new APAP is arriving today -- what pressure should I use?

[jamor]

Those are total numbers over the entire night. You would need to divide by hours slept to get the hourly index...but in general it's primarily hyponeas which is usually obstructive in nature.

Your machine in auto mode with the ability to go up somewhere will probably increase the pressure somewhat...how much is unknown but usually hyponeas don't take much more to get them under control.

The Clear Airway/Central stuff...maybe some sleep/wake/junk awake breathing getting flagged by mistake...maybe a few real centrals in there also.
Nothing you can do about them anyway with this machine and they may not even need to have anything be done about them.
Just watch them with one eye...1 or 2 per hour average isn't horrible even if they were all the real deal and I am betting some of yours weren't even real.

See how you do in auto mode...the machine will very likely want to increase the pressure but as to how much you won't know until it does its thing.

I'll report back tomorrow. In terms of what you are saying about the clear airway stuff -- I slept worse than normal last night, woke up at least a few times, so that might help explain those.

[jamor]

If you breathe or leak through your mouth, your leaks will be high and the result will be a higher AHI. Download Sleepyhead software if you want help in adjusting your therapy.

There is a setting that reports leaks -- I assume it's for mask leaks, and mouth breathing wouldn't be registered by that?

[The Wizzard]

I had a similar thing with my new machine. I had been using a loaner between sleep studies that was an S9 auto, I guess to see what ranges of pressure it used. After the follow up sleep study the sleep doctor prescribed a CPAP with a pressure at 8. I got the dreamstation pro cpap and the first couple of times using it at 8 my AHI was much higher than it was with the loaner machine ( 4.5 versus 0.8-1.5ish) and when I looked at both the dream mapper and sleephead it pointed to almost all the events being Hypopneas with only a couple of OA events. So I upped the pressure to 9 and the Hypopneas pretty much went away and then up to 9.5 and the last few nights it has been more like 2-3 events over the whole night and AHI back down to 0.8-1.5ish). So I think that while 8 might have been indicated from the auto range it was just a little too low and was allowing the hypopnea events to occur. I kind of wish they had prescribed the auto machine and I would have left it at the range since my original study showed generally low AHI except during REM when it was much more severe. However the CPAP seems to be working in the sense it has lowered the AHI and eliminated most of the events, however I still feel tired during the day. Presumably it will just take a while to get fully adjusted and caught up on sleep, hopefully anyway.

[Pugsy]

There is a setting that reports leaks -- I assume it's for mask leaks, and mouth breathing wouldn't be registered by that?

The Leak reporting statistic on the LCD is % of time with good mask fit...meaning no large leak flags. So the higher the % the better the leak management.

If your onscreen leak report was the the 90% numbers...you didn't have a lot of time in large leak and we would need to see the software graphs to know how bad the large leaks were. Meaning if you barely made it into large leak territory the AHI reported is fairly accurate. Respironics machines can compensate quite well for considerable excess leak before therapy or responding or recording comes into question.
So not only do we go into large leak territory is important but how far and how long are we up there becomes something we need to look at closely.

If you saw 100% on the LCD screen for mask fit...that means you never crossed over into large leak territory at all.

And leak is leak no matter if it is mask movement or mouth breathing. The machine makes no distinction and can't tell the difference.
If the fit % is high...you didn't do much mouth breathing if any...and even if you did unless there were large blocks of it it is unlikely that it would impact therapy all that much.

I might see 5 minutes in large leak territory out of 7 or 8 hours of sleep. That 5 minutes of maybe not optimal therapy isn't the end of the world if the rest of the time leaks were well managed.

[jamor]

If you saw 100% on the LCD screen for mask fit...that means you never crossed over into large leak territory at all.

I did see 100% -- good to know it covers open mouth leaks.

[nicholasjh]

I've had mouth leaks as well. I tried the official CPAP type headgear to keep my mouth shut and was miserable with it, however I got some black stretchy head bands from target for 4.50 and they work great. I wear the head band around my jaw and top of my head most nights to keep my mouth from opening.

