CPAP user since Feb '15, having issues.. Ideas?

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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Zoowabi
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CPAP user since Feb '15, having issues.. Ideas?

Post by Zoowabi » Wed Sep 23, 2015 8:07 am

So I was diagnosed with OSA (AHI 14 O2sat 86%) and put on CPAP (Auto 8-17cm) by my sleep doctor in early Feb of this year. my compliance rate is hovering around 95%, which is pretty good I guess for new users (one of the biggest problems I have had keeping compliant so far is sores on the bridge of my nose.. but that is for another day) The first month were pretty good, however, I am still foggy in the mornings, have trouble waking, and can, and usually do nap if the option presents itself in the daytime. I average 7-9 hours of sleep per night, and keep a fairly regular schedule sleep pattern. I do wake up 3-4 times a night from sleep but quickly go back to sleep (at least I think I do)


Here is the sleepyhead statistics for last week
AHI - .65
Obst. index - .15
Hypo Index - .06
CA index - .44
Avg Leak - .11
Avg pres - 10.96
Minimum - 8
Max - 16.92
90% - 12.66

As you can see, the apneas are really under control.. so, what gives? I have been looking into picking up an oximeter due to the fact that my sat% rates dropped so low on my sleep study, but have not yet talked to my doc about that (soonest he can see me is late October). Any ideas?
Resmed Autoset Pressure Min: 10 Max: 17

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Pugsy
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Re: CPAP user since Feb '15, having issues.. Ideas?

Post by Pugsy » Wed Sep 23, 2015 8:13 am

Do you wake up very many times during the night for any reason?
Do you take any meds of any kind (even OTC) and if so, what are they?
Do you have any other health conditions that might affect sleep quality or how you feel in general during the day?....like maybe arthritis or some other health problem?

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Zoowabi
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Re: CPAP user since Feb '15, having issues.. Ideas?

Post by Zoowabi » Wed Sep 23, 2015 8:23 am

Do you wake up very many times during the night for any reason?

Not for any particular reason, usually I will just roll to another side, and back to sleep.
Do you take any meds of any kind (even OTC) and if so, what are they?
I take diclofenac 75mg 1-2 times a day probabaly 2-3 times a week for pain (waiting on surgery for MCL,ACL,Meniscus issues) but I am usually not having pain in bed.
Do you have any other health conditions that might affect sleep quality or how you feel in general during the day?....like maybe arthritis or some other health problem?
Nothing I think would affect my sleep.
Resmed Autoset Pressure Min: 10 Max: 17

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Pugsy
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Re: CPAP user since Feb '15, having issues.. Ideas?

Post by Pugsy » Wed Sep 23, 2015 9:18 am

I am going to mention maybe trying a fixed pressure instead of auto adjusting pressures before someone else (Hi Wulfman ) does.
For some people they do better (sleep better) with fixed pressures than with auto adjusting pressures. They find that the pressure changes perhaps disturb their sleep even if the changes don't necessarily wake them up during the night.

It's worth a try for sure.

I doubt that the generic Voltaren is much of a factor unless it is causing gi problems which if it were you would be unlikely to continue with it anyway. Man, I tried it and it just caused so much gi pain that I almost had to go to the hospital and beg for a shot of morphine. I can't take any of the usual NSAIDs for that reason.

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Zoowabi
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Re: CPAP user since Feb '15, having issues.. Ideas?

Post by Zoowabi » Wed Sep 23, 2015 9:27 am

Ok, try set pressure.. check..
Thoughts on a specific pressure? Should I start with my 90% pressure (11cm past 6mo), or go higher/lower?
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Pugsy
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Re: CPAP user since Feb '15, having issues.. Ideas?

Post by Pugsy » Wed Sep 23, 2015 9:33 am

I don't normally suggest 90% pressure unless it is a long term average and yours is...so I would start at 11 cm.
Good starting point and from there you can see if you need to go up a little or might be able to go down a bit.

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Zoowabi
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Re: CPAP user since Feb '15, having issues.. Ideas?

Post by Zoowabi » Wed Sep 23, 2015 9:41 am

Ok, I will make the changes and post results in a few days or so. Thanks!
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Zoowabi
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Re: CPAP user since Feb '15, having issues.. Ideas?

