First Timer here...

Hello all. I'm a 32 y/o male who is starting his CPAP journey. I have had complaints about my snoring from friends/bed partners for as long as I can remember, certainly my early 20s, maybe even my teen years. After starting my career and eating out all the time I put on 60 pounds and the complaints regarding my snoring went from "you are annoying" to "sleep in the other room". Since starting my job I always went home exhausted and took a nap, sometimes for 1.5 hours sometimes for 3 hours, maybe more... then I'd be up till 2-3AM and do the same thing the next day. I always thought my messed up sleep schedule was due to my naps and going to bet late, not some other insidious issue. Other symptoms I've experienced over the years include dry mouth, night sweats (where I would wake up soaked) and general exhaustion.

Over the last 4 months my health seemed to worsen, I've had anxiety for awhile but my general anxiety worsened, panic attacks became more frequent, my heart rate would skyrocket out of nowhere. Naturally, I was afraid I had something seriously wrong with me. GP did basic tests, sent me to cardio, cardio did ECG, Holter, Stress Test... all normal. Back to GP who after investigating more suggested sleep study. Sleep study was Dec 12th, didn't get a hard copy of my report but the tech said the number 131. After reading a bunch on this forum I don't know if an AHI of 131 is possible or if that was the total number of events that occurred throughout the entire study. Titration was done the following week and I finally received my machine last Friday.

First night few nights were a little rough, woke up throughout the night feeling the pressure was too much, woke up feeling very bloated burping and passing gas for about an hour after waking (luckily it was the weekend). AHI Friday was 4.5 with a 100% Mask fit. Saturday AHI was 0.9 with a 99% Mast fit. After feeling bloated the first two days and knowing I'd have to come to work today I searched for how to change the settings. Machine was set to CPAP at 19 (which seems really high?). So I went into the clinical settings and turned it onto Auto mode min 8 max 20. Last night I had an AHI of 1.2 with 100% Mask fit with a 90% pressure of 10.1.

Does anyone thing I messed with the settings too soon? If my 90% pressure was only 10.1, was CPAP at 19 crazy? I know you are going to want me to upload screenshots, I ordered a SD card reader and it will be here Friday via Amazon so I'll have some better data to report then.

Also just wanted to add this really seems like a wonderful community, with many people constantly present to help and answer questions from newbees.

Welcome sounds like your doing great keep using your machine put up some charts when you can and we can see how things are going and help you improve if needed.


Jason

Just A FYI.....Most computers made over the past 4-5 years or so have a built in slot to read SD cards.

Welcome to the forum hbkslick1016. I am also a beginner in CPAP therapy and I have been getting excellent help from this forum. As for your questions I will wait for more experienced member to comment.

So my pressure was set at 19 in image 1... reset machine to auto in the 2nd two. I think I'm doing really well?

hbkslick1016 wrote:So my pressure was set at 19 in imagine 1... reset machine to auto in the 2nd two. I think I'm doing really well?

Extremely well.

They had you on fixed 19cm??? Ugh.

The time on the 1/24 report where you see you pressure go highe to 14.5 and stay up there for a couple of hours....you were probably on your back.
So maybe you need higher on your back but the rest of the time you do quite well at the lower near minimum settings. 19 cm is a bit of an over kill IMHO.

Are you feeling and sleeping good also? On paper things sure look good.

Pugsy thanks for the response. Yeah, 19 was unbearable. The blowing in my mouth/face/nose was way too much. I'd have a hard time falling asleep, staying asleep and would wake up totally full of air and was uncomfortable for an hour or so. I googled how to change the settings (hoping my ins company wouldn't flag me) and ever since I've been fine. They must have had a look at my stats though because on Monday they re-set the machine to fixed at 19. I'm going to have to tell my DR that's just unacceptable and to change the script.

As far as feeling, I can tell I'm getting a better nights sleep. Night sweats have totally gone away, I would get those regularly before. I'm sleeping through the night more and longer and I'm not TOTALLY exhausted when I get home from work. I still sometimes need a nap after work, but it's not like I'm racing to get home before I fall asleep at my desk or on the drive home like I was before. Do you buy into "sleep debt" and that it might take awhile to catch up?

