Hi It's been 9 days since I got my Resmed S8 Vantage and Swift nasal pillows.
I drift asleep and then awaken 5 to 20 minutes later. I do this over and over again for as long as I can take it before I give up. Usually an hour, sometimes up to 3 hours. Each time I awaken it's on a very deep inhale and I feel really alert afterwards (which makes it tough to get back to sleep).
My range is large (4-18) because I didn't have a titration study. I'm supposed to be titrating at home but obviously that's not happening.
I boosted my lower range to 5.5. I have tried zero settling time and 45 minutes settling time.
Heated humidifier and no humidifier.
I started taping my mouth to be sure I'm not having mouth leaks.
I'm taking sleep aids.
I tried falling asleep on my back and falling asleep on my side.
I put in ear plugs in case it was the noise of me inhaling that was waking me up.
I've been sitting awake with it and watching TV 1-2 hours in the evening.
I don't know what else to do, outside asking for another machine. And maybe this is the next step. But I thought I'd ask here to see if anyone else has been able to solve this problem.
Last night I did 35 minutes settling at a base of 5.5. Slept for 15 minutes and woke. Then 10 minutes later fell back asleep and 20 minutes later woke up again. Settling time was over by then and my machine was up to 6.6. 0.0 AHI.
Is my brain just not grasping that it's okay to have air rushing down my airway? I feel like my inhales are much deeper than my exhales, if that makes sense. And that the motion of inhaling so deeply is waking me up?
I dunno. My positive attitude is starting to wane. Jenny
More ideas on how to fall and STAY asleep with Autopap
Perhaps that is the problem. With that machine, you are not getting exhale relief in the Auto mode. Only in the cpap mode.I feel like my inhales are much deeper than my exhales
Too bad they didn't start you with the Remstar Auto with cflex. Perhaps you can ask to switch machines and then see how you do.
_________________
| Machine: DreamStation Auto CPAP Machine |
| Humidifier: DreamStation Heated Humidifier |
| Additional Comments: Compliant since April 2003. (De-cap-itated Aura). |
You don't state what you pressure is suppose to be. I have an S8 Escape so I don't have any options. But I'm getting the S8 Vantage and have read up about it. May be you should try the EPR instead of the Auto. As some people have noted in this forum, they do better on CPAP opposed to APAP. I would give that a try before giving up. Good luck to you tonight!
Caty
Caty
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jrgood27
pressure is not set yet
That's the second time I tried to type eighteen and it made a smiley!
So, yes I don't have a set pressure yet b/c I'm supposed to be titrating at home. I'm at 6 to eighteen at the moment.
Why on earth did they design the Vantage so that you can't use EPR on Auto. Bit of an oversight there!
Well, maybe I will pick a pressure and use CPAP and just see if EPR helps. I didn't think at such low pressures it would make any difference.
I'm sure my RT will be thrilled that I learned how to change my settings by myself! And I have you all to thank.
Jenny
So, yes I don't have a set pressure yet b/c I'm supposed to be titrating at home. I'm at 6 to eighteen at the moment.
Why on earth did they design the Vantage so that you can't use EPR on Auto. Bit of an oversight there!
Well, maybe I will pick a pressure and use CPAP and just see if EPR helps. I didn't think at such low pressures it would make any difference.
I'm sure my RT will be thrilled that I learned how to change my settings by myself! And I have you all to thank.
Jenny
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Darth Vader Look
- Posts: 411
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Re: pressure is not set yet
It's not the 18 that is causing the smiley. It is the 8 and the right curved bracket. For example type in an 8 followed by the right curved bracket ) in a post and preview it and this is what you getjrgood27 wrote:That's the second time I tried to type eighteen and it made a smiley!
Jenny, I thought you wrote before that you were at 4 - or did you just bump it up today?jrgood27 wrote:That's the second time I tried to type eighteen and it made a smiley!
So, yes I don't have a set pressure yet b/c I'm supposed to be titrating at home. I'm at 6 to eighteen at the moment.
Why on earth did they design the Vantage so that you can't use EPR on Auto. Bit of an oversight there!
