Need some help

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
User avatar
Slartybartfast
Posts: 1633
Joined: Wed Sep 01, 2010 12:34 pm

Re: Need some help

Post by Slartybartfast » Tue Feb 17, 2015 9:35 am

I see you're online now so I'll just pop in with a quick comment. I'm not familiar with your machine, and I don't use Sleepyhead (I use ResScan), so I'm no authority. However, the snoring around 1-2 am indicates that at that time of night, your pressure is insufficient to keep your airway open. So it appears that 10 cm isn't sufficient pressure to effectively treat your condition. Your machine appears to be a CPAP. An auto-PAP (APAP) would detect the snoring and increase the delivered pressure until the snoring ceases. Then, it would slowly taper the pressure down to whatever lower threshold pressure you set and remain there, until it again detects your need for more pressure. Effective therapy with a CPAP relies on a really accurate determination of your pressure requirement during a titration sleep study. If the tech wasn't sharp*, or your MD isn't really good, it's possible that your prescribed pressure might not be optimal for your particular needs. An APAP, on the other hand, because of its dynamic nature, is much more forgiving of the parameters programmed into it. And that is why you'll read lots of positive comments on this forum about APAP.

The leak trace shows that you lost a little air past the seals in your mask, which might have lowered the pressure delivered to your nose/mouth enough to allow you to snore. Getting the right mask is one of the biggest challenges we face using CPAP therapy.

I know what you mean about the brain fog. I had that, and didn't even know I had it, until I was diagnosed with sleep apnea. Once I got set up with my machine and learned on this forum how it works, the brain fog mostly dissipated. But we all get older, and some of the damage that has been done is permanent. I'm not as sharp as I was 10 years ago, or 20 years ago. Heck, when I was a teenager 40 years ago, I was a friggin' genius. I knew everything!

If you want a good scare, look up the symptoms of dementia, and compare them with "brain fog."

Persevere. Learn more, and keep an optimistic attitude.


*Mine told me he had been surfing all day and had bloodshot eyes and sort of slurred speech, and when he found out I was a pharmaceutical chemist, he couldn't stop asking me questions along the lines of what did I know about the medicinal benefits of marijuana)
Last edited by Slartybartfast on Tue Feb 17, 2015 10:41 am, edited 2 times in total.

lzicc
Posts: 46
Joined: Thu Nov 29, 2012 7:06 am

Re: Need some help

Post by lzicc » Tue Feb 17, 2015 9:55 am

Thanks for you input. I have changed the settings multiple times, but cannot see in SleepyHead what pressure I set it at for a particular date. I see pressure setting on the right, but it varies.

Image

User avatar
OkyDoky
Posts: 2870
Joined: Mon Aug 25, 2014 5:18 pm

Re: Need some help

Post by OkyDoky » Tue Feb 17, 2015 10:07 am

Your pressure settings show an APAP. That is good but we may have chosen the wrong model. Check again on the REF# on the bottom. It is strange because your first screenshot seems to show a straight pressure of 10.
ResMed Aircurve 10 VAUTO EPAP 11 IPAP 15 / P10 pillows mask / Sleepyhead Software / Back up & travel machine Respironics 760

User avatar
Pugsy
Posts: 63941
Joined: Thu May 14, 2009 9:31 am
Location: Missouri, USA

Re: Need some help

Post by Pugsy » Tue Feb 17, 2015 10:22 am

You are showing a model 460 PR S1 machine. Is this correct? Do you know if you still have some APAP days left available? Did you even know it has APAP mode available on a limited basis...and that even if the first 30 days are used up that it can be set to give you more?

The presence of the snores and the tendency for clustering of your apnea events points to sub optimal pressures at least these times of the night. The other times the pressure seems to be optimal.
The 2 most common causes of seemingly different pressure needs are REM stage sleep or supine sleeping (or a little of both)...something change to make the okay pressure for part of the night not be so okay for the other parts of the night.

So your therapy is a little bit sub optimal. I would try to make it more optimal if it were me and the first thing I would do is use APAP mode if it was available just to see where the machine wanted to go...and then decide how much more pressure I might need to deal with those times when the need is greater.

Is the sub optimal therapy totally responsible for your lack of perceived improvement? That's really unknown at this time as there are a lot of other reasons why we don't feel the good numbers but your reports could stand some improvement so I would start there first and see what happens. It needs to be done anyway.

While doing that...take time to investigate other factors that might impact how we sleep or feel that are unrelated to sleep apnea itself. Common things to look at ....hours of sleep and are those hours of sleep fragmented for any reason and if so how much?
Also meds...if any meds are taken dig deep into possible side effects for possible affect on sleep and how we might feel the next day so look hard at potential side effects as a possible culprit....Also, any other health conditions?...there's a big list to sort through and I think that in most situations it isn't any one thing that is the lone culprit. Most of the time it's a lot of little things adding up. Gotta start somewhere though...sleep hygiene and meds is a logical first step in the detective process.

