New and already getting discouraged

[GrumpyGurl]

Ok, I told myself I wasn't going to be one of the complainers, but here I am. I started my CPAP therapy last Wednesday the 6th. I thought everything was going fine, and even over the weekend I felt better, wasn't as grumpy, even caught myself laughing a couple of times. Now, for the 2nd night in a row, I am waking up during the night again and can't go back to sleep. My mask seems to be fitting well, I use the Swift LT (for her, of course!) and when I wake up it seems to be fine.

I don't know how to check my data on the machine, I know I need to get the ramp turned off because starting at 4 is like inhaling jelly. I am afraid to play with my settings since I have to download to the data card at the end of the month and take it to the DME, as required by my insurance.

So today at work I am falling asleep again, I can't keep doing this! I have been approached at work regarding a promotion, and this is a precarious time for me to be having issues!

Maybe I am just stressing about the possibility of a promotion?

Thanks for listening everyone.......that in itself is a wonderful thing.

[Sleepy Boy]

Hi G.G.: The ramp set at 4 is way to low. That's where they started me at, and I about suffocated. I have mine between 7-8 I also use the Swift LT. This cpap stuff is good a couple days and bad a few days. I never hear anyone saying "I'm doing great every night" I had 2 awesome days last Thur. & Fri. But it's been a struggle every since..You just have to "hang in there" ask for help on here often. I don't know about your machine or the settings, but someone can tell you how to look at your readings (if possible.) Larry...

[GuyK]

GG, I'd agree with Sleepy Boy. Ramping from 4 is probably way too low.

When I first started, the ramp wasn't set, and it wasn't an issue for me. I comfortably fell asleep quickly each night (and have ever since).

When it came time for my first major change (my somnodoc "ordered" a change via the DME, after a month), I tried out the ramp feature. My auto pressure (as I recall) was something like 10-20, and I tried ramping from 8.

I found that I felt like I wasn't getting any air. My experiment lasted just one night.

Guy

[DreamStalker]

Setting any machine at 4 (for ramp or otherwise) is just plain stupid ... and I bet if you change it to something different, your DME will be just as stupid to even notice. Remeber! IT is YOUR therapy not theirs. YOU have to take control!

goto this link for instructions ...

http://www.cpap-supply.com/Articles.asp?ID=130

[NRA_Bear]

Ok, I told myself I wasn't going to be one of the complainers, but here I am. I started my CPAP therapy last Wednesday the 6th. I thought everything was going fine, and even over the weekend I felt better, wasn't as grumpy, even caught myself laughing a couple of times. Now, for the 2nd night in a row, I am waking up during the night again and can't go back to sleep. My mask seems to be fitting well, I use the Swift LT (for her, of course!) and when I wake up it seems to be fine.

I don't know how to check my data on the machine, I know I need to get the ramp turned off because starting at 4 is like inhaling jelly. I am afraid to play with my settings since I have to download to the data card at the end of the month and take it to the DME, as required by my insurance.

So today at work I am falling asleep again, I can't keep doing this! I have been approached at work regarding a promotion, and this is a precarious time for me to be having issues! I could really use this new position/money!!!!

Maybe I am just stressing about the possibility of a promotion to a much more stressful and visable position? Ugh!!!!!

Thanks for listening everyone.......that in itself is a wonderful thing.

Hi GrumpyGurl,

I had pretty similar experiences when I first started CPAP back in March. I've got the same machine as you and the DME set the ramp at the same setting. I struggled with pulling my mask off in the middle of the night for the first 1.5 - 2 weeks. After that adjustment period I've pretty much slept right through the night. I had several problem nights with rain-out, but seem to have licked that by turning my humidifier down to 2 and pulling the hose under the covers with me. You may not even notice that until winter rolls back around.

You should (if the DME didn't lock it down) be able to change the ramp setting by holding the left and right buttons at the same time for 3 seconds. The first option that will pop up is "Settings." Just hit enter (left key I believe, the LCD has labels above the buttons) and use the up and down arrows to find the settings for the ramp. I turned mine completely off the 2nd night I had the machine and haven't turned it back on since. Using the ramp feature I always feel like I'm suffocating.

If the DME locked you out of changing your ramp, you can get into the Clinician's Menu by holding the down and right buttons at the same time for a few seconds. Just be careful not to change anything that you don't intend to. I wouldn't worry about catching a lecture from the DME or insurance on the ramp because it's only a comfort feature, not a therapy feature. Of course, that's only my opinion and I've got nothing to back it up with

As for looking at your data, get into the menu by holding the left and right buttons for 3 seconds (just like you did to get to settings). Hit the down arrow to get to "Efficacy Data" (I'm slightly fuzzy on the exact wording, but it's close if not correct) and hit enter to get into it. You can browse through your Leak Rate, HI, AI, and AHI data for the previous night. The data available from the LCD is cleared automatically at noon on my machine.

Good luck!!!

[JoyD.]

.
GrumpyGal,

Hey Gal, you're NOT so grumpy or complaining . . . you're merely a NORMAL CPAP NEWBY trying to figure it all out and trying to FINALLY get a good night's rest. I say "Congratulations" for that . . . you've ALREADY FOUND the best resource for CPAP help and you're taking the initiative to reach out for answers! So, good for you!!

The GOOD news is that you are definitely on your way to your goal to get a decent night's sleep so you can be awake, alert, and smiling the next day. And you WILL GET THERE The BAD news is not really so bad . . . you just have to be patient and "keep on keeping on" till you get there! Read all you can (use the SEARCH engine above with keywords), read NEW USERS & OUR WISDOM, and keep tuning in and asking questions. That's how we ALL made progress.