Well, maybe I will pick a pressure and use CPAP and just see if EPR helps. I didn't think at such low pressures it would make any difference.
Also, I'm not sure you should switch it to cpap, because you have no idea what pressure to use. And, who says you are at a low pressure? You might be running at a high one.
I still say you should ask the DME to switch you to a Remstar Auto with a low setting of 6 or 7.
_________________
| Machine: DreamStation Auto CPAP Machine |
| Humidifier: DreamStation Heated Humidifier |
| Additional Comments: Compliant since April 2003. (De-cap-itated Aura). |
Waking Up Repeatedly
Hi. I can share some helpful suggestions others here gave me. First, raise your lower number. It may be you are not comfortable or feel you're not getting enough air if too low. Since you apparently upped it to six, that's probably not the issue, but I raised mine to seven and it's working for me. Also, if you narrow your range it may function better. Lastly, could you be waking up due to other causes? My Periodic Limb Movement Disorder when untreated caused me to wake up every few minutes. If you've been told you kick in your sleep, or if you sleep very restlessly, or if your bedding is in disarray every morning, you will need that investigated. A good place to start is to videotape yourself sleeping. Hope you find answers soon.
Kathy
Kathy
_________________
| Mask: TAP PAP Nasal Pillow CPAP Mask with Improved Stability Mouthpiece |
| Humidifier: S9™ Series H5i™ Heated Humidifier with Climate Control |
| Additional Comments: Bleep/DreamPort for full nights, Tap Pap for shorter sessions |
I can see where this might be hard not knowing what minimum and maximum number to go with. Originally I had a CPAP with a setting of 13. Then I got the same machine you have and they set it for 8 to 17. I find that 8 is barely enough. I've been using a Swift Mask and it's 95% pressure was 15.2 to 17.2 or less during the night. I just switched to Aptiva because of sore nares and my max pressures last night was 9. Wow! I was shocked! And from 8 to 9 it seemed louder and SEEMED like it was pushing MORE pressure than usual. But it wasn't. And I slept like a baby and awoke feeling more like how I felt when I very first started on CPAP at setting 13.
Do you feel relaxed when you're going to sleep? That's a side question. Between some very mild claustophobia and just getting used to air going up my nose all the time when I'm a mouth breather was interesting to say the least. But even during my sleep study I decided I was going to make this work one way or the other. In the past after both my parents died a couple of years ago I started having panic attacks and I've had them other times after a surgery. So, it's easy for me to completely have one with this new experience but I just relaxed and told myself I'll be just fine no matter what as long as I make it work and it worked! For others it's not so easy.
Raising your minimum pressure up might help. Your top pressure is fine but you'll want to start looking at your results to find your ideal pressure range. Mine is set 8 to 17 and I've seen it low even on the Swift but I atleast had some idea of what was going on with the maximums that were needed based on the mask at the time. If you change masks your pressure could likely change. Mine did. I hope you figure out why you're waking up so you can actually use the machine. And no matter what brand you go with, I wish you success.
Do you feel relaxed when you're going to sleep? That's a side question. Between some very mild claustophobia and just getting used to air going up my nose all the time when I'm a mouth breather was interesting to say the least. But even during my sleep study I decided I was going to make this work one way or the other. In the past after both my parents died a couple of years ago I started having panic attacks and I've had them other times after a surgery. So, it's easy for me to completely have one with this new experience but I just relaxed and told myself I'll be just fine no matter what as long as I make it work and it worked! For others it's not so easy.
Raising your minimum pressure up might help. Your top pressure is fine but you'll want to start looking at your results to find your ideal pressure range. Mine is set 8 to 17 and I've seen it low even on the Swift but I atleast had some idea of what was going on with the maximums that were needed based on the mask at the time. If you change masks your pressure could likely change. Mine did. I hope you figure out why you're waking up so you can actually use the machine. And no matter what brand you go with, I wish you success.
_________________
| Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier |
| Mask: Eson™ 2 Nasal CPAP Mask with Headgear |
| Additional Comments: EPAP: 8 IPAP: 15 PS: 3.0 |
After reading several of your posts, I see the following issues:
1- you are unsure of your machine's settings and are all over the board on where to start or set it. Some advice your getting may be making it worse.
