Hello - Newbie - First Post

Hello all. I just found this wonderful site. I was hoping to get some assistance here. I am a 61 year old male who is about 6'1' and 245 lbs. I was officially diagnosed with apnea in October of 2017. I only had the first part of the sleep study as my insurance company would not approve the second part. In lieu of the 2nd part, they approved at Dreamstation APAP machine. I can post a copy of the sleep study report if anyone thinks that is needed. But the summary of the test was The results of the first test were Moderate obstructive sleep apnea with an AHI of 29.6 events per hour, associated with an oxygen nadir of 84%. Respiratory events were more severe in supine rapid eye movement sleep; Increased microarousals and decrease in rapid eye movement sleep. Even thought he doctor ordered the second part of the test, the insurance didn't cover it. So we went straight to the APAP machine.

I started therapy in early December (I had undergone a knee scope in late November so I waited until after that to start using the machine). Of course, my big issue is getting that AHI levels down. While they have improved from the 29-30 that the sleep study found, I have not been able to consistently get them lower then 8-15. I've had a few nights where they have gone as low as 4-5 but generally they are in the range of 8-15. The PA I am dealing with is at a loss to figure out why we can't get the levels lower. So I thought I would see if anyone on this forum had any ideas. I have attached my SH data from last night. I am still going through the intro materials to try to lean what all this means. I do use the Dreammapper iOS app that helps me see what the results of the nights sleep. I will also add that I have an awful time falling asleep so I use Ambien to assist in that area. I am prescribed 10mg but often times I try to cut the pill in half and use that. It does help me fall asleep. I have some other minor medical conditions that may or may not play a role in my sleeping.

But for now, here is my chart. I am open to anyone's questions, requests, thoughts, ideas, suggestions and criticisms. Thank you in advance for any thoughts.


PS - I hope I did all this correctly.

Quick glance shows your pressure in a tight range..I would increase your min pressure to 9 and then to 10 and increase your max pressure to 15...Try that for a few nights. Are you using the ramp feature? If yes...turn it off. Leaks could be a problem too...If you are breathing through your mouth, you are losing therapy there. Try a chin strap, tape your mouth for a night or two.

There's nothing wrong with the leaks and there are no large leak flags.
I see no need to do anything about leaks unless leaks are waking a person up.

The statistics for time over red line....that's based on the ResMed leak number of 24 L/min and that doesn't work well for a Respironics machine.

Need to fix SleepyHead so it better reflects the Respironic leak numbers instead of ResMed.
Preferences...CPAP tab....on the right side see the 24 L/min threshold???? Respironics never gives us an exact threshold but something around 70 L/min total leak would be a better and still conservative threshold number.

The ramp is only a comfort feature. If you do not find that disabling the ramp makes starting therapy uncomfortable, then you don't need it and should not use it.

I agree with raising the max to at least 15. However, be careful that you're not getting more "Clear Airway" events as a result. Higher pressure can cause these events in some individuals. You'll need to address that issue only if it happens!

Also try more humidity, less humidity, A-Flex or C-Flex on all the possible settings, disabling the flex, etc. In effect, your titrating yourself, so it's trial and error. Remember that a lab titration is done by a trained individual who is awake while you're sleeping and gets instantaneous feedback.

Pugsy wrote: ↑

Tue May 08, 2018 9:10 am

Need to fix SleepyHead so it better reflects the Respironic leak numbers instead of ResMed.
Preferences...CPAP tab....on the right side see the 24 L/min threshold???? Respironics never gives us an exact threshold but something around 70 L/min total leak would be a better and still conservative threshold number.

This comment has started quite a discussion on the SleepyHead Dev forum.

I think Mark is leaning toward having leaks not display by default if there is no leak data provided by the machine.

Pugsy wrote: ↑

Tue May 08, 2018 9:10 am

There's nothing wrong with the leaks and there are no large leak flags.
I see no need to do anything about leaks unless leaks are waking a person up.

The statistics for time over red line....that's based on the ResMed leak number of 24 L/min and that doesn't work well for a Respironics machine.

Need to fix SleepyHead so it better reflects the Respironic leak numbers instead of ResMed.
Preferences...CPAP tab....on the right side see the 24 L/min threshold???? Respironics never gives us an exact threshold but something around 70 L/min total leak would be a better and still conservative threshold number.

So you want me to change that setting in SH to 70.0 L/min? Am I understanding that correctly? If so, I have attached a new chart with the update.

Gator5000e wrote: ↑

Tue May 08, 2018 8:27 am

PS - I hope I did all this correctly.

You did *great*. It always gives me hope when there's new people that hop on and post a chart that shows that they took a few minutes to read a bit and learn how to post their data the best way.

Well done newbie!

As to recommendations, I echo what Pugsy and LSAT said... more pressure, leaks are fine.

Thanks! I will give the more pressure a try. Appreciate the suggestions.

Also suggest you try a soft cervical collar to keep your head up, airway more open and jaw more closed (if that's a problem).