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Terrible Results
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holden4th Offline

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Posts: 238
Joined: Dec 2015

Machine: PR System One REMStar 60 Series Auto with Bluetooth
Mask Type: Nasal mask
Mask Make & Model: Respironics Dreamwear
Humidifier: Remstar Heated Humidifier
CPAP Pressure: 11- 15 APAP
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Gold Coast Australia

Post: #1
Terrible Results
Having experimented I have settled on a chinstrap to go with my dreamware mask. The last two nights saw me going to sleep quickly and sleeping for about six hours before waking a couple of hours short of my usual get up time. Yay I thought, at last!

However, my fatigue levels the last two days are some of the worst I've experienced so I downloaded the Sleepyhead software to check. My AHIs were 33 and 27 which is horrendous. I can't understand why and am seeking advice. The machine was working at the set pressure, major mask leaks were only 3.1%. What could be going wrong. I feel better after a night without the mask. What other factors do I have to take into account? This is a very frustrating journey, one hurdle overcome and then another appears.
02-12-2016 05:45 AM
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steelerduk Offline

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Posts: 7
Joined: Feb 2016

Machine: ResMed AirSense 10 Auto
Mask Type: Full face mask
Mask Make & Model: AirFit F10
Humidifier: integrated
CPAP Pressure: 4 - 18
CPAP Software: SleepyHead

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Sex: Male
Location: Oregon

Post: #2
RE: Terrible Results
Do you know if you have Central sleep apnea ? I was told by my sleep doctor that when I started using the CPAP machine that if I also had Central sleep apnea then using the CPAP machine would make things worse. And I would know very soon after starting the treatment. She mentioned this because in my test results it showed a couple times in the results. So far with over a week of treatment my AHI numbers are 1.02 or less. My sleep test showed over 91 AHI. So have you discussed this with your doctor ?

Another possibility is :

Complex sleep apnea syndrome, also known as treatment-emergent central sleep apnea, occurs when someone has both obstructive sleep apnea and central sleep apnea.

I would get with your doctor as soon as you can.
(This post was last modified: 02-12-2016 07:44 AM by steelerduk.)
02-12-2016 07:41 AM
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OpalRose Offline

Monitors

Posts: 3,167
Joined: Nov 2014

Machine: PR System One REMstar Auto 560 with A Flex
Mask Type: Nasal pillows
Mask Make & Model: AirFit P10 For Her
Humidifier: REMStar heated humidifier with heated hose
CPAP Pressure: Auto Cpap 10-13 AFLEX 1
CPAP Software: SleepyHead EncoreBasic

Other Comments: Started CPAP Therapy October 23, 2014

Sex: Female
Location: Northeast Ohio, USA

Post: #3
RE: Terrible Results
holden4th,
Please download the Sleepyhead software. Then you will be able to see if you are having a lot of Clear Airways. Once you have that downloaded, post us a screenshot of your data: events graph,
Flow limitation graphs, leak rate graph and the data to the left of graphs.

OpalRose
02-12-2016 08:34 AM
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holden4th Offline

Advisory Members

Posts: 238
Joined: Dec 2015

Machine: PR System One REMStar 60 Series Auto with Bluetooth
Mask Type: Nasal mask
Mask Make & Model: Respironics Dreamwear
Humidifier: Remstar Heated Humidifier
CPAP Pressure: 11- 15 APAP
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Gold Coast Australia

Post: #4
RE: Terrible Results
(02-12-2016 08:34 AM)OpalRose Wrote:  holden4th,
Please download the Sleepyhead software. Then you will be able to see if you are having a lot of Clear Airways. Once you have that downloaded, post us a screenshot of your data: events graph,
Flow limitation graphs, leak rate graph and the data to the left of graphs.

Hello OpalRose

I'm now even more confused.

Put on the mask last night and lasted four about four and a half hours before awakening. At that point, so as not to compromise any data with trying to get back to sleep, I took off the mask. Just checked the data stick and an AHI of 8.1. There were no OAs at all compared to the previous two nights. This does not make sense. I only did one thing different between the two nights previous and last night.

So now I'll try to upload the three nights worth and let you folks see what's wrong.

http://i1108.photobucket.com/albums/h419...axslfv.png

http://i1108.photobucket.com/albums/h419...jrpmdn.png

http://i1108.photobucket.com/albums/h419...oks2nu.png

Back to the mask again tonight.