I'm so glad you are HERE . . . it's a great Community . . . you will pick up a LOT of helpful information and you will be encouraged that you are not alone with your problems! We really do understand.

Joy

[kteague]

Everyone's comfort level with dealing with medical providers is different, especially when cpap treatment is new and one is still testing the waters. In the big scheme of cpap treatment, changing the ramp really is a non issue. Ramp is a comfort feature, and you aren't even required to use it. I can't imagine that changing the ramp would get you in any "trouble" or make a hill of beans worth of difference to your DME or doctor. It's not like changing your treatment pressure. For one, they probably won't notice, and second, they won't care.

If they do notice, you can innocently say, "I knew I'd be seeing you in a couple of weeks, so I didn't want to bother you with something so basic that doesn't affect my prescribed treatment pressure. I wanted to be able to report some success, and I wasn't going to be able to get to the treatment pressure if I can't make it thru ramp. Now that I'm here, do you have any other suggestions that might be helpful?"

You are still very new in cpap use. Ask them to print you a detailed copy of your data when you go in, so you can go over it at your leisure and understand it. So many things can cause nighttime awakenings. Checking your data will determine if things like leaks or ineffective pressure are causing events at the time of your wakings. Are you jotting them down as best you remember to correlate the time with the reports?

Sounds like you'd be best served if you can pick your battles over what to give your attention and energies to, and worrying about having consequences to changing your ramp wouldn't be on my list. That one issue was so important in my early treatment, so I tend to get on a soapbox about it. Waiting a couple more weeks can seem like forever when one has a job requiring them to be not just employable but promotable. Let us know how things go, both with cpap and the job.
Kathy

[GrumpyGurl]

Thank you all so much for your timely and lengthy responses. I appreciate the time and thought put into each one, especially since I know how sleep deprivation makes us impatient and unable to focus. Writing these posts for us newbies cannot be entertaining for all of you and I am sure some of us NOOBs are thought to be impossible!

I used the information given here and did access the clinical settings menu last night. I changed the ramp (thanks for the encouragement) to 10mins @ a beginning setting of 8.0. That seemed to work much better. But......I couldn't stop there, oh no. Now here is where I go into land unknown. It is set on CPAP, which I left alone. It was also set to a pressure of 9, and I changed it to 10. Oh and the EPR is set on 3. I seemed to sleep a bit better last night, but that could be because I haven't sleep well the last two nights?

I also was able to access the data details from last night, I haven't looked anything up as far as what these mean yet, but thought I would throw them out there anyway.

AHI = 6.7
AI = 1.0
HI = 5.7
Leak = 0.00

Any comments are greatly appreciated.

Thanks!

[rested gal]

I used the information given here and did access the clinical settings menu last night. I changed the ramp (thanks for the encouragement) to 10mins @ a beginning setting of 8.0. That seemed to work much better. But......I couldn't stop there, oh no. Now here is where I go into land unknown. It is set on CPAP, which I left alone. It was also set to a pressure of 9, and I changed it to 10. Oh and the EPR is set on 3. I seemed to sleep a bit better last night, but that could be because I haven't sleep well the last two nights?

I think the others in this thread gave you good advice. I think you did the right thing on both counts -- raising your ramp starting pressure and raising your therapeutic CPAP pressure to 10. But I'm not a doctor!!

I also was able to access the data details from last night, I haven't looked anything up as far as what these mean yet, but thought I would throw them out there anyway.

AHI = 6.7
AI = 1.0
HI = 5.7
Leak = 0.00

I think that data for the previous night looks very, very good.
Leak rate with a ResMed machine is perfect at 0.00. You're a lucky, lucky girl!

AHI is the "apnea/hypopnea index" -- the average number per hour of apneas and hypopneas (added together) that sneaked through despite treatment.

AI is the "apnea index" -- average number per hour of just the apneas that sneaked through.

HI is the "hypopnea index" -- average number per hour of just the hypopneas that sneaked through.

I think of hypopneas as baby apneas. An obstructive apnea is complete (or almost complete) closure of the airway. Hypopnea is partial closure...still able to breathe somewhat, but not very well.

Here's an old post explaining how AHI is calculated:
Derek (an M.I.T. professor) explains how to figure AHI:
viewtopic.php?p=9427

You'll read on the message board that the "AHI" should be under 5.0. And that's what I'd want to see (AHI below 5.0) on any brand of machine other than ResMed.

If I see an AHI that's higher than 5.0 when I use a ResMed machine, but I see a very low "AI", and I see that the bulk of my AHI consists of the HI number, I mentally cut the HI number in half and re-figure my AHI. Doing that with your numbers would give an AHI of about 3.9 for that night. Very good!

Here's an old post about why I personally cut the "HI" number in half when I look at AHI, AI, HI data from a ResMed machine. Doesn't mean I'm correct about that, but that's what I do -- with ResMed data only:

High HI affecting AHI rating-Should I be worried
viewtopic.php?p=355205

Chart posted by Velbor showing the differing definitions used by the different manufacturers:
April 2, 2009
viewtopic.php?p=356255#p356255

[GrumpyGurl]

Thanks for your reply! I can tell now that I slept better last night, I have been at work since 8:30a and haven't fallen asleep yet. Yesterday by this time I had been asleep on and off all morning. It's almost 11:ooam and I am still awake. Hope this holds out!

I do have a "back of the head" headache, but I have had this for about 4 weeks now. I had hoped it would get better with CPAP, but as I feared, I think it is something neurological. I am waiting on approval for an MRI thru insurance, but I was concentrating on acquiring the CPAP and getting started on it before I started on that issue. I have an autoimmune disease that is treated by IV infusion (Remicade)every 5 weeks. So it has been hard to figure out what symptoms were from what condition.

Again, thank you for your help, I appreciate everyone here so much!