2- you are having difficulty falling and staying asleep.
3- you may be having other issues adding to the insomnia such as stress, anxiety and/or muscle pain for example.
Here's what I'd do:
Set up the machine with some basics known to work: I would set the machine to auto mode with a 30-minute Settling timer. The Settling feature is a feature supposed to allow you to fall asleep before therapy actually kicks in where it then increases pressure in response to SDB events.
If you don't fall asleep in the alloted 30 minutes Settling time frame, you can always hit the button again and it restarts the clock from zero again. You can hit that button as many times as you wish in order to fall asleep.
If you are waking up BEFORE that 30-minute timer elapses then shorten the timer (do not extend it).
Set the correct pressure range: I would set your bottom pressure to 6cm and the high pressure to 16cm (i.e. range = 6cm to 16cm). I don't recommend using ANY of the available cpap/epr modes on this machine until you know for sure your exact 95% pressure. I also don't recommend a pressure range any higher than 16cm due to the way that machine functions (can only increase by 10cm from the low) and to avoid any pressure induced central apneas. Let the machine flat-line and indicate it needs to increase pressure beyond 16cm. The worst that can happen to you is it wakes you up.
If your not starving for air using 6cm after first turning on the machine, then leave the bottom pressure set at 6cm. That is a good starting pressure. This will keep the pressure low so you can more redily fall asleep. So for the first 30-minutes the machine will run at 6cm pressure, then after that period of time therapy will begin and it will "start" to respond to any flow limitations, snores or apnea events seen. Hopefully you will be asleep in REM by that time.
Note: with a Settling feature enabled, should you fall asleep and have an apnea event say in 20-minutes, the machine will NOT respond to said event, meaning you could awaken gasping for air and rip off the mask (like you do in 15-minutes??). So if that happens, you want to LOWER the Settling value to say 20-minutes and/or even disable it. I suggest leaving it enabled until you get used to things, it does work good and will only help with getting you to sleep. Optionally, you can increase the bottom pressure from 6cm to 7cm (I wouldn't increase any more than 1cm at each attempt, go too far and you'll impact getting to sleep).
If your using the heated humidifier I wouldn't increase it beyond a setting of 2 for starters. If the incoming air is too cold then turn it up, but if the incoming air is warm enough yet you feel stuffy or water droplets begin forming in the mask then turn it down or even off. The setting you use depends on the humidity level where you reside.
I also suspect your problem may be severe sleep deprivation or lack of deep and/or REM sleep. REM may have been absent for so long that when you hit it now it is almost alarming or startling to you so it kicks you back to Stage1. All you can do is keep trying.
So set some good basics on the machine so YOU know it is set up correctly, and use it. Then try and resolve all the little items bothering you one-by-one, write them down if you need to. Make sure your pilliow is correct and if you sleep on your side do so on the edge so you can hang the mask off the pillow. If its hot put a fan in the room (those vertical Bionaire ones from Costco for $50 bucks work pretty good are very quiet and have remote control which is cool).
The mask interface you have may seem less confining, but it is also very noisy from the get go. So that interface may be making your cpap life more difficult to sleep. I would have suggested a good nasal mask like a Activa or UltraMirage2 nasal mask instead. These diffuse the air better before it enters the nares and are much quieter than the swift.
Allow yourself a good 4-6 weeks of using the machine and getting used to the mask. If you can only use that machine for 1 hr per night, so be it, one hour is better than none, but don't allow it to prevent some sleep. It takes time but you'll get over the hump. Once you do, you'll awaken after 7hrs or so of sleep with your toes tingling and feel good for a change.
If you have any leg, back or other muscle pains be sure to take something to address that pain as it can interrupt your sleep. I have taken an Aleve and it works very well. If you cannot get to sleep with the machine, don't worry about it, remove it sleep on your side or stomach and try and get some sleep if you can. Sleeping in a recliner can help. I've had some of my best sleep on this big ole leather couch.
