Started APAP

Hi guys,

I started my APAP about a week ago. I'd like to run the results so far by you all.

First of all, the most surprising thing is that I was titrated twice, in two different sleep studies, at 11 cm. However, the APAP has had my pressure much higher, as high as 17 cm! I'm not sure what to do, because my data looks to me like it's pretty good.

Last night, for example, my average pressure was 14.3 cm, with the 90% value being 17 cm. My AHI was 2.4. I seemed to do a fair amount of snoring (no girlfriend at the moment, so no feedback there). My Vibratory Snore index was 15, with most of the snoring taking place below 15 cm pressure.

Oh, my APAP is set 9 cm Min, 20 cm Max, A-flex of 1.

I'm still quite tired in the morning, and at periods throughout the day, but I recognize that a week is not long enough to really get the benefit. It has occurred to me, though, that perhaps I should raise the minimum pressure so that it doesn't take so long to get to where I seem to need to be.

Also, I must say that being at a pressure so much higher than my sleep study indicated makes me a little nervous. Who would you believe? The Sleep Center or the APAP?

Thanks,

Andy

I wouldn't worry about the high pressure setting being at 20 cms. And the Respironics are supposed to be less aggressive at chasing hypopnea than the Resmeds w/which I am familiar.

Keep in mind that that 90th percentile is the pressure AT OR BELOW which you spent 90% of the night.

You don't mention your leak rate. These newer CPAPs can compensate quite nicely for leaks by upping the pressure in response.

The C-Flex of 1 is lowering your pressure half of the night, assuming you spend half of the night exhaling and half of the night inhaling.

And it well could be that your APAP is chasing those snores thus raising the pressure.

And then there's the theory I've read that some sleep doctors prefer a setting which eliminates only 95% of the apneas.

All just guesses on my part. Some of the Respironics folks will be around soon to respond. I responded only because you post was getting further and further down the list w/no response.

Hi Slinky,

Thanks. My leak rate last night was 48. It has varied from about 41 to 48, with no large leaks. If I read my Mask manual correctly, this appears to be pretty much just the Vent rate of the mask itself.

Andy

Do you mean 4.8?

48 would be a lot.

Di

Moby wrote:Do you mean 4.8?

48 would be a lot.

Di

No, 48 LPM is what I mean, not 4.8. However, my mask instructions say that 48 L/min is what should be flowing at 16 cm of pressure. So I am taking that to mean that everything is ok.

My graphs show this "Average Leak" fairly consistently throughout the night, starting immediately (before I am even asleep). So if there really was an "abnormal" leak, I would think that I would be aware of it.

Also, the graphs say "Large Leak 0.0 minutes, 0% of the night". So I am inclined to think that this is an ok situation.

Andy

andy88488 wrote:

Moby wrote:Do you mean 4.8?

48 would be a lot.

Di

No, 48 LPM is what I mean, not 4.8. However, my mask instructions say that 48 L/min is what should be flowing at 16 cm of pressure. So I am taking that to mean that everything is ok.

My graphs show this "Average Leak" fairly consistently throughout the night, starting immediately (before I am even asleep). So if there really was an "abnormal" leak, I would think that I would be aware of it.

Also, the graphs say "Large Leak 0.0 minutes, 0% of the night". So I am inclined to think that this is an ok situation.

Andy

Moby, the leak rate for Resmed machines is measured differently than Respironics ones. For a Resmed machine, it would be in low single digits, but for Respironics, 48 would be ok, if that was the leak rate at your pressure.

If you are still tired, there could be other reasons. You should definitely get ahold of all 3 or your sleep studies, not just the doctor's reports but all the charts and graphs. This will tell you about things like RERAs and periodic limb movements that can also contribute to tiredness. You should also make sure you have the original prescriptions. Put your sleep studies and prescriptions in a safe place (some even put them in a safety deposit box).

Do you have the software or are you reading the information from the machine. I don't have that machine, but the machine readout data is less than reliable from what I've read here. Getting the software and card reader is the way to go. I wouldn't be without mine! It gives a lot more information.

I agree that a week is not long enough to tell, though.

I would try limiting the upper pressure. It sounds like the machine is chasing snores. This happened to me and limiting the upper pressure solved the problem. I also found that the apap was great for titrating but I sleep better with the machine set to cpap at one constant pressure.

Brenda