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I'm an overwelmed New APAP User, Help! - Printable Version

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I'm an overwelmed New APAP User, Help! - RWhipkey - 01-11-2017

I was diagnosed with mild OSA (8.7) by a take home test in November. My symptoms were frequent night time awakenings and general fatigue during the day. I only slept for less than 1 hour at my lab study on December 8. The tech said that he could not see how the doctor could recommend a therapy pressure with the little data gathered. Nevertheless, the sleep doc sent a script to my general physician with a fixed pressure of 6. My brother-in-law works in research in the field and recommended strongly that I get an APAP so that the machine's algorithims could detect the right therapy pressures. After considerable research on my own, I decided to get a Respironics DreamStation with humidification and a DreamWare Nasal Pillow Mask. I was able to persuade my GP to get the script for an APAP. Our local DME RT said he had little experience with this machine and mask, tried to get me to accept another, but finally agreed. After not hearing from him for several weeks, I called and found out that he had been "let go"and my paperwork was in limbo. A very nice RT who replaced him asked for several weeks to research the DreamStation. Finally last Thursday, I met with him to get it set up. He had a Respironics Rep at the meeting who was very helpful. I had to wait until Monday to get it, however, since the first RT ordered the wrong mask!

I've used it for 2 nights. I really don't expect an instant cure, and I'm willing to work hard and patiently to get results. The first 2 nights produced AHI's higher than the study! In addition, I have had considerable nasal stuffiness both nights and and dry mouth on the second. I have noticed that some air leaks out of my mouth during exhalation. (I didn't think I was a mouth breather)

Here are my settings:
Pressure Range - 5 to 20
AFlex - 3
Opti-Start enabled
Ramp - 45 minutes (I changed to 20 minutes on 2nd night)
Humidifier on Adaptive
Humidifier Heat - 3 (I changed to 4 on 2nd night; at 4 tank is almost empty in AM)
Tube Heat - 3 (I changed to 4 on 2nd night)

Here are my results (1st night, second night):
Usage - 6.5 hours, 8.5 hours
AHI - 10.7, 9.7
Pressurized Breathing: 2%, 0%
Mask Fit - 100%, 100%
90% Pressure - 9.5, 7.0

Since my DME is relatively unfamiliar with the machine and my doctor is not much involved, I need your experienced guidance. Please help!

RE: I'm an overwelmed New APAP User, Help! - Sleeprider - 01-11-2017

Pretty incredible that people that supposedly make their living managing the care of patients on CPAP are unaware of the most common machine on the market...just amazing!

You did well to stand up for your rights and get a new auto machine. Be sure to get a copy of the provider manual at this link http://www.apneaboard.com/adjust-cpap-pressure/change-cpap-pressure-settings-adjusting-your-machine-with-a-clinician-setup-manual

Your apnea is not unlike my wife's who recently started therapy. She was titrated to 8 cm, and issued an auto CPAP at 8 cm pressure. We changed that to auto mode with a range of 7.6 to 10 and immediately cut her AHI and increased comfort.

You have made some good changes to try different humidifier settings, and ramp time. You need to change your minimum pressure to 7 or 7.5. This will put the machine closer to your therapy pressure. With a minimum pressure of 5, the pressure is too low to be effective, and it keeps dropping out of therapy range. You may want to turn off ramp, or set the minimum ramp pressure to 5 or 6. Your pressures are pretty low, and you should have no problem starting at your new minimum pressure. Change your minimum pressure, and when you are able to post a Sleepyhead screen shot after 4 posts, follow the instructions in my signature for formatting the charts, and posting through Imgur. Good luck.

RE: I'm an overwelmed New APAP User, Help! - RWhipkey - 01-11-2017


Thanks for your quick reply. I will try your adjustments and keep you posted. I have downloaded SleepyHead and will collect my data.

RE: I'm an overwelmed New APAP User, Help! - kwhenrykerr - 01-11-2017

It is not uncommon to find that the low pressure needs to be raised. As it gets closer to what you need the events of no air for your lungs will start to go away.

You will need to learn how to adjust your own treatment. Read this forum for information.


RE: I'm an overwelmed New APAP User, Help! - trish6hundred - 01-11-2017

Hi RWhipkey,
WELCOME! to the forum.!
I wish you good luck with your CPAP therapy, hang in there for more responses to your post.