First night- Help-questions!

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
SleepCatz
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First night- Help-questions!

Post by SleepCatz » Thu Sep 03, 2015 9:21 am

I am new to this whole thing and hoping that I can make it work! After a split sleep study in which I hardly slept, I rented an APAP, Airsense 10 Autoset for Her, because I couldn't t wait another month for t Insurance to purchase a machine given my extreme exhaustion and fatigue. I used it for the first time last night. After the short titration portion of the sleep study, the technician told me my pressure was 12. The machine is set on 4–20. Things that worked: my Wisp nasal mask didn't leak, and I was able to keep it on for eight hours. I even slept! However, I woke up five times when the pressure got high. First at 9.2, then 9.6, then 10.4 The next two times I'm not sure why I woke up. I was able to get back to sleep, and figured that I hopefully wasn't sleeping any worse than I was before I got the machine.

My questions:

Will I get used to the high-pressure?

How exactly does the APAP work? Did the pressure go up when I had apneas? Then, would the pressure stay high or continue to fluctuate through the night? Each time I restarted the machine and started back at four.

Unfortunately, this rental did not come with a SD card and the cards I have appear to be too big to fit in the machine so hard to get efficiency data.

Any other tips as to how to make this successful?

A million thanks for all the help I've already gotten from reading a lot of this board!

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Pugsy
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Re: First night- Help-questions!

Post by Pugsy » Thu Sep 03, 2015 9:42 am

First of all there is data available on the LCD screen that you can view until you can get a SD card that will work. Pretty much any generic SD card will work.
To get to the data available on the LCD screen you have to make a little change in the setup menu...Essentials needs to be changed so it is Essentials Plus.
The manual here explains how to do it.
https://sleep.tnet.com/home/files/resme ... -guide.pdf

Secondly...yes we do get used to the higher pressures but it can take some time.
For some people the actual changing pressures can disturb sleep and you might do better with a fixed pressure but for now don't worry about it. You may need 12 all night or you may not quite need that much all night.

You might do better with the starting pressure not at 4 cm because that's a big change going from 4 to the 9ish that caused you to wake up. Maybe something like starting at 6 cm. You will get a better idea what you need once you get a SD card so you can see what the pressure is actually doing during the night.

Actually the fact that you slept all night with the machine even with the wake ups (you were able to go back to sleep which a lot of people have problems with) is a definite plus.

We do get used to the pressure and believe it or not eventually what feels like a hurricane now will seem like a gentle morning breeze later.

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SleepCatz
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Joined: Thu Sep 03, 2015 9:01 am
Location: California

Re: First night- Help-questions!

Post by SleepCatz » Thu Sep 03, 2015 10:01 am

Thanks for the info! I am assuming then that the APAP is adjusting Air pressure to ensure that your airways stay open the whole time, and that the variation in pressure is a result of what it takes at different times of the night, in different positions etc., to keep your airway open? Sorry for the simplistic description but I wanted to get a handle on how it was working. Or is there a good explanation of APAP that I can read?

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Pugsy
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Re: First night- Help-questions!

Post by Pugsy » Thu Sep 03, 2015 10:18 am

The apap response algorithm is a bit complicated but explained in the manual above in rather simple terms.
It doesn't just say "OMG the airway is closing let me kick up the pressure to blow it open" instead it measures things as it goes along and tries to prevent the airway from collapsing in the first place.

Our pressure needs can change with sleep position or sleep stage or both and the machine will try to keep up.
It can't go from 4 to 10 in the blink of an eye though. Doesn't work that way. It goes up in stages and the minimum pressure is the most critical pressure...it needs to be close enough to what is eventually needed so it can get there soon enough.
It's very possible that apnea events were happening at the time you woke up and noticed the pressure...so it's possible that the apnea events were the primary cause of the wake ups...it could also be the pressure changes. We don't really know for sure as even with the software reports we don't always have a clear cut answer.

We would need to see what is going on at the time of the pressure increases to have a better idea and you need the SD card to use the software.

Many people think that these machines are just set it at 4 to 20 and let the machine sort it out. Works well if all you need is 8 cm but not so great if you need 12 or 16 or higher because the machine simply cannot get to where it need quickly enough and maybe once it gets there...nothing happens for 30 minutes so the machine reduces the pressure since it isn't needed and then more events happen again to drive the pressure up. The machine works best when preventing and not necessarily fixing.

I don't know if your minimum of 4 is part of the issue or not but it might be so as soon as you can get the software working we can have a better idea what needs to be done to optimize things....and even when optimized it is to be expected that you have some adjustment period stuff to get used to. Let's face it, sleeping with a mask on your face blowing air up your nose just isn't normal.

Read that manual that I linked to above...there's a lot of helpful information in it that explains more about how the machine works.

_________________
Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier
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I may have to RISE but I refuse to SHINE.