The insurance company doesn't care what pressure that you use...just that you use the machine. Insurance companies have no idea what pressure is being used.

Now the DME/doctor (whoever put it back to 19) is the one who cares...so if it was the DME and they are separate from the doctor, they checked and saw you had changed it and you will need to call the doctor and get him to tell the DME to change their records. Tell him that 19 isn't doable but you are doing very well in auto mode with the settings you are now using.
If you had an in lab sleep titration (how they came up with 19) I bet they kept you on your back all night and thus the worst case scenario setting which is over kill.

If they get really ugly about it...we can see if we can figure out how to disable the feature that is allowing them access. All you have to do is remove the modem which is easy to do.
Don't worry...if insurance needs compliance hours proof we can either briefly plug that accessory back in or use the SD card report for proof.
Most insurance won't need anything past 90 days anyway.

hbkslick1016 wrote: Do you buy into "sleep debt" and that it might take awhile to catch up?

... In a way, but I don't really believe it's all about sleep debt... That's actually short hand for a much more complicated issue... There's the brain damage debt from not breathing - it can take sever sufferers up to a year for their brains to fully recover. There is also the endocrine debt - the endocrine system, especially, cortisol, Epinephrine/Adrenalin(for the UK users), and norepinephrine/noradrenaline over use/exhaustion. Sounds like your adrenals were still working - for me I had very low epinephrine and super high norepinephrine and coritsal and part of that was my body trying to keep itself alive - also studies show increased creatine metabolism at NIGHT, meaning the body ramps up it's energy catalyst system during the night in anticipation of suffocating. So in a sense... yes there's a debt, but it would be more accurate to say there is a sleep & apnea debt. The sleep debt probably won't last long.... the apnea debt can take a year (for the brain part) (or possibly more for the endocrine system normalization).

hbkslick1016 wrote: Do you buy into "sleep debt" and that it might take awhile to catch up?

I don't personally buy into the sleep debt thing long term. Now the debt caused by the long term stress to the body....yeah, the body can take quite some time to heal. We didn't get this way overnight and it's sort of unrealistic to expect to fix everything over night.
So for me it's not so much the actual hours of sleep debt because I don't think that sleeping 8 hours last night does a darn thing for a week ago when I got 3 hours. That short night of 3 hours was better fixed in terms of hours of sleep the 2 or 3 nights following the short night.

So if sleep debt is just making up for lost hours...IMHO it's short term fixing but if it is the effects of long term damage caused by apnea then yeah it can take a while but I don't call it sleep debt because to me "sleep debt" is just related to hours or quality only.

nicholasjh1 wrote:

hbkslick1016 wrote: Do you buy into "sleep debt" and that it might take awhile to catch up?

... In a way, but I don't really believe it's all about sleep debt... That's actually short hand for a much more complicated issue... There's the brain damage debt from not breathing - it can take sever sufferers up to a year for their brains to fully recover. There is also the endocrine debt - the endocrine system, especially, cortisol, Epinephrine/Adrenalin(for the UK users), and norepinephrine/noradrenaline over use/exhaustion. Sounds like your adrenals were still working - for me I had very low epinephrine and super high norepinephrine and coritsal and part of that was my body trying to keep itself alive - also studies show increased creatine metabolism at NIGHT, meaning the body ramps up it's energy catalyst system during the night in anticipation of suffocating. So in a sense... yes there's a debt, but it would be more accurate to say there is a sleep & apnea debt. The sleep debt probably won't last long.... the apnea debt can take a year (for the brain part) (or possibly more for the endocrine system normalization).

This is interesting. I've had anxiety and rapid heart beat randomly since about the time I gained that extra 60 pounds or so when I began my career. I had a theory that my body needing to be in survival mode and push my heart to wake me up so often carried over to the daytime, causing the rapid heart beat randomly when not needing to wake me up, and exacerbating my anxiety.