BTW I think I am starting to sleep more on my back but surely this should not be a problem with a correctly set CPAP machine.
(This post was last modified: 02-12-2016 09:34 PM by holden4th.)
02-12-2016 09:31 PM
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DeepBreathing Offline
Wiki Editor
Moderators

Posts: 2,294
Joined: Sep 2013

Machine: Resmed S9 VPAP Adapt
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: Resmed H5i
CPAP Pressure: EPAP: 9 - 15 PS: 3 - 10
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Male
Location: Perth, Western Australia

Post: #5
RE: Terrible Results
G'day holden4th

It would helpful to know which Icon model you have - your profile says "fixed pressure" but SleepyHead indicates it's an Icon Auto in fixed pressure mode. Also, what colour is it - light grey (older model) or charcoal (Icon+).

Looking at your charts, you're having a lot of obstructive apneas most nights and a lot of hypopneas even on the night you didn't get any apneas. Hypopneas are narrowings of the airway which restrict your breathing but don't completely block it. They are obstructive in nature - basically an apnea that didn't quite develop into a full blockage. There is no mention of clear airway apneas, so I assume your machine doesn't detect them. The repeated drops in pressure are caused by the "SenseAwake" system - the machine thinks you're awake and reduces the pressure until it thinks you're asleep again. To me this indicates that your events are causing quite big arousals. It's probably also the case that the repeated pressure changes of the SenseAwake are causing additional sleep disturbance.

I'm unsure how your machine reports leaks, but looking at the chart my guess is you're having enough to cause some disturbance on top of the other issues.

The fact that you're having so many obstructive events indicates that you need a higher pressure to control them. Sleeping on your side will definitely help - when you're on your back the machine has to fight against gravity to keep your airway clear. In your position, I would consider the following:

1. Turn off SenseAwake
2. Put the machine into Auto mode with a pressure range of say 10 - 18
3. Avoid sleeping on your back - there are various tricks such as using additional pillows to prevent you turning over, wearing a lightweight backpack or sewing a tennis ball into the back of your PJs
4. Ensure your mask is fitting correctly and comfortably and is not leaking
5. Keep the settings unchanged for at least a week and monitor your progress.

DeepBreathing
Apnea Board Moderator
www.ApneaBoard.com


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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.
02-12-2016 10:21 PM
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Sleepster Offline
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Posts: 4,991
Joined: Feb 2012

Machine: ResMed AirCurve10 VAuto
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: HumidAir and SlimLine Hose
CPAP Pressure: MaxI 13.6 | MinE 5.2 | PS 4.4
CPAP Software: ResScan SleepyHead

Other Comments: Diagnosed Nov 2011. Conquered aerophagia.

Sex: Male
Location: Houston, Texas

Post: #6
RE: Terrible Results
(02-12-2016 09:31 PM)holden4th Wrote:  Put on the mask last night and lasted four about four and a half hours before awakening. At that point, so as not to compromise any data with trying to get back to sleep, I took off the mask.

I think you're going about this backwards. First and foremost you must commit to wearing the mask every time you sleep, all the time you are sleeping. Second, get your leaks under control. Look at your leak graph and make sure you are not experiencing times when the leak rate goes up and stays up for long periods of time. This is an indication of mouth leaking, which if not remedied with a chin strap will require a full face mask. Then finally you can work on getting your AHI below 5 or so.

Sleepster
Apnea Board Moderator
www.ApneaBoard.com


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.
02-12-2016 11:00 PM
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holden4th Offline

Advisory Members

Posts: 238
Joined: Dec 2015

Machine: PR System One REMStar 60 Series Auto with Bluetooth
Mask Type: Nasal mask
Mask Make & Model: Respironics Dreamwear
Humidifier: Remstar Heated Humidifier
CPAP Pressure: 11- 15 APAP
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Gold Coast Australia

Post: #7
RE: Terrible Results
Thanks for all replies so far.

I've uploaded last nights results (7 hours sleep) but more on that later.

I've also been wondering about the pressure. My machine is a rental and was set according to prescription at 13. The woman at the rental place told me that this F&P was.

Fixed pressure only
Only able to be adjusted by a technician.

She's wrong on both counts. My machine, according to the information on the bottom, is an F&P Icon+ Auto. I had a quick play this morning to see if I could access the settings and it was easy though I haven't changed any yet. I am seriously tempted to do what Deep Breathing has suggested and set it to auto 10-18 and turn off Sensawake.

