hello, I'm new here :)

[nansaidh]

Hello all,

I'm a new CPAP user, just introducing myself - I'm Nancy, on the east coast of the US.

To backtrack, I was actually diagnosed with sleep apnea - by a lab sleep study - many years ago but no treatment was ever prescribed; I only discovered the diagnosis when I moved from California back to my hometown about 2 yrs ago and collected my records to come with me. My new primary doctor here ordered a home sleep study because of extreme fatigue earlier this year, it was overwhelmingly positive, and a pulmonary consult prescribed a trial of CPAP. I got my machine (Dreamstation Auto CPAP) and fit for a mask (ResMed F30) by my DME's respiratory therapist on the 13th of this month and after just the first night (which was filled with me fiddling with the mask, tubing, trying to adjust to the new sounds of the machine, fighting with my pillow, etc.) the difference was incredible. I felt human again after more than 25 yrs. My AHI dropped from 18 down to 4-5 and has held steady in that range since. I feel like I'm mostly adjusted to the equipment now (current pressure Rx range is 4-18) and having purchased one of those wild looking contoured CPAP pillows that freakishly turned out to be darn near perfect for me, I feel like I'm set and am really grateful things have lined up so well. I am 100% compliant though, so that might help.

Every morning isn't energy-filled, but I also struggle mightily with sleep inertia and need to work that out somehow. I'm seriously and acutely affected all day long if I wake in REM sleep, dreaming. Yes, I'm a repetitive snoozer, alarm-wise. Wondering if anyone has had good results with any of the sleep cycle alarm thingies (and which ones?) while using CPAP? I do have to get up for work, so just getting up whenever I naturally wake isn't an option.

Wishing everyone great sleep...
Nancy

[Pugsy]

You probably need a little pressure adjustment upwards so you can get that AHI down a little lower to give yourself a better chance of feeling even better.
That 4 cm minimum probably is a bit low.
Need to see what kind of events you are having though to be sure.
See the top thread in the Announcements section...Newbie please read.
It discusses software that is available (free and easy to use) along with how to post images of your reports so we can see what you are seeing.
viewtopic/t158560/How-to-post-images-for-review.html

[nansaidh]

Hi, and thanks Pugsy. I'm already using OSCAR, so here are the last two nights' reports...

monday 11-18.jpg (639.1 KiB) Viewed 263 times

tuesday 11-19.jpg (608.26 KiB) Viewed 263 times

Nancy

[Pugsy]

Yep, you need more minimum pressure. Probably up around 8 ish or so. The OAs and hyponeas...those are obstructive in nature and along with the snores, Flow Limitations and RERAs all point to the airway still trying to collapse.
The machine responds but it can't get to where it can do a good job because it takes too long to get up to around 10 ish or so from the 4 cm starting point. They don't go up in the blink of an eye. Instead it takes several minutes for it to go up and come down.
You need a more optimal baseline pressure holding the airway open to start with and then it can go up from there as needed.
I suspect that if your minimum pressure was more optimal that you would see less instances of where the pressure goes way high.
Right now the machine is trying to fix a problem after it happened and it really works best when it prevents the problem in the first place.

The CAs...those are central apneas or open airway cessation of breathing and they may or may not be real meaning you may be doing some pausing in your breath while awake or half awake that the machine is sensing and flagging. Even if they are the real deal you aren't having enough to worry about...and we can't fix centrals with more pressure anyway.

You can change the minimum yourself if you are comfortable doing that....if not you need to contact your medical care team and have them do it. It's not hard to do it yourself though. Just a little button pushing.
You can get the provider manual here via email and read up on which buttons to push to get you into the secret menu where the pressures can be changed.
https://www.apneaboard.com/adjust-cpap- ... tup-manual

If you decide to increase that minimum and the 8 cm is just too much of a jump all at once you can go up in small increments and take a few nights at each new minimum to get used to. Like add 1 cm for 3 or 4 nights and then try another 1 cm....and so on.
You can do that or use the ramp function if you like.

[nansaidh]

Thank you, Pugsy, that certainly makes sense re: reacting to the event as opposed to preventing it to begin with. I was forced to work out how to get into the clinical settings on my machine; earlier this week the machine itself was replaced for making moaning noises on inspiration and expiration (the new machine is vastly more quiet all around, so I suspect I'd gotten a lemon) and the same RT didn't set up my new one, he left out a lot of things actually - including the humidifier preheat. Fortunately I'd watched him set it up and remembered he'd used a combination of the ramp button and dial/button so I was able to access the hidden settings when I got home. I think I'll increase the minimum pressure a little at a time as you suggested; with the min set to 4, I haven't been using the ramp.

Your welcome and comments are much appreciated!
Nancy