depressed about things - what to do?

I wrote the other day that my numbers were changed from 17/22 to 10/15. Two nights with the new air pressure and my apneas are gong wild. On the higher numbers they were in the 5.0 and below range my OAs were in the 3 and 1 range at times. My OAs for Thursday night was 9.92 and last night 12.71. Thursday night my Clear airway was 5.73 and last night 7.08. Both night had BP 4.71 and 3.06. Looking at all my data from the beginning back on Sept. 19, 2011 my pressure numbers were 13/25 and everything was off the charts. The old numbers 17/22 seemed to be getting the OAs under control most of the time, but my clear airs were still hanging around 5.0+.

From what I see, it looks like I might have to go back to the 17/22. Monday I am going to get my numbers changed again and was wondering if something in the range of 15/20 might do the trick? Am I correct in assuming (that's not good to do) that if my IPAP number is high, it only comes into play if I need it? or does it just automatically go there no matter what? (I'm on BiPap). I really don't know exactly what the EPAP number really does.

The thought of going back to 17/22 really really depresses me because I wake up feeling like I've been hit by a truck - I have no choice but to pull the straps on any mask as tight as I can to avoid leaks and doing that I still get pretty major leaks. So when I wake up I have first of all a bad nose ache (had that prior to the surgery too) and that expands as the day goes on into a bad headache. Right now, thanks to the Ritalin I'm able to make myself stay out of bed and do something, but I really don't have much energy at all. With the higher numbers the Ritalin helped me have the energy to accomplish quite a bit and I felt better except for the painful headaches and nose ache. I have snipped my charts but now have to figure out how to get them into a post. They are sitting on my desktop.

Does anyone have any suggestions for me? I really really want this to work. I want my life back and I want to be able to hold down a job again because I definitely do not like poverty. I just wish wearing the mask at higher pressures could be as comfortabe as wearing it was the past two nights. No headache, no nose ache and my leaks were substantially lower. With the higher numbers I dreaded going to bed because I knew the pain that I was going to have.

I am gong to get some liners to be prepared for the rise in numbers. What I can say about the higher numbers is that they give me a better chance at life, but the life I am getting is filled with pain the majority of the time.

Even though your numbers are higher I would stick at the level for a few more days and then gradually increase them a bit at the time. Get the manual and do it your self so you can adjust SLOWLY! a 1/2 level at the time, leave it for a few days and then adjust again.

A proper fitting mask does not need to be tightened until painful, in fact most of them don't work well when you do that. Most of them are like hovercrafts and need their skirts inflated to work properly.

Sort of like Marilyn over the vent!
(Somebody had to get nostalgic.)

chunkyfrog wrote:Sort of like Marilyn over the vent!
(Somebody had to get nostalgic.)

Yes IPAP on the auto only goes up as it needs to.
EPAP needs to be high enough to get the bulk of the work done. It is obvious that 13 cm EPAP is not enough but do like BlackSpinner said...go up in 0.5 increments over several days and see if maybe you won't need the 17 EPAP. Going up slowly will also be much easier to adjust to.

This was me at 13/25 back in November and that was when my nose got so bad that it hurt to just breathe regular air. I figure that my nose had severe wind burn. LOL
So, I figure if that didn't work, the 10 EPAP I'm on now won't work either. I'm going to print some of this out to take to her on Monday. Might hep me speed the process up a bit.

RemStar BiPAP Auto with Bi-Flex
Mode: Bi-Level
EPAP: 13.0 IPAP: 25.0 cmH2O
PS: 12.0
Date Sleep Wake Hours
11/6/2011 21:47 06:50 09:02:17
AHIApnea / Hypopnea Index 99.58
HypopneaHypopnea 16.15
ObstructiveObstructive Apnea 20.58
Clear AirwayClear Airway Apnea 62.85
RERAResp. Effort Related Arousal 0.00
Flow LimitFlow Limitation 0.00
VSnoreVibratory Snore 0.00
PB/CSRPeriodic Breathing 44.55%

Pugsy wrote:Yes IPAP on the auto only goes up as it needs to.
EPAP needs to be high enough to get the bulk of the work done. It is obvious that 13 cm EPAP is not enough but do like BlackSpinner said...go up in 0.5 increments over several days and see if maybe you won't need the 17 EPAP. Going up slowly will also be much easier to adjust to.

macewa wrote:RemStar BiPAP Auto with Bi-Flex
Mode: Bi-Level
EPAP: 13.0 IPAP: 25.0 cmH2O

BiLevel Mode....Straight fixed pressures bouncing between 13 and 25..no wonder the wind burn.

