Newbie

[marvod]

Hello everyone, my name is Mark and I have Sleep Apnea. It’s been 3 ½ months since my fist sleep study. I’ve been lurking on cpaptalk for awhile and decided it was time to ask for info. I have tried searching and have found a wealth of information here. I have definitely come to the right place. I first give my sleep study info then move on to my questions. Thanks for you patience.

Diagnostic Analysis:
Sleep efficiency reduced at 80% for 361 minutes of sleep
Onset of sleep normal at 4 minutes
Onset of REM severely prolonged at 248 minutes
Awakenings elevated at 39
Arousal index mildly elevated at 17

Sleep Staging: Absence of slow-wave sleep. Marked reduction in REM to 9%

Apnea-Hypopnea Index:
Mildly elevated at 8
Non-REM 5
REM 31
Supine 12
Non-Supine 7

40 obstructive hypopneas. Mean hypopnea was 25 seconds, longest was 66 seconds. That is the part that scared the hell out of me. I dont think I can hold my breath that long when I'm awake.

Assessment Axis A
Obstructive sleep apnea mild, but in REM severe.

So in my second sleep study they found that 10cm would be a great place to start. My DME is worthless and I’m forced by insurance to go through them. My first machine was a Respironics Remstar M-series Plus. I also received a Respironics comfort gel mask. Not a lot of talking went on with the DME. They just handed me the bag and showed me how to put it on. Needless to say my first month was pretty bad. I don’t think I wore the mask for more then 1 hour a night. That’s when I turned to the internet and found this site. After talking to my dr and discussing what I had found out, we decided to try a APAP machine with humidity. I now have a Respironics M-series auto with c-flex with humidifier.

This made a big difference. Much easier to sleep with this machine and no sore throat in the morning. I still hated the mask and was only using it about 2 hours a night now. After more research on this website I decided to try the Swift II and found a great deal on the auction side. Needless to say I am a happy camper now. Sleep through most nights and have my average sleep time with CPAP up to 6 hours I think.

As I mentioned before, this website has been a god send. I have learned more here then any other site I have found. Thank you everyone for all the information.

I have finally received my smartcard reader and Encore viewer software and have started taking a look at my progress. Ok, I really have no clue as to what I am looking at. I was hoping to find a Primer or something on this site that would explain the different categories and what is considered normal or average. My searches have reveled some answers but no single source of info. Is there such a document? I’ve posted the PDF on my website if anyone wants to take a look and help a fella out. Does it look like I’m doing ok or am I missing something? It only includes the time since I started with the swift II. I feel a little better but still a little tired during the day.

One of the other issues I have is of course a deviated septum and enlarged turbinates. It’s hard to do APAP when you can’t breathe through your nose. I have surgery scheduled for November 28th and I’m really looking forward to breathing better. I’m very confident I will still need APAP but this is the first step. Losing weight is the next.

Thanks for letting me ramble. I hope to be more active on this site now that I’m armed with all my weapons. I’m really sad that I did not get picked for the product challenge, Bravo vs Swift. I think that would have been a great thing to try.

So take a peek if you like and let me know if I’m on the right track. Point me to more info if you know where it is. I won’t be offended if you slam me for not finding it on my own searches.

Thank you,
Mark Vodka
http://www.markvodka.com/swift2.pdf

[Wulfman]

Hi Marvod.

Welcome to the forum.

I'm surprised that your AHI is as low as it is considering the fact that your machine is set wide open (4 - 20 cm).
I would suggest starting to move your bottom pressure up some.....maybe to at least 6 cm. and then see how that looks on the reports.

As far as guidance on how to read these reports, basically it's a matter of getting your "numbers" as low as possible and your leak line as flat as possible. Finding the right mask and pressure settings can be a challenge at times.

Best wishes,

Den

[ozij]

Hi Mark, and welcome.
You are very much on the right track.

I too would raise the bottom pressure a bit. It might get rid of some of those snores and hypopneas, and might have you feeling even better.

I wouldn't worry about the top of the range since you breathing pattern isn't driving the machine too high. In your 2 weeks on the auto you hit a maximum pressure of 10 (or more) on 2 nights- and I guess you needed it on those two. Most of the time you don't - no wonder you were miserable with a straight pressure of 10!.

The 90% number is the pressure at or below which you spend 90% of your time.

If you look at the tables beneath the daily details screen, you'll see that on most days, your FL (flow limitations) become distinctly and consistently less at a pressure of 7.

Flow limitations can be precursors of apnea or hypopneas - so my guess is you'll do best with your bottom pressure at about 7.

You don't have to rush to make the change, do it gradually if you find it bothersome in the beginning - but aim for it.

Good luck!
O.

[rested gal]

That was an excellent post you wrote, Mark. It helped a lot that you put your Encore Viewer results up.

I agree with Den and ozij... I'd raise the minimum pressure. I'd put the minimum at 7 or 8. At the very least I'd raise the minimum to 6. Top can stay where it is at 20.

Your first experiences with the DME were the same kind of things that so many new cpap users go through, unfortunately. Few and far between are the ones like you who go looking for more information about how to make it work. Most probably just take it for granted that what the DME gives them is "what the doctor wants me to have" and never question anything.

No wonder there's such a high dropout rate. Good thing you were determined to make it work and started searching. Glad to see you found your way here!