What pressure to start with? Is my Prescription correct?

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
book_bus
Posts: 9
Joined: Thu Sep 20, 2007 8:33 pm
Location: Michigan

What pressure to start with? Is my Prescription correct?

Post by book_bus » Wed May 27, 2009 11:58 pm

Hi everyone,

I was diagnosed with Obstructive Sleep Apnea (OSA) and delayed sleep syndrome in 1999 based on my first sleep study. I was around 225lbs at the time.

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My doctor said, clinically my sleep apnea was very mild; however, based on my everyday symptoms, I had severe sleep apnea.

My next sleep study was for titration and my prescription was cpap @ 7cm.

After many months of fighting with different nasal masks, I finally was settled in with a first generation ResMed Ultra Mirage full face mask. My treatment was fantastic for about a year. The treatment totally changed my life!

Then, ResMed decided to discontinue the Ultra Mirage full face mask and released the second generation Ultra Mirage mask. I fought with this second generation mask for a few months with no success whatsoever. The new mask was totally uncomfortable, and I had on going issues with non stop leaks. After a few months, ResMed decided to recall and discontinue this new mask and started to offer the old mask again.

After about six months or so, ResMed redesigned the new mask and discontinue the old mask that I loved once again. I fought with the new mask for the next couple of years, and never was able to get the same treatment. At the time, I wasn’t aware of how leaks could affect my treatment. So, I went back to my doctor, and they decided to do a retitration.

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In the middle of this sleep study, a nurse came in and woke me up. Then the tech that was monitoring my sleep study, told the nurse over the loud speaker that she was in the wrong room!

My new prescription was cpap @ 11cm. I couldn’t get use to this new pressure at all. After fighting with this new higher pressure for about a year and still not getting near the results I got in my first year, ResMed released the Mirage Quattro full face mask. Wow, the new mask was a lot like the first mask that I loved! It was around this same time I got a new ResMed S8 Elite cpap machine.

After doing some research on line, I learned about being able to pull data from my cpap machine. As far as I can tell, it doesn’t appear that I’m having issues any more with leaks, however I’m still not getting the treatment I once did years ago with the lower 7cm pressure.

At about this same time I went on a diet and lost 50 lbs. I’m 6’4” and was at 215lbs before the diet. After losing the first 25lbs, the cpap treatment didn’t even seem to work for me at all, and I found sleeping with out cpap machine gave me the same results as the first year of using a cpap machine.

At the end of my diet I was 165lbs! In 9 weeks I lost all this weight! I was at the gym 5 days a week, for 1.5 – 2 hours at a time. 75% of the workout was cardio.

After about a year of not going to the gym and eating fast food for most meals, I gained back all 50lbs, and am now in need of the cpap machine. My severe everyday symptoms, have slowly returned.

So, now I know that I’ll be in the gym for the rest of my life and simply avoiding fast food as much as possible!

Based on my current data, I’m wondering if my pressure is maybe too high?

I'm also in the market for a CMS 50E Oximeter!

Any thoughts or feedback would be greatly appreciated! Thanks!



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_________________
Mask: Mirage Quattro™ Full Face CPAP Mask with Headgear
Additional Comments: ResMed S8 Elite (version 1) cpap pressure @ 11 CM EPR @ 3 - ResMed ResLink - ResScan Software 3.4
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ChrisC
Posts: 176
Joined: Tue Nov 25, 2008 11:39 am
Location: Ontario, Canada

Re: What pressure to start with? Is my Prescription correct?

Post by ChrisC » Thu May 28, 2009 12:56 pm

Numbers look pretty good.. nice low AI. HIs on the Elite II can be reported a little high, so you should be delighted with an AHI of 4.8. Your leak rate is a little higher than mine. I've had great success with nasal pillows (often have 0.00L/S) but I understand they're not for everyone.
"Human beings, who are almost unique in having the ability to learn from the experience of others, are also remarkable for their apparent disinclination to do so."
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Sleep dude

Re: What pressure to start with? Is my Prescription correct?

Post by Sleep dude » Thu May 28, 2009 10:09 pm

2 points. Your titration seemed to have ended just before 1am. Why?

Also, this wasnt a titration. For what I can tell, the sleep tech started you off at 11cmH2O, and let you rot there for the next 3 hours. I cant see any evidence of starting at a low CPAP pressure and TITRATING it to the correct pressure.

Just my 2 cents.

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turbosnore
Posts: 293
Joined: Wed Nov 05, 2008 7:00 am
Location: Nokia (town), Finland

Re: What pressure to start with? Is my Prescription correct?

Post by turbosnore » Thu May 28, 2009 11:21 pm

Sleep dude said it. The pressure curve looks like CPAP, not titration.
I disagree a bit with ChrisC about the goodness of the numbers. If the machine is calibrated with the mask type, then
the leak is too high for the numbers to be trusted. It looks like the high leak time matches to the low AHI time.
That may affect the median AHI.

_________________
Mask: AirFit™ F10 Full Face Mask with Headgear
Additional Comments: Not sure about the gear yet, SW used is SleepyHead
De-bugging is for sissies, real men do de-monstrations.