Treated Snoring ....Found Apnea?

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
User avatar
qbquixote
Posts: 14
Joined: Wed Aug 26, 2015 4:25 pm

Treated Snoring ....Found Apnea?

Post by qbquixote » Thu Aug 27, 2015 7:02 pm

Hi everyone,

I'm new to the forum, but have been lurking frequently over the last two weeks.
Two weeks ago I finally got fed up with loud snoring that led my wife to seek shelter in another room if she was not asleep before me.
Snoring had become over the last couple years more and more frequent, as I fell asleep almost instantly as I hit the pillow, but was more and more tired often falling asleep after dinner in the evening.

This year I had tried using a couple over the cpunter snoring aids not much help, and I looked around and two weeks ago I found an old M series cpap machine I could purchase for snoring. I read online that cpap can stop snoring even if you don't have apnea. And of course since no one had heard me gasp or stop breathing I couldn't have THAT. Anyway two weeks ago I got that, and the most unobtrusive mask I could easily get (an aloha nasal pillow mask) and adjusted the pressure a little while I watched TV to see what I could tolerate and wore it to bed.

I was way quieter, and felt a little better in the morning and tolerated it OK it wasn't great but I wasn't shaking the house with snoring anymore. I looked up the data on the machine and found the AHI was 11.6 at 6 cm. I looked that up online and thought, wow, even when I am not snoring I still have apnea. So over the last two weeks, I have read this forum, dealt with rainout by wrapping towels and an ace bandage around the hose, ordered a smart card to get better data, got encore basic online, and started the whole titration thing, edging up to 8.5 where now my AI is less than one this week and AHI between 1 and 2. I feel a lot better and have not fallen asleep in front of the TV all week. My coworkers are noticing my energy already, and this week I got way more work done with less to bring home.

Sorry about the long post, the site has been great for practical ideas to help me tolerate CPAP with my little setup.

Now my question. I know my AHI on the Remstar was at least 11.6 at 6 cm.
I have a PCP appointment in December where I will chat with him about my new discoveries.
Are there reasons to call in sooner? Should I push for a sleep study?
At this point I dread the idea of sleeping without it in a study I feel so much better in the morning.
It would be nice if insurance bought supplies.

Burt

Thanks in advance for any advice.

_________________
MachineMask
Additional Comments: PR 560 APAP backup no foam, Pressure 7.6-11.4, EPR, Oscar, sleepyhead, Encore Basic for my old M-series

User avatar
kteague
Posts: 7768
Joined: Tue May 16, 2006 8:30 pm
Location: West and Midwest

Re: Treated Snoring ....Found Apnea?

Post by kteague » Thu Aug 27, 2015 7:22 pm

Congrats on stumbling across your need for treatment and taking steps to help yourself. My first thought is to say continue as you have been and save yourself some money, but I had second thoughts. An in-lab sleep study looks at so much more than just the AHI. Good information to have, and sometimes other issues are revealed in a study. As to having the insurance pay for supplies, don't make your decision based on suggested replacement schedules and full DME prices. I've found my replacement needs are few and far between - even years on some items. If it would be helpful, make a list with one side all the doctor visits, copays, etc and the other side replacements supplies costs. Maybe your answer will be apparent. Or maybe the possible benefit of more information from a study will weigh heavier than the merely the cost factor. Good luck going forward.

_________________
Mask: TAP PAP Nasal Pillow CPAP Mask with Improved Stability Mouthpiece
Humidifier: S9™ Series H5i™ Heated Humidifier with Climate Control
Additional Comments: Bleep/DreamPort for full nights, Tap Pap for shorter sessions

User avatar
Wulfman...
Posts: 6688
Joined: Mon Sep 01, 2014 6:41 pm
Location: Nearest fishing spot

Re: Treated Snoring ....Found Apnea?

Post by Wulfman... » Thu Aug 27, 2015 7:30 pm

qbquixote wrote:Hi everyone,

I'm new to the forum, but have been lurking frequently over the last two weeks.
Two weeks ago I finally got fed up with loud snoring that led my wife to seek shelter in another room if she was not asleep before me.
Snoring had become over the last couple years more and more frequent, as I fell asleep almost instantly as I hit the pillow, but was more and more tired often falling asleep after dinner in the evening.

