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Recently Diagnosed, First Post, Couple Q's
#1
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Recently Diagnosed, First Post, Couple Q's
Hello everyone, first post here! Was recently diagnosed with OSA, 22.2AHI. Declined a follow-up overnight titration stay and ended up with an auto-PAP with my prescription pressure 6-20.

3 nights so far with a nasal mask, machine and OSCAR both showing less that 3 AHI so far. So congrats to my numbers, but honestly I don't feel any better really, so kinda bummed about that; was hoping for some miracle revelation on what feeling rested was based on family\coworker stories.

Couple questions for a beginner:
1. The first night of use my PR DreamStation APAP started off low pressure, wasn't uncomfortable. But that was the, ever since, the thing turns on at what feels like pressure setting 9000. I have to vigorously exhale into the thing and after a couple mins it chills out and I can finally breath. What's going on here? How do I get it to start off really low?

2. At what point should I change my pressure range? Currently it's 6-20 but after 3 nights the 90% is about 12. Should I wait longer and look at more data in OSCAR before bringing that max 20 down? Or just let my Dr. change it via the modem whenever they get around to reviewing the data?

Thanks!
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#2
RE: Recently Diagnosed, First Post, Couple Q's
G'day Fatsleeper15. Welcome to Apnea Board.

I'm not totally familiar with Dreamstations but I believe they have a feature called OptiStart. A bit of searching found this:

DreamStation Auto goes a step beyond traditional APAP therapy with Opti-Start. When Opti-Start is enabled DreamStation Auto will begin each therapy session at a pressure that is close to the previous session's 90% pressure, in order to reduce the likelihood of residual events at the beginning of a therapy session.

So that would explain why your machine starts each session at a high pressure. If it bothers you (as it obviously does) then turn it off, or get you doc / therapist to turn it off for you.

Quote:3 nights so far with a nasal mask, machine and OSCAR both showing less that 3 AHI so far. So congrats to my numbers, but honestly I don't feel any better really, so kinda bummed about that; was hoping for some miracle revelation on what feeling rested was based on family\coworker stories.

The lucky few do get a rapid, obvious and very joyful improvement in their overall condition immediately they take to the hose. But for the the rest of us 99%, it's a bit of a process and takes a while for the effects to come through. Sleep apnea is an insidious disease that creeps up on you - likewise the improvements will also creep up over time. You've already got your AHI down to a manageable level after just three nights - that's quite an achievement in itself. Let's see some OSCAR daily charts and we'll see if there other tweaks that you can discuss with your doctor (or implement yourself if you're minded to).
DeepBreathing
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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.
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#3
RE: Recently Diagnosed, First Post, Couple Q's
Just to echo DeepBreathing: it will probably take some time, and it may be gradual, but you will feel better. Patience is your watchword. Plus keep in mind all the good you are doing for your long-term health.

I wish I knew the answer to your problem with super-high pressure when you start. Others who are familiar with the PR machines may be able to help.

Once you can post a daily chart, I know you will get good advice about your settings and any other aspects of treatment that are problematic for you.
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#4
RE: Recently Diagnosed, First Post, Couple Q's
(10-19-2019, 09:13 PM)DeepBreathing Wrote: I'm not totally familiar with Dreamstations but I believe they have a feature called OptiStart.

Thanks! I actually found that setting shortly after getting the clinician manual but unfortunately it's already turned off. So I'm not sure what's going on, I'll have to look around more.

I'll upload some OSCAR captures, maybe tomorrow so I've got at least 5 days worth of data.

Been reading a lot since joining, interesting stuff on the flow waveforms!
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#5
RE: Recently Diagnosed, First Post, Couple Q's
Should I turn off the VS2 indicators in OSCAR before uploading screenshots?
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#6
RE: Recently Diagnosed, First Post, Couple Q's
(10-22-2019, 06:40 PM)FatSleeper15 Wrote: Should I turn off the VS2 indicators in OSCAR before uploading screenshots?

Yes, that removes a lot of clutter.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
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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.
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#7
RE: Recently Diagnosed, First Post, Couple Q's
Ok great, and I guess lastly before posting some screenshots, when I post some daily screenshots, I don't have anything in particular that I'm looking at, is it OK to post the entire session where the flow rate just looks solid black (can't see detail) or should I focus in on something (OA, H, or FL flag?)? I have some PB areas, don't seem to have any leaks (no LL flags), and once on CA flag on my first night of CPAP early on, what appears to be junk sleep as I'm wrangling with my newfound hose attachment!
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#8
RE: Recently Diagnosed, First Post, Couple Q's
Let's see the whole night so we can get an overview of how you're travelling. Plus a close up of the periodic breathing just to rule out anything nasty. Make sure you organise the charts properly: see the link in Bonjour's signature.
DeepBreathing
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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.
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#9
RE: Recently Diagnosed, First Post, Couple Q's
Alright, here we go! As mentioned above, diagnosed with moderate OSA at 22.2 AHI. Prescription was an APAP set from 6-20 cmH2O. Given a PR DreamStation APAP machine with humidifier and heated hose. Using a PR Wisp nasal mask. I've got the humidity set to 3 and the hose set to 1. Ramp is from 4cmH2O over 15mins and I've got mask type set to X1 (matches what's on the Wisp mask). I've got my Flex set to 3. Mask check is giving me a green check mark on my back and side.

Nights 1-5 attached. Next post will be night 6 and the zoom in of a PB event from night 6.


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#10
RE: Recently Diagnosed, First Post, Couple Q's
Night 6 and the zoom in of a PB event from night 6.

Generally speaking, I don't feel much different. It's not like a night and day difference. I don't feel more "rested" or anything. I actually feel like I'm sleeping "worse" but don't feel any more tired because of the "worse" sleep. I think maybe I'm just still adjusting to the whole thing. I have noticed that it seems like I'm not as tired as I used to be at the same time at night if that makes sense? So I think maybe I am sleeping better but just can't really tell? For example, I'm usually tired/ready for bed around 11pm and I wake up at 6:15am for work Monday-Friday. At 11 I'm not feeling as tired, so for example, last night I stayed up till midnight. Normally that'd make me tired all next day at work, but even after going to bed at midnight, I still woke up before my alarm at 5am and couldn't get back to sleep easily, so I took the mask off and kinda crappy slept till my alarm. Some people don't require as much sleep as others to function. Is it possible that now because I'm sleeping more efficiently(?) that I only need say 6 hours of sleep to feel "rested" instead of 7?

Any tips, pointers, comments on my charts?


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