Not sure what to do

First time to post but been here for awhile. I've seen others with the same problems I'm having. Had a sleep study 2yrs. ago and have had 3 good mornings since I started. Have a Resmed vpap s that was given to me but looking at getting a new machine. My study showed I have 35 incidents but I'm down to 1 now. My pressure is suppose to be 6-10 but had problems breathing out so I'm at 4. But think I could raise it. The ERP is on and ramp is at 45. I'm also on 10mg. of Ambien to help me stay asleep. But I'm as tired when I get up as when I went to bed. Hope I have given enough info to start. Know I have posted more than you wanted to know. But feel like I've run out of options with the doctor. He just tells me the machine is doing what it suppose to. Thank you for any help.

Sorry if some of my profile is omited. Thought I had it all set up.

Kim A wrote:My study showed I have 35 incidents but I'm down to 1 now.

That's some excellent therapy. Congratulations on that part.

Now, how are you doing with these items,

- Practice good sleep hygiene (Google it and read several sources)
- Eat a good diet
- Have a regular, moderate exercise program
- Try to avoid daytime naps.
- Practice total abstinence of caffeine including sources like chocolate
- Review all medicines, vitamins and supplements you are taking to make sure none are interfering with sleep
- Optimize emotional stress in your life
- Use CPAP software to make sure your therapy is optimized
- If you still don't feel or sleep well, make sure you have regular wellness visits to confirm there are no other medical problems.

What do you think about working on those and eventually trying to stop the use of Ambien? It's a powerful drug that could contribute to fatigue.

Common side effects of Ambien may include these and others:

daytime drowsiness, dizziness, weakness, feeling "drugged" or light-headed;
tired feeling, loss of coordination;

You're on ramp time of 45 min. to get all the way up to a low setting of ... 6? Seriously? You realize you're getting almost no therapy for all that time (few events are going to occur that the machine can't reach 6 at in a very short time). I think I must be missing something... but, if I'm not, turn the ramp off - you can't really need it to just go to 6, or if you do, try 5 mins at most to get there... it's so low many people have trouble breathing comfortably there and it's not likely to treat you much (unless that is your prescribed # from your sleep study). Using EPR may give you a slightly higher AHI than you'd have without it, but probably not enough to matter.

Julie wrote:it's not likely to treat you much

She says her untreated AHI was 35 and her treated AHI is 1 and you want her to change her machine settings????

She's not happy though, so I'm suggesting she change something that might make her more comfortable. The ramp is not 'settings', just a comfort feature.

Tricky Wash wrote:

Julie wrote:it's not likely to treat you much

She says her untreated AHI was 35 and her treated AHI is 1 and you want her to change her machine settings????

If she isn't comfortable, she can't sleep with the machine. If you are awake most of the night, or not using the machine most of the night, then you aren't really getting good therapy. You can have so many sleep disturbances that you don't relax enough to have events that need to be treated. We don't know if that is the case here or not, but clearly she is having trouble feeling good after using it, so something isn't right yet. And we aren't clear on how much she is using it. If she is having trouble breathing out at a pressure of 6-10 after 2 years, I suspect she hasn't had many full nights with it.

I would like to make some suggestions. Kim, you mentioned having trouble breathing out. Do you feel like you are suffocating? Many people feel this way at a pressure of 4 or 5, and the solution is usually to start with a higher pressure of at least 6. For new people, it is often hard to figure out what the problem is since this is all new. So, many people think they are having trouble with too much pressure when sometimes it is too little pressure. Also, when using ramp, that forces you to stay at lower pressure, so you may feel like you are suffocating and rip the mask off, and never get to good treatment. Since you would be awake most of that time, the ahi wouldn't mean much.

Can you get the free software, download some data, and then post a typical night of graphs? Also, tell us how you are feeling with the machine running. How many hours of sleep do you typically get? how many times do you remember waking up? With more info,we can give you better advice.

Thanks so much for the responses. I am a male but it's ok I get it all the time Sorry about the ramp deal. It is on 20. It use to be on 45. The settings I have are the ones the doctor put in. Last time there he turned the ERP Off and would wake up feeling I was suffocating. Doctor was out of town and could not get one of the other doctors to chance it back. So this was my first try at changing the machine. Turned the ERP back on and set it at 3. First time I have breath this easy. Feel like I can go from 4 to 6 where I'm suppose to be. I go to sleep around 9 every night but I wake up at 3 and really don't want to wake till 5. But when I'm asleep nothing could wake me. But I'm tired when I get up. And that way all day especially in the afternoons. I have had 3 times that I have woke up and felt great and tons of energy but I didn't do anything different the day before. I was having problems at first breathing out at 6 so the doctor turned it to 4. I have an older resmed vpap s. will the software work with it? I want to get a new machine. Any suggestions? Thanks again everyone for your help.

Have you tried going to sleep a bit later than 9 so you'll wake up at a more 'normal' time? After all, once you're on Cpap you're not going to need as many hrs of sleep as you did previously, though if therapy's not adequate, you probably won't feel very rested. But turning the pressure down to 4, where it's so difficult to get any air for almost everyone, is not the answer to exhale problems... using the EPR (exhale relief) feature is and I asked if you were aware of having it on your machine, if you'd tried using it, but you haven't responded to that.

Going to bed later doesn't change anything except I'm more tired. Have tried the EPR on but the last time at the doctor he said some people don't respond well and he turned it off. I felt like I was suffocating with it off so I turned it back on. Going back to see him in 2 weeks and see about getting a new machine while I have this insurance. Retiring at the end of the year and will have to get insurance. Going to turn it up to 6 and try that. Will post readings when I can get software and learn to use it. Thanks.

Kim A wrote:I have an older resmed vpap s. will the software work with it?

Which model VPAP? S8 maybe?

Check whether the data card is standard SD or a proprietary card. If it is proprietary, you may have trouble finding a card reader.

You really need to use the software to get your therapy optimized. Before recommending a new model machine, what was your diagnosis? Do you have a copy of the summary of the sleep study?

Do you have any response to Granny's comments about the Ambien you are taking?

Thanks for the response. I will post back tonight when at home and can look. At work right now.

Are you sure the machine is a VPAP? I didn't think that EPR was available on the VPAP models except when in CPAP mode which I suppose you could be using. If you are using a VPAP and in cpap mode you aren't utilizing the machine's full capabilities.
Yes there is software available but which software can be used is going to depend on just how old your machine might be.

Yes Pugsy it is a vpap and I'm in the cpap mode. Machine was given to me. Guess you get what you pay for. Nobody told me it is any different. Going to get a new machine in a couple of weeks. Anything I need to look for? Thanks

Ahh...a freebie...I understand now. Actually those old VPAPs are good machines. They were the Cadillacs of their time.

With your pressure needs...I doubt that you will qualify for another VPAP/bilevel machine.

Are you using insurance to get a new machine? You want full efficacy data...and you need to learn the models that offer that data and the ones that don't. Where are you getting the new machine from?