Looking for Mr. Goodsleep--Newbie Seeks Knowledge

[Drowsy Dancer]

I was unofficially diagnosed with OSA two hours into my sleep study on 2/8/2011 when they slapped a mask on me after only two hours of observation (a familiar experience to many of those here).

I do not have my dictated report from the sleep doc yet. My followup appointment is 3/10. They told me my AHI was somewhere in the 70's (I think they told me the exact number but I was too stunned to take it in) for the first two hours of the sleep study. I have been reading and reading here and other places trying to soak in knowledge.

I got my machine (best guess at what I have listed) a week ago Thursday and have been going through all the adjustments that becoming a hosehead entails.

My challenges/comments/complaints so far:

1. According to the machine display, my AHI is still above 8 (8.2 7-day average). That seems less than Ideal, but it's sure better than 70+. My pressure is 8.0 and my C-Flex+ (whatever that is) is set at 2.
2. Both my computers have the 64-bit Windows 7 OS. Will the Encore software, which says it is only 32-bit, run on my machine? This is perhaps more a Windows than an Encore question, but I am wondering about the experience of others here.
3. The skin on my face is killing me. I have two huge zits/cysts, one by the side of my nose, one on the bridge of my nose, where the mask hits me. I was probably cinching the mask down too tightly the first few nights. I'm going to try to get another mask that rests on a different place.
4. I have horrible stiff necks--the DME provider chirpily said, "Boy, that's a new one!" which astonishes me. I have switched to a Bucky travel pillow and am sleeping flat on my back. With constant Advil and several hours of heating pad a day my neck seems to be getting better. I think it was caused by my trying to sleep in my preferred position (on my side, face rotated down) with the mask.

My initial questions: Am I correct in thinking that the goal of therapy should be to reduce my AHI still further?
If I buy the EncoreViewer, will I be able to coax it to run on a 64-bit machine?

Drowsy Dancer

[BlackSpinner]

Your AHI should be well below 5.

Search for padacheek she sells mask liners which will help too protect your skin.

Many of us have muscle aches at first because for the first time in a long time we are sleeping all night without moving, our bodies need to adjust to this and also our sleeping environment like better pillows, mattress pads etc.

[Pugsy]

Encore Pro 2.4xxx has a 64 bit version. Would you like to try it? It is for clinics and doctors so it has a bunch more stuff in it that will never be used.

EncoreViewer 2.0 is the patient version and has much less stuff to sort through. I don't know if anyone has been able to get it to work on a 64 bit computer. I think most have got the Pro version.

Yes, your goal should be to reduce the AHI a bit more. So hard to follow it though with only being able to use the 7 and 30 day averages. Can't see just one night. So software really is needed.

There are ways to sleep on your side with any mask. I just imagine you will get some ideas here soon about that.
Different pillow or a special pillow is common. I use a buckwheat pillow. It allows me to make a little spot or indentation for part of the mask when I am on my side which is my usual position also. Others use a pillow that has a special cut out to place the mask in.

[Drowsy Dancer]

Hmm. I was assuming that a vendor wouldn't sell a "civilian" the pro version of Encore (although it looks like the default setting to wipe the smart card of data after reading can easily be changed).

<runs off to find software>

DD

[Pugsy]

Hmm. I was assuming that a vendor wouldn't sell a "civilian" the pro version of Encore (although it looks like the default setting to wipe the smart card of data after reading can easily be changed).

They don't sell EncorePro to end users us civilians. Doesn't mean it can't be obtained.
Same thing with ResMed software, they don't sell it either. But it can be obtained.

And yes, the default setting to erase the card is easily changed.

Check your PM while off and hunting for the software. Give me a couple of minutes to compose a place to hunt.

[Lizistired]

While you are running, get the complete report from your sleep study, WITH CONDENSED GRAPHS!

[Drowsy Dancer]

Last night (if I did this right):

[Pugsy]

Some background information please.
Do you have a copy of your sleep study? If so, did it mention central apnea events? If you do not have a copy of the sleep study you need to get a copy.

Do you have a bed partner that is reporting you still snore?

Is the 8 cm of pressure the machine is set at from the titration part of the sleep study?

