I'm new to posting but have been lurking for a while. I'm about one month into using a CPap machine and when I read about people still having hypopnea (spelling?) I don't really understand what that is and how it's different from obstructive apneas. My 1st sleep test showed 49 obstructive apneas, and 105 hypopneas for an RDI of 68.5/hr. During the titration study I had 9 obstructive apneas and 48 hypopneas for an RDI of 15.7/hr. the Cpap level was set at 8 cm.
I feel slowly but surely more rested, last night was the first night I only awoke one time due to a mask leak. I use the Breeze - not with "pillows" but the one that covers my nose. I find if I don't rinse/wash it out every other night, it leaks more often. How often should I wash it?
Is 15.7 RDI acceptable? Should I ask the Dr. to see if it can be reduced more with a higher level, or is this a "good" number. I have no idea what range I'm in. My Dr. is less than forthcoming with info so I've read most of what I know about sleep apnea on the web.
This board is very helpful too. Sorry for the long post, but hope to learn more about what to expect on improvements.
Connie
Explanation of Hypopnea vs apneas please...
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-
rested gal
- Posts: 12883
- Joined: Thu Sep 09, 2004 10:14 pm
- Location: Tennessee
Hi Connie,
Apneas are when the airway (throat) closes completely and no air can get through. Hypopneas are when it collapses partially - some air gets through, but not as much as should.
I don't really know anything about the "numbers" - perhaps another person will explain them more fully and can suggest whether your RDI on cpap is "ok". Obviously cpap is helping you, though, since it's brought down the numbers of apneas and hypopneas you were having before the titration. You're lucky too, in that most people find a pressure of "8" easy to take - easy to exhale against.
Since you said this:
My Dr. is less than forthcoming with info so I've read most of what I know about sleep apnea on the web.
I'll say this...heheh (I'm not a doctor - this is just two cents worth)... the time may come when you want to take more control of your own therapy. If you decide to do that, you might want to think about switching from a cpap machine to an autopap machine. With an autopap you can set a range of pressures - e.g. 6 - 11. An autopap will "read" your breathing all night long, delivering just the pressure needed to keep your airway open. If there are occasional times during the night when your throat actually needs a bit more than the prescribed 8, that upper setting of 11 would give some leeway for the machine to deliver the little bit extra (9 or 10) you might need for a few minutes.
A sleep study is a one night "snapshot" (thorough as it is). I like having an autopap which can vary the pressure all night long, depending on my breathing, night after night, in case conditions change. If your titration (finding the pressure for you) at the sleep clinic was done with you laying on your back, but at home you actually sleep on your side almost all the time, it might be that a pressure of just 6 or 7 is all you need most of the night. Lower pressure (if not lower than 5 or 6) usually means more comfortable breathing and less chance of mask leaks. There are a lot of things in favor of having an autopap "find" the correct pressure for you all night. For that matter, an autopap can be run as a straight cpap too - two machines in one.
Another thing an autopap can do, in terms of you taking more control of your own therapy (especially if you feel your doctor might not have the time or inclination to help you a lot) is this: you can use software with an autopap to download your nightly data to your own computer the next morning. You can see for yourself how many apneas, hypopneas, flow limitations, snores and leaks there've been the night before. You can also see what pressures the machine used.
Bottom line really is how you feel each morning. It sounds like your present machine is doing a good job for you. I'm just nosy about what's going on in my own therapy, so I prefer an autopap with software.
Apneas are when the airway (throat) closes completely and no air can get through. Hypopneas are when it collapses partially - some air gets through, but not as much as should.
I don't really know anything about the "numbers" - perhaps another person will explain them more fully and can suggest whether your RDI on cpap is "ok". Obviously cpap is helping you, though, since it's brought down the numbers of apneas and hypopneas you were having before the titration. You're lucky too, in that most people find a pressure of "8" easy to take - easy to exhale against.
Since you said this:
My Dr. is less than forthcoming with info so I've read most of what I know about sleep apnea on the web.
I'll say this...heheh (I'm not a doctor - this is just two cents worth)... the time may come when you want to take more control of your own therapy. If you decide to do that, you might want to think about switching from a cpap machine to an autopap machine. With an autopap you can set a range of pressures - e.g. 6 - 11. An autopap will "read" your breathing all night long, delivering just the pressure needed to keep your airway open. If there are occasional times during the night when your throat actually needs a bit more than the prescribed 8, that upper setting of 11 would give some leeway for the machine to deliver the little bit extra (9 or 10) you might need for a few minutes.
A sleep study is a one night "snapshot" (thorough as it is). I like having an autopap which can vary the pressure all night long, depending on my breathing, night after night, in case conditions change. If your titration (finding the pressure for you) at the sleep clinic was done with you laying on your back, but at home you actually sleep on your side almost all the time, it might be that a pressure of just 6 or 7 is all you need most of the night. Lower pressure (if not lower than 5 or 6) usually means more comfortable breathing and less chance of mask leaks. There are a lot of things in favor of having an autopap "find" the correct pressure for you all night. For that matter, an autopap can be run as a straight cpap too - two machines in one.