Post by Zoowabi » Thu Oct 08, 2015 7:40 pm

Update: so, after a couple of weeks setting the pressure to 11.6, I have noticed that my AHI has shot up a few points, and I am still having daytime sleepiness issues, as well as waking during the nights. I have gone ahead and switched back to an APAP mode and increased the minimum pressure to 10, as it would increase to that anyways usually within 20-30min of going to bed.

I am still wondering if it could be a lack of O2 sat, as posted previously, but have yet to pick up an Oximeter to verify that theory.

I am still almost a month out for the sleep doc visit, but does anyone have any ideas I could try before then?
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Wulfman...
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Re: CPAP user since Feb '15, having issues.. Ideas?

Post by Wulfman... » Thu Oct 08, 2015 8:24 pm

Zoowabi wrote:Update: so, after a couple of weeks setting the pressure to 11.6, I have noticed that my AHI has shot up a few points, and I am still having daytime sleepiness issues, as well as waking during the nights. I have gone ahead and switched back to an APAP mode and increased the minimum pressure to 10, as it would increase to that anyways usually within 20-30min of going to bed.

I am still wondering if it could be a lack of O2 sat, as posted previously, but have yet to pick up an Oximeter to verify that theory.

I am still almost a month out for the sleep doc visit, but does anyone have any ideas I could try before then?
Are you using software (like Sleepyhead) to monitor your data? If not, you NEED to see what's going on and WHY.

Edit: I see it's in your profile. But, I'm curious as to why you seem to be wondering about your results. I would think it should be clearer.


Den

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kteague
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Re: CPAP user since Feb '15, having issues.. Ideas?

Post by kteague » Fri Oct 09, 2015 4:30 am

Can you please clarify exactly what you mean when you say you are 95% compliant? By some insurance standards 4 hours of most nights is considered compliant. Just want to understand exactly what you are saying. Oh, about the oxygen, do you have a copy of your titration report? It should show if treatment resolved your oxygen issues. Unless you have something else going on, treatment should equal adequate oxygen. Can't speak for any time off the machine. But if you have reason for doubt, you could ask your doctor to order an overnight oxygen monitoring. You could decide after that if it's a worthwhile investment to buy one.

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Zoowabi
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Re: CPAP user since Feb '15, having issues.. Ideas?

Post by Zoowabi » Sat Oct 10, 2015 4:19 am

Edit: I see it's in your profile. But, I'm curious as to why you seem to be wondering about your results. I would think it should be clearer.
I have listed a week statistics in the first part of the post.. All in all, great numbers, but I am still having daytime sleepiness issues. After nine months, I would imagine that any lack of sleep would have been resolved. I average 7 hours of sleep per night (which is great considering a few times a month I get 3-4)
Can you please clarify exactly what you mean when you say you are 95% compliant?
I have been averaging 7-9 hours of sleep a night with the mean avg being 7.48hrs -- The only time I do not use it is when I get break outs on my nose (but as I said, that's for another day)
Resmed Autoset Pressure Min: 10 Max: 17

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Wulfman...
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Re: CPAP user since Feb '15, having issues.. Ideas?

Post by Wulfman... » Sat Oct 10, 2015 12:25 pm

Zoowabi wrote:
Edit: I see it's in your profile. But, I'm curious as to why you seem to be wondering about your results. I would think it should be clearer.
I have listed a week statistics in the first part of the post.. All in all, great numbers, but I am still having daytime sleepiness issues. After nine months, I would imagine that any lack of sleep would have been resolved. I average 7 hours of sleep per night (which is great considering a few times a month I get 3-4)
Can you please clarify exactly what you mean when you say you are 95% compliant?
I have been averaging 7-9 hours of sleep a night with the mean avg being 7.48hrs -- The only time I do not use it is when I get break outs on my nose (but as I said, that's for another day)
My suggestion would be to switch to a straight pressure instead of having the machine potentially disturbing your sleep all night long with changing pressures. It's a very common complaint of APAP users who use a range of pressures. Good numbers but never feeling rested. As you enter deep or REM sleep stages, your breathing can change and that may trigger pressure increases which bump the user out of that needed sleep stage and into lighter ones. So, the user spends most of the night in lighter sleep stages with fewer events.


Den

.
(5) REMstar Autos w/C-Flex & (6) REMstar Pro 2 CPAPs w/C-Flex - Pressure Setting = 14 cm.
"Passover" Humidification - ResMed Ultra Mirage FF - Encore Pro w/Card Reader & MyEncore software - Chiroflow pillow
User since 05/14/05