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[Treatment] Recently diagnosed with mild sleep apnea - Printable Version

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Recently diagnosed with mild sleep apnea - kevinpz - 10-21-2019

Hi everyone! And thanks for this awesome forum!

I've recently had a sleep home test (Philips Alice NightOne) with the following results:
  • AHI: 8.4 events / hour
  • Average SpO2: 95%
  • Lowest SpO2: 91%

My symptoms are:
  • I can sleep 6,7,8,9,10+ hours and I will always be so tired in the morning, and I need at least 1 or 2 hours to be functional.
  • My GF says that I also snore a lot during the night.
  • Headache the morning
So I've got a renting machine to test from the sleep lab (Canada), a ResMed Airsense 10 AutoSet for her.
I've the ResMed AirFit N30i small size.

When I'm on my back, everything is okay, and no leaks. But as soon I try to sleep on my side it seems to move a little bit, and sometime air is leaking ... So I wonder if I have the right size, or if I need to tight it more.

Here're the results from the last night (I don't specially feel better, but I have it since last Tuesday (15/10), and I'm in France since for my sister wedding, so 6h jet lag ... not the best moment to try it I guess!)

The AHI is 1.54 which seems great, but the pressure is almost always at 6. Is it normal?



RE: Recently diagnosed with mild sleep apnea - DeepBreathing - 10-21-2019

Welcome Kevinpz. Welcome to Apnea Board.

The numbers look pretty good, so we need to concentrate on improving your comfort with the machine and get you to feel more refreshed. Obviously international travel is not going to help...

The first thing to realise is that not all tiredness and fatigue is due to apnea. Other common causes include anaemia, thyroid deficiency, Vitamin D deficiency etc. So if you haven't done so, talk to your doc about getting a comprehensive blood test done.

Second thing is that not everybody gets instant results with CPAP therapy - some people do, but they're in the minority. For most of us it's a process, usually with a few false starts along the way.

Looking at your chart, you can see that there are hardly any obstructive events, but a few central apneas. Your machine will increase pressure as required to ward off obstructives but does not react to centrals (which usually need a different type of machine called an ASV). So the fact it stayed around 6 for most of the night is normal. The number of central apneas is small but you might be able to reduce them further by reducing the EPR setting from 3 to 1 (or even turn it off if you can do that comfortably). You might also want to reduce the ramp period, which is currently set at 45 minutes. Most people don't need a ramp time anywhere near this long, especially if they have a relatively low therapy pressure.

Mask leaks are persistent but not especially high. Leaks under about 24 L/min won't upset the therapy and the machine can adjust to compensate. However these leaks can disturb your sleep - eg if the air blows in your eyes or makes "face fart" noises. The fact the mask moves when you roll over is normal and not a problem unless it's disturbing you. Don't be tempted to over-tighten the straps: they should be firm but not tight. If you prefer to sleep on your side you might like to consider a different pillow. There are special cpap pillows with cut-out sections to accommodate the mask. Alternatively use a duck feather or buck-wheat hull pillow which you can push into a comfortable shape. Finally, try a different type of mask - no two faces are the same and there are dozens of different makes and models of mask. Finding one which suits you ideally can take a bit of time and effort (and $$).

Hope this all helps. Please come back with any further questions.

RE: Recently diagnosed with mild sleep apnea - SarcasticDave94 - 10-21-2019

I'd agree with DeepBreathing on the edits suggested. Minimizing or eliminating Ramp and the edit to EPR could lower the Central Apnea count, in my thinking, by reducing pressure fluctuations. Leaks aren't real bad IMO as long as it remains near the amount here. They're not high enough to hinder therapy, but could hinder comfort. As is, note what you do edit, try to only do one at a time and observe the effects. If it happens to get worse, undo whatever you last changed.

RE: Recently diagnosed with mild sleep apnea - Sleeprider - 10-21-2019

Your pressure is 6-16 and EPR 3. There is no evidence of obstructive activity at all. Leaks are low and these low pressures seem to work pretty well. There is not much we can do with that, so the outstanding feature of therapy is with EPR 3, your exhale pressure never gets off 4 cm. It is the EPAP pressure that resolves any obstruction and improves oxygenation, so the suggestion by Deepbreathing is absolutely correct. you need to back off on the EPR setting. I think a setting with a minimum pressure of 7.0 and EPR at 1 or 2 would work well, but there are few problems here to resolve.

RE: Recently diagnosed with mild sleep apnea - mesenteria - 10-21-2019

Part of the half of successful therapy that is comfort means not being aroused often. Leaks will often arouse you. If they ever do, don’t be afraid to experiment. You’ll learn things. It can all be undone. Tighten your straps, but just a bit. Also, do it in pairs, top two first, then the bottom two (depending on strap configuration).

Sometimes just pulling the mask away from your face enough to reseal it, or adjusting its height or angle will do. Or, you really might need to trial another mask.

Sometimes our greatest assets are our open minds.

RE: Recently diagnosed with mild sleep apnea - kevinpz - 10-29-2019

Hi there!

Thanks a lot for all your answers. I did some change, and I totally disabled the ramp. I also changed my mask from an AirFit N30i to an AirFit P30i.
That's really better in term of comfort, and I totally forget the machine the night now, I can sleep in all the positions without having air in all my face.

BUT I still wake up a few times the night (at least 3 or 4), and I don't really know why.

I've noticed that I sleep a lot more, and I'm as tired, or even more than before. But the numbers are really good.

I've also noticed than now when I wake up in the middle of the night, I have numb hands / foot, that disappear when I move a little bit, but I still have tingling by moment during the day. This is something I've never had before, could it be related to my sleep pattern (my GF says that I move less in the bed when I'm sleeping now)

Thanks a lot!

Here's more data coming with my new mask: