4th Day on CPAP - Question

Last night was my 4th day (evening) on CPAP. I woke up once during the night after noticing my mouth was open slightly and air was blowing through my mouth. It had made my mouth very dry. I rolled over and went back to sleep.

Oddly enough, my sleep report doesn't show any leakage. Could it be that even though my mouth was open slghtly and air was blowing through it, I was still breathing only through my nose?

Also, do my results show I had a great night of sleep?


Day 4:
Used Hrs - 7.4 hrs
Pressure - 10
Leak 0L/min
AHI - 0.0
Total AI - 0.0
Central AI - 0.0


Below are the first 3 days for reference:

Day 1:
Used Hrs - 6.3 hrs
Pressure - 10
Leak 0L/min
AHI - 1.1
Total AI - 0.9
Central AI - 0.7

Day 2:
Used Hrs - 8.7 hrs
Pressure - 10
Leak 2L/min
AHI - 0.8
Total AI - 0.8
Central AI - 0.8

Day 3:
Used Hrs - 7.7 hrs
Pressure - 10
Leak 1L/min
AHI - 0.2
Total AI - 0.2
Central AI - 0.2

I am envious of those AHI's and you say no leaks.

Tell us all your secrets. I usually have crazy leaks even when I have decent #'s . Last night was my best ahi in couldn't tell you when 0.29 and still had at least one leak that went to 47

steeve wrote:I am envious of those AHI's and you say no leaks.

Tell us all your secrets. I usually have crazy leaks even when I have decent #'s . Last night was my best ahi in couldn't tell you when 0.29 and still had at least one leak that went to 47

Must be just pure, dumb luck steeve. I guess the medium nose pillows fit just right.

JCWarrior wrote:do my results show I had a great night of sleep?

On paper..yes.
How do you think you slept? Numbers don't tell the whole story. You could have a gazillion wake ups and horrible sleep quality and have the most perfect numbers in the world.

It takes very little mouth breathing to dry out the mouth...maybe you were only doing a little mouth breathing/leaking when mouth was open. Like maybe 5 minutes or so. It wouldn't be enough to show up on the digital display and it might not even be enough to show up on software leak line like we expect it would. Not all mouth breathing means every bit of therapy air is going out the mouth..some yes..all, not necessarily.

Numbers are nice affirmations that things are going reasonably well but there's so much more to getting good sleep and feeling well rested than just a set of numbers.

Are you using the software to see what is going on in more detail or just using the LDC display?

Pugsy wrote: On paper..yes.
How do you think you slept? Numbers don't tell the whole story. You could have a gazillion wake ups and horrible sleep quality and have the most perfect numbers in the world.

Fairly well I think. I woke up, slightly, a few times so not as pefectly sound as I prefer. I fell well rested today.

Pugsy wrote:Are you using the software to see what is going on in more detail or just using the LDC display?

Just using numbers from LDC at this time. I will be installing Sleepyhead and getting a card reader very soon.

Pugsy,
I have another, off-topic question. Let me know if I should start a new thread, please:

During my first/initial visit with my DME last Friday, I had requested an "Autoset" CPAP from my DME. They agreed it is billed the same as my S9 Elite but they stated they follow what the order states. They stated I could hold off on taking possesion of my Elite, discuss this with my doctor and have him send them the order for APAP. When I told them that's what I would do, the DME went to discuss with his manager, cam eback in and told me they would prefer to let me get set up with the Elite and I could exchange it for an Autoset if the docotr send them a revised order.

I am planning to call my docotor to make the request but I want to be sure of the following:

1) What reason do I give for wanting the Autoset vs. CPAP?

** My thoughts are so it is avaiable as my therapy evolves and I then I will not have to wait 5 years to switch nachins.

2) Even though I am only 4 days into CPAP, the Elite seems to be working well for m. How hard should I fight for an Autoset?

APAPs are nice but as you see you can get great therapy with cpap mode only machine.

It gets harder to justify an APAP in your situation. Some docs will go along with whatever a patient wants and some docs won't.
You know the AutoSet can be set in CPAP mode too.
I think that if a patient wants the AutoSet to have it available in APAP mode is good enough reason to get one but some docs don't go along with that. Mine didn't.

Some reasons you might justify APAP mode available machine.

You simply want one...that's a tough sell to some docs but some docs shrug their shoulders and say "Okay". You can always remind them that cpap mode is still available on the APAP machines....2 machines in one.
If you don't ask the answer is "no"...so it hurts nothing to ask.

If you are heavy and plan to lose weight...pressure needs might change so having auto adjusting mode might help.

If your sleep studies point to different degrees of severity or pressure needs related to supine sleeping or REM stage sleep the auto adjusting pressure mode might really come in handy...this is what happened to me...my REM stage sleep sometimes pressure needs. That's how I got my doc on my side. Do you have copies of your sleep studies? If not, get them..might be something in there to give you some ammunition for APAP mode machine.

If you have aerophagia issues...using a lower pressure part of the night and only using higher pressure some of the night in APAP mode can help any aerophagia issues.

Also remember that while APAP mode is nice...for some people the variable pressures actually are more of a sleep disturbance if they happen to be sensitive to the least little pressure change. They still have to have an optimal minimum pressure and can't respond quickly enough to the warning signs if set too low. I think this is where a lot of doctors get their impressions that APAP mode doesn't always work...they allow a wide open range and 4 cm minimum doesn't work so great if someone needs pressures 10 and above..it can't get there fast enough to prevent the airway collapse.

