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New to CPAP, wondering how well it's going - Riayain - 01-26-2023
Hello, I was officially diagnosed with sleep apnea last Saturday and started CPAP therapy on Tuesday, so three or so days ago.
I live in Japan and my doctor seems to be a bit old-fashioned, so my machine is set to fixed-pressure CPAP, I had to get a titration study, and I can't seem to view any results besides mask fit and time spent using the CPAP on the machine. I plan to complain about that in my next appointment since I want to learn more about my results to see if they really are optimal... Until then, however, I thought I'd use OSCAR and the myAir app. Problem is, I'm a bit lost analyzing the data, so I thought I'd make a post...
Summary of sleep study results (done at a lab, they're all in Japanese and I'm not 100% fluent):
- AHI: 20.6
- SPO2: 67.6 minutes total where it dropped between 80-90%
- Snoring mainly when sleeping on back
- Sleep stages normal
- Sleep efficiency: 92.0%
- Diagnosis: OSA type moderate sleep apnea, CPAP therapy recommended
- Constant (all day): Hypersomnia, tension headaches, a sense of lightheadedness, fatigue (last three could all be linked to the hypersomnia though)
- Occasional: Acid reflux and other stomach issues
- Related to sleep: Snoring, grinding teeth, coughing, inability to sleep beyond 7 AM even when sleeping late, waking up never feeling rested, not dreaming unless it's a nightmare
- Had a series of medical tests to rule out other possible issues, all tests came back normal. Also visited psychiatrists who said I did not appear to be a typical case for depression, anxiety, bipolar, or any of the usual culprits for these symptoms.
- Noticeable change even on the first night (titration study). Woke up with a headache, prior I was so tired I couldn't tell the difference between headaches, dizziness, and fatigue. Felt strangely alert and had some energy even by the end of the day.
- Second night onwards, headache upon waking up has been slowly fading away. Much more alert in the morning and able to sit up without grogginess nearly as soon as I'm awake. I do get more sleepy as the day passes (sense of heaviness around my head), but I still have energy by the end of the day. Mild discomfort around stomach and chest areas, burping and farting a bit more.
Thank you!
RE: New to CPAP, wondering how well it's going - Brazen - 01-26-2023
Welcome!
Check out this link to help you organize and post your OSCAR charts.
OSCAR Chart organization
Then re-post your chart.
Aerophagia is the name for the extra gas you're feeling - it's from swallowing too much air and common among new cpap users.
It sometimes gets better with time, as your body gets used to cpap, sometimes it requires lowering your cpap pressure.
The experts here can assist with settings when you post your OSCAR charts in the format they request.
They need to see the left side panel data and the most helpful graphs.
You've landed in a great place for help. Cpap takes time to get used to and to optimize treatment.
It's quite common for the medical professionals to be less than helpful about cpap settings.
It also takes time to feel real improvement from cpap. It sounds like you're one of the lucky ones who feel some improvement right from the start!
Stay patient and take time with each setting change to determine if it's an improvement.
RE: New to CPAP, wondering how well it's going - Dormeo - 01-26-2023
Welcome! It's very good to hear that you're already feeling the benefits of PAP treatment. From your chart, you're clearly off to a great start.
How do you feel about adjusting your settings yourself? I would suggest an EPR of 3, which might help with your flow limitations and snores. You might also want to try APAP mode, with a relatively tight pressure range, perhaps 7 to 10. Finally, many people feel somewhat air-starved at 4; you might want to turn the ramp feature off.
All that said, I'd suggest *starting* by turning off the ramp and setting EPR to 3. After you see how that goes, you could try using a pressure range.
Do you think your leaks wake you up? If they don't, then ignore them. If they do, do you suspect mouth leaks?
The burping and farting are pretty common; they come from what is called aerophagia. The EPR of 3 might help, and for some people, these issues go away with time.
RE: New to CPAP, wondering how well it's going - Riayain - 01-26-2023
Wow, thank you both for the quick replies!