The problem with going to my sleep doctor is that I don't really have one and this would be true for most Australian sufferers. My sleep trial and titration study were done with SNORE Australia, a reputable anjd respected organisation. Both studies were bulk billed (free through Australian Medicare) but on both nights I had a different doctor/technician. The doctor/technician on the second night was, maybe fortuitously, a parent at the school I teach at and I am wondering if it would be unprofessional to approach him personally for advice. Medicare Australia does not cover ongoing sleep apnoea treatment which is astounding. One of the biggest killers on our vast road sytem is labelled "driver fatigue". To give an example of Aussie driving conditions,there is a stretch of highway on the Nullarbor Plain that is completely straight for 142 kms and this typifies the long straight roads you encounter in our outback. Many of these include our major highways.

Here are last nights results

http://i1108.photobucket.com/albums/h419...llcn7w.png

AHI of 15.4 - horrible was the Sleepyhead description. However, I've noticed something interesting. I woke up after 150 minutes. I had something quick to drink, read a book and was back asleep within 30 minutes. You can see it on the graph that I had the machine turned off at thaqt time.

That first period of sleep my AHI was 1.6. So what happened after I went back to sleep that made the OAs rise so significantly? At least they are better than the previous nights but that's little consolation.

I do wear a chin strap but suspect that I do still leak from the mouth. If I got a FFM I would need one where the hose went directly above my head like the Dreamwear does. Do they exist?

Thanks in advance for your comments and advice
02-13-2016 05:58 PM
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Sleeprider Online
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Posts: 3,331
Joined: Dec 2014

Machine: Resmed Aircurve 10 Vauto
Mask Type: Nasal pillows
Mask Make & Model: Resmed Airfit P10
Humidifier: Resmed Climateline
CPAP Pressure: Auto Bilevel 18/9, PS 3
CPAP Software: ResScan SleepyHead EncoreBasic

Other Comments:

Sex: Male
Location: Where they make Respironics

Post: #8
RE: Terrible Results
You seem to have some pretty stubborn OA and H events that your pressure of 13 is not touching. It could be positional, or a need for higher pressure, but at 15+ you have plenty of room for improvement. By all means, you need to continue therapy through the night, and not worry about "data", but I think you can switch to auto mode. Given what we're seeing on your posted chart, I'd go with 10 minimum pressure and let the machine titrate to 18. This could settle down in a while, or if you don't see significant improvement, you might be headed to bilevel, and some means of staying off your back.

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02-13-2016 07:45 PM
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holden4th Offline

Advisory Members

Posts: 238
Joined: Dec 2015

Machine: PR System One REMStar 60 Series Auto with Bluetooth
Mask Type: Nasal mask
Mask Make & Model: Respironics Dreamwear
Humidifier: Remstar Heated Humidifier
CPAP Pressure: 11- 15 APAP
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Gold Coast Australia

Post: #9
RE: Terrible Results
(02-13-2016 07:45 PM)Sleeprider Wrote:  You seem to have some pretty stubborn OA and H events that your pressure of 13 is not touching. It could be positional, or a need for higher pressure, but at 15+ you have plenty of room for improvement. By all means, you need to continue therapy through the night, and not worry about "data", but I think you can switch to auto mode. Given what we're seeing on your posted chart, I'd go with 10 minimum pressure and let the machine titrate to 18. This could settle down in a while, or if you don't see significant improvement, you might be headed to bilevel, and some means of staying off your back.

Got the Icon+ manual from the nice people on this board and have turned off Sensawake and set the machine to Auto 10-18. It was a remarkably easy process. I will leave it set like this for the next week and see what happens.

It's good to see that your advice matches those of other experienced hoseheads on this forum so I'll follow the consensus.

Here's to a good nights sleepSleep-well
02-15-2016 04:37 AM
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Sleeprider Online
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Posts: 3,331
Joined: Dec 2014

Machine: Resmed Aircurve 10 Vauto
Mask Type: Nasal pillows
Mask Make & Model: Resmed Airfit P10
Humidifier: Resmed Climateline
CPAP Pressure: Auto Bilevel 18/9, PS 3
CPAP Software: ResScan SleepyHead EncoreBasic

Other Comments:

Sex: Male
Location: Where they make Respironics

Post: #10
RE: Terrible Results
Good luck and keep us posted. Give the new settings a chance to work for a while, before you decide to make additional changes.

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02-15-2016 09:39 AM
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