I'm beginning to despair

[roadrunnerNM]

I've had my machine since March, and though it's helped, I still regularly have nights bad enough that I can't go to work the next day. After my titration study, pressure was set to 11. My doctor reviewed the data and said I was still having obstructions; so the pressure was raised. To make a long story short, we're now up to 16, and I'm still having problems. I have good nights, with AHI of about 5, occasionally, but right now, I've being getting AHI readings of 10-12 for the night for about 3 weeks now. I have absolutely no idea what makes the difference between a good and a bad night. I've tried everything I can think of, including banning the cats from the bedroom (a real sacrifice). My doctor has looked puzzled the last few times I've seen him. Does anybody have any suggestions?

[OkyDoky]

I've had my machine since March, and though it's helped, I still regularly have nights bad enough that I can't go to work the next day. After my titration study, pressure was set to 11. My doctor reviewed the data and said I was still having obstructions; so the pressure was raised. To make a long story short, we're now up to 16, and I'm still having problems. I have good nights, with AHI of about 5, occasionally, but right now, I've being getting AHI readings of 10-12 for the night for about 3 weeks now. I have absolutely no idea what makes the difference between a good and a bad night. I've tried everything I can think of, including banning the cats from the bedroom (a real sacrifice). My doctor has looked puzzled the last few times I've seen him. Does anybody have any suggestions?

We need to start with what equipment you have. You can use this link to help you register it where it will show each time you post. wiki/index.php/Registering_Equipment_in_User_Profile
We need to find out if your machine is data capable and what type of apneas are making up your AHI. Are you having leaks? Do you wake up frequently?

[BlackSpinner]

There is software called sleepyhead see tutorial in above section.

Install it, take screen shots, post them on photobucket and link them here.

Tell us EXACTLY what machine you use and its settings.

Get a copy of the clinical manual and learn to drive your machine. If you were a diabetic you would not be running to your doctor every time you need to adjust your insulin.

[DreamStalker]

Doctors are pretty good at diagnosis but when it comes to CPAP therapy ... most are about as stupid as they come.

Most failures are due to inability to understand pressure leakages. Increasing pressure without fixing leak problems just leads to more leaks and ineffective therapy.

As others have noted, you need to provide more details re: blower machine, settings, mask type, etc.

[Wulfman...]

I've had my machine since March, and though it's helped, I still regularly have nights bad enough that I can't go to work the next day. After my titration study, pressure was set to 11. My doctor reviewed the data and said I was still having obstructions; so the pressure was raised. To make a long story short, we're now up to 16, and I'm still having problems. I have good nights, with AHI of about 5, occasionally, but right now, I've being getting AHI readings of 10-12 for the night for about 3 weeks now. I have absolutely no idea what makes the difference between a good and a bad night. I've tried everything I can think of, including banning the cats from the bedroom (a real sacrifice). My doctor has looked puzzled the last few times I've seen him. Does anybody have any suggestions?

WHAT machine?
Please give specific make and model. If it's capable of collecting full data (not just hours used), you need to use software to see what's going on.


Den

.

[Dennis de NorthWet]

roadrunnerNM wrote:
"......... I have absolutely no idea what makes the difference between a good and a bad night. I've tried everything I can think of, including banning the cats from the bedroom (a real sacrifice). My doctor has looked puzzled the last few times I've seen him. Does anybody have any suggestions?"

Not directly C-PAP related, but if you want to know what's going on while you're asleep, set up a video system that will show you. Who knows, perhaps the cats are sitting on your chest, or some such. If you are thrashing around, or sleeping in a position that would reduce your breathing ability or air supply, you'll be able to sort that out.
Regards,
D

[roadrunnerNM]

OK, I got my act together sufficiently to download Sleepyhead and take a look. I have a Respironics Auto-CPAP, and I use a full-face mask.



Not sure what to make of it, but I guess you can see why I'm tired.

[palerider]

the summary is pretty useless.

https://sleep.tnet.com/resources/sleepyhead/shorganize

do it like that, and show us the detail chart.

[bonjour]

getting close,

Still need the charts, I I do see a 90% number of 16 cmH2O so we will need to make changes,

Let us see the charts so we can get a better idea of what is going on.

see the organization portion as that is important

[Pugsy]

Please be aware what a 90% number represents....in this case it's a pressure number and all it means is for 90% of the time you were at OR BELOW that number. 10% of the time you were above that number. How far above depends on what your maximum setting might have been and how long the machine was at the max or close to it. It does NOT mean you were there at that pressure for 90% of the night.

Really need to see the detailed graphs but while it's obvious the 13 cm minimum isn't getting the job done very well I don't know that you will need to go all the way to 16 as a minimum. It will probably be close though.

Are you sleeping on your back very much? Back sleeping will sometimes affect the pressure needed for some people.
It might explain some of the good vs bad nights...if you happen to be one of those people whose OSA is worse when on their back and need more pressure. It's fairly common. Maybe some nights you were on your back more than other nights.
REM sleep stage same thing...and fairly common but we can't do anything about REM...we can sometimes do something about back sleeping.

[raisedfist]

Don't despair, you have identified that your current therapy is not working, which is great because many people on this forum can help you.

[roadrunnerNM]

More like this?

Are you sleeping on your back very much? Back sleeping will sometimes affect the pressure needed for some people.
It might explain some of the good vs bad nights...if you happen to be one of those people whose OSA is worse when on their back and need more pressure. It's fairly common. Maybe some nights you were on your back more than other nights.
REM sleep stage same thing...and fairly common but we can't do anything about REM...we can sometimes do something about back sleeping.

I wondered the same thing; so I've slept with a pillow jammed behind my back for about a week or so. I'm pretty sure I've been on my side since I get pressure points on my hips (which I would consider a totally reasonable trade-off for a good night's sleep). But it hasn't helped, as far as I can tell.

[Pugsy]

Open your maximum back to 20 cm.
Are you having any problems using the 13 cm starting point?....problems breathing in and out at that pressure?
You are fast approaching the need for a bilevel machine in terms of pressure needs.

Do you think you could handle changing the minimum to 15? If that's too much try 14 for a few nights then try going up to 15.

[palerider]

I get pressure points on my hips

try adding some thickness of pillow just above your hips when sleeping on your side, reduces the pressure on the hip bones.

[D.H.]

Open your maximum back to 20 cm.
Are you having any problems using the 13 cm starting point?....problems breathing in and out at that pressure?
You are fast approaching the need for a bilevel machine in terms of pressure needs.

Do you think you could handle changing the minimum to 15? If that's too much try 14 for a few nights then try going up to 15.

Yes, I agree to put the max as high as it goes, which is 20. You are actually hitting the celing you set of 16, so you want to let it go higher. You don't seem to have any significant "clear airway" apneas, so you should be OK with this. If you're having issues falling asleep, you can try turning the minimum down and/or using the ramp. Personally, I turned my ramp off some time in 1999 and never used it again; couldn't stand it! However, that doesn't mean that nobody else should use the ramp.

Also, if you're topping still topping out at 20, you'll need to consider a special machine that goes higher (usually a Bi-PAP will go as high as 25, a few models can go higher).

Furthermore, if that doesn't work, you can try "pressure relief" *(another feature that I couldn't stand).