Some quick newbie questions

[Cdburkhart]

I just received my Philips Respironics System One and ComfortGel Blue nasal mask for OSA.

I was diagnosed with mild sleep apeana, with an AHI of 5.1, (so much lower then what I see on here.) I am a 32 year old male, 6'4" @ 275 lbs.

I started using the machine 4 December and I have noticed somethings that I aren't sure if they are normal.

1. I have woken up twice with a severe headache. It feels very similar to being hungover, and this morning I was super thirsty.
2. I feel jittery, almost like when you drink too much coffee.
3. I am getting bizarrely hungry...like hungry when I was teenager. I mean I feel so hungry it effects my personality.
4. At times, laying in bed, I feel like I am not getting enough air. Prior to CPAP, I typically fell asleep breathing only through my nose.

I mean there are immediate benefits:

1. My wife says I haven't woken her with my snores.
2. My gout symptoms have cleared up. Since I was diagnosed with gout, my acid levels have been through the roof and I have been in almost constant pain.
3. So far, no more sleep paralysis

I was told of some side effects, and was also told everyone reacts differently...so, yeah, not sure what is related and what is not to the machine.

Thanks

*edited because I forgot some stuff

[grayghost4]

Welcome to cpaptalk

Your maching is capable of full data ... have you downloaded Sleepyhead software ?
after you do you can look at the data and post it or one of the graphs and someone here may be able to help you understand what it says.

[Pugsy]

Welcome to the forum.

Which PR System One machine model did you get? If unsure look on the bottom of the blower unit (remove water chamber first if it has water in it) and tell us the 3 digit model number and we can tell you exactly which machine you are using. Model numbers may have DS, REF or P in front or behind it.
Once you have the exact model known please add your equipment to your equipment profile like I have mine.
Hopefully you will have a full data model and be able to use Sleepyhead software (links in my signature line) but with the starting AHI pre cpap of 5ish...it may not be all that remarkable but you can at least check for leaks (which mouth breathing would show as a leak).

Regarding your questions...
1...I wonder if the straps or bed pillow and/or combination of them is causing some odd positioning of the neck which could be a cause for the headaches. I have a bad neck and I know if I sleep in a weird position I will wake up with a headache.
Super thirsty...was your mouth dry? Might be from mouth breathing. It doesn't take much mouth breathing to dry out the mouth.
2..jittery feeling...I have seen others report similar sensation but I have never had it myself so I really have no useful comment about it
3..same thing about the hungry thing...I actually found my appetite decrease a bit with cpap therapy because I wasn't craving the sugars and carbs to get energy bursts...so I have no useful comment about being hungry...that's a new one for me to see...not common though.
4..not getting enough air could be the starting pressure and/or you prescribed pressure depending on setting and your machine and if you are using the ramp feature. More information would be helpful...like are you using the ramp feature and/or what is your pressure setting(s)?

[70sSanO]

Just wondering, and a followup to Pugsy's question...

When you say that you typically fall asleep breathing only through your nose, does that mean that you usually also breathe through your mouth. I only ask because you say you have a nasal mask and with that type of mask you can't breathe through your mouth.

John

[Cdburkhart]

Here is the screen shot of summary: https://dl.dropboxusercontent.com/u/189 ... 150924.png

I have a Philips Respironics System One (60Series) RemStar Auto with A-Flex (560P), is that enough info or did I miss something?

The pressure is Variable with 4 being the lowest and 20 being the highest.

I assume I may open my mouth during sleep, hence snoring. But I could be wrong.

[Pugsy]

The PR S1 model 560...
These would be your equipment choices in your profile.
Machine...PR System One 60 Series Auto CPAP
Humidifier...PR System One 60 Series heated tube humidifier with heated tube (even if you aren't using the optional heated hose right now).