[sbradley]

With mostly obstructive apneas I would not lower the pressure. In fact, I may raise it a bit. But and AHI of 1.3 is pretty decent in my view.

Actually was all Hypopnea. At 7.5 was 0.8 AHI first night, 0.3 the next. I tried 7.0 but was uncomfortable. Surprising 0.5 makes a difference in that respect.
Interestingly, SmartLink shows my mask fit is poor, even though I don't feel any leakage. I wondering if it is misreading this.
Any any rate I have found settings that work well for me.

[jamor]

Day 2 Update (First using APAP)

So much better results using APAP. I decided to set the range from 8-20 to 8-15 right before I went to bed (just being safe with having to work today).


I woke up at 4am to use the bathroom, and decided to peek at my AHI -- at that point it was 1.7 (down from 17.2 the night before). However I had trouble falling back asleep and was awake for about 45 minutes. When I woke up in the morning around 7am my AHI was showing 5.4. Does having the machine on for 45 minutes while not asleep have the ability to affect my AHI? If not, it's very strange that it took such a bad turn the last 3 hours.

the 5.4 numbers showed as follows -- 20 Clear Airway Apneas / Zero Obstructive Apneas / 20 Total HypoApenas

As an aside, another 100% leak night and my 90% pressure was 9.0 (which helps my start to focus on settings for my previous/now travel machine).

[LSAT]

Day 2 Update (First using APAP)

So much better results using APAP. I decided to set the range from 8-20 to 8-15 right before I went to bed (just being safe with having to work today).


I woke up at 4am to use the bathroom, and decided to peek at my AHI -- at that point it was 1.7 (down from 17.2 the night before). However I had trouble falling back asleep and was awake for about 45 minutes. When I woke up in the morning around 7am my AHI was showing 5.4. Does having the machine on for 45 minutes while not asleep have the ability to affect my AHI? If not, it's very strange that it took such a bad turn the last 3 hours.

the 5.4 numbers showed as follows -- 20 Clear Airway Apneas / Zero Obstructive Apneas / 20 Total HypoApenas

As an aside, another 100% leak night and my 90% pressure was 9.0 (which helps my start to focus on settings for my previous/now travel machine).

I'm guessing that during the 45 minutes that you were awake you were restless and got a bunch of CAs. Look at the Sleepyhead charts to see the events during the last 3 hours. The CAs in your case are considered sleep/awake junk. CAs are events where you stopped breathing for 10+ seconds but there was no blockage of air.

[jamor]

Day 2 Update (First using APAP)

So much better results using APAP. I decided to set the range from 8-20 to 8-15 right before I went to bed (just being safe with having to work today).


I woke up at 4am to use the bathroom, and decided to peek at my AHI -- at that point it was 1.7 (down from 17.2 the night before). However I had trouble falling back asleep and was awake for about 45 minutes. When I woke up in the morning around 7am my AHI was showing 5.4. Does having the machine on for 45 minutes while not asleep have the ability to affect my AHI? If not, it's very strange that it took such a bad turn the last 3 hours.

the 5.4 numbers showed as follows -- 20 Clear Airway Apneas / Zero Obstructive Apneas / 20 Total HypoApenas

As an aside, another 100% leak night and my 90% pressure was 9.0 (which helps my start to focus on settings for my previous/now travel machine).

I'm guessing that during the 45 minutes that you were awake you were restless and got a bunch of CAs. Look at the Sleepyhead charts to see the events during the last 3 hours. The CAs in your case are considered sleep/awake junk. CAs are events where you stopped breathing for 10+ seconds but there was no blockage of air.

Getting SleepyHead up and running is one of my goals for this weekend.

[D.H.]

Yes, I sometimes do worse in the last few hours. I think that we tend to do more REM sleep at that time, and that's the deepest sleep and the most prone to SDB episodes.

Do yo feel better?