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What does this mean?
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Donna Offline

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Posts: 28
Joined: Nov 2013

Machine: REMstar Pro C-Flex+ Auto IQ
Mask Type: Nasal mask
Mask Make & Model: Respironics Wisp
Humidifier: System One Heated
CPAP Pressure: 10
CPAP Software: SleepyHead

Other Comments:

Sex: Female
Location: Tennessee USA

Post: #1
What does this mean?
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.
11-20-2013 01:25 PM
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Peter_C Offline

Advisory Members

Posts: 1,308
Joined: Sep 2013

Machine: System One DS960HS
Mask Type: Full face mask
Mask Make & Model: Mirage Quattro "MED"
Humidifier: Attached
CPAP Pressure: Auto mode-script is:15/3/3
CPAP Software: EncoreBasic Other Software

Other Comments: Severe obstructive sleep apnea 1999/Just got an ASV machine

Sex: Male
Location: Akron, Ohio USA

Post: #2
RE: What does this mean?
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."
11-20-2013 02:20 PM
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zonk Offline

Advisory Members

Posts: 7,908
Joined: Feb 2012

Machine: A10 AutoSet
Mask Type: Nasal mask
Mask Make & Model: Activa LT
Humidifier: Integrated /ClimateLineAir
CPAP Pressure: 9/13
CPAP Software: ResScan

Other Comments: CPAP since Nov 2010

Sex: Male
Location: Australia

Post: #3
RE: What does this mean?
Any dry mouth or stuffy nose?
Whats the data say about AHI and leaks?

Here SleepyHead download link http://www.apneaboard.com/forums/Forum-Private-Files-and-Links
11-20-2013 02:37 PM
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Donna Offline

Preferred Members

Posts: 28
Joined: Nov 2013

Machine: REMstar Pro C-Flex+ Auto IQ
Mask Type: Nasal mask
Mask Make & Model: Respironics Wisp
Humidifier: System One Heated
CPAP Pressure: 10
CPAP Software: SleepyHead

Other Comments:

Sex: Female
Location: Tennessee USA

Post: #4
RE: What does this mean?
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%.
11-20-2013 02:57 PM
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Tez62 Offline

Monitors

Posts: 837
Joined: Feb 2013

Machine: Resmed S9 Autoset
Mask Type: Full face mask
Mask Make & Model: Resmed Mirage Quattro
Humidifier: Resmed
CPAP Pressure: 5-15
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Melbourne, Australia

Post: #5
RE: What does this mean?
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.
11-20-2013 03:22 PM
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zonk Offline

Advisory Members

Posts: 7,908
Joined: Feb 2012

Machine: A10 AutoSet
Mask Type: Nasal mask
Mask Make & Model: Activa LT
Humidifier: Integrated /ClimateLineAir
CPAP Pressure: 9/13
CPAP Software: ResScan

Other Comments: CPAP since Nov 2010

Sex: Male
Location: Australia

Post: #6
RE: What does this mean?
(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
11-20-2013 03:40 PM
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PaulaO2 Offline
Wiki Editor
Moderators

Posts: 8,062
Joined: Feb 2012

Machine: S9 Autoset
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: H5i
CPAP Pressure: 14-20
CPAP Software: SleepyHead

Other Comments: Ehlers-Danlos Syndrome, Hypermobility Type; chronic sarcasm

Sex: Undisclosed
Location: western NC, USA

Post: #7
RE: What does this mean?
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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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.
11-20-2013 03:51 PM
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robysue Online
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Advisory Members

Posts: 1,217
Joined: Oct 2013

Machine: PR Dreamstation BiPAP Auto
Mask Type: Nasal pillows
Mask Make & Model: Swift FX
Humidifier: PR Dreamstation humidfier
CPAP Pressure: min EPAP = 4; max IPAP = 9;
CPAP Software: SleepyHead EncoreBasic EncorePro

Other Comments: Papping since September 2010

Sex: Female
Location: Buffalo, NY

Post: #8
RE: What does this mean?
(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.
11-20-2013 04:06 PM
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trish6hundred Offline

Advisory Members

Posts: 6,430
Joined: May 2012

Machine: Resmed S9 AutoSet for Her
Mask Type: Full face mask
Mask Make & Model: Fisher & Paykel Simplus
Humidifier: H5i Heated Humidifier
CPAP Pressure: 10 - 7-20 Cm H2O
CPAP Software: Not using software

Other Comments: I started CPAP in 2008. Totally blind since birth.

Sex: Female
Location: Missouri, USA

Post: #9
RE: What does this mean?
Hi Donna,
WELCOME! to the forum.!
Hang in there for more responses to your post.

trish6hundred
11-20-2013 04:31 PM
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zonk Offline

Advisory Members

Posts: 7,908
Joined: Feb 2012

Machine: A10 AutoSet
Mask Type: Nasal mask
Mask Make & Model: Activa LT
Humidifier: Integrated /ClimateLineAir
CPAP Pressure: 9/13
CPAP Software: ResScan

Other Comments: CPAP since Nov 2010

Sex: Male
Location: Australia

Post: #10
RE: What does this mean?
(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
11-20-2013 04:54 PM
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