Lastly, don't worry about your numbers or pressures. Your goal should be sleeping until morning, those AHI scores and numbers are meaningless to you at this point. the machine is recording everything so don't worry about.
1- you are unsure of your machine's settings and are all over the board on where to start or set it. Some advice your getting may be making it worse.
2- you are having difficulty falling and staying asleep.
3- you may be having other issues adding to the insomnia such as stress, anxiety and/or muscle pain for example.
Here's what I'd do:
Set up the machine with some basics known to work: I would set the machine to auto mode with a 30-minute Settling timer. The Settling feature is a feature supposed to allow you to fall asleep before therapy actually kicks in where it then increases pressure in response to SDB events.
If you don't fall asleep in the alloted 30 minutes Settling time frame, you can always hit the button again and it restarts the clock from zero again. You can hit that button as many times as you wish in order to fall asleep.
If you are waking up BEFORE that 30-minute timer elapses then shorten the timer (do not extend it).
Set the correct pressure range: I would set your bottom pressure to 6cm and the high pressure to 16cm (i.e. range = 6cm to 16cm). I don't recommend using ANY of the available cpap/epr modes on this machine until you know for sure your exact 95% pressure. I also don't recommend a pressure range any higher than 16cm due to the way that machine functions (can only increase by 10cm from the low) and to avoid any pressure induced central apneas. Let the machine flat-line and indicate it needs to increase pressure beyond 16cm. The worst that can happen to you is it wakes you up.
If your not starving for air using 6cm after first turning on the machine, then leave the bottom pressure set at 6cm. That is a good starting pressure. This will keep the pressure low so you can more redily fall asleep. So for the first 30-minutes the machine will run at 6cm pressure, then after that period of time therapy will begin and it will "start" to respond to any flow limitations, snores or apnea events seen. Hopefully you will be asleep in REM by that time.
Note: with a Settling feature enabled, should you fall asleep and have an apnea event say in 20-minutes, the machine will NOT respond to said event, meaning you could awaken gasping for air and rip off the mask (like you do in 15-minutes??). So if that happens, you want to LOWER the Settling value to say 20-minutes and/or even disable it. I suggest leaving it enabled until you get used to things, it does work good and will only help with getting you to sleep. Optionally, you can increase the bottom pressure from 6cm to 7cm (I wouldn't increase any more than 1cm at each attempt, go too far and you'll impact getting to sleep).
If your using the heated humidifier I wouldn't increase it beyond a setting of 2 for starters. If the incoming air is too cold then turn it up, but if the incoming air is warm enough yet you feel stuffy or water droplets begin forming in the mask then turn it down or even off. The setting you use depends on the humidity level where you reside.
I also suspect your problem may be severe sleep deprivation or lack of deep and/or REM sleep. REM may have been absent for so long that when you hit it now it is almost alarming or startling to you so it kicks you back to Stage1. All you can do is keep trying.
So set some good basics on the machine so YOU know it is set up correctly, and use it. Then try and resolve all the little items bothering you one-by-one, write them down if you need to. Make sure your pilliow is correct and if you sleep on your side do so on the edge so you can hang the mask off the pillow. If its hot put a fan in the room (those vertical Bionaire ones from Costco for $50 bucks work pretty good are very quiet and have remote control which is cool).
The mask interface you have may seem less confining, but it is also very noisy from the get go. So that interface may be making your cpap life more difficult to sleep. I would have suggested a good nasal mask like a Activa or UltraMirage2 nasal mask instead. These diffuse the air better before it enters the nares and are much quieter than the swift.
Allow yourself a good 4-6 weeks of using the machine and getting used to the mask. If you can only use that machine for 1 hr per night, so be it, one hour is better than none, but don't allow it to prevent some sleep. It takes time but you'll get over the hump. Once you do, you'll awaken after 7hrs or so of sleep with your toes tingling and feel good for a change.
If you have any leg, back or other muscle pains be sure to take something to address that pain as it can interrupt your sleep. I have taken an Aleve and it works very well. If you cannot get to sleep with the machine, don't worry about it, remove it sleep on your side or stomach and try and get some sleep if you can. Sleeping in a recliner can help. I've had some of my best sleep on this big ole leather couch.