Auto Mode...flexible pressures that don't go up unless the machine senses the need. In Auto mode while awake you only see a 2 cm difference between your EPAP and IPAP settings. IPAP defaults to 2 cm more than EPAP until events start driving the pressures up then you have your Pressure support settings up to whatever max you have set for IPAP.

Hey OP,

I'm going through this kind of thing too. It all takes time apparently but I have faith. If you are actually feeling very depressed about this situation whilst you figure it out and get it right - I can suggest two great anti-depression/anxiety organisations that have helped me in the mean time. Remember that one of the symptoms of sleep apnea is depression. It is a dark, malicious depression that is for sure. I imagine you are in America and have your own organisations but gives these two links a go- they are great and very high quality with lots of tips..

http://www.blackdoginstitute.org.au

http://www.beyondblue.org.au

thanks Matty. I will check out those links. I do go to therapy but the bottom ine is who understands what I'm going through? The guys and gals here. I have a friend I talk to and she just doesn't get it. Yes, I'm in America in the state of New Mexico.

Matty332 wrote:Hey OP,

I'm going through this kind of thing too. It all takes time apparently but I have faith. If you are actually feeling very depressed about this situation whilst you figure it out and get it right - I can suggest two great anti-depression/anxiety organisations that have helped me in the mean time. Remember that one of the symptoms of sleep apnea is depression. It is a dark, malicious depression that is for sure. I imagine you are in America and have your own organisations but gives these two links a go- they are great and very high quality with lots of tips..

http://www.blackdoginstitute.org.au

http://www.beyondblue.org.au

This is from this morning. I woke up and then was so tired I went back to sleep

Pugsy wrote:

macewa wrote:RemStar BiPAP Auto with Bi-Flex
Mode: Bi-Level
EPAP: 13.0 IPAP: 25.0 cmH2O

BiLevel Mode....Straight fixed pressures bouncing between 13 and 25..no wonder the wind burn.

Auto Mode...flexible pressures that don't go up unless the machine senses the need. In Auto mode while awake you only see a 2 cm difference between your EPAP and IPAP settings. IPAP defaults to 2 cm more than EPAP until events start driving the pressures up then you have your Pressure support settings up to whatever max you have set for IPAP.

I think that this area of medicine is getting more and more advanced BY THE DAY, so don't give in. It is so financially lucrative for companies that is why they are pumping money into research. Soon they will know so much more and be able to help alot more. We just have to make sure we have the right insurance and save a few dollars for the new gear.

What do the numbers on the side of the flow rate chart and AHI graph (not posted) mean?

macewa wrote:This is from this morning. I woke up and then was so tired I went back to sleep

Pugsy wrote:

macewa wrote:RemStar BiPAP Auto with Bi-Flex
Mode: Bi-Level
EPAP: 13.0 IPAP: 25.0 cmH2O

BiLevel Mode....Straight fixed pressures bouncing between 13 and 25..no wonder the wind burn.

Auto Mode...flexible pressures that don't go up unless the machine senses the need. In Auto mode while awake you only see a 2 cm difference between your EPAP and IPAP settings. IPAP defaults to 2 cm more than EPAP until events start driving the pressures up then you have your Pressure support settings up to whatever max you have set for IPAP.

macewa wrote:What do the numbers on the side of the flow rate chart and AHI graph (not posted) mean?

The numbers that go from -120 to +120? Just a flow charting. Breathing involves inspiration (above the baseline and thus into positive territory and expiration which will show in the negative territory. If you zoom in really close you can see each individual breath above and below the baseline.