Help me please, new user, new to message board

[teresamichele]

This might be a stupid question, but since I am changing out from an Escape to an Ellite, would it be best for me to go to AN EVEN BETTER VERSION?

I know for my DME (who I actually like, most of the time), they wouldn't give me an APAP without a script from the doctor specifying that I needed one. They said they had an order for a CPAP set at 16 pressure, so I got a CPAP set at 16 pressure. At least they gave me the S8 Elite II without my having to beg!

[TylersDad]

Well guys, I got my Ellite today so I will start with it tonight.

The DME said that I would have to have a perscription for the auto unit from my Dr. He suggested that I use the Ellite and monitor my progress and if there were problems, then he would let me "borrow" an auto unit for a few weeks and take what we learn from that to either: 1) change my pressure settings, or 2) justify going back to the doctor and saying that I must have the auto unit. If #2 happened, then they would help me on the price. I thought that was a reasonable solution.

So I took everyone's advise and got the Ellite and then I went on the Australian site to order the software and they are "out of stock". My luck has been going that way today. I wonder how long they are normally out of stock before they get new stock in?

[Pugsy]

http://www.cpapaustralia.com.au/shoppin ... combo.html

The combo says it is still in stock. Wonder if they are wanting to bundle do to the number of recent US software business. Did you check it? $200 AUS is about $168 US. I would confirm that it is Australian currency being quoted. I am not sure what the card reader cost is from the states with shipping.... Don't know how much shipping from Australia is either but the software has to come from there. I don't know of another Aussie site but there might be another one. Just a thought...

But you still will have some very good information available just from the LED screen on your new machine..

[TylersDad]

The site says dollars so I figure it is in US dollars.

According to the site that just sales the card reader, the shipping is $7.99 and the flat rate from the Austrailian company is $20.00. So I guess when I do the math, it is about $23.00 difference to just buy the bundle from the one company. That was the reason I asked if they show out of stock often for just a day or two, if so, then I would just wait, but I may just go ahead and get it on order.

[TylersDad]

UPdate - I went ahead and purchased the smart card reader and software from the Australian site hoping it would ship before the weekend and it did.

I used the Ellite last night and I tried to get the information off of the machine this morning and I cant find the information. I read the book and it does not tell me. Can anyone tell me how to get the valuable information off of the unit itself since I do not have the smart card reader and software yet?

Thanks for the help!

[Pugsy]

To access the data on the LED you hold the left and right arrow buttons down for a few seconds. Use the up/down arrow keys until you see "Results" and press the left arrow key (Enter). Use the up/down arrow keys until you see "Efficiency" and press the left arrow key (Enter). Use the up/down arrow keys to scroll through the data: 95% pressure (if applicable), Leaks, AHI, AI and HI. If you back out of that menu (right arrow key), you can also check "Usage": compliance, # of hours run and duration used in the previous night. Do it before 12 Noon.

If the Therapy data has not been turned on to make it available to you then you have to go to the clinician menu and turn it on. Same area where pressure is changed so be careful.
Scroll down till you see your machine info
http://www.cpap-supply.com/Articles.asp?ID=130

[TylersDad]

Got the data, here it is:

Leak - .18 L/s
AHI - 18.3
AI - 4.5
HI - 13.8

Is there a summary somewhere that helps me interpret this data?

Does this show my machine is helping me or I still need some fine tuning?

Thanks for your help, it is greatly appreciated.

[Pugsy]

When you have time please update your user account equipment Profile to your new machine.

Your AHI is high. I don't remember what pressure you are using. Your leak is okay, not great and can be improved upon but it isn't horrible. ResMed says they can compensate fairly well for leaks up to 0.20 and they don't start talking compromising sleep or effectiveness till 0.40 L/sec. That said remember that what you are seeing report is actual leak because ResMed already subtracts the intentional leak/flow rate for the mask you choose from their menu of choices. To optimize the menu choices obviously you should have the correct choice made.
I think most ResMed users will say they will try to have as close to 0.0 leaks as possible and for sure less than 0.1.