Another thing an autopap can do, in terms of you taking more control of your own therapy (especially if you feel your doctor might not have the time or inclination to help you a lot) is this: you can use software with an autopap to download your nightly data to your own computer the next morning. You can see for yourself how many apneas, hypopneas, flow limitations, snores and leaks there've been the night before. You can also see what pressures the machine used.
Bottom line really is how you feel each morning. It sounds like your present machine is doing a good job for you. I'm just nosy about what's going on in my own therapy, so I prefer an autopap with software.
Thanks so much for your reply and I agree whole heartedly with your comments about taking charge and using the software to help! My Insurance company requires that I rent my machine for 10 months and then it's paid for. Well, they charge $76/mo for the machine, heater, and mask, so that makes the cost of the whole thing over $760 by the time I've rented it for the required 10 months.
My DME only offers 2 machine choices and the one I had until today, had no way to change the ramp level. I called and complained that it was so low I felt like I was sufficating during the first 10 minutes. I had learned to turn on the ramp and then wait 10 minutes for it to get to a pressure that was reasonable before I put the mask on.
The first machine was a Fisher-Pykal (sp?). They traded that for a RemStar Pro w/C-flex. It's bulkier and sits atop a heating unit for the humifier (2 separate parts) but it does allow you to start at a higher cm number to ramp up from + they showed me how to reset it myself if I wanted it higher or lower. I tried it when I got home today, and it was MUCH better.
I don't seem to be having many problems with adapting to the mask or noise and find that I am beginning to dream (which I don't remember doing for years). Another plus is that I used to get up 5,6,7 times a night to go to the bathroom (or so I thought I needed to). Now I believe I was
just waking up due to the apneas and I just thought I had to go to the bathroom!
One question I had, was whether you have a "puffy" face in the morning after using a Cpap. I don't remember my eyes being quite so puffy and my face "mushy". It clears fairly quickly as I get up and move around in the morning, but I think it must be due to the cpap since I don't remember this happening before. Anyone experiencing this too?
Well once again, I've rambled, but thank you for the information on the Bipap and can you tell me where you got the computer software to read the information? I thought that was only sold to technicians.... but I think that's a bunch of whooie..... why shouldn't we be able to see how we're doing without having to pay through the nose for some doctor to do what we could do at home with a home computer.
Thanks again
Connie
My DME only offers 2 machine choices and the one I had until today, had no way to change the ramp level. I called and complained that it was so low I felt like I was sufficating during the first 10 minutes. I had learned to turn on the ramp and then wait 10 minutes for it to get to a pressure that was reasonable before I put the mask on.
The first machine was a Fisher-Pykal (sp?). They traded that for a RemStar Pro w/C-flex. It's bulkier and sits atop a heating unit for the humifier (2 separate parts) but it does allow you to start at a higher cm number to ramp up from + they showed me how to reset it myself if I wanted it higher or lower. I tried it when I got home today, and it was MUCH better.
I don't seem to be having many problems with adapting to the mask or noise and find that I am beginning to dream (which I don't remember doing for years). Another plus is that I used to get up 5,6,7 times a night to go to the bathroom (or so I thought I needed to). Now I believe I was
just waking up due to the apneas and I just thought I had to go to the bathroom!
One question I had, was whether you have a "puffy" face in the morning after using a Cpap. I don't remember my eyes being quite so puffy and my face "mushy". It clears fairly quickly as I get up and move around in the morning, but I think it must be due to the cpap since I don't remember this happening before. Anyone experiencing this too?
Well once again, I've rambled, but thank you for the information on the Bipap and can you tell me where you got the computer software to read the information? I thought that was only sold to technicians.... but I think that's a bunch of whooie..... why shouldn't we be able to see how we're doing without having to pay through the nose for some doctor to do what we could do at home with a home computer.
Thanks again
Connie
-
rested gal
- Posts: 12883
- Joined: Thu Sep 09, 2004 10:14 pm
- Location: Tennessee
You're doing fine, Connie.
Most online stores that sell autopaps also have "package deals" that include the machine, software and both manuals (user's and clinician's.)
I sometimes have a little puffiness in my face in the morning, but I had that before I ever started using xpap. "xpap" means any kind of cpap machine - cpap, autopap or bipap.
By the way, when you go looking for autopaps at online stores, they are sometimes referred to as auto-titrating cpaps or auto-adjusting cpaps.
Glad to hear you're adjusting so well to this odd kind of therapy.
Most online stores that sell autopaps also have "package deals" that include the machine, software and both manuals (user's and clinician's.)
I sometimes have a little puffiness in my face in the morning, but I had that before I ever started using xpap. "xpap" means any kind of cpap machine - cpap, autopap or bipap.
By the way, when you go looking for autopaps at online stores, they are sometimes referred to as auto-titrating cpaps or auto-adjusting cpaps.
Glad to hear you're adjusting so well to this odd kind of therapy.
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