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Starting Treatment - APAP Settings/First Night Results
#1
Starting Treatment - APAP Settings/First Night Results
Good morning. Starting this thread to document my APAP settings and any issues that occur, starting with my first night of sleep. This will be the only thread I use for my treatment now that it's begun.

The device detected an AHI value of 1.23 for the night, which is incredibly good, considering the original diagnosis of 37 AHI from my doctor.

Device: 
Resmed AirSense 10 AutoSet

Settings:
Min: 5
Max: 20
EPR 3

Using a full face mask. What I want to know is if the first night's results from Oscar indicate that any settings need to change or not (probably not anything major considering the 1 AHI - maybe increasing the min to 8?). And, is it common to wake up multiple times in the night and remember being awake for those times when beginning CPAP/APAP treatment? I also noticed that my nose was slightly sensitive upon awakening in the morning - I woke up due to leaks once or twice and adjusted my mask maybe slightly tight probably just need to adjust my mask better when going to sleep.


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#2
RE: Starting Treatment - APAP Settings/First Night Results
Minimum pressure of 5cmw does not allow your EPR 3 to fully function.
The lowest your machine can go is 4cmw so your EPR is effectively 1.

If you want to take full advantage of your EPR, set your minimum to 7cmw.


I'm not an expert so I won't speak to the rest of your question but, I do understand that bit of the machine.

It is normal for it to take time to get used to treatment and to find comfortable mask placement.
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#3
RE: Starting Treatment - APAP Settings/First Night Results
Hi willaien,
Welcome to Apnea Board!

As stated above, your minimum pressure is a bit low.  A minimum pressure of 7cm is good to try.  I was going to suggest 8cm, but you can always work up to it if need be.
You may not need it.  

With this change, and EPR 3, you should see a reduction in Rera's, Hypopnea and Flow Limitation.  

One more thing... bring the maximum pressure down to 16cm.  This narrows the pressure range a bit and eliminates pressure swings which could be waking you.

Have you read the Mask Primer?
http://www.apneaboard.com/wiki/index.php...ask_Primer

Good luck, and repost in a day or two.  One day doesn't make a trend!
OpalRose
Apnea Board Administrator
http://www.ApneaBoard.com

_______________________
OSCAR Chart Organization
OSCAR - The Guide
Soft Cervical Collar
Optimizing therapy
OSCAR supported machines
Mask Primer



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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#4
RE: Starting Treatment - APAP Settings/First Night Results
Thanks for your responses! I have set the device to 7-16 for now.

I looked through the mask primer, which has inspired me to go ahead and look at getting a couple different styles to try out over the next few weeks. My insurance probably won't cover them, but I can afford it for the comfort.
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#5
RE: Starting Treatment - APAP Settings/First Night Results
Wow - what great first night results. Min of 7 as suggested is a good step. Persevere!

One other thing. After your mask gets full of air, pull it out just 1/4" in from your face for just a second, to be sure the mask is fully inflated. Then reseat it.
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#6
RE: Starting Treatment - APAP Settings/First Night Results
Weird. I appear to have had a cluster of central apneas last night, a while in followed by a major leak, which I fussed about with until it went away. The CAs went away for the most part after that. And I seemed to be struggling with leaks less. I don't feel like I'm getting a good night's sleep yet, though - a lot of waking up and hard to go back to sleep.

I think the CAs were due to me struggling to fall asleep - I kept forgetting to breathe, waking back up, then trying to go back to sleep.


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#7
RE: Starting Treatment - APAP Settings/First Night Results
Not sure what was going on during that period of CA clusters.  As you stated, you were fussing with your mask and not yet asleep, maybe holding your breath?

Half the battle with Cpap use is getting the mask to behave.  Read the Mask Primer as you may find some hints on adjusting your mask.

http://www.apneaboard.com/wiki/index.php...ask_Primer

I would stick with these settings another night.  If we continue to see CA's, then we could try to lower the EPR to 2, but for now... concentrate on your mask fitting.
OpalRose
Apnea Board Administrator
http://www.ApneaBoard.com

_______________________
OSCAR Chart Organization
OSCAR - The Guide
Soft Cervical Collar
Optimizing therapy
OSCAR supported machines
Mask Primer



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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#8
RE: Starting Treatment - APAP Settings/First Night Results
Didn't have a cluster of CAs last night, but I feel tired. Very tired. I don't know if it's me rousing and having trouble going back to sleep with the mask on. Would it be worth trying sleep aids while I adjust, or is that generally not recommended?

I have a couple of different mask styles coming in soon that will hopefully bother me less.


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#9
RE: Starting Treatment - APAP Settings/First Night Results
The second half of your night seemed much calmer than the first half.
Look where the pressure rises.  Line that up with the leak and FL graph.
The Flow Limitation causes the pressure to rise.  This may be what's waking you.

Your numbers look good.  Just watch the mask leaks.

As far as a sleep aid, you may want to touch base with your doctor..
OpalRose
Apnea Board Administrator
http://www.ApneaBoard.com

_______________________
OSCAR Chart Organization
OSCAR - The Guide
Soft Cervical Collar
Optimizing therapy
OSCAR supported machines
Mask Primer



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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#10
RE: Starting Treatment - APAP Settings/First Night Results
Hi willaien,



I would not recommend "sleep aids" unless dr prescribes them for a specific reason.

Arousals during the night does effect restful reenergizing sleep.
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