Leaks can and will impact your therapy numbers but since yours aren't huge you may not see a huge drop in the AHI even if you get the leak cut in half. You can always try though.

This is just one night of numbers. I don't know where there might be any "summary" that explains things in great detail other than what the forum members come up with. I am assuming that you already know what AI, HI and AHI are.

You will be getting the software and then you can really see if the time in leak is allowing some events. If it isn't then if it were me I would be thinking of increasing the pressure just maybe 1 cm to start with to see if it brings down the numbers. As they stand right now, the therapy is not optimally effective. When I first started I had AHI 7-9 for a week, felt awful. Ended up increasing my minimum pressure from 8 to 10 cm and I pretty much have AHI less than 3 every night. So don't be alarmed with your current AHI, just realize that if it continues a bump in pressure may be needed. One night of numbers doesn't really give but a glimpse of the whole story but I wouldn't wait overly long before I changed the pressure either. Then again, I am pretty aggressive..... 3 or 4 nights of the same report and I would give the pressure a little nudge.. Your choice, your therapy and your body.

If you haven't already read the ResMed HI discussion, I would suggest that you do so. While ResMed does tend to score hypopneas a little more aggressively than Respironics machines, they still need to be addressed, especially when in substantial numbers. At a minimum, I would say you need to get that AHI cut in half and see how you feel then. Don't tunnel vision on the numbers, always factor in how you feel. Some people feel great with an AHI of 5, some people need less than 2 AHI to feel great, some people don't feel so great even with AHI 1. The numbers are just a starting point or guideline. There is more to feeling great than a perfect number.

[TylersDad]

Pugsy,

Thanks. I updated my profile and my pressure setting is an 8.

I will be checking the numbers again tonight.

Thanks.

[Pugsy]

I updated my profile and my pressure setting is an 8.

I was titrated to a pressure of 8. So I started my auto unit with minimum of 7 and max of 12. Ran it that way for a week till the software arrived. Felt awful the whole time and saw AHI numbers ranging from 7-9 on the LED screen. Once I got the software and looked at the reports it was very obvious that the pressure wanted to be at least 10 and often more. So I bumped the minimum up to 10 and opened up the max. It suits my own needs because sometimes I need the upper ranges and the pressure changes don't seem to bug me.

With the minimum at 10 cm, my AHI immediately was cut in half and now I average between 2 and 3 AHI. I feel the best with AHI below 1 but that is hard to come by. I am toying with increasing my minimum just a little bit more to see how I do.

You may need to increase your pressure. Give yourself a few more days of data just to be sure last night wasn't a fluke, then consider your increase.

[lazyace]

Please help.

I started with my CPAP machine about a month ago. I heard all of the stories about how "I would feel like a new man" when I started using the machine and "my bloodpressure would go down", but instead, I do not feel any better and my bloodpressure is the same or even higher.

I sleep every nite with the machine on and I do not have much trouble using it. I do not think I have many leaks during the night.

In reading posts on this site, everyone keeps talking about the software and the card reader. I will spend the money for this if it can help me, but I also thought I saw somewhere on this site where the software does no good with the S8 Escape that I have. Will someone please clear this up for me and tell me if getting the software and card reader would help me. If so, please tell me where I can get the software and the cardreader from, I have vista on my computer.

Please help!

Thank you very much! I want to feel better again.

Hey TD,

I am in the same boat, and apparently neither of us have an oar. After two weeks I feel NO better at all. In fact, maybe slightly worse. I have my first visit with my sleep doc this week, and I am hoping for some amazing revelation (or at least a little hope). Everyone that I have queried here has suggested that more time is needed to achieve results. After doing considerable research, it seems that more than three months is not unusual. Perhaps you can post some of the data from your sleep study, and some of the experts here can shed some light or offer some suggestions. There are some VERY knowledgeable folks here!