Leak seems okay. The software defaults to unintentional leak but it can be changed to show Total leak and the line will be above the zero baseline. Hurts nothing to have it this way though. Though it looks pretty darn perfectly straight which is uncommon especially with the events you are having.

Obviously with all the events and snores and such, things are not optimal but the CA (clear airway obstruction) centrals kind muddy up the waters. So has anyone ever mentioned central events to you?
Increasing pressure to try to ward off the Obstructive events is NOT advised when we see centrals because it can actually create more centrals. Now some CA might just be turning over in bed but until we know for sure if you have a history of centrals and if the doctor knows, I wouldn't change the pressure to try to kill the events that are occurring. They are mainly Obstructive and we normally would say bump up the pressure but not with the centrals showing until other information is known and / or you speak to your doctor.

[Drowsy Dancer]

1. Re: Sleep Study. I have requested a copy of it from the medrecs department of the hospital where I took it. I am told it will take a week. Oh, well.
2. Re: Snoring. Bed partner reports that I stopped snoring when I lost some weight at the beginning of the year, and says I don't snore with the mask at all. I noticed that my VS went WAY up Sat and Sun, when I started sleeping on my back with my new pillow.
3. Yes, the 8.0 is the number from the titration after the first two hours of the sleep study.
4. I will review software options for leak reporting.
5. I noticed, and found disturbing, the central events. Oddly enough, four of them show up in the first 13 minutes I was in bed--I can't believe I was even asleep yet. No, nobody had said anything about my having CSA or mixed. More I'm sure will be revealed.

For the last week my CA indices were:
2/21 7.7
2/22 5.2
2/23 1.2
2/24 1.3
2/25 1.2
2/26 2.7
2/27 1.4


I don't suppose that could have been my swallowing to get the remains of the water from using the neti pot out of the back of my throat...

DD

[snnnark]

5. I noticed, and found disturbing, the central events. Oddly enough, four of them show up in the first 13 minutes I was in bed--I can't believe I was even asleep yet.

DD

Those are probably sleep onset centrals and nothing to be concerned about.

[Pugsy]

Yes, most likely sleep onset centrals and not a big deal. If no history of centrals or anything like that in your sleep study an occasion one on the report may not mean much. I just always want to be extra careful when I see them. Sure don't want to make things worse. The random ones during the night could be from turning over or waking slightly and again going back to sleep.

Are all the reports that you get the detail graph data from showing the VS like this one? Too bad we can't get to those old reports when sleep partner said no snores.
Now sometimes the hose movement noise can fool the machine into thinking you are snoring... routing the hose over part of the headboard that is hard, iron bed, stuff like that. How is the hose routed, does it touch anything except the mattress? Do you use any sort of hose huggy?

When do you see the sleep doc again? Have you made her/him aware of these findings? The AHI is too high and normally we would suggest a tiny bump in pressure to see if it helps. I am just cautious about the centrals because pressure can induce centrals and we don't want to make it worse.

How are you feeling?

[Hawthorne]

You say, in your profile that you have a PR System One Remstar PLUS but if you are getting that detailed data in the software,you probably have a PR System One Remstar PRO or a PR Remstar System One Auto set in cpap mode.

[Drowsy Dancer]

Hawthorne, I am probably confused about the name of my device. The report printout says it is a REMstar Auto.

Pugsy, no hose huggy, hose just goes over the side of the bed.

I do not feel drowsy while driving anymore but I still feel tired. My next appointment with the sleep doc is 3/10.

DD

[Hawthorne]

Sounds like you have the auto set in cpap mode then. That's good then. You can try it in auto with a range of pressure some time in the future when you get sorted out a bit. I have the same machine.

Your CAs don't look too bad and the most are sleep onset - nothing to worry about. The others could be holding your breath when you turn over in your sleep. Many of us do that.

Your OAs are another story - a bit too high. Too much Vibratory snore as well. I expect your doctor will want to begin raising your pressure gradually. He may want you in auto mode to get a feel for your 90% pressure. Two hours of sleep at a study may not have gotten you an optimum pressure.

[Drowsy Dancer]

Here's last night. Looks better but I feel worse. Tried to sleep on my side.