pressure went from 8 to 14 can't sleep

[judyhorowitz@aol.com]

.comAfter a second sleep study, my pressure was raised from 8 to 14. I can't seem to sleep through the night with the mask on. I have a Mirage Ultra and a Hybrid. Both burp and leak badly. I'm exhausted from not sleeping. I wake up at 2 AM and can't fall back to sleep. Should I ask the doctor to try a lower pressure?

[kteague]

Hi. Wow, that's quite a jump from 8 to 14! I do hope you are using a data capable machine. If not, you could ask your doctor to order a two week loaner of an autopap to see exactly what your pressure needs are in the home setting. If doing that, it seems reasonable that the trial period pressure range should be started at or near your original titration of 8.

Just lowering your pressure without watching the data could leave you inadequately protected. Look at both of your sleep reports to see if your apnea worsens when sleeping supine. If more of your second study was spent on your back, it could account for the titration difference. If significantly so, you take measures to stay off your back and ask your doctor about lowering your pressure to what the studies indicate would be therapeutic while side sleeping (but they may not be able to tell).

Best wishes.

[rested gal]

Hi. Wow, that's quite a jump from 8 to 14! I do hope you are using a data capable machine. If not, you could ask your doctor to order a two week loaner of an autopap to see exactly what your pressure needs are in the home setting. If doing that, it seems reasonable that the trial period pressure range should be started at or near your original titration of 8.

I agree with Kathy. That's a HUGE difference in titrated pressure from one study to another.

Since you're having problems handling the much higher pressure of 14, I'd definitely ask for a home titration trial with an autopap. Kathy is absolutely right, imho, that if you do get to do a home trial with an autopap, the minimum pressure for the autopap ought to be set no lower than 7 or 8 cm H2O.

Many times, doctors think a home titration trial with autopap should be done at a wide open pressure range of 4 - 20. The full range the machine can use.

I think "wide open" trial is a mistake. Especially when someone already has been prescribed a pressure at one time, like your pressure of 8. I think it's better to set the minimum at, or fairly close under, the previously prescribed pressure, if that previously prescribed pressure happens to be under10 cm H2O.

So, an autopap trial with a range of 7 - 20 would be what I'd do, if it were me. I'm not a doctor, though!!

What was the reason a second sleep study was ordered for you, Judy? How long had it been since your first sleep study? Had you gained a significant (25 lbs or more) amount of weight since your first sleep study?

[LSAT]

To Judy......Just courious why you have posted under 12 different names...Hard to keep track of your experiences.

[Wulfman]

To Judy......Just courious why you have posted under 12 different names...Hard to keep track of your experiences.

All those identities are the ones who use the same Internet provider when a person "guest" posts......with AOL, there's a much longer list.


Judy,

I'd recommend taking your machine back down to about where it was and gradually increase the pressure.....over maybe a week. I remember (way back in time) when I increased my pressure from 10 to 12 (in one night) and I had a bit of trouble getting to sleep that first night. The next night wasn't bad at all.


Den

[hikewv]

I was started out needing 17cm on 15cm now, and It did take awhile to get use to that pressure, I would wake up multiple times at night and also have back pain in the mornings since my muscles around lungs were working more. But it took me about a month to get use to the pressure and back pain went way about the same time.

[judyhorowitz@aol.com]

Thanks for all your advice. I spent the day calling my sleep clinic/doctor. FINALLY, I got through to the assistant who talked to the doctor who looked again at my sleep study and agreed to lower the pressure to 11. The homecare nice man just left. I sure hope I sleep tonight. It's been rough.
I had the second study since all my reports from the last 6 months showed that I was still having events and leaks. After the first visit, I changed masks, but had the same results. This has not been an easy road for me, but i'm determined that it will work. Now if I could only solve the nose bridge issue and dry mouth problem. The pad a cheek caused leaks.
I had no idea I had all those usernames. Never noticed.

[Wulfman]

Thanks for all your advice. I spent the day calling my sleep clinic/doctor. FINALLY, I got through to the assistant who talked to the doctor who looked again at my sleep study and agreed to lower the pressure to 11. The homecare nice man just left. I sure hope I sleep tonight. It's been rough.
I had the second study since all my reports from the last 6 months showed that I was still having events and leaks. After the first visit, I changed masks, but had the same results. This has not been an easy road for me, but i'm determined that it will work. Now if I could only solve the nose bridge issue and dry mouth problem. The pad a cheek caused leaks.
I had no idea I had all those usernames. Never noticed.

What machine do you have? Change the pressure yourself.

Also, what mask?


Den

[judyhorowitz@aol.com]

I have a Hybrid and a ultra Mirage FF mask. I have a Respironics Pro M machine. After a most annoying day, I finally got a new prescription from the doctor to change the pressure to an 11. The therapist kindly came and changed it. I have to be his most challenging patient. Slep decently last night. Felt much better on the lower pressure. Hope it continues.

[Wulfman]

That's good to hear. Your machine if fully data-capable. If you were to get the Encore Viewer software and card reader, you could monitor your own therapy and see how you're doing. That would save a lot of hassle with the doctors and DMEs.


Den

[BleepingBeauty]

Thanks for all your advice. I spent the day calling my sleep clinic/doctor. FINALLY, I got through to the assistant who talked to the doctor who looked again at my sleep study and agreed to lower the pressure to 11. The homecare nice man just left. I sure hope I sleep tonight. It's been rough.
I had the second study since all my reports from the last 6 months showed that I was still having events and leaks. After the first visit, I changed masks, but had the same results. This has not been an easy road for me, but i'm determined that it will work. Now if I could only solve the nose bridge issue and dry mouth problem. The pad a cheek caused leaks.
I had no idea I had all those usernames. Never noticed.

Hi, Judy. For the nose bridge irritation, have you tried moleskin? It helped me get used to my FullLife FFM (after using nasal pillows for about 18 months, meaning I wasn't used to anything putting pressure on the bridge of my nose). It's very comfortable (apply it to the mask, not your skin) and allowed me to sleep through the night without creating a pressure sore on my nose. After almost seven weeks, I'm now able to use my mask without the moleskin. (Took awhile, but I was determined, since this mask is giving me the best therapy I've ever had. I was prepared to use moleskin forever, if need be.) You can find moleskin at most any pharmacy (or even grocery stores with pharmacy sections) near the Dr. Scholl's products.

The dry mouth issue might be helped by increasing the level of humidity. But if you're mouth-breathing all night, chances are you'll still have dry mouth, even with higher humidity. Try to breathe only through your nose, even with a FFM.

Some people use a product designed to keep the mouth moist (I think it's called Biotene). Or you could tape your mouth. Or the use of a chinstrap might remind you to keep your mouth closed.

There ARE solutions; just have to figure out what works for you. HTH