If you do have a 460 machine and you don't have APAP mode showing available there is a way to reset the 30 day thing and unless those resets have been used up you can get more APAP days. All you have to do is reset the therapy hours data point to zero.
You lose prior stored data on the machine but you have it already on the SD card as well as in your software so no big deal.

_________________
Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier
Additional Comments: Mask Bleep Eclipse https://bleepsleep.com/the-eclipse/
I may have to RISE but I refuse to SHINE.

If you want to try the Eclipse mask and want a special promo code to get a little off the price...send me a private message.

lzicc
Posts: 46
Joined: Thu Nov 29, 2012 7:06 am

Re: Need some help

Post by lzicc » Tue Feb 17, 2015 1:05 pm

Ok, that post is overwhelming. Below is a picture of the bottom of my CPAP. I am not real sure how to check if I have any APAP's left. How do I do that and what does that do for me? Is that more or less running the machine in monitoring mode so it can adjust the pressure as I sleep to see what works best?

Image

User avatar
Pugsy
Posts: 63941
Joined: Thu May 14, 2009 9:31 am
Location: Missouri, USA

Re: Need some help

Post by Pugsy » Tue Feb 17, 2015 1:11 pm

The model 460 is indeed the model that has APAP mode available for 30 days.
Give me a few minutes and I will send you a link for the clinical/provider manual for that machine.
You need to figure out if your APAP mode has been used up or not first...then we decide what to do if you want to try APAP mode just to see where your pressure wants to go during those snores and clusters of events.

Look for a private message shortly.

_________________
Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier
Additional Comments: Mask Bleep Eclipse https://bleepsleep.com/the-eclipse/
I may have to RISE but I refuse to SHINE.

If you want to try the Eclipse mask and want a special promo code to get a little off the price...send me a private message.

lzicc
Posts: 46
Joined: Thu Nov 29, 2012 7:06 am

Re: Need some help

Post by lzicc » Tue Feb 17, 2015 1:13 pm

Ok. Thank you.

Now in saying where the pressure wants to go, I'm sure it will fluctuate throughout the night, it could maybe go between let's say 8 and 14, would I then set my pressure to 14 for CPAP mode?
Pugsy wrote:The model 460 is indeed the model that has APAP mode available for 30 days.
Give me a few minutes and I will send you a link for the clinical/provider manual for that machine.
You need to figure out if your APAP mode has been used up or not first...then we decide what to do if you want to try APAP mode just to see where your pressure wants to go during those snores and clusters of events.

Look for a private message shortly.

User avatar
Pugsy
Posts: 63941
Joined: Thu May 14, 2009 9:31 am
Location: Missouri, USA

Re: Need some help

Post by Pugsy » Tue Feb 17, 2015 1:20 pm

lzicc wrote:I'm sure it will fluctuate throughout the night, it could maybe go between let's say 8 and 14, would I then set my pressure to 14 for CPAP mode?
Maybe..maybe not. Depends on how long it wants to stay up there and where you are starting from.
Sometimes once the minimum pressure is set more optimally then sometimes the machine won't have the need to go so much higher.

From your reports I doubt that you need that much higher to break up the clusters...while it wouldn't be impossible to see a significant difference there is a better chance that probably all you need to break up the clusters is more in the range of 1 to 2 cm more pressure.

_________________
Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier
Additional Comments: Mask Bleep Eclipse https://bleepsleep.com/the-eclipse/
I may have to RISE but I refuse to SHINE.

If you want to try the Eclipse mask and want a special promo code to get a little off the price...send me a private message.

library lady
Posts: 1116
Joined: Wed Feb 05, 2014 11:10 am
Location: Rochester, MN

Re: Need some help

Post by library lady » Tue Feb 17, 2015 1:50 pm

lzicc wrote:I did a google search on brain fog and this is pretty much how I feel everyday.

you can't focus,

forget why you came into a room,

when you read a paragraph from a book, you can't read further without having to start over again because you've forgotten what you've read,

you feel like running on autopilot all day, not interacting with anything and anyone,

you feel that your body is not physically tired, but your brain is,

you feel like watching a life rather than participating in it.

you are trying to remember something but everything is just blank,

ordinary activities require an extra effort to perform or complete,

can't think of the correct words to use in conversation,

you can't solve math problems as well as you once could,
Izicc, what the above is saying is symptomatic of a number of things, so it may not have anything to do with cpap use. The question is, are you sleeping better, waking up less during the night, etc?