So how urgent or critical is it that you have APAP? In all honesty, probably not that critical at this point unless you are having problems. Your current pressures aren't horribly high...you might be able to use a lower pressure with the APAP and let the machine go up if it senses the need. Is it a deal breaker though?...probably not.

You know if your pocketbook permits....you may want to have a spare machine for travel or just for general backup and you can always try to find AutoSet at that point. There are sources available for new or gently used low hour machines that won't break the bank.

Lots of great info Pugsy. I do like the fact that the Autoset machine can run in CPAP mode if I find that to be optimal for me. I like having choices.

I fully plan to lose weight. My sleep doctor was cured of OSA by losing 100 pounds and he doesn't think I fall into the catagory of someone that would be cured by losing weight. I plan to lose for overall health reasons but I am also hoping it would cure my OSA.

I wigh 215 now at 6' tall. I was 168 until I was 26 years old. I have more muscle than those days but also more fat.

I do have my sleep test results. I'll post them shortly.

I'll contact my doc to see if they'll agree. If I lose the battle, I still have a full data machine that is working well for me at this time.

Pugsy,
Are attachments allowed on this forum? I was hoping to post PDF's of my Sleep and Titration studies.

Can't do attachments but we can link to images or pdfs by using some sort of web hosting site.
This is how we do images of our software reports.
Screen shot thread viewtopic.php?f=1&t=81072&p=737779#p737779
Similar steps to link to somewhere that you have a pdf uploaded....then we click on link.
Of if you can do a readable screen shot..you can treat it like a normal screen shot.

Here are my Original Sleep Study and Titration Study Results:

Original Sleep Study







Titration Study

JCWarrior wrote:Lots of great info Pugsy. I do like the fact that the Autoset machine can run in CPAP mode if I find that to be optimal for me. I like having choices.

I fully plan to lose weight. My sleep doctor was cured of OSA by losing 100 pounds and he doesn't think I fall into the catagory of someone that would be cured by losing weight. I plan to lose for overall health reasons but I am also hoping it would cure my OSA.

If your plan only includes loosing weight I would tend to agree with your doctor.

Weight (e.g. BMI) is a single indicator of over all metabolic health.

I think learning to eat well is a life long endeavor I wish I had started early in life. I am glad I worked with a dietitian for at least three years and highly recommend this. Medicare was happy and wise to pay for this.

I think that learning to move well is also a life long endeavor that I wish I had started early in life. Combined with learning to eat well I now use half the pressure I did two years ago set by a doctor about three years ago.

I was tested with severe sleep apnea with extreme hypoxia. You on the other hand show a profile much less affected by the disease. I think you do have a good chance of beating this disease. Please to go for it!!!

JCWarrior wrote:I weigh 215 now at 6' tall. I was 168 until I was 26 years old. I have more muscle than those days but also more fat.

I do have my sleep test results. I'll post them shortly.

I'll contact my doc to see if they'll agree. If I lose the battle, I still have a full data machine that is working well for me at this time.

Well managed PAP treatment is an important part of beating sleep apnea. Learn to download and use your data several times a week.

Establish your vitamin D3 levels above 50 but less than 80.

You might also try some traditional Chinese medicine and if so inclined some Buddhist meditation. Lowering the stress levels is likely to make PAP therapy work better for you I do believe.

Todzo wrote:If your plan only includes loosing weight I would tend to agree with your doctor.

Thank you for the advice and encouraging words Todzo. I am not sure what you mean here though.

JCWarrior wrote:

Todzo wrote:If your plan only includes loosing weight I would tend to agree with your doctor.

Thank you for the advice and encouraging words Todzo. I am not sure what you mean here though.

I am talking about:

Well managed PAP therapy. Download data regularly and use to modify lifestyle (or therapy if indicated) such that good sleep is the way you live.

Learning to eat well. I think this should be life long learning for everyone. But it is learning a new good thing or two or three a week. Dietitians are good (sometimes). Lots of mis-direction in the area of diet but you find what works for you and use it. I think the time to care for you is a big part of this.

Learning to move well. Life long. Personal trainers and all. Yoga, dance, many other good forms. Martial arts. Plenty of activities and sports.

Lifestyle management. Not too much or too little stress. Work with rather than against your circadian rhythms. Find stress and activity levels where you are the most productive. Move away from crime. Move toward good people. Get involved. Find good purpose and pursue it. Give lots of love to your friends.

Include other forms of healing. Many have been around much longer than our western medicine. Western medicine is based in the so called "scientific method" which is too reductionist to be able to deal with how interactive life really is. It tries to control one variable to look at one result. But we have many many many thousands of interacting variables which none can control. So the scientific method is of very limited usefulness as it currently is practiced. If they learn to deal with interaction...

I guess I simply wish someone had really taken the time to teach me how to take care of myself. As I have learned how to do this better I now see half the CPAP pressure needed.

I think you have about 1/10th the damage from Sleep Apnea that I deal with (mine was severe with extreme hypoxia when tested). So from where I am looking I think you have a much better chance than me of making it to PAP free.