Second night on APAP, questions

Hi,

I just finished my second night on my new APAP machine -- I had been using a bare bones CPAP machine--and I have some questions because I don't have EncoreViewer and the card reader, yet.

My range for treatment is 7-15 and was arrived at based on my tritation study in September where the ranges there were from 5-12 with an AHI of 0.0 at both 7 and 12--if I read the report correctly. I switched to APAP because of snoring and generally not feeling as well as I felt when I first started CPAP.

The night before last, I had a lot of leaks, so I'm throwing that night out. I should state that I feel pretty good, now. I got about 7.5 hours sleep last night. What troubles me is this: The machine starts at 7, I fall asleep, and when I woke up it was at 15. I had a small leak on the mouth seal slightly above my chin. Is it normal for such radical adjustments to occur throughout the night?

Thanks,

Scott

dunkonu23 wrote:Hi,

I just finished my second night on my new APAP machine -- I had been using a bare bones CPAP machine--and I have some questions because I don't have EncoreViewer and the card reader, yet.

My range for treatment is 7-15 and was arrived at based on my tritation study in September where the ranges there were from 5-12 with an AHI of 0.0 at both 7 and 12--if I read the report correctly. I switched to APAP because of snoring and generally not feeling as well as I felt when I first started CPAP.

The night before last, I had a lot of leaks, so I'm throwing that night out. I should state that I feel pretty good, now. I got about 7.5 hours sleep last night. What troubles me is this: The machine starts at 7, I fall asleep, and when I woke up it was at 15. I had a small leak on the mouth seal slightly above my chin. Is it normal for such radical adjustments to occur throughout the night?

Thanks,

Scott

Yes.......Leaks and snoring will definitely drive up pressures.
If you're going to use such a wide range of pressures, you shouldn't be surprised to see it happen. You're probably going to snore more at lower pressures. Then, if your mask is adjusted to the LOWER pressure, by the time it gets up a few more centimeters, it's going to start to lose its seal......and then becomes somewhat of a "feeding frenzy".....leaks, pressure increases, more leaks, more pressure increases.

Den

Den, Curious to know what you would recommend for settings.

DoriC wrote:Den, Curious to know what you would recommend for settings.

If you're asking about Scott's settings......I'd have to see some reports first.

Den

[quote="Wulfman
Yes.......Leaks and snoring will definitely drive up pressures.
If you're going to use such a wide range of pressures, you shouldn't be surprised to see it happen. You're probably going to snore more at lower pressures. Then, if your mask is adjusted to the LOWER pressure, by the time it gets up a few more centimeters, it's going to start to lose its seal......and then becomes somewhat of a "feeding frenzy".....leaks, pressure increases, more leaks, more pressure increases.

Den[/quote]

Understood. I adjusted the mask at 15 prior to sleep and it seemed okay, but I suspect I moved or bumped the mask. The leak was very slight. So, I'll readjust and wiggle the mask more.

Scott

Wulfman wrote:

DoriC wrote:Den, Curious to know what you would recommend for settings.

If you're asking about Scott's settings......I'd have to see some reports first.

Den

I won't have the software and reader until after Christmas, but I'll be certain to post results once I get them. Thanks!

Scott

Two new things that happened today as I slept in advance of going to work. I performed a test. I lay in bed, still for an hour--awake--then after an hour, and no events by me that would cause anything to change, no leaks, no nothing, the machine bolted to 15. Then, after a power off/on, I fell asleep. When I awoke, the pressure was at 10. I'm about lost.

My plan is to get the software and card reader, then arrive at a new minimum pressure so there's no big jumps for no apparent reason--of course, because I don't have the software yet, I'm guessing that the jump to 15 was warranted, but I don't know.

Scott

Scott,

This is nothing against you, but I've been saying for a long time that trying to do this therapy with an Auto and without the software is basically an exercise in frustration. Too many things going on and variables that can't be "seen" that drive pressure changes. If you want to "de-frustrate" yourself in the meantime, set it to CPAP mode at a fixed pressure and monitor the results in the LCD. If I were to pick a pressure, I'd say 10 to start.

Den

Wulfman wrote:Scott,

This is nothing against you, but I've been saying for a long time that trying to do this therapy with an Auto and without the software is basically an exercise in frustration. Too many things going on and variables that can't be "seen" that drive pressure changes. If you want to "de-frustrate" yourself in the meantime, set it to CPAP mode at a fixed pressure and monitor the results in the LCD. If I were to pick a pressure, I'd say 10 to start.

Den

Yeah, I've figured that out. I was just wondering if it's normal for a machine to jump so fast to 15 when a person is awake and breathing normally. I guess I'll get there when the software arrives. Thanks for the suggestion. I think I'll do it.

Scott

For me, when I am awake and being hyper-conscious of my breathing, I probably am NOT breathing normally. I know I don't have apneas, but I do record hypopneas, snores, flow limitations - the auto establishes a running average of breaths taken, and that is probably all over the place for me. Once I fall asleep, things settle down.

However, I agree you won't know what is happening until you see the reports.

sepool wrote:For me, when I am awake and being hyper-conscious of my breathing, I probably am NOT breathing normally. I know I don't have apneas, but I do record hypopneas, snores, flow limitations - the auto establishes a running average of breaths taken, and that is probably all over the place for me. Once I fall asleep, things settle down.

However, I agree you won't know what is happening until you see the reports.

Yep. We don't breathe the same when we're awake as we do when we're asleep, and since these machines are using "air flow" to determine what may be going on, there can be a big discrepancy in what they're "detecting".

It don't know if are sleeping.....it don't know if you're awake...........so go to sleep for goodness sake......
(sorry, the holidays are upon us and I couldn't resist)

Den

It's my understanding that Auto machines are not equipped to deal with "awake" breathing. A much narrower pressure range than 7 - 15 is often suggested when in auto mode. I have not seen a titrated pressure of 7 - 15, only single pressures such as 7, 8, 9 or 10 etc.