2 weeks on CPAP

[sleepymike]

I was diagnosed with moderate apnea that is positional and I've been on CPAP for over 2 weeks with a pressure of 8. My oxygen stayed above 90 for my study. I found this forum and learned a lot from lurking here before I met with my DME. I was able to get a CPAP with full data and that has really made adjusting to therapy easier. It's been amazing to look at what's going on with my sleep on Sleepyhead so I can tweak my treatment (C-Flex setting, humidifier setting and nasal pillow size). I think everything is going very well. Unfortunately, apnea is not a primary diagnosis for me, so I'm not going to experience any miraculous improvement in my condition until I'm able to successfully beat Lyme disease that has been hanging on for almost a year now, but anything I can do to help with the fatigue I've been dealing with for almost a year is a benefit and it sure can't hurt to eliminate the damage apnea is causing to my body.

It only took me a few days to get my AHI below 3 consistently from the 20's I had at my sleep study and it seems like I'm headed toward sub 1 this week.

The struggle I'm having is over the last week snoring has started to wake me up through the night and Sleepyhead shows me that my snoring has increased from a 1 to a 5 since I started therapy. I still don't sleep very deep at times and have some difficulty falling asleep and staying asleep because I have a lot of pain from Lyme disease. I didn't think it was possible to snore with my mouth closed, but I've accomplished it with the CPAP. The snores don't coincide with leaks and my leaks have been very minimal with only a 95% leak rate of 33 and the mask is supposed to leak 28 at my pressure, so I think I'm doing very well on that. I ordered a chinstrap to try, because I know there are a few times through the night that I am opening my mouth a little and the air leakage wakes me up.

I can see that Sleepyhead tags my breathing quite a bit with the colored squares before I snore and I can often see an irregular breathing pattern show up before it too. It also seems like Sleepyhead has been tagging more incidents in my breathing as the days progress, even though my AHI is continuing to decline. I'm amazed at how long I can go without breathing and have it not count toward hypopnea or apnea. RERA seems to go up and down, but is staying below 2 pretty consistently now.

I see my sleep doctor again next week for a follow-up and I'm wondering if upgrading to the Respironics Auto from the Pro would help to reduce the snoring problem. I'm thinking that if I can see the snore coming with Sleepyhead that maybe the machine could predict it and raise the pressure to prevent it? I don't know enough about the auto algorithms to be sure. What do you think? Any suggestions on how to convince the doctor to upgrade me to an auto, if you think it might help?

My insurance is renting the unit for 3 months and then buying it, so I can still exchange units if the doctor orders it.

Thanks for your help!
Mike

[RandyJ]

Can you activate the AutoIQ mode on your machine for at least 5 days? If you need a higher pressure due to the snoring it would find the right pressure. Otherwise you'd need to do it yourself, raising by .5 cm every 5 days or so until you find the pressure that deals with the snores. A regular auto machine would do the job as well, but your machine comes with 30 days of auto function (if you haven't used them all yet).

Of course, since you are seeing your sleep doctor you could just ask him what he thinks... He might just instruct your DME to supply an auto if you push for it; he'd probably need to give you a new script with an auto range specified in order for the DME and insurance to go along with it.

[jweeks]

The struggle I'm having is over the last week snoring has started to wake me up through the night and Sleepyhead shows me that my snoring has increased from a 1 to a 5 since I started therapy.

Mike,

One possibility is that you are actually sleeping better than before. That has the effect that you are much more relaxed when you sleep. As a result, your tissue might be a little looser, or you are sleeping a little deeper. The net effect is that your pressure need might have drifted upwards a centimeter or two. As Randy pointed out, tweaking the pressure upwards a bit might help. I noticed a few snores creeping in my data about two weeks after I got started, and bumping it up by 1 cm of pressure knocked them out.

-john-

[sleepymike]

John and RandyJ,

Thanks for the replies!

I didn't think about the reason for the snores that I was sleeping better. There is no doubt I am sleeping better when I'm able to sleep.

I don't know my doctor very well. I'll probably wait to see her and see about changes before I tinker with pressure or activate AutoIQ mode. I don't want to irritate her by adjusting her prescription without her knowledge this early on.

My cost for an upgrade to the full auto machine is only $20. If I would benefit from a full auto machine then I want to talk to the doctor about it. I just don't know whether she is one of the docs I've read about that hate auto or not. So, I really want to go to her with a good argument for the full auto - if people think a new script with an auto range would be the best choice for me.

Thank,

Mike

[RandyJ]

Mike,

I would go to that appointment with printouts of my graphs showing the snoring, stress to her that 8 cm is not taking care of business, and say you'd like a script with an auto range that would allow an apap machine to creep upwards to take care of the snoring. If you are prepared and know what you're talking about, it may get the desired result, depending on the dr.

Good luck!

PS If she doesn't comply with your wishes you can do things on your own as we mentioned above.

[sleepymike]

Wow! My sleep doc is awesome!

I went over the details of my data with her and she asked me whether I would prefer to increase my pressure or get an auto machine. She agreed with me that the auto machine was probably the best choice, but was concerned with how much more it would cost me. But, it's really not much more money than the Pro.

She had never heard of Sleepyhead software. She was told the data was proprietary so she has been relying on the DME to provide it. In any case, she will be downloading Sleepyhead to play with. She would also like me to email her my data.

Anyone have any instructions for emailing my sleep doc my data either from Sleepyhead or just the data from my Respironics card?

Thanks for all the help!

Mike

[Pugsy]

Anyone have any instructions for emailing my sleep doc my data either from Sleepyhead or just the data from my Respironics card?

I guess it depends on what she wants to see.
There is a way of just sending the contents of the SD card for import into SleepyHead but would involve some work on her end with SleepyHead. Not all that difficult but she may not want to do the work.

She might be happy with screen shots of the overview section. Send them like you would any other photos...jpg attachments.

I would ask her what she wanted. Then you can figure out the best way to send them.

[chunkyfrog]

Darling hubby would NEVER have used a straight cpap.
He couldn't stand the continual pressure.
Autoset made pappin' possible for him.
His apnea is so positional that it is almost entirely supine.

[sleepymike]

Pugsy,

She is wanting to analyze the data for herself by looking at just what I would in Sleepyhead. I copied the data from the SD card to my computer and I was thinking I could zip it and email it. I'm assuming it would work that way, but I'm not certain she will know how to unzip it. I didn't see any way in Sleepy head to export the data so it would be in the proper format when she receives it.

In the meantime I have sent her a couple of screen shots.

Thanks,

Mike