Post Reply 
[Pressure] Rem Sleep Issue
Author Message
jimmyfreddy Offline

New Members

Posts: 1
Joined: Jan 2013

Machine: Resmed S9 AutoSet
Mask Type: Full face mask
Mask Make & Model: Fisher&Paykel FlexiFit432
Humidifier: ResMed H5i
CPAP Pressure: 14-16
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Male
Location:

Post: #1
Rem Sleep Issue

Have been on CPAP treatment for 1 1/2 years. Having problem with early AM rem sleep cycle awakenings. Have 40% central; 46% obstructive;14% hypopneas. Did 2nd sleep study last night. Tech did titration from 10 up to 25. tried 5 different masks. All leaked profusely at higher pressures. My normal on my S9 Resmed Auto is 14-20. Tech is baffled and I will do another session tonight. Anyone have ideas on adequate mask to handle high pressure settings oe other suggestions? VPAP? Thanks.
06-24-2014 01:23 PM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
robysue Offline
Wiki Editor
Advisory Members

Posts: 1,225
Joined: Oct 2013

Machine: PR Dreamstation BiPAP Auto
Mask Type: Nasal pillows
Mask Make & Model: Swift FX
Humidifier: PR Dreamstation humidfier
CPAP Pressure: min EPAP = 4; max IPAP = 9;
CPAP Software: SleepyHead EncoreBasic EncorePro

Other Comments: Papping since September 2010

Sex: Female
Location: Buffalo, NY

Post: #2
RE: Rem Sleep Issue
Welcome to the forum, jimmyfreddy.

There are two things that stand out in your post:
(06-24-2014 01:23 PM)jimmyfreddy Wrote:  Have been on CPAP treatment for 1 1/2 years. Having problem with early AM rem sleep cycle awakenings. Have 40% central; 46% obstructive;14% hypopneas.
and
Quote: Did 2nd sleep study last night. Tech did titration from 10 up to 25. tried 5 different masks. All leaked profusely at higher pressures. My normal on my S9 Resmed Auto is 14-20.

Both of those facts point to the question: Is an APAP really the right machine to treat your problem?

First, it's becoming pretty routine to start switching people to bi-level during a titration study once the pressure has reached about 15cm. Mostly it's for patient comfort: The fact that the IPAP and EPAP can be more than 3cm apart on a bi-level does make it much easier to exhale against the required positive air pressure. And if, for some reason, the doctor who reviews and signs the sleep study report recommends using a pressure over 20, you'll have to get a bi-level since APAPs only go up to 20cm. Bi-levels can go up to 25cm of pressure.

Second, did your original diagnostic study say anything about central apneas? Or have the CAs emerged since you started on APAP therapy? And if they emerged, what is the treated AHI? And the treated CAI? The answers to these questions are very important for you and your medical team to be looking at. Approximately 15% of PAPers wind up developing clinically significant problems with central apneas after starting PAP therapy; when this happens, the PAP winds up with a diagnosis of Complex Sleep Apnea or CompSA for short. PAPers with higher pressures may be more at risk for CompSA than PAPers with lower pressures.

Hence it's worth asking your sleep doctor to look at your APAP's data and ask whether or not the combination of 40% CAs together with pressure levels of 14-20 warrants an investigation into whether you have CompSA. If CompSA is indeed the problem, a VPAP (bi-level) may or may not make much of a difference. Some people's CompSA does resolve after a few weeks or months on a plain old bi-level, but many CompSA sufferers continue to have problems with too many CAs on a bi-level. The next step is usually either a bi-level ST or an ASV machine, both of which are capable of "triggering" inhalations when the central apneas start manifesting themselves.
06-24-2014 02:02 PM
Find all posts by this user Post Reply Quote this message in a reply
trish6hundred Offline

Advisory Members

Posts: 6,430
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: #3
RE: Rem Sleep Issue
Hi jimmyfreddy,
WELCOME! to the forum.!
Best of luck to you with your second sleep study and hopefully, you will get your CPAP difficulties straightened out.
Hang in there for more responses to your post.

trish6hundred
06-24-2014 02:13 PM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
Post Reply 


Possibly Related Threads...
Thread: Author Replies: Views: Last Post
  My Leak Issue! harmon k 5 286 11-14-2016 05:22 PM
Last Post: edfreeman
  CPAP toppled over/water issue Visitor 5 611 11-12-2016 05:47 PM
Last Post: Sleeprider
  Dreamstation possible setting issue Sector001 5 370 10-14-2016 03:11 PM
Last Post: trish6hundred
  Climateline hose end issue PsychoMike 4 389 10-13-2016 09:34 PM
Last Post: garymda
  [Equipment] Respironics REMstar Auto A-Flex 550P Issue PreciousRoy1981 27 24,069 09-30-2016 06:51 PM
Last Post: Sleeprider
  New to this w/mask issue Caseous 3 236 09-20-2016 07:29 PM
Last Post: Caseous
  Major leak issue, and anything else? Drkeith 2 409 07-04-2016 03:52 PM
Last Post: trish6hundred

Forum Jump:

Who's Online (Complete List)