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[Treatment] Chasing Zero - Newbie needs advice
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retired_guy Offline

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Posts: 2,744
Joined: Jan 2014

Machine: ResMed S9 Autoset
Mask Type: Nasal pillows
Mask Make & Model: Resmed Airfit P10
Humidifier: ResMed
CPAP Pressure: 10.6/14, EPR 3
CPAP Software: ResScan SleepyHead

Other Comments: Is it bedtime yet?

Sex: Male
Location: Beautiful, albeit very wet Oregon Coast

Post: #11
RE: Chasing Zero - Newbie needs advice
Once again the medical world has prescribed a top of the line, fully auto-titrating machine and dummied it down by setting it to a fixed cpap mode arrived at by overnight testing with significantly different masks and machines.

If you were running in Auto mode, with a range of say 8 minimum, 14 maximum, then you'd have a good idea of what is needed to control your events. But you aren't. So if you raise the fixed pressure a little at a time, you'll get there, it's just a little more of a crap shoot to get it done.

As to the getting discouraged? Don't do that. You will get great results from your treatment once the equipment starts catering to your needs, rather than expecting you to cater to it.
03-15-2015 05:13 PM
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Sleeprider Offline
Wiki Editor
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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: #12
RE: Chasing Zero - Newbie needs advice
Thanks for your earlier explanation. Your pressures are effectively 8.0/11.0 with EPR. I think you're doing great, but strongly suspect the lower EPAP is why you still have fairly high OA. If the machine was put into Auto mode, I agree with Retired_Guy that a span of 10 minimum 14 maximum would be about right. My "guess" for your minimum is higher because you're using EPR that makes that minimum drop to 7.0 on exhale. So you should not perceive much difference, but the machine could move higher when needed.

The pattern of OA in the chart you posted suggests that you have events when you roll onto your back. The machine in auto mode could deal with that. If you don't want to try Auto mode, then what I said in my first post still applies. You need a higher CPAP pressure, or you can't sleep on your back. Raise pressure by 1.0 to prove it.

Since your ability to attach images is very limited, use the tips in this tutorial and you will have unlimited ability to post charts. https://sleep.tnet.com/reference/tips/imgur

Hey, you're doing great! Keep at it.

______________________________________________
Organize your SleepyHead Data
Post your SleepyHead Data from Imgur
Robysue's Beginner's Guide to Sleepyhead
03-15-2015 05:43 PM
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Lkallen Offline

Members

Posts: 5
Joined: Mar 2015

Machine: Resmed
Mask Type: Full face mask
Mask Make & Model: S9 Autoset
Humidifier: H5i
CPAP Pressure: 11
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Male
Location: Colorado

Post: #13
RE: Chasing Zero - Newbie needs advice
Thanks all, every one of you are kind to take the time to encourage and explain.
03-15-2015 07:40 PM
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quiescence at last Offline

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Posts: 753
Joined: Nov 2014

Machine: REMstar System One with Autoflex
Mask Type: Full face mask
Mask Make & Model: Quattro AirFit F10
Humidifier: yes typical setting = 4
CPAP Pressure: 5-13 Autotritrating CPAP
CPAP Software: SleepyHead EncoreBasic

Other Comments: CMS-50F Plus oximeter /w SPO2 Assistant software. Avowed mouth-breather switching to nose-breathing

Sex: Male
Location: US

Post: #14
RE: Chasing Zero - Newbie needs advice
your study is somewhat revealing regarding the lack of energy or euphoria.

both in non-PAP and in CPAP periods, you have 0% deep sleep (Stage III/IV). you should do a little reading on this. see below comment *

also, you had 80.9% sleep efficiency during first half and 51.3% sleep efficiency during second half of your study.

that is a lot of loss of sleep and if it turned out to be normal for you, this could explain a little of the effects so far.

But, your brain and body will eventually settle their dispute.

Stay with it.

Can anyone on the forum recall their own sleep architecture during lab sleep study, and whether there was an absence of deep sleep? It is certainly possible that no deep sleep is the norm while they are studying you....