This year I had tried using a couple over the cpunter snoring aids not much help, and I looked around and two weeks ago I found an old M series cpap machine I could purchase for snoring. I read online that cpap can stop snoring even if you don't have apnea. And of course since no one had heard me gasp or stop breathing I couldn't have THAT. Anyway two weeks ago I got that, and the most unobtrusive mask I could easily get (an aloha nasal pillow mask) and adjusted the pressure a little while I watched TV to see what I could tolerate and wore it to bed.

I was way quieter, and felt a little better in the morning and tolerated it OK it wasn't great but I wasn't shaking the house with snoring anymore. I looked up the data on the machine and found the AHI was 11.6 at 6 cm. I looked that up online and thought, wow, even when I am not snoring I still have apnea. So over the last two weeks, I have read this forum, dealt with rainout by wrapping towels and an ace bandage around the hose, ordered a smart card to get better data, got encore basic online, and started the whole titration thing, edging up to 8.5 where now my AI is less than one this week and AHI between 1 and 2. I feel a lot better and have not fallen asleep in front of the TV all week. My coworkers are noticing my energy already, and this week I got way more work done with less to bring home.

Sorry about the long post, the site has been great for practical ideas to help me tolerate CPAP with my little setup.

Now my question. I know my AHI on the Remstar was at least 11.6 at 6 cm.
I have a PCP appointment in December where I will chat with him about my new discoveries.
Are there reasons to call in sooner? Should I push for a sleep study?
At this point I dread the idea of sleeping without it in a study I feel so much better in the morning.
It would be nice if insurance bought supplies.

Burt

Thanks in advance for any advice.
In all honesty, I don't know.
If it were me, I'd just try tweaking the machine therapy settings and see if you can get your numbers lower. You may find that by the time you get the pressure up to about 10 cm., you'll start seeing some really good numbers.

You might fill out your profile with your exact equipment so others can see it more readily. You can add them to the "additional comments" section like I have, if the equipment isn't in the drop-down menus.


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

User avatar
Goofproof
Posts: 16087
Joined: Mon Dec 05, 2005 3:16 pm
Location: Central Indiana, USA

Re: Treated Snoring ....Found Apnea?

Post by Goofproof » Thu Aug 27, 2015 7:38 pm

If you can meet your own needs, I wouldn't waste my time with a doctor in the loop. Flying under the radar, leaves no paper trail. Jim
Use data to optimize your xPAP treatment!

"The art of medicine consists in amusing the patient while nature cures the disease." Voltaire

User avatar
qbquixote
Posts: 14
Joined: Wed Aug 26, 2015 4:25 pm

Re: Treated Snoring ....Found Apnea?

Post by qbquixote » Thu Aug 27, 2015 7:57 pm

Sorry Den,

I entered the PR Remstar Pro M Series with C Flex in my profile, I am not sure why it is not showing at the bottom of the posts.

I'll move the pressure up a bit more this week.
At 8.5 I notice it more with a little stomach upset, not sure if I am swallowing a little air, so I'll probably not jump all the way to 10.
I was pretty happy to have AI below 1. Hypopneas are the main component. Only 6 OA events in the last 3 days, more earlier in the week keeping the average up.

Burt

_________________
MachineMask
Additional Comments: PR 560 APAP backup no foam, Pressure 7.6-11.4, EPR, Oscar, sleepyhead, Encore Basic for my old M-series

User avatar
Wulfman...
Posts: 6688
Joined: Mon Sep 01, 2014 6:41 pm
Location: Nearest fishing spot

Re: Treated Snoring ....Found Apnea?

Post by Wulfman... » Thu Aug 27, 2015 8:02 pm

qbquixote wrote:Sorry Den,

I entered the PR Remstar Pro M Series with C Flex in my profile, I am not sure why it is not showing at the bottom of the posts.

I'll move the pressure up a bit more this week.
At 8.5 I notice it more with a little stomach upset, not sure if I am swallowing a little air, so I'll probably not jump all the way to 10.
I was pretty happy to have AI below 1. Hypopneas are the main component. Only 6 OA events in the last 3 days, more earlier in the week keeping the average up.

Burt
Hi Burt.

Have you had acid reflux or GERD-type symptoms in the past? Take antacids?
Swallowing air could indicate a weak LES.
Try sleeping on your left side (if you can) and see if that helps.