With regard to data, it is REALLY helpful. While it can make some people (like me) a little obsessive, it also provides invaluable feedback on how your therapy is working. For example, I found I was having a lot of leaks. After switching masks with some improvement, but not a lot, I taped my mouth shut to see if I was leaking through my mouth. Sure enough, I was losing a lot of air through my mouth. Rather than taping my mouth shut every night (not recommended), I searched postings here and learned that my machine has a setting called EPR. This is a feature that provides some assistance with exhalation. My DME had that set to "0" (no help). So, I went back to them (before I obtained the clinicians manual from the good folks here) and had them change it to the maximum of 3. This made an immediate difference in lowering leaks as well as my AHI. Granted, I still feel like junk, but I am still learning how to tweak the machine to achieve the right therapy.

After my study, I went to the DME and basically bought into whatever they told me. I didn't know enough about what questions to ask, let alone what machines were out there, and what their capabilities were. If it were me, I would go back to your DME or sleep doc and demand a data capable unit. In the mean time, posting some of your data might help someone here help you figure out what machine (or type) is best suited for you.

The more time you spend here, the more you will learn...I know I am.

[TylersDad]

My numbers from last night were:

Leak .06 L/s (compared to .18 night before)

AHI - 22.5 (18.3 nigh before)

AI - 6.4 (4.5 night before)

HI - 16.1 (13.8 nigh before)

I feel like crap. Does the higher numbers tell me that I should feel worse today? I have a terrible headache (like I used to have before the cpap.)

I thought I leaked a lot last night (because I awoke to leaks during the night a few times), but it looks like my leak number is down some. One question on the leak, I have the full face mask and the leaks are always on both sides of my nose. Does anyone have any tricks to resolve leaks in those areas?

I adjusted the EPR from 3 to 0 the other day, can the EPR effect leaks and/or the other numbers?

Any other thoughts?

Thanks for the help!

[WhoKnew]

Hiya TD,

I have my first month in now, and sure do know what you're going through. I don't wear the mask you have. I have a Liberty and it's working well for me. Everyone has different mask needs and preferences. Do a search here to find comments and suggestions about your particular mask. That helped me a lot. As far as your numbers, mine were high the first 2 weeks, similar to yours. I changed masks, turned off the EPR, set the humidity to the third level, and it helped a little. I then upped my pressure from 10cm to 11cm. Last night, my AHI was 5.8, with an AI of 0.6 and HI of 5.2. I'm starting to feel better.

I wonder if you need to bump up your pressure from 8 to 9 and see if it helps. I know my numbers were up and down for the first little while, but they seem to be settling into a better pattern now.

I also read here that your body needs to adjust to what you're doing. Make one change at a time, evaluate that, and then change again if needed. While some people have the immediate joy of feeling better after one night of CPAP, it seems that most people take a while to ease into this. I'm one of those. The first two weeks I felt worse, because the nasal pillows didn't work well for me, and I wasn't used to something blowing on my face. Then I changed masks, twiddled around with the machine a bit and saw better numbers. I also feel more energetic now. It's taken a month, but then, sleep apnea didn't affect me overnight either.

Good luck, keep at it and use the resources here. They help me so much. I look forward to following your progress. It's worth it.

[Pugsy]

I feel like crap. Does the higher numbers tell me that I should feel worse today? I have a terrible headache (like I used to have before the cpap.)

Yeah, bad numbers like that will usually equal feeling like crap. Heck, I had AHI of 5.2 last night and woke up with massive headache myself. Of course I have been painting inside and my neck hurt pretty bad too.

Can't help you with your mask as I don't use that kind but if you woke with a few leaks they must not have been for very long because your leak rate is much better.

I suspect you need to increase your pressure. Up to you if you want to wait till you get the software to see but if it were me I probably wouldn't wait but maybe (big maybe) one night more. Other than pressure the only other thing that might play into the picture is sleep position. I don't remember if you have mentioned position. Sometimes we have more events on our backs and sleeping on our side will help reduce the events or reduce pressure requirements.
That is also a "maybe" it will help or not.

8 cm of pressure is really relatively low. I foresee a pressure increase in your very near future. Your choice how much but at least 1 cm.

[TylersDad]

I am more confortable without a mask sleeping on my sides, however with the mask I have been sleeping more on my back (because I think it helps with the leaks). I will try to sleep more on the side.

Can someone provide the link on how to change my pressure with my machine?

Thanks for the help.