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SleepCatz
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Joined: Thu Sep 03, 2015 9:01 am
Location: California

Re: First night- Help-questions!

Post by SleepCatz » Thu Sep 03, 2015 10:28 am

Thanks for the Long explanation. I am reading the manual now.

yaconsult
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Re: First night- Help-questions!

Post by yaconsult » Thu Sep 03, 2015 10:42 am

SD cards are available everywhere - walmart, 7-11, walgreens, amazon - just about anywhere. Pick one up so that you can see your data.

Many of us end up setting the minimum pressure near or just below the prescribed pressure. But it does take a little getting used to and experimentation for many people. Many people also turn off the ramp as it can be difficult to breathe at such a low pressure.

Congratulations - it sounds like you're off to a great start! Hope they can get you your stuff quickly.

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Additional Comments: January 2015 Sleep Study Results: Apnea/Hypopnea Index (AHI): 80.2, Sleepyhead

SleepCatz
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Location: California

Re: First night- Help-questions!

Post by SleepCatz » Thu Sep 03, 2015 11:10 am

Thanks all! I found the ST card slot, and there was a card in it! I tried to download sleepyhead software, but it looks like they don't have a version for windows 10, correct?

Thanks to Pugsy, I did get some sleep report information off the clinical menu.

AHI 0.6
Pressure 10
Leak 5L/min
Total AI 0.5
Central 0.5

Pretty good stats for the first night?

The AHI looks good! So I wonder why I am not feeling better, could've been the five wake ups or could be the long-term sleep debt I need to repay.

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Pugsy
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Re: First night- Help-questions!

Post by Pugsy » Thu Sep 03, 2015 11:23 am

The wake ups would have contributed to not feeling the good numbers for sure.
Also...while we all yearn to have that overnight miracle it really doesn't happen that often. Most people will find that it takes a while to get adjusted and sleeping better and feeling better even under the best of circumstances.

Remember...a nice low AHI doesn't guarantee that we will feel the miracle.
Lots of things impact how restorative our sleep is and play a factor in how good we might feel (or don't feel).
Hours of sleep
Fragmented sleep (those wake ups)
Meds
Other health issues (the machine can't fix a problem that is unrelated to sleep apnea and as much as we want to put everything in the OSA basket for the machine to fix it just isn't possible)

The pressure and leak numbers from the LCD screen are both what we call 95% numbers and they simply mean we were at OR BELOW that number for 95% of the night.
Your leak is excellent...minimal excess leak.

It's very possible that the variations in the pressure are playing a factor in your sleep quality and if you consistently see the machine wanting to be up around 10 (can't tell for sure by the 95% number because of the "or below" part of the definition so need to look at the actual software details) then depending on what the graphs show and how easily you adjust to the pressure that minimum pressure may need to come up to lessen the chance of pressure variations waking you up.

Need a few nights of your getting used to things and a few nights of detailed reports to have a better idea what (if anything) needs to be done.

_________________
Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier
Additional Comments: Mask Bleep Eclipse https://bleepsleep.com/the-eclipse/
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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.

Tdub210
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Re: First night- Help-questions!

Post by Tdub210 » Thu Sep 03, 2015 12:19 pm

I've been on mine for just over three weeks (actually using it). The first week was awful. I did not do well the first 4 or 5 days. But, once I did, I've been with it ever since. I generally get 8 hours of sleep a night and my AHI is always below 1.5, and usually below 1. I've not woke up with that miraculous burst of energy. Nor do I feel some great increase in it. But, I have noticed a significant decrease in irritability, and increased focus and attention span. I make it through the night with 8 hours, but I do wake up during the night. I don't know why yet. Usually I simply wake up. I don't notice pressure changes. And, on many of the wake ups, I'll note the time and go back to sleep. The next day I check sleepyhead and there was nothing going on at the time, no pressure changes or leaks. Other times I'll wake up to change positions. I think this is probably my subconcious waking me to make sure I settle with the mask still seated properly. At any rate, after nearly 4 weeks, I feel successful that I've adjusted to the machine and make it all night. I figure the wake ups should take care of themselves.

Other info, my machine is set for 6-18. It rarely gets over 8. It spends most of the night at 6. This is from looking at the charts, not the 95% number. My machine (I think they're fairly similar), does not increase pressure for an OA. It does for flow limitations and hypopnea. I don't have many OA's, but the few I have tend to happen out of the blue without a flow limitation or hypopnea around them. Like Pugsy said, there's some algorithm built into the machines that you can investigate.

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Pugsy
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Re: First night- Help-questions!

Post by Pugsy » Thu Sep 03, 2015 12:22 pm

SleepyHead will indeed work with Windows 10...lots of reported Windows 10 users now have reported Sleepyhead working just fine.

What problem are you having?
Did you follow the instructions here
https://sleep.tnet.com/resources/sleepyhead

ResScan (ResMed's software) will also work on Windows 10...if you want it send me a private message.

_________________
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.