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Terrible Results
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holden4th Offline

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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

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Sex: Male
Location: Gold Coast Australia

Post: #11
RE: Terrible Results
Had to stop last night as my nose was blocked. Felt like I was suffocating. Will get some nasal spray and carry on tonight.

I noticed that the new setting required quite a bit more exhalation. Is this normal?
02-15-2016 09:09 PM
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DeepBreathing Offline
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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

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Sex: Male
Location: Perth, Western Australia

Post: #12
RE: Terrible Results
Quote:I noticed that the new setting required quite a bit more exhalation. Is this normal?

I suspect it was going to a higher pressure than you're used to, which will make exhaling a bit harder. Does your machine have some sort of pressure relief (eg Resmed have EPR and Philips have Flex)?

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.
02-16-2016 12:22 AM
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holden4th Offline

Advisory Members

Posts: 239
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: #13
RE: Terrible Results
(02-16-2016 12:22 AM)DeepBreathing Wrote:  
Quote:I noticed that the new setting required quite a bit more exhalation. Is this normal?

I suspect it was going to a higher pressure than you're used to, which will make exhaling a bit harder. Does your machine have some sort of pressure relief (eg Resmed have EPR and Philips have Flex)?

It doesn't have either but last night was much easier. I suspect that I might have had a blocked nose on one side, easily fixed last night with a basic nasal spray.

Last night I slept for 7+ hours, woke once to go to the bathroom and straight back to sleep. I think maybe things are improving.

My AHI was not good at 15.4 which consisted of 5.0 OA and 10.4 Hypopnea but I've had much worse.

Major mask leakage was small but acceptable. There was one large leak. Does this mean that the chinstrap is controlling my mouth breathing?

I was under 18cm for 95% of the night

The largest %age of the OAs occurred, once again, when I went back to sleep after a bathroom break.

Let's see what happens tonight.
02-17-2016 03:43 AM
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Sleepster Offline
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Machine: ResMed AirCurve10 VAuto
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Other Comments: Diagnosed Nov 2011. Conquered aerophagia.

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Location: Houston, Texas

Post: #14
RE: Terrible Results
(02-17-2016 03:43 AM)holden4th Wrote:  Major mask leakage was small but acceptable. There was one large leak. Does this mean that the chinstrap is controlling my mouth breathing?

Certainly that statistic is an indicator that it might be, but that alone is not enough to be sure that it is. You have to look at the leak rate graph and see if it rises for extended periods of time. If it does that could indicate mouth-leaking. While it interferes with therapy effectiveness, it can also wake you up and interfere with sleep quality.

The only solution for me was to go to a full face mask. It made a big improvement in the way I feel during the day.

Sleepster
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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.
02-17-2016 06:49 AM
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holden4th Offline

Advisory Members

Posts: 239
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: #15
RE: Terrible Results
Sorry if this is looking a bit like a blog - not my intention.

The main reason for the post is to thank those who gave me advice to change to APAP and the 10-18 pressure setting. On Wednesday night I slept all the way through to 3:05 am and recorded an AHI of 6.67. I didn't feel too bad through the day either. Last night it went up to 9.82 but I'm hoping that this is a sign of progress and that things will slowly improve though I personally see this as a dramatic improvement.

Most important is that my leak rate is quite good and the last two nights there was no dry mouth which I hope means minimal mouth breathing. If so then I can keep the Dreamware nasal mask which I really like. I think that putting the chinstrap over the top of the mask has helped to keep it stable.

At last I'm starting to feel some confidence with using CPAP. Now, when will that really refreshing full night's sleep finally happen. It will be a Hallelujah day!

Once again, thank you to all who have provided advice.
02-19-2016 04:24 AM
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holden4th Offline

Advisory Members

Posts: 239
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: #16
RE: Terrible Results
OK, it's been a while and time to report back on progress. Recommendation was to set pressure APAP 10-14 cms. I've been doing this for 9 days

My AHIs have gone up into the low teens and one or two at 20.

I have woken up feeling starved for air some nights and this is getting more frequent. It s a horrible feeling and I now realise that I had similar experiences before CPAP but didn't realise what they were.

My OAs are in clusters and my hypopneas a bit more spread out.

Mask leak does not appear to be an issue.

I have hit and maintained the top pressure of 14 on quite a few occasions. As I fall asleep I notice the pressure slowly rises from 10. Conversely I also have times where the pressure sits comfortably at 10

Time for some changes

I am almost positive that my head falls forward when I relax, even on my side and that this might be causing flow limitations, hypopneas etc. so I'm going to try a cervical collar. I bought one today and will use it tonight. I will not use my chinstrap.