* I believe you would benefit from a combo of exercise and brain wave entrainment treatment. Hold back for a moment on the quackery comments, and do some reading, and maybe do some trials. Ask your GP about that.

QAL

one study you should read is ## http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3417155/
note the point about lower-carb dieting as well.

Dedicated to QALity sleep.
You'll note I am listed as an Advisory Member. I am honored to be listed as such. See the fine print - Advisory Members as a group provide advice and suggestions to Apnea Board administrators and staff concerning Apnea Board operation and administrative policies. Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
(This post was last modified: 03-15-2015 09:38 PM by quiescence at last.)
03-15-2015 09:14 PM
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vsheline Offline

Advisory Members

Posts: 1,907
Joined: Jul 2012

Machine: S9 VPAP Adapt (USA Model# 36007, not better 36037 or 36067)
Mask Type: Full face mask
Mask Make & Model: F10 or SimPlus w/ 2Liners. MirageQuatro & Gecko gel pad
Humidifier: H5i
CPAP Pressure: 15 EPAP, PS 5-10
CPAP Software: ResScan

Other Comments: Marfan Syndrome, chronic bradycardia, occasional Cheyne-Stokes Respiration

Sex: Male
Location: California, USA

Post: #15
RE: Chasing Zero - Newbie needs advice
Hi Lkallen,

It speaks well of your Durable Medical Equipment (DME) provider that you were dispensed an APAP set up in CPAP therapy mode, rather than a cheaper fixed-pressure or less data-capable machine.

EPR is considered a "comfort" adjustment which patients are usually encouraged to adjust for themselves.

The provider took it upon himself to increase EPR to 3, which lowered EPAP (your exhale pressure) to 11 - 3 = 8. During the titration you had better results when EPAP was 11 - 2 = 9.

I suggest lowering EPR to 2 or lower.

I also recommend making sure you never roll onto your back while sleeping, or else call your doctor to ask for a change to APAP therapy mode right away.

If you haven't already by that time been changed (at least temporarily) to APAP therapy mode, when you next see your doctor (hopefully you will have an appointment soon with your doctor) I recommend requesting a change to APAP therapy mode, along the lines suggested by other posters. A titration is a portion of just one night. It is pretty common that the pressure prescribed on the basis of a titration study which lasts just a few hours is significantly off from an optimal setting.

Take care,
--- Vaughn

Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
(This post was last modified: 03-15-2015 11:05 PM by vsheline.)
03-15-2015 10:54 PM
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snowdrop Offline

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Posts: 26
Joined: Mar 2015

Machine: REMstar Pro C-Flex+
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: unsure
CPAP Pressure: 6
CPAP Software: Other Software

Other Comments:

Sex: Undisclosed
Location:

Post: #16
RE: Chasing Zero - Newbie needs advice
(03-15-2015 09:14 PM)quiescence at last Wrote:  Can anyone on the forum recall their own sleep architecture during lab sleep study, and whether there was an absence of deep sleep? It is certainly possible that no deep sleep is the norm while they are studying you....

My initial study showed 95% light sleep, 5% deep sleep, and 0% REM.

The study with CPAP showed a huge improvement - 11% deep and 25% REM
03-16-2015 12:16 AM
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snowdrop Offline

Preferred Members

Posts: 26
Joined: Mar 2015

Machine: REMstar Pro C-Flex+
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: unsure
CPAP Pressure: 6
CPAP Software: Other Software

Other Comments:

Sex: Undisclosed
Location:

Post: #17
RE: Chasing Zero - Newbie needs advice
Welcome Lkallen!

I'm fairly new to all this too. As a word of encouragement, I got 0.0 AHI last night (with 8+ hours of sleep!). Fortunately my initial setting have worked like a dream.

Keep at it though! The difference in how I feel through the day is incredible and definitely worth sticking it out.

I'm fairly clueless re. tracking/tech stuff. I just check the data directly on my machine each machine. But there are lots of really knowledgeable people around here Smile
03-16-2015 12:20 AM
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