New to CPAP. Sleep is far worse when using it. Desperate

[Rk]

Hi guys. I started using my cpap last week. Initially I was given a nasal mask but it didn't work as every time I was nodding off to sleep I would awake gasping for breath and would eventually end up turning the cpap off. So then I was prescribed a chin strap and this did nothing to help. Now I have been given a full face mask but am still experiencing the same problem. Last night I went to bed at 11.15 and was still awake at 3.45 having had a few episodes of nodding off and being suddenly woken. Needless to say I took the mask off and tried to sleep without it. This is beginning to make me a little depressed. I spent many years not sleeping well and it was only recently when I started going out with my partner that she noticed my apnoeas and I thus went and got diagnosed. I was so so elated with the diagnosis but now it seems not even cpap treatment can help me. Has anybody here got any advice they can give me based on the issues I've discussed above?
I have been diagnosed with a combination of obstructive and central sleep apnoea. At the time of my home sleep study, my AHI index score was 28 and blood oxegen can fall to 80. My cpap machine is a Philips Respironics REMSTAR auto Aflex with humidifier. It is on an auto setting which begins at 6 and is programmed to max at 20. FYI I am a 31 year old male who is of average weight and has never been overweight. I have a normal sized neck and am not a heavy smoker.

Any response or advice would be greatly appreciated.
Thanks for taking the time to read this.

[MarylandCPAPer]

Welcome to the forum! It would be helpful if you would fill out your equipment profile in the User Control Panel using TEXT (not pictures). Are you using a ramp setting? It sounds as if a change in ramp and/or the minimum pressure settings may help you, since you feel like you are not getting enough air. What mask are you using? The more information you provide, the likelier that experienced people here may be able to help you optimize your treatment.

Nasal pillows masks are another option. What is it about the nasal and full face masks that you have tried that bothers you? Others here who have used the same masks may be able to give you ideas on how to make the masks more comfortable.

It takes time for the body to adjust to CPAP therepy and get all your settings right, so don't be discouraged.

[Rk]

Hi. Thanks for your response. I am having trouble registering with the website, the page freezes each time I complete the registration page.
As far as I am aware my care provider has the ramp setting disabled. The mask is a Philips Respironics Amara.
What bothers me is that each time I am nodding off to sleep I am suddenly woken gasping for breath. With the nasal mask it was far more pronounced. Whilst it is not as severe a gasp with the full mask, its still happening nonetheless. Otherwise there are no issues, I feel relatively comfortable with the mask on.
Could it be anything to do with the central sleep apnoea? Are CPAP's the recommended treatment for a combination of central and obstructive sleep apnoea?

Thanks again

[Julie]

As was said, your min. pressure is very low and it probably should be raised. Try it at e.g. 8 and see if you have better luck.

[Pugsy]

Could it be anything to do with the central sleep apnoea? Are CPAP's the recommended treatment for a combination of central and obstructive sleep apnoea?

Depends on just how many centrals you had without cpap....and how many you might be having now with cpap.
Normally APAP/CPAP isn't the best way got go...but again it depends on just how many happened...was it 1 or 2 centrals which is not abnormal or 20 of them in an hour?

Is your machine the PR System One 60 Series model 560 machine? If it is auto adjusting then it is a full data machine.
I would start by looking at the data that it gathers before I went changing anything like pressure.
https://sleep.tnet.com/equipment

[Julie]

Raising pressure from 6 to 8 for a few days is highly unlikely to cause any problems and could provide answers.

[Rk]

Could it be anything to do with the central sleep apnoea? Are CPAP's the recommended treatment for a combination of central and obstructive sleep apnoea?

Depends on just how many centrals you had without cpap....and how many you might be having now with cpap.
Normally APAP/CPAP isn't the best way got go...but again it depends on just how many happened...was it 1 or 2 centrals which is not abnormal or 20 of them in an hour?

Is your machine the PR System One 60 Series model 560 machine? If it is auto adjusting then it is a full data machine.
I would start by looking at the data that it gathers before I went changing anything like pressure.

Hi it is the PR System One REMstar Auto CPAP Machine with A-Flex. It is a 50 serious. It does have data storage via a memory card which is inserted into it. But I have no idea how to check central episode data. Could you tell me how to do this?

Thank you

[SunnyBeBe]

I'm pretty new myself to cpap therapy. I started in early June, so I really don't have much to offer, however, I was very curious about your situation.

You say you had a home sleep study. So, I guess that means you did not have a titration study in a lab setting. I just find that very unusual for someone who has central apnea. How do you know it's central and not OSA? Wouldn't you qualify for a lab tritation study. I would think that once there, they could adjust what you need and monitor what treatment is needed to get you straight. What does your doctor say about all of this?

[Guest]

Could it be anything to do with the central sleep apnoea? Are CPAP's the recommended treatment for a combination of central and obstructive sleep apnoea?