Your settings are what I expected..wide open with minimum starting pressure of 4.0 and max of 20 but it never seems to get close to the maximum
The setting of 4 cm to start with is very minimal and a lot of people have problems with a stifled or suffocation type of feeling at that low of a pressure. We won't suffocate but sometimes it sure feels like it. When ramp is used it will start out at 4 cm unless a person changes the starting pressure. In this case ramp isn't even kicking in because with the 4 cm starting pressure the machine won't increase the pressure until the events start driving the pressure.

Your leak number is great...the % of time in large leak is minimal. If you are mouth breathing it isn't much or for very long.
If you are having snores it is probably because the pressure is still a bit too low.

The maximum the pressure has ever reached is just a little under 10 cm.

Your AHI is within acceptable limits but if you are seeing a good number of snores, which this particular statistic section doesn't tell us about snores, you probably need just a little more minimum pressure to give the machine a better head start on things.

I think that a minimum pressure of 5 or 6 would probably do 2 things for you...reduce the suffocation feeling that you are sometimes feeling and also help reduce the snores and hyponeas you are seeing (not that the hyponeas are all that high in numbers but you might as well see if they will reduce as a byproduct of a little more pressure which will probably allow you to be more comfortable).

All in all a good report and no urgent need to really change anything but increasing that minimum would likely afford a little more comfort while falling asleep. There is no need to do anything with the maximum..it's a moot point because the machine doesn't even want to go anywhere close to it.

Snoring doesn't always mean the mouth is open. The snoring sounds are from the floppy airway tissues sagging and vibrating. A person can snore with their mouth closed. Snores are warning signs that the airway is trying to collapse. They don't always grow up to be flagged apnea events but they could grow up to be full apnea events...so we try to keep snores down also even though they aren't a part of the AHI.

[Tatooed Lady]

I got headaches when I first started therapy, and got rid of them by:
1 changing humidity setting (my body prefers a setting of 2 at the moment) and
2 bumping the low end from 4 cm pressure up. I think 5 or 6 worked initially.

Since May I have tweaked settings in an effort to minimize snores and events while being comfortable. A jump in pressure initially can feel huge, even just 1 cm at a time.

[archangle]

Lots of things happen when you have apnea. Low oxygen, stress hormones, blood pressure changes, etc. Your body adjusts. I think that once you stop having apnea, your body is sort of out of adjustment. I use the analogy that it's like stopping smoking, drinking, or drugs. You may feel weird or even sick until your body stops doing all the things it used to do to try to live with apnea.

Even if your therapy is going "perfectly," you may feel some "apnea hangover" effects.

Of course, you might also have something wrong with your CPAP treatment that's causing problems, too. Or some unrelated medical problems, so don't get too complacent and blame all your problems on apnea or CPAP.

[OkyDoky]

I agree with Tatooed Lady. Changing humidity may help with headaches. At first my humidity caused drainage and I switched to only passover humidity but then when I started to wake up with headaches and my sinuses felt burning/irritated, I realized that we had turned on the heat and reset my humidifier to 2. That change took care of my headache. So I would suggest to play with your humidifier settings.

[Cdburkhart]

Awsome, thanks y'all.

I tired to figure out how to adjust starting pressure last night and couldn't figure it out.

I am dealing with a good bit of water in the mask and hose, any pointers on that?

Also, don't know if others have experianced this, but I have started to get zits/sores around the mask. I wash the parts of the masks that touch skin with soap every morning, but didn't know if folks did other things.

[Pugsy]

You may need to change mask type if your skin is breaking out..either that or make (or buy a mask liner).
That Comfort Gel blue has a lot of skin contact area to deal with and you may be sensitive to the materials...since you say you are washing it daily.
Also make sure your face is free from facial oils at night.
There are other masks that don't have so much skin surface contact points so maybe consider a different mask.

When you have time please add your equipment to your profile so we can see at a glance what you are using.
wiki/index.php/Registering_Equipment_in_User_Profile

Mask liners can be found here...she makes some nice ones http://www.padacheek.com/
You can make your own with an old T shirt.

[Cdburkhart]

So I figured out that I could preheat the water, and that seemed to get rid of the condensation