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auto-CPAP without sleep study?
#1
Question 
auto-CPAP without sleep study?
I'm going to post a bit about my sleep journey in the hopes that someone can give me more insight Smile , but my main question about CPAP is in the last paragraph.

I'm male and in my 30s, not overweight and I'm physically active due to my job. I'm a nose breather and rarely (as far as I know) breathe through my mouth while sleeping. I'm not aware of that I snore, maybe if I sleep on my back but more on that later.

I've been functioning most of my life on 5 hours of sleep a night. In my 20s I could function a lot better even with the 5 hours but now, in my 30s, the short sleep duration is either starting to take a toll on me or my sleep has gotten a lot worse. I don't have trouble falling asleep (that's another story), I have trouble with staying asleep and getting a good nights sleep. The sleep that I get isn't good, I wake up tired but I can never fall back asleep.

OTC sleeping pills never really worked for sleep maintenance/sleep quality when I've tried them and I generally prefer not to take them. When I tried them in the distant past, I took them because I couldn't fall asleep, but they just made me feel more tired and groggy the next day and I still didn't sleep any longer than usual. I'm currently experimenting with time release melatonin but so far no positive results to report either.

Over the last few months I've been changing a lot of variables in my life and my sleep and seeing how it affects it. I don't have a lot of stress or anxiety anymore. I even completely changed my diet to a whole foods diet and I track my calorie intake, weight, vitamins and minerals, making sure I get everything my body could need. I also experimented with when I eat, what I eat and how many hours before bed I eat it. I almost completely avoid sugar and limit coffee to the mornings. At some point in the past I cut out coffee completely but it didn't make a difference back then so I still drink it in the mornings. I also started lifting weights again like I did in my 20s, but not as hard. Taking a nap later in the day does offset the tiredness somewhat but it doesn't feel like a long term solution because sometimes it also makes it a lot harder to fall asleep at night. I've also mostly eliminated my environment from the equation, I sleep with ear plugs and a face mask and experimented with different heating settings in my bedroom.

So at this point I'm starting to wonder if it may be sleep apnea. I always sleep on my side or on my stomach, never on my back and there's a reason for this. I remember in my 20s I tried sleeping on my back here and there and there were times where I was at the point of  falling asleep but woke up because I noticed I couldn't breathe. Since then I didn't even attempt to sleep on my back, as I assumed I'm just snoring when I sleep on my back. I didn't think much of it back then but after reading quite a bit about sleep maintenance insomnia and sleep apnea I'm thinking that it may be the issue.

So long story short: I'm thinking about getting a used auto-CPAP for around 200-400 Euros to give it a shot without a sleep study and just sell it again if it doesn't help me. Assuming I buy an Auto-CPAP which OSCAR supports, could one reliably determine if sleep apnea is part of my sleeping problems? I assume the answer is yes, both physically and from the OSCAR reports, but I'd like to know your thoughts on just giving it a shot. Thanks a lot in advance!
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#2
RE: auto-CPAP without sleep study?
Welcome

That should work. We can tell by Oscar charts you post how you are doing on the machine. Then, if it is helping you, you can, at some time, have a sleep study and have a new machine issued through insurance.

Again, welcome, and best wishes on your quest! Smile
Machine:  ResMed AirCurve 10 Vauto
Mask:  Bleep DreamPort Sleep Solution and F&P Nova Micro

Link to thread about switching from Autoset to Bilevel:
https://www.apneaboard.com/forums/Thread...+a+bilevel

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#3
RE: auto-CPAP without sleep study?
OSCAR reports are somewhat like a limited sleep study each night of PAP machine use.  An SpO2 ring would add another part to a makeshift sleep study.  So yes, with an APAP machine, OSCAR, and maybe a ring for measuring blood oxygen levels you can graphically see sleep apneas on a report after a sleep session.

Stopping breathing and snoring when on one's back is very common.  It is in that position that others may notice someone ceasing to breathe during sleep, and then gasping for air.  If I could control sleeping on my back there is a good chance I would not need CPAP therapy but due to back sleeping, I have severe sleep apnea.  It's on my back, mouth breathing, that causes long clusters of many apneas due to tissues collapsing in that position.  If a long run camera is available it can help determine how you sleep and when you stop breathing.

Minimal pressure settings on an APAP (Auto-adjusting CPAP) machine,  will adjust pressure upward as the need arises due to flow limitations and events like obstructive apneas, clear airway apneas, and hypopneas.  Events will be recorded onto an SD card that can be moved to a computer with OSCAR for review.

Look to the top of this forum page for a great deal of information about the topic. (Wiki)
I only give suggestions from experience as a fellow CPAP user, not professional advice.
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#4
RE: auto-CPAP without sleep study?
OSCAR reports are somewhat like a limited sleep study each night of PAP machine use.  An SpO2 ring would add another part to a makeshift sleep study.  So yes, with an APAP machine, OSCAR, and maybe a ring for measuring blood oxygen levels you can graphically see sleep apneas.