Lastly, don't worry about your numbers or pressures. Your goal should be sleeping until morning, those AHI scores and numbers are meaningless to you at this point. the machine is recording everything so don't worry about.
BRAVO!!
Bravo Snoredog!!! Well done!
Jenny, GREAT ADVICE!!!
Chuck
Jenny, GREAT ADVICE!!!
Chuck
People are dying every day in Darfur simply for who they are!!! PLEASE HELP THEM!
http://www.savedarfur.org
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http://www.savedarfur.org
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jrgood27
thanks
This is all great advice. Thanks everyone. Especially snoredog for explaining things so clearly.
To clarify: my setting was originally set at 4-18. It's a wide range because I'm titrating at home. I bumped the minimum up to 5.5 and will try 6.0 tonight. (I took a break last night to catch up on sleep).
I won't switch to straight CPAP, b/c I don't have any reliable 95% pressure data as of yet.
I'm seem to be waking whether I'm in settling mode or not, but I'll try to confirm if it's happening in one or the other more.
Interesting that the nasal pillows are louder. The noise of my inhaling is bothering me (hence the earplugs). I'm trying out new masks next week.
[quote="Snoredog"]
I also suspect your problem may be severe sleep deprivation or lack of deep and/or REM sleep. REM may have been absent for so long that when you hit it now it is almost alarming or startling to you so it kicks you back to Stage1. All you can do is keep trying.
That's interesting. i have about 10 years of disrupted sleep under my belt. and have tons of arousals in Stage 1,2,and REM sleep. I'm very easily awoken, so I thought taking sleep aids would take care of that problem, but they aren't working.
I'm trying to be patient and this board is a big help. If one hour a night is all I can manage for now. So be it. My husband is rubbing my feet before bed to make I am nice and relaxed.
This may just be a long process for my brain/respiratory system to adjust to. I guess. I knew that would likely be the case for me, but I have to say I didn't know it would be THIS difficult. Especially with the good drugs. : )
Jenny
To clarify: my setting was originally set at 4-18. It's a wide range because I'm titrating at home. I bumped the minimum up to 5.5 and will try 6.0 tonight. (I took a break last night to catch up on sleep).
I won't switch to straight CPAP, b/c I don't have any reliable 95% pressure data as of yet.
I'm seem to be waking whether I'm in settling mode or not, but I'll try to confirm if it's happening in one or the other more.
Interesting that the nasal pillows are louder. The noise of my inhaling is bothering me (hence the earplugs). I'm trying out new masks next week.
[quote="Snoredog"]
I also suspect your problem may be severe sleep deprivation or lack of deep and/or REM sleep. REM may have been absent for so long that when you hit it now it is almost alarming or startling to you so it kicks you back to Stage1. All you can do is keep trying.
That's interesting. i have about 10 years of disrupted sleep under my belt. and have tons of arousals in Stage 1,2,and REM sleep. I'm very easily awoken, so I thought taking sleep aids would take care of that problem, but they aren't working.
I'm trying to be patient and this board is a big help. If one hour a night is all I can manage for now. So be it. My husband is rubbing my feet before bed to make I am nice and relaxed.
This may just be a long process for my brain/respiratory system to adjust to. I guess. I knew that would likely be the case for me, but I have to say I didn't know it would be THIS difficult. Especially with the good drugs. : )
Jenny
Questions on Settling Time
Snoredog,
The more I read the more I realize I don't know. Since during the Settling time the machine does not respond to events,
1) does it count the events in the data reported?
2) does it include that time in usage reported?
Kathy
P.S. Thanks for making the piece of equipment available. I'm looking forward to getting it mid next week and learning lots more.
The more I read the more I realize I don't know. Since during the Settling time the machine does not respond to events,
1) does it count the events in the data reported?
2) does it include that time in usage reported?
Kathy
P.S. Thanks for making the piece of equipment available. I'm looking forward to getting it mid next week and learning lots more.