I can't seem to edit my old post, but I tried organizing my charts according to the Wiki. Is this format correct?
The aerophagia does seem to be getting better by the day. The first day was the worst, and since I'm still feeling some of it, but it doesn't feel uncomfortable anymore, just sort of... there. I'm hopeful that it's just temporary and a part of getting used to the CPAP.
As for changing settings, I actually can't do any of that myself. All that's been disabled by my doctor, and is something I intend to discuss in my next appointment which is 2-3 weeks from now. But I definitely do appreciate and want to know any ways to possibly improve my results, as that'll come in very useful during my discussions with my doctor.
I'm a bit confused on what flow limitations are supposed to look like when the CPAP therapy is working well.
The leaks don't wake me up, luckily. I've been sleeping surprisingly well with the CPAP, haven't once taken it off in my sleep and everything. I'm guessing I'm so tired that my body can sleep in nearly any situation. The doctor was also very surprised with my sleep study because I slept at least an hour longer than most patients do...
RE: New to CPAP, wondering how well it's going - staceyburke - 01-26-2023
The only change I would suggest is making the EPR 3
RE: New to CPAP, wondering how well it's going - Melman - 01-26-2023
I don't believe your Dr can disable setting changes. Here's s link to instructions for changing settings on your machine.
https://www.apneaboard.com/resmed-airsense-10-aircurve-10-setup-info
Give it a try. You can also order a setup manual using the link at the top of the page. If he or the DME is monitoring your machine from the data transmitted by the modem they can reverse any setting changes you make but I doubt anyone is following it that closely. Give it a try.The worst that can happen is that they be changed back. I agree with Dormeo's recommendations; pressure 7-10. EPR 3. and no ramp.
RE: New to CPAP, wondering how well it's going - Brazen - 01-26-2023
Your cpap treatment is in your control with the information offered here. You just have to access the clinician menu of your machine.
When I first changed my own settings it was completely unnoticed by the DME - only folks with access - but my doctor commented on it in my follow-up appointment.
I told her the wide open settings she first prescribed- without any titration study - weren't working so I took matters into my own hands.
FWIW, I then asked her what she could offer to improve my flow limitations and she fired me. Told me to see a different doctor if I needed anything.
To me, I have all the OSCAR data to support my setting changes and then better results to show improvement. That matters more than the 10 mins a doc spends telling me everything is good because AHI is under 5.
Flow limits...
Many here look at the 95% flow limit in the left panel on your daily OSCAR data. We aim for that to be under 0.1, ideally under 0.03.
Flow limits are airway restrictions under the time of hypopnea or apnea. Basically, mini-hypopneas that can affect sleep quality. It's not severe enough for the machine to flag but can affect arousals and sleep quality.
RE: New to CPAP, wondering how well it's going - Riayain - 01-27-2023
Ah, I didn't see a lot of settings on my device so I thought I couldn't access the clinician's menu. Whoops, turns out you actually have to do a bit more to unlock it! Thanks a lot, I'll give it a try.
And thank you for explaining flow limit. I'll try a few more days and see how I feel, then maybe fiddle with EPR and see if flow limit improves.
RE: New to CPAP, wondering how well it's going - Jay51 - 01-27-2023
Hello Riayain,
Your sleep study summary says,
- SPO2: 67.6 minutes total where it dropped between 80-90%. Here in the United States, 5 minutes or more total time below 88% qualifies a person for supplemental oxygen. I am not sure what the criteria is in Japan. you might want to check and see if you qualify for supplemental oxygen also.
RE: New to CPAP, wondering how well it's going - Dormeo - 01-27-2023
Jay51 raises a good issue.
Given how well treated your apnea how is, you're probably now doing well on the O2 front. But it you'd like to be sure, you can get a recording oximeter that is compatible with Oscar. Just click on Oximetry Wizard on the welcome page for Oscar to see a list of compatible devices.