Stopping breathing and snoring when on one's back is very common.  It is in that position that others may notice someone ceasing to breathe during sleep, and then gasping for air.  If I could control sleeping on my back there is a good chance I would not need CPAP therapy but due to back sleeping, I have severe sleep apnea.  It's on my back, mouth breathing, that causes long clusters of many apneas due to tissues collapsing in that position.  If a long run camera is available it can help determine how you sleep and when you stop breathing.

Minimal pressure settings on an APAP (Auto-adjusting CPAP) machine,  will adjust pressure upward as the need arises due to flow limitations and events like obstructive apneas, clear airway apneas, and hypopneas.  Events will be recorded onto an SD card that can be moved to a computer with OSCAR for review.

Look to the top of this forum page for a great deal of information about the topic. (Wiki)
I only give suggestions from experience as a fellow CPAP user, not professional advice.
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#5
RE: auto-CPAP without sleep study?
Thank you Deborah K. and ejbpesca.

I went ahead and got a Resmed S9 Autoset with a BMC full face mask and also got a fitbit to track my sleep. I've been reading a lot on this board and I've read that it's possible to export the fitbit data into OSCAR, so I'll try doing that when I get to it. It may well be possible that I end up sleeping on my back so I'll set up a camera to check.

I've currently set the machine to 4-10 as I've read higher pressures can cause CA events so I wanted to play it safe. First night I just wore it for an hour to get accustomed to it but went to sleep without it. Second night I managed to fall asleep a few times and had vivid dreams, which is quite rare for me, but my sleep was very fragmented, I'm not sure I got much sleep. Third night I slept twice (also had dreams) and then took off the mask and slept without it because I wasn't able to fall back asleep with it.

Interestingly, the next few days I also had dreams without the machine but today I'm back to not having dreams again.

From the data it seems like the machine wants to go beyond 10 in pressure. I feel like I should increase the pressure range to 7-13, however I don't have any obvious events flagged by the machine. By the way, I turn the machine off and on when I try to go to sleep and also when I wake up during the night so it's hopefully easier to determine when I'm sleeping in the charts.

I'll keep trying to get one long 5 hour sleep with the machine so I can compare it properly with my regular sleep.

Any thoughts on these charts?  Thinking-about


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#6
RE: auto-CPAP without sleep study?
You need to change your pressure setting to 7 to 15. This should be way more comfortable.
Machine:  ResMed AirCurve 10 Vauto
Mask:  Bleep DreamPort Sleep Solution and F&P Nova Micro

Link to thread about switching from Autoset to Bilevel:
https://www.apneaboard.com/forums/Thread...+a+bilevel

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#7
RE: auto-CPAP without sleep study?
I am not an expert but looking at your OSCAR report the data would make me question if I needed PAP therapy.  An in-lab sleep study would help answer that question.  

Min 4 pressure setting is lower than what adults have for that setting.
I only give suggestions from experience as a fellow CPAP user, not professional advice.
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#8
RE: auto-CPAP without sleep study?
It's a lot easier falling asleep with 7-15, thanks! After a few minutes it starts to feel like regular breathing or maybe I'm just starting to get used to the pressurized breathing.

Thank you for having a look at it. Regarding the in-lab sleep study: I don't believe I would be able to fall asleep unfortunately, not even if they drugged me. The other issue is time and cost. We're looking easily at many months waiting time and high cost. I have a high deductible + I get a good chunk of money back each year because I didn't need health services in the past 5 years, as I have private health insurance. An at home sleep study seems to be my best option regarding that right now. I'll look around online and see what options I have, I'd prefer not having to go through the whole healthcare system for this however (doctors, referrals, waiting times...).

Two more charts with the new pressure settings, unfortunately I didn't strap on the mask tight enough in the second chart given the leak spikes. Not sure about those 2 CA's at the end of the second chart, I think I may have already been awake at that point. If air gets pushed into the stomach, would it be flagged as CA or show up as a leak or something? Is it possible to tell from the chart? I think that happened there but not sure. I've also attached a screenshot of a 3 minute segment of my breathing from when I believe I was sleeping.


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#9
RE: auto-CPAP without sleep study?
Raise your starting pressure to 9.4. Your median pressure was 9.4 and 10.4, so go to 9.4 for now.

I can't see if you are using EPR, but if not, turn it on to full-time, set at 2 or 3. That would drop your flow limits and should make for more comfortable breathing as well. It may increase your CAs a little, but the comfort will more than make up for it.
Machine:  ResMed AirCurve 10 Vauto
Mask:  Bleep DreamPort Sleep Solution and F&P Nova Micro

Link to thread about switching from Autoset to Bilevel:
https://www.apneaboard.com/forums/Thread...+a+bilevel

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#10
RE: auto-CPAP without sleep study?
DK,

When you suggest a "starting," pressure isn't that the minimum pressure in the clinical settings menu for an APAP machine?

I too have found setting my min. pressure close to the Median pressure gets the therapy into position for better continuous results as opposed to having to jump up to the rescue.  The less the APAP has to move pressures up and down the better.  Doing this stopped most of my "positional apneas."
I only give suggestions from experience as a fellow CPAP user, not professional advice.
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