I have fibromyalgia which was diagnosed at least 15 years ago, OSA was diagnosed just a year ago. I had some of these symptoms for a long time before that diagnosis of fibro... still exhibit some of them. My mother had dementia, and was an avid reader all her life, until she started forgetting what she had read in the previous chapters. She went to see the film "As Good As It Gets" five times, each time having completely forgotten she'd already seen it... it would never have happened prior to the onset of her illness, but at the end of her life, she had all of the problems you mention above, and more. My father had some of these symptoms prior to his cancer diagnosis.

I'm not trying to scare you, just pointing out that cpap isn't a cure-all - it's just a therapy for something that has no cure, and that your symptoms mimic many issues besides OSA. For me, just knowing that it no longer takes me three hours to get to sleep every night, that I don't wake up two or three times for a trip to the bathroom, that my AHI is within the normal range (<5) each night, and that I'm sleeping better is enough. I never feel completely rested in the morning, and struggle to get myself out of bed, but once I'm up and have had my coffee I am much better able to function. I rarely need to take a nap in the afternoon now, and while I have more energy, I still experience some brain fog, probably because of fibromyalgia.

_________________
Machine: PR System One REMStar 60 Series Auto CPAP Machine
Mask: AirFit™ F10 Full Face Mask with Headgear
Additional Comments:  Sleepyhead
Now using AirFit F10 mask; Quattro Air is backup mask. RemZzzz mask liners with both.

lzicc
Posts: 46
Joined: Thu Nov 29, 2012 7:06 am

Re: Need some help

Post by lzicc » Tue Feb 17, 2015 1:57 pm

I will say since being on CPAP, I can run up the stairs without being out of breath, I sleep throughout the night and never really wake up throughout the night. I just feel like my brain is oxygen deprived for some reason.

I have such a hard time remember anything, trying to hold a conversation takes all of my concentration that I have.I can't think to save my life anymore. Even trying to map out simple things is a hard task for me.

lzicc
Posts: 46
Joined: Thu Nov 29, 2012 7:06 am

Re: Need some help

Post by lzicc » Tue Feb 17, 2015 1:58 pm

Here is a screenshot of prescription settings since day one. I know a few at the bottom of the list says fixed and CPAP and the rest of them say APAP. What does that mean, that the machine is running in APAP mode?


Image

User avatar
Pugsy
Posts: 63941
Joined: Thu May 14, 2009 9:31 am
Location: Missouri, USA

Re: Need some help

Post by Pugsy » Tue Feb 17, 2015 3:26 pm

That's odd. The model 460 only has limited APAP mode available...it's obvious you should have or would have exceeded the 30 days that it comes with initially and even any reset abilities.

Go into the clinical set up menu to confirm mode and settings.
Something weird is going on.
Further more it looks like in the past you tried a higher minimum.

_________________
Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier
Additional Comments: Mask Bleep Eclipse https://bleepsleep.com/the-eclipse/
I may have to RISE but I refuse to SHINE.

If you want to try the Eclipse mask and want a special promo code to get a little off the price...send me a private message.

User avatar
OkyDoky
Posts: 2870
Joined: Mon Aug 25, 2014 5:18 pm

Re: Need some help

Post by OkyDoky » Tue Feb 17, 2015 4:10 pm

Were you doing these pressure changes yourself or was the DME. If you were not making the changes did you take your card or machine into the DME or is the modem still attached? I can't figure out your machine yet but you did a good job of figuring out how to post images.
ResMed Aircurve 10 VAUTO EPAP 11 IPAP 15 / P10 pillows mask / Sleepyhead Software / Back up & travel machine Respironics 760

User avatar
SGearhart
Posts: 434
Joined: Fri Nov 07, 2014 8:54 am
Location: Georgia

Re: Need some help

Post by SGearhart » Tue Feb 17, 2015 4:17 pm

It's odd that the 10cmH2O is in the middle of the 7-13 setting. But what do I know, I'm a Resmed user.

_________________
Mask: AirFit™ P10 Nasal Pillow CPAP Mask with Headgear
Humidifier: S9™ Series H5i™ Heated Humidifier with Climate Control
Additional Comments: CMS-50F & 50IW - SleepyHead 1.0.0-Beta

User avatar
Pugsy
Posts: 63941
Joined: Thu May 14, 2009 9:31 am
Location: Missouri, USA

Re: Need some help

Post by Pugsy » Tue Feb 17, 2015 4:22 pm

Your Feb 15 detailed graph shows 10 cm fixed pressure...no movement...so that's cpap mode.
Yet SleepyHead is saying Auto mode which I think is a SleepyHead bug.
No way was it ever 7 cm with a range to 13.
Can you get me another screen shot of the Feb 15 detailed page like you have but instead of the events tab can you show the detailed tab and the statistics?

_________________
Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier
Additional Comments: Mask Bleep Eclipse https://bleepsleep.com/the-eclipse/
I may have to RISE but I refuse to SHINE.

If you want to try the Eclipse mask and want a special promo code to get a little off the price...send me a private message.