Good luck and hang in there.


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

User avatar
qbquixote
Posts: 14
Joined: Wed Aug 26, 2015 4:25 pm

Re: Treated Snoring ....Found Apnea?

Post by qbquixote » Thu Aug 27, 2015 8:13 pm

Thanks,
Yes, I have had some GERD symptoms more this year.
Taking Pepcid... I'll try the left side sleeping as well.
I have lost about 8 pounds in the last two weeks I think I was snacking to stay awake.


I am off to bed to get up at 5 for work.
Sleeping 7 hours or so is a lot more relaxing now, but takes a little setup time.

Burt

_________________
MachineMask
Additional Comments: PR 560 APAP backup no foam, Pressure 7.6-11.4, EPR, Oscar, sleepyhead, Encore Basic for my old M-series

User avatar
Pugsy
Posts: 63942
Joined: Thu May 14, 2009 9:31 am
Location: Missouri, USA

Re: Treated Snoring ....Found Apnea?

Post by Pugsy » Thu Aug 27, 2015 8:20 pm

The machine choice isn't showing up in the profile because the links to all those discontinued machines are broken.
I would just add it with the comments you already have noted...just say "M series Pro" and we will know what it is.
If increasing the pressure causes some discomfort...there's no urgent need to go up further than 8.5 cm at this time. Your AHI is already nice and low and you are feeling the benefits. AHI between 1 and 2 is totally acceptable especially if trying to reduce it with more pressure causes problems.

About going the sleep study and formal route....I have mixed feelings about it.
Yes, you might learn something else ...and you might not and while the paper trail that would come from it isn't nearly as big of a deal in terms of health insurance now that pre existing conditions can't be held against us...that's only for health insurance. Sleep apnea WILL affect your insurability when it comes to life insurance and not in a good way. At worst a denial and at best probably a rate up. It's not fair but there's a lot about how insurance works that isn't fair.

Remember if you have a high deductible for your insurance it may not be all that much of an advantage cost wise. If you do decide to go ahead with the formal evaluation...schedule everything after Jan 1 so that all the expenses will be applied to next year's deductible if your deductible is very much at all.

There are ways to get machines and masks without breaking the bank and without have an official RX. Finally, plain jane vanilla OSA with no other complicating factors is fairly easy to manage like you are doing now. Up to you just how much you want your insurance involved which means DME involvement and a whole other can of worms there that will be opened up.

I know you are curious as to how "bad" your OSA might be without the machine. I probably would be curious too. Just make sure that you do the math and understand what happens once that paper trail is started...you can't undo it. Now if you are all set up in terms of any life insurance you will ever need and your deductible is nice and low then that's one thing but if not...just think about how far you want this to go.

Good job on taking control of your situation and getting therapy and congrats on actually feeling the benefits. I don't know your age but you are likely saving yourself from a lot of problems down the road by getting this taken care of now and not later when things progressed and worsened and caused potential damage to your body.

Edit: I see you mention possible GERD issues...that may or may not respond with a lessening of symptoms with cpap therapy. It helps a lot of people...didn't help me I am sad to say but I also have a hiatal hernia which makes things worse.

_________________
Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier
Additional Comments: Mask Bleep Eclipse https://bleepsleep.com/the-eclipse/
I may have to RISE but I refuse to SHINE.

If you want to try the Eclipse mask and want a special promo code to get a little off the price...send me a private message.

User avatar
Wulfman...
Posts: 6688
Joined: Mon Sep 01, 2014 6:41 pm
Location: Nearest fishing spot

Re: Treated Snoring ....Found Apnea?

Post by Wulfman... » Thu Aug 27, 2015 8:26 pm

qbquixote wrote:Thanks,
Yes, I have had some GERD symptoms more this year.
Taking Pepcid... I'll try the left side sleeping as well.
I have lost about 8 pounds in the last two weeks I think I was snacking to stay awake.


I am off to bed to get up at 5 for work.
Sleeping 7 hours or so is a lot more relaxing now, but takes a little setup time.

Burt
From my personal experience, for a number of years before I started therapy, I started getting "heartburn" (stomach indigestion) from eating some of the things I had enjoyed earlier in my life.......things with spices like cinnamon, onions and garlic to name a few. Was consuming Zantac when I had those experiences. But, not long after starting therapy, all that went away and I've been enjoying just about everything food-related since then.


