New User Thoughts/Advice Appreciated

First, thanks to everyone here. Simply said, I would never have tried this without this wonderful forum and the great support! I easily navigated the DME and early steps thanks to you guys. Now, I've had my first night and was looking for some comments and thoughts on my Sleepyhead data. After being a world class snorer for years, finally made the decision to investigate SA. My intial test was a home test as follows:

Night 1= 6 Hours, AHI 9.8, Pulse 48-102, CAI 0, 3015 Snores, Oxygen Sat Nadir 88%
Night 2= 5 Hours, AHI 15, Pulse 49-100, CAI 0, 697 Snores, Oxygen Sat Nadir 84%

My first thought was that other than a few big leaks it wasn't too bad leak wise the first night. Probably, because I stayed awake a lot and tried to be still. My actual OSA's look good for what little I slept. Am I correct to assume that the CA's are probably awake events such as salivating the dry mouth, mask adjustments, conscious breathing, etc. In other words do they look normal for night one or something to look into?

It was hard and I had some anxiety that I really didn't expect. Mostly, I felt it hard to exhale. This was the case even at the DME trying masks and the EPR at 3. My breathing really felt like work. What really got me was it seemed really hard to get a good breath with the mask off this morning. Is this normal part of the adjustment process? I almost felt like I was suffocating, especially when trying to lie there with the mask off and cheat a few winks? I did sleep supine and am a mouth breather at times, old habits and preexisting conditions. Got some dry mouth at leak points, and of course some air went down the wrong tube. It wasn't painful and went right out the backside during the night.

I guess my last question is does it look like I'm positively set-up for these pressures or should I be investigating anything else in the days ahead? I sincerely appreciate all you guys do, and many thanks in advance. With everyone's support I'm going to do my best to make it work.

Best,

Mike

Mike, do you also have the ramp in use? This may help you to sleep as it's no good to sleep all night long trying not to move and make the mask leak. You can reengage the ramp when you wake up during the night- soon it won't be necessary.
I hope your O2 sats come up with the machine- it should be over 90. CA's are not due to the things you mention (to my humble knowledge) I don't see that you had any Clear Airway Apneas during your home test., but may also be some Central apnea events, but you won't know unless you're in a sleep lab. My eyes aren't good enough to read your pressures so I can't comment on that, but your AHI should be under five.
Some folks buy simple (or complicated) O2 oximeters which tells the O2 sat during the night. This is up to you, I've never used one.

Some folks do experience the symptoms you describe of not being able to get a deep breath while awake. I've never understood why this happens.

You also seemed to be awake half the night- not good- talk to your doc. I believe in prescription help in getting over the first month hurdles.

The forum is great, but don't leave your doc out of the loop. He/she may be able to help.
Mike, please keep us posted and good luck.
Oh and I wouldn't make pressure changes for a month or two.

Thanks Mary. I did use the ramp but feel I need to adjust it. The start level of 4 can definitely feel suffocating. I've read here that a lot of CA's can just be mis-scored or perhaps relate to a lot of sleep/wake noise. I was awake a lot so this makes since. I thought they just might be me lying there thinking and taking a rest from the work. However, I don't recall the pauses being as long as listed in the data (>10 seconds). I also read that newbies like me get freaked out when seeing them on the data. I can post a zoomed version of some of these on SH if it helps anyone offer an opinion. I'd love to know what everyone thinks. I can't tell any difference between the CA's and the OSA's on the graphs, hardly surprising!

The O2 was the reason I decided to go with therapy. It would be nice to know how it's scored on the home test. My report doesn't give a % of the time spent <90, just the minimum. Could be bad or maybe not as bad. However, my issues mild or otherwise need addressed. It would be great to get my spouse back in the BR

Don't know about the breathing thing either. Perhaps, it's a structural issue. My core muscles aren't anything much these days. I will ask my DR at follow-up. He can easily work-up a pulmonary function test if it continues to be an issue. I just need to get a little more sleep each night as you say. It's way early in the game. I've got medication on hand to use as necessary.

Best,

Mike

Macpage wrote:Thanks Mary. I did use the ramp but feel I need to adjust it. The start level of 4 can definitely feel suffocating.

you can easily go into the clinician menu and raise the starting pressure on the ramp, if you think that would help.

Yes. I am going to do that tonight. I think I will just see if I can start with it off. It will put me at my start Apap pressure of 8.

At ramp start of 4 at 80 hose temp last night, I thought I was breathing car exhaust. Quick change of temp to 72 to match the room temp was much better. The auto humidity seemed to work last night as advertised. No issues except for dry mouth from large leak and some mouth breathing.

Best,

Mike

Macpage wrote:Yes. I am going to do that tonight. I think I will just see if I can start with it off. It will put me at my start Apap pressure of 8.

you can just turn the knob till you see ramp, press, then turn to OFF.

you only need to go into the clinician manual if you want to change the ramp start pressure.

Thanks. I'll give it the go. I will post another SH data set when I get a few days for you guys to reassure me on the CA's. It really looks like sleep/wake periods to me, though there are some in the middle of otherwise quieter periods.

Best,

Mike