Newbie could do with some advice

[maccknight]

Hi

I am newly diagnosed with moderate sleep apnea. I have been using an F & P Icon + Apap machine and a Quattro FFM.

For the first two weeks of use I felt absolutely brilliant - this time last week I was on top of a mountain skiing on my own.

I came back with a cold and this week feel like my world has fell and couldn't even drive 2 miles up the road.

Is this normal? I am struggling to see any way out of this at the moment and all my anxiety and depression has come flooding back.

How can I go from feeling so good last week to like I did before I started treatment in less than a week?

The stats on my machine say I have been using it for on average 7 hours a night the last week and my AHI is averaging 4.9

I have increased my initial pressure to 7.5 but that does not seem to have made any difference.

Any help would be really appreciated

[Julie]

If you have a cold (could your humidifier have been turned higher than necessary, causing cold symptoms?), you won't breathe properly and will feel lousy (to be expected), but to allow yourself to emotionally 'crash' so badly because of it is a bit surprising. Of course you're breathing (and Cpap experience) will be affected by a cold, and your AHI could be lower, but you can't tell what it will be until you're recovered, so why not wait til you feel better and then give it a few days at least to see if it goes down again.

[zoocrewphoto]

MOst people feel better if their ahi is lower than 2, so some tweaking may optimize your treatment better.

There are also some other factors that may affect how you feel. Getting a cold may be one. Also, as we feel better with cpap and start to trust it, we tend to sleep more deeply than we used to. That means that we may need more pressure than we did during the titration or when we first started treatment.

It is also possible to have a low ahi, but longer events, so it is a good idea to check that as well.

And how is your sleep quality? Do you feel like you sleep straight through all night, or do you wake up a lot? Some people do best with a range of pressures, while others find it hard to sleep as the pressure changes. Some people sleep through major leaks while others wake up at the tiniest leak.

What are your current pressure settings? Does your machine have full data? If so, have you looked at it?

[maccknight]

I thought you had the humidifier turned up higher to prevent colds and stuffed nose? Or have I got that wrong? I have had it set at 6 out of 7

I feel like I sleep all the way through but Senseawake feature said I woke 21 times

The starting pressure is now 7.5 and the max pressure is 18

I have looked at the full data in sleepyhead but to be honest find it all a bit confusing

[Julie]

Very many people develop colds, etc. if humidity's too high - for them, in their particular climate, environment, time of year, etc. etc. I rarely use mine at all because I live close to water, though occasionally use it in winter when central heating makes everything dry... but you need to experiment for yourself. Humidity is a comfort thing, not therapy in itself, so feel free to turn it off or raise it, depending on how you feel.

[kteague]

Hi. It is discouraging to have a setback when things started off so well. I agree with Julie about not expecting too much until you've recovered from your cold. Hopefully you'll be back on track soon and seeing improved numbers. Usually only some of our events wake us, but looking at your numbers, if you had 4.9 events per hour x 7 hours of sleep, that's 34 opportunities in one night to be aroused from sleep, so 21 doesn't sound unthinkable. Most arousals we don't remember. Getting that AHI down should help. When you look at your Sleepyhead data, see if where your pressure ends up most of the night is very far above your starting pressure of 7.5. If the climb is very far, the machine might have difficulty preventing events. Sometimes raising the starting pressure helps, but if your pressure is staying around 8 or 9 that's probably not your answer. I'd hate to see you put too much effort into chasing this if you still have the cold. The problems may resolve once you're breathing more freely. When I'm dealing with a cold sometimes I up my pressure just a half digit or so then drop it back when I'm better. Whatever works.

[archangle]

Some people find too much humidity bothers them, some need as much as they can get. It's just trial and error to find what's right for you.

[robysue]

I thought you had the humidifier turned up higher to prevent colds and stuffed nose? Or have I got that wrong? I have had it set at 6 out of 7

Humidity is a very funny thing.

Some people's noses need the humidity cranked up all the way or they dry out and become painful (and that can trigger congestion). Pugsy's nose and my nose are both in that camp.

Some people's noses don't like sleeping in a swamp, and even a tiny bit of extra humidity causes their noses to swell up and get congested. Julie's nose and my brother's nose are in this camp.

And some people's noses want some extra humidity, but not a lot of extra humidity: Either too much or too little humidity can make their noses feel congested. Hubby's nose is certainly in this camp.

It takes some experimentation to figure out which camp your nose likes. Since you've got the humidifier set on the high side, you could try turning it down to 3 or 4 for one night. If the nose is better, keep the humidifier at the new setting for a while. If the nose is screaming at you after only one night of sleeping with the humidity at that level, crank it back up. If there's no real improvement, but the nose is not unhappily dried out, then consider turning the humidifier down further.

As for preventing colds: Head colds are caused by viruses. And while a humidity setting that your nose doesn't care for can leave the nose more vulnerable to getting infected by a cold virus, the correct humidity level is not going to act as a cold preventative. But once you are sleeping better all around (which includes figuring out how much humidity your nose likes), you may find that your immune system does a better job of fighting off the routine head colds we tend to get multiple times a year.

I feel like I sleep all the way through but Senseawake feature said I woke 21 times

Senseawake has tracked 21 times where there were breathing patterns that can indicate a brief awakening. It turns out that most people have to be awake for at least 5 minutes in order to remember the wake the next morning. If the wakes are shorter than that, you probably won't remember them. And sometimes an "awake-type-breathing-pattern" might just indicate a natural normal change in sleep state. In other words, unless the Senseawake numbers are consistently high AND you're not feeling well even when you are not sick with a cold, it's worth mentioning the Senseawke numbers to your sleep doc. Sleep fragmentation in terms of repeated short wakes can be a real problem for some people. And it's not just CPAPers who can experience sleep fragmentation problems; it can happen to people who don't even have OSA.

But until the cold symptoms clear up, I'd attribute the high Senseawake numbers to the combination of the head cold itself and the experience of dealing with the first head cold on CPAP.

I have looked at the full data in sleepyhead but to be honest find it all a bit confusing

Start with Pugsy's Pointers. There's also some information over on apneaboard.com targeted at new SleepyHead users. And you can always post a day or two of detailed data here and ask for input.