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

User avatar
qbquixote
Posts: 14
Joined: Wed Aug 26, 2015 4:25 pm

Re: Treated Snoring ....Found Apnea?

Post by qbquixote » Fri Aug 28, 2015 5:12 am

Pugsy,

Good points about the broader consequences and limited benefits of the paper trail given deductibles.
Although maybe I could get a better data machine.
And yes I am curious about how bad the apnea really was. I mean looking back I had all the symptoms.
Falling asleep in the afternoon and evening, headaches, weight gain, rising glucose, rising BP, GERD Sx.
My dad had it too (though he did not know it) and died from an arrhythmia and passing out while driving before he turned 60.
And I guess I know it was at least mild to moderate OA given the 11.6 initial reading with the machine at 6.

I am turning 50 in a couple months so I probably will have a lot years with CPAP.
I guess I am new to this and am not sure how much cost is associated with continuing to run the machine.
Though, the CPAP will probably pay for itself with extra work I have the energy to do, so insurance coverage is not a necessity if no other health issue pops up and prevents me from working.

I'll hope the GERD stuff fades like it did for Den.
I guess for now there is not a hurry to rush off to a study. I'll gather data and bring my questions here for now.

Lots of helpful folks on the forum

Thanks,

Burt

_________________
MachineMask
Additional Comments: PR 560 APAP backup no foam, Pressure 7.6-11.4, EPR, Oscar, sleepyhead, Encore Basic for my old M-series

User avatar
Pugsy
Posts: 63942
Joined: Thu May 14, 2009 9:31 am
Location: Missouri, USA

Re: Treated Snoring ....Found Apnea?

Post by Pugsy » Fri Aug 28, 2015 8:08 am

There are ways to get machines that offer more comprehensive data than the M series offers but in it's day the M series was considered state of the art when it comes to data if someone was using the smart card and the software.
We have a few forum members here that are reliable if you want to get a newer model machine.

Given what you mention about potential GERD and/or aerophagia issues from your current pressure I think I would tend to recommend the ResMed AirSense 10 AutoSet (either the regular or the for Her) because the exhale relief on the ResMed machines might be a bit more helpful in terms of comfort. The way the ResMed machines go about their exhale relief is different than the way the Respironics does things and ResMed machines will offer up to 3 cm exhale relief and the Respironics can only offer up to 2 cm.
If the aerophagia issues continue then I think that the ResMed machines might offer a little better relief.
Thinking along the lines of have the "best" just in case it is needed.
It's not the the Respironics form of exhale relief is crap because it is actually quite decent but I have used both brands and the way the ResMed uses the EPR exhale relief can be more of a benefit in some situations for some people.

Also using apap mode might allow for a lower pressure part of the night and only go higher if needed at other parts of the night might allow for less chance of the aerophagia monster to show up.
Remember an APAP capable machine still has the 2 modes of operation...apap/auto and cpap (like what your Pro does now)...so you still have a choice.

_________________
Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier
Additional Comments: Mask Bleep Eclipse https://bleepsleep.com/the-eclipse/
I may have to RISE but I refuse to SHINE.

If you want to try the Eclipse mask and want a special promo code to get a little off the price...send me a private message.

User avatar
qbquixote
Posts: 14
Joined: Wed Aug 26, 2015 4:25 pm

Re: Treated Snoring ....Found Apnea?

Post by qbquixote » Fri Aug 28, 2015 11:43 am

Last night - OA 0.4 Hypopnea 0.4 VS 0.1 AHI 0.8
No stomach issues at all, I woke up at 4:45 this morning (that was 7h5min sleep) and had to check the CPAP was even on (which it was) at 8.5.
I hope I am skipping the "mask awareness" stage.
I have done so well with this machine so far, it makes me a little hesitant to move to another

Thanks for the ideas for a new machine. The extra data I would get would be "breath by breath" and compatibility with sleepyhead?
I think I am just getting used to this and I'll see over the next few weeks about how my little M Series does.
If I continue to stay more comfortable, and the AHI hangs out around 1 or more I may tweak it up toward 10 as suggested.

My GERD symptoms have been intermittent, although I understand silent GERD is an issue with obstructive apnea.
So I am hoping this won't be too bad.

