Adventures of a human guinea pig

sleepyWI · Post by **sleepyWI** » Thu Jan 25, 2007 7:41 am

Background: In January I had my 3 month followup with my sleep doc (a neurologist with certification in sleep medicine). I complained to him that my therapy was not working, I was still tired all the time, even moreso than prior to cpap. I threw out several ideas, a new sleep study, home titration, apap and he said no....lets just wait 3 more months.

So ... I went to my DME and was able so swing a free 2 week loan of an Autoset Vantage to collect some data with. The RT set it up for me at my prescribed pressure of 7 (incorrectly it turns out). I did not tell her that my plan was to re-titarate myself.

My Experiment: I tested myself for several nights each at a variety of constant pressures and got the AHI data from the readout in the morning (I don't have the software). At the end I tested myself got 5 nights on apap with a pressure range of 5.6 to 12.6. I came up with this range using an equation from a medical journal article on auto-titration. My results are in the chart below.

I pretty clearly have a "sweet spot" at cpap of 8.2. My results on apap were no better on average and I had some bad nights mixed in. I have returned the apap to the DME, set my cpap on 8.2 and am having long involved dreams for the first time in ages.

Lesson: TAKE CHARGE!

Nitro Dan · Post by **Nitro Dan** » Thu Jan 25, 2007 12:21 pm

Aside from the dreaming, do you feel more rested?

sleepyWI · Post by **sleepyWI** » Thu Jan 25, 2007 12:50 pm

Honestly I need a nice long sequence of nights now at my new pressure to tell how it will work out in the long run.

An aside.....when I returned the machine I did tell my RT what I had done. Her response was "your doctor is not going to be happy about this". My response .... "its not his happiness that concerns me"

Nitro Dan · Post by **Nitro Dan** » Thu Jan 25, 2007 12:56 pm

sleepyWI wrote:"its not his happiness that concerns me"

Atta boy! Sounds like you should be on your way!

Wulfman · Post by **Wulfman** » Thu Jan 25, 2007 1:04 pm

Nitro Dan wrote:
sleepyWI wrote:"its not his happiness that concerns me"
Atta boy! Sounds like you should be on your way!

DITTO!!!

Den

Rabid1 · Post by **Rabid1** » Thu Jan 25, 2007 2:59 pm

[quote="sleepyWI"]Lesson: TAKE CHARGE!

bookwrm63 · Post by **bookwrm63** » Thu Jan 25, 2007 3:20 pm

Hope it all works out well for you! Good luck!

Mary

cpapqueen · Post by **cpapqueen** » Thu Jan 25, 2007 3:51 pm

Please be careful when increasing your own pressures....too much pressure can cause heart arrhythmias. Consult your sleep study to see if you were tested at the higher pressure.

Also when you did the self titrate...did you change the mask feature on the machine to the interface you were using??

sleepyWI · Post by **sleepyWI** » Thu Jan 25, 2007 4:13 pm

I was titrated in my sleep study up to about 12 if I remember correctly and purposely did not exceed that. My auto pressures never went higher than about 10. Since I was not using a Resmed mask there was no option to select other than "Standard Mask" which is what I did. (I used a CL2 exclusively for this). I was pretty conservative on the whole. It is interesting that some "supervised" home titrations that I have read about on here have used apaps set wide open from 4-20.

ColoZZZ · Post by **ColoZZZ** » Thu Jan 25, 2007 6:31 pm

Is the journal article available freely online or could you send a copy to interested parties via the net?

NightHawkeye · Post by **NightHawkeye** » Thu Jan 25, 2007 9:05 pm

cpapqueen wrote:Please be careful when increasing your own pressures....too much pressure can cause heart arrhythmias.

Where did you learn this information? Can you provide a reference?

Regards,
Bill

russpat · Post by **russpat** » Thu Jan 25, 2007 9:29 pm

I have been on my CPAP machine for one week and was able to sleep pretty much through the night from the beginning except for some rainout problems which I am still working on. You mentioned that you are having long involved dreams. I very seldom dream, almost never in color, and when I do, they are very short. Will the CPAP therapy help increase dreaming?

sleepyWI · Post by **sleepyWI** » Fri Jan 26, 2007 6:28 am

I am finding this to be true. My dreams were often short and fragmented, I guess becasue of being aroused by the apnea. Now am starting to have long "stories" that go somewhere ... interesting. Others have reported on here similar things.

sleepyWI · Post by **sleepyWI** » Fri Jan 26, 2007 6:41 am

ColoZZZ wrote:Is the journal article available freely online or could you send a copy to interested parties via the net?

The article is freely available here:

http://ajrccm.atsjournals.org/cgi/content/full/162/1/94

To use the equation you need your Body Mass Index (%), neck circumference in centimeters and your untreated AHI. In my case it overestimated the needed pressure (9.6 vs. my new value of 8.2) but I think it is a reasonable starting point. Once they determined this pressure they set the upper limit plus 4 cm H20 and the lower limit -3 cm H20.

Mask

Additional Comments: I love my ComfortSleeve and my Pad-A-Cheeks! See www.ComfortSleeve.com and www.padacheek.com

Adventures of a human guinea pig

Adventures of a human guinea pig

Re: Adventures of a human guinea pig