First week on CPAP

[elessadil]

Well I have had full week on CPAP and I have to say I have noticed a difference already. I am not so groggy and foggy and don't want to sleep so early in the day. I seem to be one of the lucky ones who took to the therapy like a duck to water and I seem to have found a good mask right off the bat. I just wish I had done this sooner.

If you read my earlier posts you'll know that I went out and bought myself a used machine as it looked as though I might not get one for a few months and I just wasn't willing to wait that long. I finally got my prescription from the Dr, but only because I complained about the fact that I was going to have to wait 2-3 months for it because of vacations and the lack of backups to replace those on vacation, but I won't get my unit for another week as that was the first appointment I could get with the supplier. I am only getting a CPAP machine as here in Canada you have to meet certain criteria in order to get an APAP machine covered by OHIP. At $2300 for the unit, which I could buy out of pocket, I really can't afford that right now. Using the APAP I bought I was self titrating and the 95% pressure has been around 9cmH2O. The prescription the Dr wrote is for 12cmH2O on straight CPAP. This is a bit higher and I am wondering why the difference? Is it because on straight CPAP that is what it took to lower my events to acceptable level?

Last night was my worst night since I started therapy. The only difference is that I changed the size of the pillows I am using. Went from small to x-small. They fit me sooo much better. I also went from using the Swift FX Bella Loops to Swift FX headgear. Not sure if this would have any effect or if I was just having a bad night. Having said that though I did feel OK when I woke up this morning, better than when I wasn't on therapy, and I don't remember having a bad night as far as arousals go. So all in all I guess even if the numbers don't look the best, the fact that I feel OK is more important. My AHI is still way below acceptable levels.

Here's my data from last night:

[Pugsy]

Often time when pressures are prescribed they tend to offer the worst case scenario pressure. That may account for the difference in what was finally prescribed and what you are seeing. I wouldn't worry about it.

You will find as time goes by you will have nights where maybe things don't look so great on paper but you feel you slept well and feel quite decent despite an ugly report.

I normally have rather boring reports and my pressures don't vary much but last night something was different and it sure shows on my reports. A lot more obstructive type of events and my pressures which normally barely fluctuate very much were quite exciting and I hit nearly 20 cm last night for my IPAP which for me is a 6 cm increase...big change. AHI was double what it usually is...even though even doubled it was still under 5.0 but for me a generally less than stellar report. I slept well though and feel quite decent today.

[hueyville]

Your worst night is better than my best night in 2.5 years. I am envious. I have yet to have a night with an AHI less than 10 as I can't tolerate the pressure they want me at of 21cm yet.

[alphawaves]

Well I have had full week on CPAP and I have to say I have noticed a difference already. I am not so groggy and foggy and don't want to sleep so early in the day. I seem to be one of the lucky ones who took to the therapy like a duck to water and I seem to have found a good mask right off the bat. I just wish I had done this sooner.

If you read my earlier posts you'll know that I went out and bought myself a used machine as it looked as though I might not get one for a few months and I just wasn't willing to wait that long. I finally got my prescription from the Dr, but only because I complained about the fact that I was going to have to wait 2-3 months for it because of vacations and the lack of backups to replace those on vacation, but I won't get my unit for another week as that was the first appointment I could get with the supplier. I am only getting a CPAP machine as here in Canada you have to meet certain criteria in order to get an APAP machine covered by OHIP. At $2300 for the unit, which I could buy out of pocket, I really can't afford that right now. Using the APAP I bought I was self titrating and the 95% pressure has been around 9cmH2O. The prescription the Dr wrote is for 12cmH2O on straight CPAP. This is a bit higher and I am wondering why the difference? Is it because on straight CPAP that is what it took to lower my events to acceptable level?