Burt

_________________
MachineMask
Additional Comments: PR 560 APAP backup no foam, Pressure 7.6-11.4, EPR, Oscar, sleepyhead, Encore Basic for my old M-series

User avatar
Pugsy
Posts: 63942
Joined: Thu May 14, 2009 9:31 am
Location: Missouri, USA

Re: Treated Snoring ....Found Apnea?

Post by Pugsy » Fri Aug 28, 2015 12:04 pm

Yes, the extra data available from a newer machine would mean breath by breath availability but if you are doing well there's no urgent need to have that data except to maybe scratch the curiosity itch. But I do understand that the curiosity itch can be pretty powerful...been there myself.

If your AHI stays around 1.0 or less I don't know that I would worry too much about it as you may not be able to get it any lower no matter how high the pressure is set but again you may need to scratch that curiosity itch. Back when I was first starting therapy it took a couple of weeks to settle on a therapy pressure range. I was using auto adjusting (apap) mode because I learned rather quickly that my pressure need varied substantially during the night due to REM stage sleep events being a bit stubborn.
So I settled on a minimum of 10 and maximum of 20 because sometimes I would see 18 cm needs but overall I would average around 12 cm. It was a nice compromise..I slept well and felt good and my AHI ranged from 1 to 2 with sometimes into the 3s. So the curiosity itch hit me as to what would the AHI do with more minimum and would it make me feel any better? So I gradually worked up to a 13 cm minimum by doing 0.5 cm for a week at a time. I needed a week's worth of data at each setting so I could allow for normal nightly variation.
You know what I discovered....the AHI never really changed. I would still have some nights around 1 and 2 and even 3 once I got to 13 cm minimum and I still saw pressure needs of up to 18 cm on occasion.
Sleep quality never change and I continued to sleep well and my overall daytime feeling never really changed either. I would still have an occasional "bad" night but that was from other health issues unrelated to sleep apnea.

So I stopped my experiment at 13 cm minimum because nothing was really changing and I liked starting the night at 10 cm a whole lot better than starting the night at 13 cm even though I was managing it okay...there just wasn't anything being gained by using more pressure to start with.
But I did get the curiosity itch scratched.

Sometimes scratching that itch is worth it but there's no rush to scratch it right now.

FWIW...I very rarely have the need to look at my breath by breath stuff or for that matter anything on the software and I do good to download the data once every couple of weeks and when I do I just glance at leak data and AHIn for the most recent night. I do like the idea that the extra data is available though...just in case.

_________________
Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier
Additional Comments: Mask Bleep Eclipse https://bleepsleep.com/the-eclipse/
I may have to RISE but I refuse to SHINE.

If you want to try the Eclipse mask and want a special promo code to get a little off the price...send me a private message.

User avatar
Wulfman...
Posts: 6688
Joined: Mon Sep 01, 2014 6:41 pm
Location: Nearest fishing spot

Re: Treated Snoring ....Found Apnea?

Post by Wulfman... » Fri Aug 28, 2015 1:11 pm

qbquixote wrote:Last night - OA 0.4 Hypopnea 0.4 VS 0.1 AHI 0.8
No stomach issues at all, I woke up at 4:45 this morning (that was 7h5min sleep) and had to check the CPAP was even on (which it was) at 8.5.
I hope I am skipping the "mask awareness" stage.
I have done so well with this machine so far, it makes me a little hesitant to move to another

Thanks for the ideas for a new machine. The extra data I would get would be "breath by breath" and compatibility with sleepyhead?
I think I am just getting used to this and I'll see over the next few weeks about how my little M Series does.
If I continue to stay more comfortable, and the AHI hangs out around 1 or more I may tweak it up toward 10 as suggested.

My GERD symptoms have been intermittent, although I understand silent GERD is an issue with obstructive apnea.
So I am hoping this won't be too bad.

Burt
Lookin' good! Congratulations.

On a side note, it's probably good that you're using a straight pressure because GERD (in whichever flavor) can drive an APAP crazy and really disrupt a person's sleep. I've seen reports posted on the forum from people (with GERD) who used APAPs in ranges of pressure that were frightening. Since APAPs trigger pressure increases on Flow Limitations and Snores, the Flow Limitations can typically increase (sometimes dramatically) for those with GERD-type conditions.

Hang in there and good luck.

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