Using APAP machine to measure apnoea events

[Londonia]

Hello, I'm newly registered although I think I've passed through before when I was looking at buying a machine. I have a F&P Icon+ and half a dozen different masks. So far I've found the whole experience quite unpleasant. I'm going through a period of rebound insomnia at the moment which is exasperating my efforts to acclimatise to the device. Ho hum.

The Icon+ records data to its USB stick, and I'm using the excellent SleepyHead software to analyse my recordings. I've also got a pulse/oximeter which records, and I can import that data into SleepyHead too.

The recording shows Apnoea events, but it doesn't show events that it has prevented. This makes sense, but it leaves me in an awkward position, wondering if my machine is just an "Elephant prevention stone" (a stone which keeps Elephants away. How do you know it's working? Well, there aren't any Elephants here, so it must be!).

My theory is that if I set the machine maximum and minimum levels to their lowest setting, it won't be able to prevent any events and should therefore record them.

SO, my question is: Will that work?

I'm not convinced by the results of the home sleep study which led me to CPAP land because there were a number of factors in play at the time which I believe would exaggerate any breathing issues. These include the medication I was taking at the time (which suppress CNS), allergies and some other, at the time, undiagnosed issues.

I will organise another sleep study at some point, but I imagine it won't be before I see my consultant again in January.

Thank you.

[ChicagoGranny]

Why did you have a sleep study in the first place?

[ramblingasian]

If you complete your "test" and it shows events, what is your next step? You're really just hoping that you don't have apnea, aren't you?

[Sheffey]

So far I've found the whole experience quite unpleasant.

You probably haven't tweaked your therapy and learned how to use CPAP well. I find putting on the mask is very pleasant - I need to breathe. Waking up in the morning and feeling that air flowing is also pleasant.

rebound insomnia

You invented that term, didn't you?

Get Granny to post her simple guideline to conquering insomnia. It's fairly easy and it should become a lifestyle.

You're really just hoping that you don't have apnea, aren't you?

Yes, she/he is in the denial stage.

[Jay Aitchsee]

My theory is that if I set the machine maximum and minimum levels to their lowest setting, it won't be able to prevent any events and should therefore record them.

It's a theory many have tried, but I think the results are mixed. Part of the problem is that even at the lowest setting (usually 4 cm) some therapy remains. If at the minimum settings AHI increases, it could be a clue.
I don't know about your Icon, but most newer APAP algorithms work to prevent apneas by sensing flow limitation and snores, raising the pressure before events happen. So another clue might be provided by raising the max pressure to see if the pressure has risen during the night to prevent apneas from occurring.

[Pugsy]

My theory is that if I set the machine maximum and minimum levels to their lowest setting, it won't be able to prevent any events and should therefore record them.

SO, my question is: Will that work?

My problem with your theory is the word "any".
Even the lowest pressure setting of 3 or 4 (I think that maybe one brand will go to as low as 3) has therapy value thus it can and will prevent some apnea events for some people at the minimal setting and there's no way to know if you are one of those people or not.
Believe it or not but there are people who only need a pressure of 4 or 5 to deal with their OSA.

But since it sounds like you are in denial and looking to prove the other sleep studies wrong....give it a try.
Just understand that if nothing at all shows up at 4 cm (you need to use fixed cpap mode too) that it doesn't totally mean you don't have a problem.
All it means is you don't have a problem at 4 cm which can be very effective for some people.

If you can be comfortable at 4 cm...give it a try...the odds are it will likely reinforce the need for cpap and maybe help you climb out of the DeNile boat.\
Just remember that 4 cm works and does a good job for some people.

[Londonia]

Hey, thanks for the feedback.

In no particular order:

I'm not exactly in denial. I used it for a couple of months while medicated and it didn't seem to improve my fatigue during the day during that time. If anything I'm disillusioned. I was delighted that I had found a solution to what has been an "f"'ing nightmare. So far it just hasn't delivered, although during this time we (I'll call them my medical team) have discovered other "stuff".

Rebound insomnia is insomnia caused by withdrawal from medication or substance that makes you sleepy. Commonly this includes some illicit narcotics, sleeping tablets (obviously), anti-depressants, anti-psychotics, pain meds and so on.

The original sleep study was done because I don't benefit from sleep (when I do sleep). I'm always severely fatigued.

My machine has a minimum pressure of 4, so I'm going to experiment with it set at min/max 4/4. In normal operation I experimented with min/max pressures until I found a comfortable compromise. Max was kinda irrelevant, just set it to what ever the mask will accept as its maximum. Minimum was more interesting and found 6 to work best. My AHI while using the machine at 6/15 is usually about 3 or 4. Max pressure actually achieved, I've never gone over 9, it usually just flat lines at 6.

So we have an operating range of 6-9, spending 90pc of the time at 6, an ahi of 4 or less and no respite from the fatigue. This is what leads me to question the value of my little box of puff.

The Icon+ is quite nice. It's small, very quiet, about 6 inches cubed and has a built in humidifier and heated hose. It uses a USB stick onto which it writes all the telemetry, and I use the free software SleepyHead to analyse it. I've also got a COMTEC pulse oximetry finger reader which can record 24hours of data and importantly saves it in a format that sleepyhead can import. It's fiddly and I have to tape it to my finger with medical tape, but it works.

Part of the problem is that I started talking to doctors a year ago about some random pain. This led via a convoluted path and probably a dozen disparate specialists of varying ability/personality to the present day, largely because I've project managed the whole thing. The biggest problem is specialists specialise. All the symptoms of anything above moderate sleep apnoea look exactly like CFS to one specialist, depression to another, sinusitis and CHVS to another and the list goes on. Thus I'm in the unedifying position of doing my own science and attempting to herd cats into a consensus position. (actually I quite enjoy the science, it's the project management that feels nasty).

Sorry to rattle on.

[Julie]

To clarify - are you still on any meds now, tapering or otherwise? They could be making quite a difference in your sleep... and good luck with a setting of 4/4 - it's the default machine low and most of us literally can't breathe there, just not enough air at all. But I appreciate your complications otherwise.

[LSAT]

So we have an operating range of 6-9, spending 90pc of the time at 6, an ahi of 4 or less and no respite from the fatigue. This is what leads me to question the value of my little box of puff.

.

Actually the 90% at 6 means that 90% of the time you were at 6 or less. You really do not know what your AHI would be with out the CPAP. You will need a sleep study for that. You are getting some therapy with the machine to achieve the AHI of 4...without the therapy you might be at 8.

[Jay Aitchsee]

Problem is people often have more than one cause of fatigue. An easily identified and treated cause is Sleep Disordered Breathing such as sleep apnea. Fixing the sleep apnea eliminates one cause, but others may remain. I suggest you continue the therapy while you continue to search and rule out other causes. That way, at least you'll know what it isn't.

[zoocrewphoto]

Keep in mind that an ahi of 3 means that your sleep is being disturbed an average of 3 times an hour. That is still not great, even though doctors consider it good. A lot of people need to get below 2 to actually feel better.

Also, some people are very sensitive to pressure changes, so your pressure going up and down could be disturbing your sleep. Also, do you have any leaks disturbing your sleep.

And what side effects do your medications have? Sometimes those can cause us to not feel good.