New to CPAP….Not good results

Hello all!

I started using CPAP (non data capable M-Plus) on 1/4/08 so I am new.

For the last 3 days I have been using a Repironics M Series Auto C-Flex CPAP Machine operating as a CPAP with C-Flex. My pressure is set at 8 cm H2O. I am also using an M Series Passover Humidifier set on 4 with a Swift II pillow mask. The intentional leak rate of this mask at 8 cm H2O is 29. I am also using the Pur-Sleep system as well.
Here are my performance numbers as taken from the LCD display for the past 3 days

Leak rate…………AHI
29.2………..……….8.2
29.2……..………….5
32.7…………..…….1.3

My overall leak rate is < 3.3 which I understand to be good.

I wakeup a 3-5 times during the night but go right back to sleep; when I get up in the morning (in the bed at 11pm up at 5:45am) I do not feel rested. My eyes are red and baggy and I have a hard time staying focused on most tasks throughout the day. I start feeling better in the afternoon.

My stats indicate that I am “sleeping” well but I do not feel that way.

Any advice is welcomed.


Thanks

John

John,

A couple of questions:

How did you feel on the earlier machine? Were you also waking up about the same number of times?

You're leak rate looks reasonable based on what I was told and is similar to what I've experienced with the Swift. However, do you know if you mouth-breathe? Some people think they don't but then find out that they really do! If you do, it would be a good idea to improve that; there are a variety of ways different folks use to help with that. There's no one method that works for all so I'd suggest doing some searching on this forum.

An easy way to search is to use google something like the following:

mouth breathing site:cpaptalk.com

Using the LCD is fine as long as you remember that it's a 7-day running average so when you get to day 8, it's the average of the most recent 7. There is a way to clear the LCD every night so you'll get better numbers. Also, I find it best to check the LCD a little later in the day so it has calculated the final numbers.

That's about as much as I feel comfortable commenting on and I'm sure others will stop by with suggestions.

Mindy

Hello Mindy, thanks for the feedback.

I felt the same way with my first machine as I do with this one with the same amount of wakeups.
My best night with a CPAP was at the sleep evaluation center. I woke up feeling great that day.

I was able to talk the local DME supplier into upgrading my original machine to the data capable one because I was not feeling rested and I need the ability to accurately measure my progress. A “feeling” was not going to get it. There has to be data along with the feeling.

I use a chin strap but there still times that I do wakeup with my mouth open so limited mouth breathing is happening even with the chin strap.


John

Hi John,

Welcome to the forum!

The first thing that jumps out at me....is you are not allowing enough time TO SLEEP. Is there any way to adjust your schedule so that you can get to bed earlier?

By the time you fall asleep, wake up 3-5 times, and have to arise at 5;45, I can understand why you're not feeling well. I know it's hard, I struggle with the same thing. But see if you can try to go to bed a couple hours earlier for a few days and see if that will make any difference.

I'm sure you will hear from others soon, with some more CPAP related advice.

Best of luck to you,

Gail

i am not what to expect either. i have been on my mahcine a weak.

while i am not sleeping through the entire night, i do think i am getting some better sleep

I know how frustrating cpap can be at first but I'd say you're off to a decent start. One of the most important things is to stick with it long enough that your body and brain can make the adjustments so you can really sleep. Believe it or not the time will come that you will hardly be aware of the back-pressure when you exhale. It will feel like you're breathing normally. I will leave to others to make suggestions based on your data. You're at the right place for some excellent help!

Gail – Good advice….I probably need more sleep but it is hard to do during the week.

SleepGuy – Actually I already feel natural breathing with the resistance of the air pressure.
It is funny, I woke up one night freaking out thinking the CPAP machine had quit working because I could not feel it. I pulled the mask off and air was shooting everywhere! The CPAP machine was working fine.

jnorris wrote:I woke up one night freaking out thinking the CPAP machine had quit working because I could not feel it. I pulled the mask off and air was shooting everywhere! The CPAP machine was working fine.

Excellent! It took me a LONG time to experience that transformation. CPAP has been much easier for me ever since though I still have a hard night from time to time, like last night. I woke up at 2am with my mask off and I don't remember taking it off.... I didn't sleep well after that. It has been a long time since I unconsciously took off my mask. So my advice to you is to relax, realize that you're a lot better off getting a little sleep with your equipment than any "sleep" without it, and keep tweaking things till you see improvement. You're at the right place for good advice, especially if you have data to share (I don't--yet, but my next machine will definitely be one that records data).

That reminds me of the first time I woke up and thought the machine wasn't working and opened my mouth! I was totally floored!

Also, as far as feeling better -- how long it takes seems to be a very individual thing. Some people report feeling better fairly quickly but many report that it's a gradual process than can take months. It's easy to get discouraged but in dealing with xPAP, IMHO the turtle always beats the hare.

John - getting a data-capable machine is definitely a good step. Many of us on the forum feel quite strongly about that. You'll find there are a variety of opinions on how far to push the AHI down so you'll need to find your sweet spot. It generally seems to work better to make small changes and then wait awhile to see how it settles down.

Mindy

jnorris,

Your AHI numbers are hige they should bi below 5.0. What pressure do you have your machine at.

Frank

Those numbers don't appear to be "huge" to me - especially considering that some people have untreated numbers in the 50s, 60s and above.

If I'm reading the numbers correctly, there's only one day above 5. That's not ideal, but a single night's number is not enough to go on.

Mindy

It takes time but when everything does finally come together things will improve. Your working well on it already but try to nail down 1 thing at a time and watch the results. Xpap is something you must fine tune over time.

First make sure your happy with your mask and if you can breath normally and can forget its on your getting there.

Next is leaks, the swift leaks more then most masks but I like mine alot. Play with the pillows if they gave you all 3. Find the one that seals best. The Swift likes to leak around the nares when you side sleep with it. Also as the Swift ages it gets kinda leaky around the O grooves for the pillows. Plumbers tape can help but over time it will simply need replacing. I run at 17 cm though so mine wears out fast but with care I got mine to last a year.

Make sure you look up some of the mouth breathing solutions on the forums here. You can train yourself to not mouth breath but its not always 100% effective. Practice during the day by keeping a suction between your pallet and tongue once you get into the habit it will follow you into your sleep. It worked for me but I have an issue with talking in my sleep so like I said its not always 100% but it helps.

Remember your retraining yourself and the way you sleep it takes time to make these things second nature but the sooner you can nail down all the adjustments the sooner you will start feeling better.

After your body is use to the Xpap and you have all the gear issues nailed if your still having issues (and most likely will ) you can start focusing on your data. Every change you make will take at least a week or 2 of data to reflect the true effect of the change. Playing with your pressure's and some of the other more advanced things wont work or help you though if you dont have the basic's in place first.

GL with it all and even though 1 night be awesome or down right terrible just keep with it and give it time. This isn't something thats Black or White or an instant fix.

Thank you all for the great feedback.

I had my data card read with the Encore software and as it turns out, most all the leak numbers happened around the same time, between 3am and 5am and that is also where most of my AH events occurred. The earlier hours in the night were for the most part clean.
It seems that I am leaking through my mouth! I ware a chinstrap but it seems that it is not doing the job.


John