CPAP newbie, question about pressure increase

[jillk]

Hello! Thanks SO much for this forum; I have learned so much from you all.
I've been on CPAP now for about 5 weeks. I have the first follow-up with the sleep doc next week.

I'm looking forward to feeling rested, but I'm not there yet. Over these weeks, I've used 4 different masks (and I'm not too happy yet, hence questions below), and swallowed more air than I'd like, but otherwise I'm ok with the CPAP. My home sleep study showed AHI of 31.5 so that was my starting point.

Question 1: My numbers are jumping around like crazy each night. The lowest was 10.something and the highest with CPAP was 22 or so (just the other night). I hate to ask "is that typical?", but .... is it? I was thinking either a flatline or slow decrease would be more normal? (I guess it doesn't really matter; it is what it is!)

Question 2: Of course I'm having mask troubles, seems very common so I know I'll get good advice. I tend to get leaks around 2-3am, and of course I'm so tired that I can't always think straight to adjust and make them go away. Usually the pressure is high at this time, hence the leak which might not be so bad at lower pressure. Question is, should I hit the button on the Dreamstation to reset my pressure when this happens? Is it better to go lower and resolve the leak than to be higher when the machine thinks I need higher?

Question 3 (related to 2): Does pressure increase as a result of leaks? Either directly (mask is leaking -> increase pressure) OR indirectly (mask is leaking -> more events because CPAP is not being effective -> increase pressure)

Many thanks!!

[D.H.]

Your AHI should be 5 or under. I really think even that's too high, but let's get there first.

The first thing is ask yourself whether the pressure is too high or too low (or just right). If you fell like you're fighting the machine, it's probably too high. If you feel like you're not getting enough air, it's probably too low.

[LSAT]

Hello! Thanks SO much for this forum; I have learned so much from you all.
I've been on CPAP now for about 5 weeks. I have the first follow-up with the sleep doc next week.

I'm looking forward to feeling rested, but I'm not there yet. Over these weeks, I've used 4 different masks (and I'm not too happy yet, hence questions below), and swallowed more air than I'd like, but otherwise I'm ok with the CPAP. My home sleep study showed AHI of 31.5 so that was my starting point.

Question 1: My numbers are jumping around like crazy each night. The lowest was 10.something and the highest with CPAP was 22 or so (just the other night). I hate to ask "is that typical?", but .... is it? I was thinking either a flatline or slow decrease would be more normal? (I guess it doesn't really matter; it is what it is!)

Question 2: Of course I'm having mask troubles, seems very common so I know I'll get good advice. I tend to get leaks around 2-3am, and of course I'm so tired that I can't always think straight to adjust and make them go away. Usually the pressure is high at this time, hence the leak which might not be so bad at lower pressure. Question is, should I hit the button on the Dreamstation to reset my pressure when this happens? Is it better to go lower and resolve the leak than to be higher when the machine thinks I need higher?

Question 3 (related to 2): Does pressure increase as a result of leaks? Either directly (mask is leaking -> increase pressure) OR indirectly (mask is leaking -> more events because CPAP is not being effective -> increase pressure)

Many thanks!!

What are your pressure settings? How do you know how high the pressure is when you wake up?. If you keep resetting the ramp to lower pressures you are just asking for a higher AHI. More leaks can mean more events.

[zonker]

Hello! Thanks SO much for this forum; I have learned so much from you all.
I've been on CPAP now for about 5 weeks. I have the first follow-up with the sleep doc next week.

why, hello! be prepared to learn more.

if you've read here before, you've maybe come across the newbie post. if not, please see the link in my signature.

we are each of us different in how we respond to cpap therapy. as you may have already read, it can take some time to get the good feels.

you may want to browse you tube and search for mask fitting videos associated with your mask.

and later, maybe download oscar and start sharing data with the experts.

good luck!

[Bednbones]

I’m with you on the problems. 4 face masks- 2 full face that leak when pressure gets close to 11. I had Ahi’s as high as 34.8. So I lowered the pressure to 9 and get 100% mask and Ahi’s of 16.3 which is a miracle for me. I play with pressure, humification, masks etc. I have cpap rhinitis and treating w Zyrtec, saline nasal sprays or nettie, and even prescription Azelastine. My eyes are dry, my ears get plugged, headaches in the morning but I feel like my sleep has improved 1000% so there is that.

Half japanese with a little nose and can get leakage there even with a small or near the mouth.

Next, upload the Oscar reports ... but hoping I can fine tune the pressure with the masks.

Still trying ....

[jillk]

Thank you!
My pressure settings are 5-20. Usually the pressure when I wake up is 10-12 or so, and I don't worry about that. Sometimes thought it's 15-17, and that's usually when I have leak problems.

[zoocrewphoto]

Thank you!
My pressure settings are 5-20. Usually the pressure when I wake up is 10-12 or so, and I don't worry about that. Sometimes thought it's 15-17, and that's usually when I have leak problems.

If you post some graphs of a typical night, you will get better advice. It sounds like your minimum is too low, but it is best to make changes based on the data.

[jillk]

Thanks, and yes I will post some results as soon as I read/learn about how to do so effectively, and figure out what a "normal" night is for me since I'm all over the map. I should also have said that I definitely have very mixed apneas. Sometimes OSA's are much higher, sometimes CSA's are much higher, and sometimes they are close.

[zonker]

Thanks, and yes I will post some results as soon as I read/learn about how to do so effectively, and figure out what a "normal" night is for me since I'm all over the map. I should also have said that I definitely have very mixed apneas. Sometimes OSA's are much higher, sometimes CSA's are much higher, and sometimes they are close.

i understand your intent. but, it's possible that you are all over the map because your therapy isn't optimized.

and we don't sleep the same every night.

now, having said THAT, i would suggest you post some charts sooner than later.

good luck!

[NoOnesPerfect]

Leaks lower the pressure at the mask level, so yes pressure will increase as the machine tries to maintain the level being delivered. For me, turning the machine off and back on again to reset to the minimum pressure has been the most effective response. Trying to reseat the mask to eliminate the leak has not worked - I am usually too groggy to do it right. Hitting the button twice is easier.

[NoOnesPerfect]

Just a thought - the leak may be happening because you are changing sleep position part way through the night. It doesn’t take much movement to break the seal.

[jillk]

Thank you!
Here are a few within the last week. Please forgive if these are not formatted as you would like...

[Dog Slobber]

I'm not convinced all those events are occurring while you are sleeping.

On every posted graph you machine has been turned on and off numerous times, and there are huge clusters at the beginning and end of the session.

There are a few occasions where your breathing is less erratic and during those calmer periods the events also reduce dramatically. I think it's a lot of SWJ (Sleep/Wake/Junk)

Do you think you're sleeping?

Your leaks are not all that bad (well within the acceptable for Respironics stye of measuring) but perhaps it's the leaks that are inferring with sleep.

[jillk]

The turning off and on are potty breaks.... Or sometimes an afternoon nap. Cause I'm exhausted.

I see the sleep doc in just a few hours with all this data, can't wait and hope it's a good appt with answers for me

[Bednbones]

The turning off and on are potty breaks.... Or sometimes an afternoon nap. Cause I'm exhausted.

I see the sleep doc in just a few hours with all this data, can't wait and hope it's a good appt with answers for me

What did the doctor say? On pins and needles ...