First night AHI problem

Hoping for some feedback. I had my first night with the mask, and it didn’t go as well as I had hoped, although I know this is an adjustment that won’t happen over night (pun intended). I wore the mask for a total of 1 hr 45 minutes. I know this doesn’t sound like a lot, but the DME suggested that I do the best I can, and well, for me last night, that was best I could do. In addition, I have a newborn at home who needed my attention in the middle of the night and by the time I went back to bed it was 2 am, and I was too confused/exhausted to try again, but will tonight of course.

This is what confused me, and I am hoping for insight. I have a Dreamstation AutoPap set to the CPAP mode at a pressure of 13. I started with a flex of three, because I was forcefully trying to exhale. Once I had the mask on for a little while, my body and mind adapted and I ended up actually not liking the flex mode so I set it at 1. That was fine. I started my first ramp at 6, and by the time it got up to 13 I got a little panicky, so I reset the ramp. On the second ramp, I realized 6 was too low and set it to 8 and was fine. This time around I didn’t even really realize when I got up to 13! Yay! I started to get comfortable and thought I was awake (maybe drowsy), but then a few times I must have woken up right as I was falling asleep to a racing heart, and what felt like an air bubble going down my throat. It also made a soft gurgling sound in my throat, similar to a gurgling sound that your stomach would make. At first I thought it was odd and tried to resettle, but it happened again and again.

By this time, I got pretty frustrated because when it would happen I would fully wake up in a state of panic and it was take me several minutes to settle back down and then it would happen again. I checked my settings and it showed during the 1 hour and 45 minutes I had 5 events, which I am assuming is what I was experiencing with the racing heart/air bubble sensation. During my sleep study, my pressure was set at 13 and I only had 2 events in 3 hours, so it seemed to have worked (AHI without the mask during the study was 73). What gives? Any insight or suggestions? I had no leaks in the duration I wore the mask last night.


Can someone also tell me how to fill out my profile? I click on the hyperlink of my name, but I only see user statistics? Thanks!

How to add your equipment to your profile
wiki/index.php/Registering_Equipment_in_User_Profile
But I think the only thing available to you might be your mask choice.
Cpap.com doesn't have the DreamStation machine yet so the new Respironics equipment won't be in the equipment menu yet.
I suggest you add it to the comments section instead. Just manually type DreamStation APAP into the comments section will be fine. Might add "cpap mode 13 cm" so we know you are using a fixed pressure instead of apap auto adjusting pressures.

As far as the events for last night...with such short hours of use and the probability that some awake breathing irregularities were likely flagged last night...I don't think I would be putting much importance as to the AHI at this time.

I would instead concentrate on whatever settings are the most comfortable for you in terms of ramp starting pressure and/or Flex settings because you have to get the sleep first and then worry about the treated AHI.

Until we have some software that will work with the Dream Station machines were are going to have to wing it in terms of data and unfortunately the data that is available on the machine's LCD screen sucks.
We don't know what kind of events you are having and we don't know if those are awake events getting flagged by mistake. We don't count awake events when evaluating AHI.

Thank you for this information. I will try again tonight. It's just jarring me out of my drowsiness and the air bubble sensation is not comfortable. I also woke up with a bit of gas (TMI sorry) so I must be swallowing air.

Perhaps you can answer another question of mine. If for some reason it continues to happen again tonight or the pressue is too much, would you suggest waiting and calling the nurse/doctor in the morning, or calling into the hotline at night? The Dreamstation has a modem so they can see exactly what is happening. Not sure if they are allowed to change the settings without the doctor's sign off.

I have no idea what the "air bubble" sensation might be. That's a new descriptive term for me and what I think may not be what you are trying to convey.
If it is related to the swallowing of the air (we call that aerophagia if you want to search the forum for potential solutions)
wiki/index.php/Aerophagia

I know there is a modem that transmits the data but I am unsure as to the level of detail of that data that gets transmitted. For all I know it may simply be the same data that you see on the LCD screen.
The DreamStation model is very new and there's a lot we don't know about what it might transmit or what software is being used on the DME end of things.
Eventually we will have some software available to see the details.

DMEs aren't normally allowed to change things (except maybe comfort features) without a doctor signing off on them but the doctor may have already given them an okay to do some things within certain parameters.