_________________
| Mask: TAP PAP Nasal Pillow CPAP Mask with Improved Stability Mouthpiece |
| Humidifier: S9™ Series H5i™ Heated Humidifier with Climate Control |
| Additional Comments: Bleep/DreamPort for full nights, Tap Pap for shorter sessions |
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Guest
Re: thanks
[quote="jrgood27"]This is all great advice. Thanks everyone. Especially snoredog for explaining things so clearly.
To clarify: my setting was originally set at 4-18. It's a wide range because I'm titrating at home. I bumped the minimum up to 5.5 and will try 6.0 tonight. (I took a break last night to catch up on sleep).
I won't switch to straight CPAP, b/c I don't have any reliable 95% pressure data as of yet.
I'm seem to be waking whether I'm in settling mode or not, but I'll try to confirm if it's happening in one or the other more.
Interesting that the nasal pillows are louder. The noise of my inhaling is bothering me (hence the earplugs). I'm trying out new masks next week.
[quote="Snoredog"]
I also suspect your problem may be severe sleep deprivation or lack of deep and/or REM sleep. REM may have been absent for so long that when you hit it now it is almost alarming or startling to you so it kicks you back to Stage1. All you can do is keep trying.
That's interesting. i have about 10 years of disrupted sleep under my belt. and have tons of arousals in Stage 1,2,and REM sleep. I'm very easily awoken, so I thought taking sleep aids would take care of that problem, but they aren't working.
I'm trying to be patient and this board is a big help. If one hour a night is all I can manage for now. So be it. My husband is rubbing my feet before bed to make I am nice and relaxed.
This may just be a long process for my brain/respiratory system to adjust to. I guess. I knew that would likely be the case for me, but I have to say I didn't know it would be THIS difficult. Especially with the good drugs. : )
Jenny
To clarify: my setting was originally set at 4-18. It's a wide range because I'm titrating at home. I bumped the minimum up to 5.5 and will try 6.0 tonight. (I took a break last night to catch up on sleep).
I won't switch to straight CPAP, b/c I don't have any reliable 95% pressure data as of yet.
I'm seem to be waking whether I'm in settling mode or not, but I'll try to confirm if it's happening in one or the other more.
Interesting that the nasal pillows are louder. The noise of my inhaling is bothering me (hence the earplugs). I'm trying out new masks next week.
[quote="Snoredog"]
I also suspect your problem may be severe sleep deprivation or lack of deep and/or REM sleep. REM may have been absent for so long that when you hit it now it is almost alarming or startling to you so it kicks you back to Stage1. All you can do is keep trying.
That's interesting. i have about 10 years of disrupted sleep under my belt. and have tons of arousals in Stage 1,2,and REM sleep. I'm very easily awoken, so I thought taking sleep aids would take care of that problem, but they aren't working.
I'm trying to be patient and this board is a big help. If one hour a night is all I can manage for now. So be it. My husband is rubbing my feet before bed to make I am nice and relaxed.
This may just be a long process for my brain/respiratory system to adjust to. I guess. I knew that would likely be the case for me, but I have to say I didn't know it would be THIS difficult. Especially with the good drugs. : )
Jenny
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Guest
Re: Questions on Settling Time
1 - yes it would still count the event but you wouldn't see a corresponding pressure increase. would it be included in any AHI scoring? I doubt it because as far as the machine is concerned it has not really started with therapy mode until that timer expires.kteague wrote:Snoredog,
The more I read the more I realize I don't know. Since during the Settling time the machine does not respond to events,
1) does it count the events in the data reported?
2) does it include that time in usage reported?
Kathy
P.S. Thanks for making the piece of equipment available. I'm looking forward to getting it mid next week and learning lots more.
2 - I believe it does include the settling time in compliance data.
It will ship on Monday, you should have it by Friday (I'll check the chart when I drop it off).
Reply
I absolutely hated BiPap. Never could fall asleep with it. Horrible experience. C-flex gives an entirely different feeling. It makes it feel very natural. I have other problems with CPAP, but for sure C-flex is a better alternative for me.
If I had known I would have lived this long, I would have taken better care of myself.