A couple of thoughts have arisen as I read other posts. I notice that some machines have some sort of auto trial setting to help determine the optimum APAP setting based on 30 days readings. I don't think the F&P Icon has this feature. So if I now reset my machine to APAP 8-20 and leave it like this will I achieve the same result after I look at all the data or is this a bad idea?

I am going to ask the hire company to change my machine. The best they can do is a Resmed S9. They are reluctant to give me this because I don't have a prescription for auto. Can I get my GP ( he's very obliging) to write a prescription or does it have to be a sleep specialist? I feel I need the relief that EPR provides.

Thanks in advance for your advice.
03-06-2016 04:10 AM
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DariaVader Offline
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Other Comments: diabetes II, Thyroidectomized, Primary Immune Deficiency, and the list goes on :P

Sex: Female
Location: Oregon

Post: #17
RE: Terrible Results
any doc or dentist can write a prescription. your insurance may tie your hands. your current prescription covers apap if the dme wanted to issue one - some dmes only issue auto. if they won't issue apap call around to whoever is in network for you and find one who will and give them their rental back Smile sometimes the threat of that will cause them to change their minds about their policies.

هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
Tongue Suck Technique for prevention of mouth breathing:
  • Place your tongue behind your front teeth on the roof of your mouth
  • let your tongue fill the space between the upper molars
  • gently suck to form a light vacuum
Practising during the day can help you to keep it at night

هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
03-06-2016 05:32 AM
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DeepBreathing Offline
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Machine: Resmed S9 VPAP Adapt
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
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CPAP Pressure: EPAP: 9 - 15 PS: 3 - 10
CPAP Software: ResScan SleepyHead

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Sex: Male
Location: Perth, Western Australia

Post: #18
RE: Terrible Results
You don't need a prescription in Australia (unless they do things differently in Qld). Insurance will pay out a small lump sum ($300 - $700 roughly) once every 3 to 5 years depending on which fund you're with and whether you have ancillary cover. They will need a letter from a doctor stating that it's medically necessary. As you are just hiring a machine at the moment, you're a paying customer and as Daria said if they won't oblige you can try elsewhere. I'm sure there are plenty of providers in Brisbane if not in Gold Coast.

The S9 Autoset is a very good machine, but the Airsense 10 is even better as it also registers RERAs which the S9 doesn't. These are like mini-hypopneas which will also disturb your sleep. The S9 and A10 will also give you up to 3cm exhale pressure relief which might make the higher pressures easier to bear. If that fails, then you might need to consider a bilevel machine, but let's take one step at a time.

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.
03-06-2016 05:49 AM
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Sleeprider Online
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Post: #19
RE: Terrible Results
I hope the use of a soft cervical collar helps. We have had other members that reported similar clustering of apnea, and their solutions varied from body position to using aids like the cervical collar, and almost all of them allowed their machines to go to maximum pressure as needed. The fact you are hitting your maximum pressure pretty fast is a sign, and it appears you read it and are taking appropriate action.

I have a lot more respect for the Resmed than Icon, but that may just be familiarity. Both are capable of producing up to 20 cm pressure, but the Resmed comfort feature of EPR is going to be useful as your pressure rises. I'd go with DeepBreathing's answer with regard to the AU medical system. I use my GP for prescription and care management here in the U.S.

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03-06-2016 09:33 AM
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holden4th Offline

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Posts: 239
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: #20
RE: Terrible Results
OK, as I mentioned previously, I bought a soft cervical collar and used it for the first time last night. The results are very promising. For a good part of the night I was below 5.0 but somehow, once again the OAs and Hs kicked in right at the end. But an overall AHI of 8.12 for a full nights sleep is a new benchmark. Great not to have to use the chinstrap and the bulk of the collar helped with leaks while side sleeping.

The most encouraging thing is the significant decrease in hypopneas. They are actually outnumbered by the OAs for the first time ever.....and I didn't have a dry mouth which suggests minimal mouth breathing.

The pressure range was 8-15 and the 95% pressure was 12 with a max of 13. Am I finally coming to terms with this condition or will another barrier be thrown into my path? I am going to increase the minimum pressure to 9.0 for tonight. Good idea?

I still feel I need EPR and will address this very soon. Seeing my GP and will ask him to prescribe APAP set for 8-14. This will get me around the loaner comapny issues. I don't blame them as they are legally liable for any unprescribed changes but I can do what I like.

Anyway, here is the data.

http://i1108.photobucket.com/albums/h419...vzz6t9.png
03-07-2016 03:44 AM
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