Newbie 2nd Night on APAP.

[cAtLeYx]

Hi All, I hope everyone is well.

I am new here and just wanted to add my experience after only two nights using my CPAP. I was diagnosed this week with moderate sleep apnea AHI-19. Have this morning downloaded SleepyHead (love it) it details my AHI as 0.98 for my first night and 0.70 for my second. I felt great yesterday and already wide awake this morning feeling refreshed. My question:- is this just psychological or does the above result confirm this.

Many Thanks

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[Pugsy]

Welcome to the forum.

Your report looks pretty darn good for 2 nights on cpap. It's real....some people do see marked improvement almost immediately...others not so lucky for any number of reasons. Sounds like you are one of the lucky ones who feel those good numbers right away.
Having a nice low AHI doesn't guarantee that a person will feel those nice low numbers but it is sure nice when someone does.

A little thought about your snores and FLs....if they continue like this you might want to consider seeing about increasing that minimum pressure just a little. Clean things up a bit more...it's the snores and FLs that are causing the pressure to increase as it's not quite doing an optimal job...it's close though and certainly nothing critical. Give yourself a week or two and see what those snores and Flow Limitations do or don't do.

[cAtLeYx]

Thank you Pugsy, thats very reassuring. if I could just ask one question based on your comments.

Can I assume that when an event happens the air pressure automatically rises to keep my airway open. If this is correct, and (in time) I adjust the lower level pressure, would this then stop an event from happening in the first place rather that reacting to it afterwards.

Hope that makes sense & thanks again.

[Pugsy]

Yes, when we use the minimum pressure to better hold open the airway then we are preventing the airway collapses. That's how these machines are really designed to work...prevent in the first place so that they don't have so much "fixing" to try to do after the fact.

They don't really increase the pressure immediately when some sort of apnea event is sensed. They can't respond fast enough to do that but what they do is take that event(s) into consideration along with the other signs of airway collapsing (that would be the snores and Flow limitations) and make pressure adjustments at that time.

This is why the minimum pressure is actually much more critical than the maximum pressure.
It is better to prevent in the first place whenever possible. We can't really expect to prevent them all but we try to keep the ones that slip past the defenses to a minimum.
Snores and flow limitations are usually considered warning signs that the airway is trying to collapse. I say usually because in some situations the snores & FLs could maybe be nasal congestion in which case that really isn't the part of the airway that the pressure is supposed to hold open.

Often when the minimum pressure is doing a better job holding the airway open in the first place we find that the pressure/machine doesn't have to work so hard to "fix" things so then the pressure line becomes more stable and we don't see as much variation all over the place. Less variation could potentially improve sleep quality if a person happens to be sensitive to the variations in pressure. So a win win situation all the way around.

[cAtLeYx]

Thanks again Pugsy, really appreciate the advice. I will, as you advised, continue as I am for a week or so and then post another SleepyHeads screen shot after. I now understand that "prevention is better than cure".

Thanks again

[andycole]

Pugsy - is it true that my machine automatically starts at 4.0 even though my min was seet at 5.0?

[Pugsy]

Pugsy - is it true that my machine automatically starts at 4.0 even though my min was seet at 5.0?

It depends on whether you are using the ramp feature and if you are using the ramp then it is probably starting at 4 cm (that's the default setting). Ramp starting pressures don't have to be 4 cm.
If ramp is turned off then the machines start out at whatever the minimum pressure setting is in apap mode and whatever the fixed pressure setting is in cpap mode.
On the ResMed machines you have to go into the clinical set up menu area to turn off the ramp feature or make adjustments to ramp....the default from the factory is for ramp to be on so you get it no matter what unless you change it.

[andycole]

Pugsy - my machine allows me to change ramp time from off up to 45 without going into clinical setup

[Pugsy]

Pugsy - my machine allows me to change ramp time from off up to 45 without going into clinical setup

The default from the factory is with that feature not being available to the patient (I think...at least that is the way it is on my machine).
It seems the DMEs often lock people out the ability to change some of these features....I never know if a person's DME has set it up for the patient to change or not so I always just tell people to go into the clinical menu because I know it can be changed there.

It seems your DME has already unlocked that feature for you...that's great.
It isn't that way for everyone though...so that's why I respond with "go to the clinical menu setup area".

Also my ResMed machine which is a model older than yours doesn't have the same ramp feature adjustments you have and I can't ever access my ramp without going into the clinical setup menu area.
I try to respond with explanations that will work for all people for sure....saves them saying "I can't find so and so what can I do now" and saves me some time typing.

[andycole]

Pugsy - my DME had me locked out but I was able to adjust ramp time immediately. I now know how to get to clinical setting but don't. The respiratory therapist at my sleep service are very helpful and are tweaking min(5)/max(10) for me. I am having a problem with swallowing air and when I first sit up I start burping and later there is another issue with swallowed air (won't go into that but it is PITA). I have only been on the machine for about 4 months so mine would be the latest model and possibly different standard adjustments available.

[cAtLeYx]

Hi All, Hopefully everyone is well.

After my 3rd night on CPAP machine, I have this morning woken up with really puffy bags under my eyes. I did adjust my straps last night so am assuming my nasal mask was too tight and therefore was pushing my checks upwards.!!.

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On a more positive note, my AHI was lower again last night and I only woke up 3 times.
Feely really positive and more awake already