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leaf blower on my face
#1
First, I'd like to thank you all for being here. I'll ready feel better knowing that I'm not alone.
Several weeks ago I was sent for a sleep study. My doctor is great and after she heard my symptoms she recommended the study. I can sleep 12+ hours and still be tired, headaches, missing work, excessive naps, etc. The first sleep study I had trouble falling to sleep, but the technician said that I slept enough and that they would be calling me back for a second one. Two weeks later, I had the titration (armed with Ambien) then had to wait for my doctor to do the prescription. The results are: AHI=92, 23 Ipap/19 Epap with a back up rate of 14

So now, I 'm trying to learn how to sleep with what feels like a leaf blower on my face. I wish that I could work my way up to a higher pressure. It seems funny that one day it is okay to sleep "naked faced" and then next day bam. I am looking forward to feeling like a real person again, but I don't know how I will ever get used to this bipap even with the ramp. I've been practicing using it as long as possible yesterday and today. I tried really hard to nap with it and to sleep with it last night, but once the pressure starts to ramp up, sleeping seems out of the question. At least I'm getting used to the mask. I can get it on and off pretty well and don't seem to have any leaks. The air pressure seems to be getting the best of me.

I am open to any and all suggestions. PS My DME said, "Don't call us, we'll call you." I live in a small town and they are the only game around here.
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#2
(04-26-2015, 09:00 PM)CArmistead Wrote: PS My DME said, "Don't call us, we'll call you." I live in a small town and they are the only game around here.

That is an unforgivably wrong attitude. Please inform your primary Doc of this and see if he/she can effect some attitude amending remedy for this DME.

As to your issues, I'm thinking you are entirely correct that the pressures you are using are too high for you to begin with. Others with better knowledge of your machine will come along to help advise, but I don't think a pressure max higher than about 16 is appropriate until you start seeing some results. Then, as you become more used to the therapy the pressures can be increased if necessary.

Speaking of which, if you haven't done it yet, download, install and begin looking at your results on the sleepyhead software. That's the best way to know if this therapy is working for you. Far better than the don't call us DME.

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#3
You may need to try out different types of masks before you find one that meets YOUR needs. As for the DME, they are there to provide a service, whether they believe it or not. If all else fails, you can buy supplies and equipment from vendors on our Suppliers List, that is found on the top of each page.

Oh, BTW, Welcome
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 OPINIONS ONLY AND NOT NECESSARILY STATEMENTS OF FACT.
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#4
Hi CArmistead,
WELCOME! to the forum.!
I would talk to your doc about that DME and see if she could reccomend another one. Unfortunately, this DME situation is a common problem.
Hang in there for more suggestions and answers to your questions and much success to you with your CPAP therapy and fine tuning it to work well for you.
trish6hundred
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#5
Hi CArmistead, welcome to Apnea Board.

With an AHI of 92 you have very severe apnea, so its not surprising you were feeling bad. However the prescribed pressures are right at the top of the range and you will definitely have trouble adapting to them. Have a talk to your doc - explain that you cannot be compliant at that pressure and ask for a much lower setting, then work up to the prescribed setting over a period of time. In fact I wouldn't be surprised if you find a lower setting gives better results.

I am not a fan of the one night titration as practised in the US - there are too many variables, to say nothing of the unnatural situation of sleeping in a hospital bed using PAP for the first time. I strongly believe the titration should be over a period of weeks, with regular tweaks of the machine to home in on an ideal pressure range. Where a very high pressure is required, then you have to build up to it gradually.

I also have a question about your machine - I did a quick search, and it looks to me like the OminiLab is designed for sleep lab purposes, not for home use. You might have a sledgehammer to crack a peanut. It would be as well to confirm with your "friendly" DME that you actually have the right machine. Also that it's a NEW machine and not something that has been pensioned off from the sleep lab.

Good luck in this new venture into sleep therapy. Once it all comes together you will feel very much better. In the meantime, we're all here to help.
DeepBreathing
Apnea Board Moderator
www.ApneaBoard.com


Bed

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.
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#6
I want to thank you for your response... Last night I settled in to try to sleep again. I gave it two + hours. It was clear that it wasn't going to work. So, I used the info available in the clinician setup instructions on this website to take matters into my own hands. I changed the setting to cpap with a pressure of 16. Without fighting the machine about who was breathing when... I fell ASLEEP!!! Then I came home from work tired today, put the mask on and promptly took a nap! I am so relieved to be moving forward again. At least I'm sleeping and getting used to the machine.

I called a DME in a town about an hour away. They won't come to me, but I can go to them and they take my insurance. So, they've got a message in with my doctor to see about an auto machine that they recommended.
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#7
Good job taking responsibility CA,

Now you need to install the Sleepyhead software so you can find out for yourself how well you are doing.

The "Sleeping" thing is an excellent sign.
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#8
Yep, get sleepyhead even if just to look at your AHI. Generally the goal of PAP therapy is 5 or less. I've managed to stay at 3 or less for the few days of A-CPAP therapy I've been on, though I'm having my own issues adjusting (mostly that I hate this Mirage Quattro mask, but my DME didn't have a Simplus mask, so I've got to wait to buy one out of pocket online.

My mask was making the dreaded farting noises constantly at 13 last night, the high end of my range (untreated AHI: 67) so I can't imagine having to deal with 23/19. Best of luck!
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#9
(04-27-2015, 10:15 PM)TravitoDLM Wrote: Yep, get sleepyhead even if just to look at your AHI. Generally the goal of PAP therapy is 5 or less. I've managed to stay at 3 or less for the few days of A-CPAP therapy I've been on, though I'm having my own issues adjusting (mostly that I hate this Mirage Quattro mask, but my DME didn't have a Simplus mask, so I've got to wait to buy one out of pocket online.

My mask was making the dreaded farting noises constantly at 13 last night, the high end of my range (untreated AHI: 67) so I can't imagine having to deal with 23/19. Best of luck!

I have used my Mirage Quattro at 20 cm/H2O night after night with a median leak rate of 0 and max of less than 10 l/min. I would venture to guess that either your mask is the wrong size or it is not properly fitted. As long as the mask is not making your nose sore you should be able to get rid of the leaks.

There is a good fitting method outlined on the Mask Arrayed blog. Just Google Mask Arrayed and look for "Taming the Mirage Quattro". Once you have it fitted properly, all you have to do is put it on each night. No Futzing required. After a while the straps will stretch and you will need to refit it. One thing to remember is that the mask needs to be fitted at your max pressure unless you actually enjoy mask farts?? Big Grin Didn't really think so.

Best Regards,

PaytonA
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#10
Well, I did just find out how to get into the clinician's menu, so I've A. enabled the ability to see my AHI and pressure stats right on the device so I don't have to mess with sleepyhead before work to see how I did, and B. I've enabled the mask fit feature, so hopefully I can check it at 13 instead of just 10.

Also looked at the manual and remembered how to preheat the humidifier, maybe that'll be helpful too for my breathing comfort...
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