Do you trust your APAP? You have on your profile a CPAP but you referred to having a APAP before? $2300.00 Canadian dollars?!!!! What brand is that? Anyways, would you tell us what was the pressure plateau time (%) during the 4-5 hour therapy? are you able to get that number? I've just posted something I think you should take a quick look at. Other thing though... a CPAP is like a robot trained to do the same thing all the time. APAPs are a little bit smarter than that. They react accordingly to the software based on criterions represented by the manufacturer. Not all of the criterions are exactly the same and that is why the battle between APAPs is lauder than between APAPs versus CPAPs. One thing is clear: APAPs whether they follow different criteria to "fix" or "act" on an event of apnea or hypoxia the results in LAB are similar and clearly superior to what CPAPs are capable of achieving. The doctor put you on 12 cm/h20 maybe because when an apnea event occurs that is the pressure that could fix it. It doesn't mean that you need to be tortured to accept and endure such high pressure all night long >even when there is no reason to worry about apnea<
Sometimes apnea events are linked to REM sleep stages or bed positions or even the size of the pillow. but those factor come and go and you neither keep the same posture on bed nor have REM sleep all the time. It would have been easier for them and for us if that would have been the case... but it's not! APAPs are capable to "sense" the difference by the minute and choose the right movement to make in order to stop the apnea from present itself causing the damage to the brain we all are aware of.

Anyways, if you Pressure Plateau Time is higher than 10% elevate the 9 cm/h20 you saw in the 90th and 95th percentile pressure a little bit.

thanks

Last night was my worst night since I started therapy. The only difference is that I changed the size of the pillows I am using. Went from small to x-small. They fit me sooo much better. I also went from using the Swift FX Bella Loops to Swift FX headgear. Not sure if this would have any effect or if I was just having a bad night. Having said that though I did feel OK when I woke up this morning, better than when I wasn't on therapy, and I don't remember having a bad night as far as arousals go. So all in all I guess even if the numbers don't look the best, the fact that I feel OK is more important. My AHI is still way below acceptable levels.

Here's my data from last night:

[elessadil]

Your worst night is better than my best night in 2.5 years. I am envious. I have yet to have a night with an AHI less than 10 as I can't tolerate the pressure they want me at of 21cm yet.

Wow!!! That is a high pressure. I feel for you. Hopefully you will be able to work your way up to it.

Do you trust your APAP? You have on your profile a CPAP but you referred to having a APAP before? $2300.00 Canadian dollars?!!!! What brand is that? Anyways, would you tell us what was the pressure plateau time (%) during the 4-5 hour therapy? are you able to get that number?

Yes I do. The person who has it previously took very good care of it and it only had 1100 hrs on it when I bought it. My profile says Resmed S9 Autoset CPAP . Autoset is the key. $2300 is what you pay here in Canada for an APAP unit w/ humidifier and climateline hose. I haven't yet been able to get a copy of my sleep study or the titration study, but I am working on it.

The doctor put you on 12 cm/h20 maybe because when an apnea event occurs that is the pressure that could fix it. It doesn't mean that you need to be tortured to accept and endure such high pressure all night long >even when there is no reason to worry about apnea<

I agree, but I will have to try it as I am on a month's trial with the CPAP, when I get it, and at the end of the month they will send a report to the Dr and if necessary then changes will be made before I buy the brand new CPAP.

Anyways, if you Pressure Plateau Time is higher than 10% elevate the 9 cm/h20 you saw in the 90th and 95th percentile pressure a little bit.

Not sure what you mean by that.

[jweeks]

... I can't tolerate the pressure they want me at of 21cm yet.

Hi,

21 cm can be difficult to deal with. I was on 14/20 on BiPAP for a number of years. Are you doing BiPAP or ASV, or trying to do 21 cm on straight CPAP? If you don't have one of these more advanced machines, consider talking to your doctor about getting one--they can be much easier to breathe from. I did go through a period of time where air ingestion was a problem for me. I never did find a solution other than backing down on the pressure (which I was able to do after some additional weight loss).

-john-