Depends on just how many centrals you had without cpap....and how many you might be having now with cpap.
Normally APAP/CPAP isn't the best way got go...but again it depends on just how many happened...was it 1 or 2 centrals which is not abnormal or 20 of them in an hour?

Is your machine the PR System One 60 Series model 560 machine? If it is auto adjusting then it is a full data machine.
I would start by looking at the data that it gathers before I went changing

As well the thing is I haven't fallen asleep yet whilst using the cpap, every time I get to the point of nodding off I suddenly jolt and awaken. Then the process of trying to get sleepy starts again until the same thing happens again each time I'm falling asleep. Eventually I give up and turn the cpap off

[Pugsy]

The 50 Series PR S1 APAP will flag centrals but calls them Clear Airway apneas on the software reports.

So you need to use the software (you choice which you use or both) and let's see what the machine is actually doing before you start changing pressures.
The data is there..might as well make use of it.

Probably would be a good idea to get copies of your sleep studies....the diagnostic portion and the titration sleep study (if you had one)...if you didn't have one then they are likely using the APAP to find a suitable pressure and all the more reason with the history of centrals to pay close attention.

Until we know more about what is going on...I wouldn't change anything.

The link above has information on how to get and use SleepyHead as well as how to post images....here's a thread with some examples.
viewtopic/t103468/Need-help-with-screen-shots.html

[Pugsy]

Please go ahead and do the software thing.
What you are describing could be sleep onset centrals which normally aren't a big deal unless they keep you from falling asleep and staying asleep.

What kind of home sleep study did you have? Did they use just the finger sensor for oxygen levels (and maybe a little cannula thing just in your nose)? Or did they also use some sort of chest belt to measure thoracic activity?

Do you have a copy of the home study report? If not, get one?
If you do have a copy...can you post more details?
Do you take any meds to suppress respiration?
Any health conditions that might suppress respiration?

[Pugsy]

For those who might wonder why I don't blindly suggest "increase the pressure"....it's because I like to know what the problem is before I go trying to fix something if at all possible.

With a history of centrals...until I have more information I don't blindly go suggesting more pressure because it could potentially make things worse.

Remember this thread? It involved a home study initially too.
viewtopic.php?f=1&t=106598&st=0&sk=t&sd=a&hilit=central

What's so difficult about taking a step back and at least looking at what might be going on before suggesting something that may not help and might hurt?
We have someone here saying that centrals are a known issue....how about just a little caution and common sense?
Centrals and APAPs don't always play nice together.

[Pugsy]

Rk....where do you live?
How come they gave you a 50 series machine?

[Rjk]

Please go ahead and do the software thing.
What you are describing could be sleep onset centrals which normally aren't a big deal unless they keep you from falling asleep and staying asleep.

What kind of home sleep study did you have? Did they use just the finger sensor for oxygen levels (and maybe a little cannula thing just in your nose)? Or did they also use some sort of chest belt to measure thoracic activity?

Do you have a copy of the home study report? If not, get one?
If you do have a copy...can you post more details?
Do you take any meds to suppress respiration?
Any health conditions that might suppress respiration?

I am really grateful for the interest you are taking and the help you are giving me right now.
I will download SleepyHead and try to figure out how to use it and post some results on here.

The sleep study: It involved using one of these http://en.bmc-medical.com/products_deta ... Id=35.html. It used the finger sensor, cannula, and chest belt.

Report: I do not have a copy of the results, I was given them verbally. All I was told was that my blood oxygen went as low as 80%, my AHI was 28, and that I experienced a combination of central and obstructive apnoea episodes throughout the night.

Meds: Not that I am aware of. What type of meds would you be referring to?

Health conditions: Again, not that I am aware of.

I am scheduled to have a CT brain scan next week and a breathing exam. Both just precautionary and at my request.

The reason for the home sleep study is that I was on a long waiting list in my local public hospital for a sleep study (there was at least another year to go before I would even get an initial consultation), and I was beginning to really struggle having not slept properly for many years at this stage. So I took out a loan and went to see a private consultant. Its costs €150 for each consultation and that is why I have not been back to see him, yet. Their method of assessment is to use the home sleep study.

I live in Dublin, Ireland by the way. The public health system over here isn't very good as you can see.

I was only alerted to the possibility of sleep apnoea when I got into a relationship with my girlfriend and she noticed my apnoeas during the night. Up until then, I had tried a myriad of things to help me sleep. When I received the sleep apnoea diagnosis, I was over the moon. Im determined to keep using the CPAP or whatever treatment is necessary in order to alleviate my symptoms. Maybe Im being a little impatient also.

My home care provider has just phoned to say they will send a nurse to my home on Monday and she will assess me. I also mentioned to them about the combination of central and obstructive episodes, and they said they will take this into consideration when making any decisions on how to progress.

Once again, thank you for listening and giving me such helpful advice.

[Rjk]

Rk....where do you live?
How come they gave you a 50 series machine?

Oh and by the way I was able to successfully register, hence the new username.