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What does this mean?
#1
I had my sleep study two years ago and was diagnosed with severe OSA. I just obtained a copy of my sleep study this week which showed that I only slept 62% of the night. 45% of my sleep was at Stage 2 level with 7 obstructive Apneas (mean duration of 20.4 seconds) and 114 hypopneas (mean duration of 25.3 seconds). Longest events were 23.8 seconds and 48.0 seconds respectively with oxygen saturations dropping to 86%. I was started on CPAP with fixed rate of 8 cmH2O and Swift nasal pillows. That worked well in the beginning. My morning headaches went away, my hypertension corrected and I was able to get off my blood pressure medication but I never experienced more energy nor noticed any difference in my level of tiredness.

After one year, my blood pressure creeped back up and headaches returned. My Physician restarted my blood pressure medication. I started using a Wisp nasal mask because the nasal pillows were dislodging with movement (I can't seem to stay in one position, thrashing about all night). My Pulmonologist prescribed an increase of cmH2O pressure ranging from 8-16, at increments of 2. Pressure was increased to 10 with no noticed change. Recently, I had the pressure increased to 12, which I tolerated without difficulty. That resulted in a headache that has not subsided since, even with over the counter analgesics. Could the headache just be a coincidence or is it possible that this pressure is too high? Are there risks associated with CPAP pressure being too high? Am I overlooking something? Any advice is greatly appreciated.
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#2
A recording Oximeter like a CMS50F can be had for around $100 bucks. This would record your O2 levels during the night. The primary goal of treating OSA is to both get better sleep, AND, keep your O2 levels in a normal range while you are sleeping. For me, using the Oximeter is an easy way to find out what's going on.

Others will chime in with other thoughts and ideas for you as well Smile Welcome to the forum!
*I* am not a DOCTOR or any type of Health Care Professional. My thoughts/suggestions/ideas are strictly only my opinions.

"Only two defining forces have ever offered to die for you. Jesus Christ and the American Soldier. One died for your Soul, the other for your Freedom."
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#3
Any dry mouth or stuffy nose?
Whats the data say about AHI and leaks?

Here SleepyHead download link http://www.apneaboard.com/forums/Forum-P...-and-Links

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#4
Zonk, thanks for helping me with answers to my concerns. I have had no dry mouth or stuffy nose. AHI 2.8 and large leaks at 1%.
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#5
Welcome Donna, a pressure of 12 isn't that high but as your not using an auto CPAP it may be harder for you to tolerate and causing your headache. You need to speak to your doctor about it maybe you go back to 10 for a while then increase by 1 every couple of weeks. I'm fairly sure your CPAP is not data capable meaning you can't read your own data, is your doctor looking at your data? Get it looked at you shouldn't be getting regularly headaches due to CPAP, let us know how you go.
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#6
(11-20-2013, 02:57 PM)Donna Wrote: AHI 2.8 and large leaks at 1%.
Unlike ResMed reports unintentional leak and tell us that leak at or below 24 L/m is an acceptable leak.
Your machine report total leak [intentional leak (vents leak) plus unintentional leak (mask and mouth leak)].
According to Respironcis, large leak is defined as the level of leak that is so large, it is no longer possible to determine respiratory events with statistical accuracy.

SleepyHead shows you both total leak and unintentional leak also shows AHI, the number of obstructive, hypopnea, and clear airways events

Tez62 ... Donna machine is data capable machine
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#7
The headache could be from the blood pressure as well. How is that doing?

I'm surprised the sleep doc increased the pressure without doing any sort of extra test such as oximeter. Or was your AHI increasing along with the blood pressure?
PaulaO2
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#8
(11-20-2013, 02:57 PM)Donna Wrote: Zonk, thanks for helping me with answers to my concerns. I have had no dry mouth or stuffy nose. AHI 2.8 and large leaks at 1%.
Donna,

Has anybody ever looked at the detailed data recorded by your machine???

In other words, did the doc just increase your pressure without bothering to look at any of the detailed data?

Since your equipment profile says you're not using any software, I assume that AHI = 2.8 is a 7-day or 30-day average coming from your machine's LCD. Sure, that's below the magic "keep the AHI < 5" standard. But has that AHI been creeping up as the headaches have returned? It it also possible that you're having some clusters of nasty events or perhaps some long events that might explain the return of the headaches.

And it is troubling that your blood pressure is also on the rise and that you are once again on HBP medicine. (Could the HBP be causing the headaches?)

Also, you need to understand that to have even 1% time in Large Leak show up on the machine LCD can indicate a pretty bad leak problem. The reason why is this: The boundary for Large Leak territory on the System One is kind of vague (it's not officially defined by Philips Respironics in any of their literature) and 1% of 7 nights sleep is a pretty significant chunk of time---if the leaks are on one night, you'd need almost 30 minutes of leaks to make the LCD go from 0% Large Leak to 1% Large Leak in the 7-day averages. In other words, you're either hitting Large Leak territory every single night for several minutes (and likely having some pretty decent, but not quite large leaks for a lot longer every night) OR you are having some extremely long, but rarer Large Leaks on an intermittent basis.

Since your machine records efficacy data and it indicates that you are spending some regular time in Large Leak territory, it would be worth your time and effort to download SleepyHead and learn how to read the basic data that your machine is recording each night while you are asleep. It could very well be that at least a partial answer to your current woes lies in your data.

And looking at your data in SleepyHead is a cheaper and easier place to start than investing in a recording oxymeter at this point in time in my humble opinion.
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#9
Hi Donna,
WELCOME! to the forum.!
Hang in there for more responses to your post.
trish6hundred
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#10
(11-20-2013, 04:06 PM)robysue Wrote: Has anybody ever looked at the detailed data recorded by your machine???

In other words, did the doc just increase your pressure without bothering to look at any of the detailed data?
I,m hoping Donna doctor looked at detailed data, my first sleep doctor only looked at the LCD data and AHI was over 10. She kept bumming my pressure until 20 is reached. She did not realize or knew that first you need get leaks under control and improve sleep quality otherwise increase pressure would cause more problems than try to solve. The software is valuable tool, learn how use it, you only need knowing the basics to figure whats going on
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