just like over-tightening, too much humidity can be just as bad as too little.

You mention a chin strap. The strap should be tight enough that when you relax, your mouth does not fall open but not so tight you cannot chew. You do not want it so tight that you cannot force your mouth open should there be some sort of emergency.

Quote:-I am at my wits end ,and am using my resmed,but I am awake all night and day.
-I am trying to find someone here to help me,cause Honestly I dont understand all of this.I am not stupid,but i am very tired,and still afraid to go to sleep.
-do I use the bipa? or the C-pap?

There's no reason to be afraid to sleep. You were sleeping with undiagnosed sleep apnea for a long time, you'll be fine until you can figure this out. Honest. And the stress from that is not helping you to keep calm and work through these issues. I know it can be tough! You are not alone and we can help.

The bilevel PAP will not help with leaks. What it does is make the difference between inhale and exhale larger than 3 points. As an example, if your treatment pressure is 17, you breathe in at 17 and exhale is 13 or less, depending on the setting. Regular CPAPs do 1-3 points difference. In the example, if your EPR on your ResMed is set to 3, then your inhale is 17 and your exhale is 14. Bilevel PAPs are better for folks who have lung issues and cannot push against the pressure.

Thank you Paula,I already bought the pillow and they have my $,also I do have blocks to put under bed ,i am alone,sleep in a tempurpedic,very heavy,dont have anyone but will try...I slept on my back propped on a few pillows ,a few times,would that work?
2-so if i dont tighten the mask that will help.will try it,I was in hospital in octand the nurse said she could hear the leaks,
3-willing to try the chin strap, and will give it a go,will make sure i can chew.
4-they say I have lung issues asma but I dont take inhalers.
5-Since march and beginning c-pap,I have woken many times so short of breath,
in canada its slow,checked heart dr,and others long process.anyway its a scary feeling so thats why I am afraid at night.
anyway I will try these things ,
thank you so much for your responses.
I will keep trying.
You are so helpful,all of ou
Kayla
01-14-2013 12:40 AM
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IDRIck Offline

Preferred Members

Posts: 60
Joined: Nov 2012

Machine: Resmed S9 Autoset
Mask Type: Full face mask
Mask Make & Model: Resmed Mirage Quattro
Humidifier: H5i plus climateline
CPAP Pressure: CPAP mode 18 cm
CPAP Software: ResScan SleepyHead

Other Comments: Pad-a-cheek anti leak strap

Sex: Male
Location: Idaho, USA

Post: #50
RE: Please offer advice
Kayla,

Take a look at the anti-leak strap from pad-a-cheek. I wear it with the strap below the ear and attached to the bottom of the headgear. My leaks are mostly non-existent after adding the anti-leak strap to my setup.
01-14-2013 02:56 PM
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