Questions after 1 1/2 months on CPAP

[BrianR4743]

I've managed to stay 100% compliant (not always easily), and believe I'm probably making some headway. I've enjoyed the CPAPTalk forums, and continue to be educated by them daily. I've got just a couple of questions after this short time, and am hoping that other members can lend a hand;

1) Resmed vs Respironics data... I've got the idea that data is measured differently between the 2, and am curious how my numbers measure up. I keep reading about AHIs of 1.8 or below, and am concerned that I'm not getting anywhere near that mark.

2) Hypopneas... Have a great number of them in comparison to apneas. I understand that the pressure serves as a stint to keep the airway open, but am a bit confused as to why the HI numbers don't seem to be reducing.

3) ResMed EPR... Mine is set at 3, apparently to make it more comfortable when I exhale. Would a change in that setting have a positive effect on the hypopneas? Is an increase difficult to adjust to?

4) Dreams... Holy smokes! I can't recall having so many and how vivid they are. Some are pretty disturbing (a shrink would probably have a field day with them!). What kind of indicator is that?

5) Early bedtime... Before therapy, I was wiped out early in the evening, and usually hit the hay at around 10pm. Now that I'm on therapy, 9pm is stretching it. I'm just tuckered out. Usually up and around at 6-6:30 in the AM. I thought I'd have quite a bit more fuel in the tank by now.

6) Tape... Is working well, as my leak rate is headed down. My MD isn't real keen on the idea, but as I've been a mouth breather, it seems the best way to keep my trap shut.

Thanks to all of you, and have a great 2010!!!!

Brian

[rjjayrt]

Its my opinion after having several of my patients using higher EPR numbers and having to lower them that the use of EPR can affect Hypopneas, I can't prove it, its just what I've seen over a coarse of time. Theres also the possibility of some central apneas being brought on by the cpap itself. If this continues you should speak to your sleep doc about this.

[ozij]

I've managed to stay 100% compliant (not always easily), and believe I'm probably making some headway. I've enjoyed the CPAPTalk forums, and continue to be educated by them daily. I've got just a couple of questions after this short time, and am hoping that other members can lend a hand;

1) Resmed vs Respironics data... I've got the idea that data is measured differently between the 2, and am curious how my numbers measure up. I keep reading about AHIs of 1.8 or below, and am concerned that I'm not getting anywhere near that mark.

If you look at their equipment, the majority of those will have Respririonics machines. Resmed call more things "hypopneas" and for a resmed, your HI of 4.8 is excellent.

2) Hypopneas... Have a great number of them in comparison to apneas. I understand that the pressure serves as a stint to keep the airway open, but am a bit confused as to why the HI numbers don't seem to be reducing.

Each company scores hypopneas somewhat differently - when your say "reducing" - what are you comparing against?

3) ResMed EPR... Mine is set at 3, apparently to make it more comfortable when I exhale. Would a change in that setting have a positive effect on the hypopneas? Is an increase difficult to adjust to?

It may change your results -- try it.

4) Dreams... Holy smokes! I can't recall having so many and how vivid they are. Some are pretty disturbing (a shrink would probably have a field day with them!). What kind of indicator is that?

A good one. It means you're finally getting into the phase of sleep in which people dream - formerly you started choking each time you slipped into that phase, and were snapped out of it. That intensive dreaming is called REM rebound, it will mose probable recede eventually.

5) Early bedtime... Before therapy, I was wiped out early in the evening, and usually hit the hay at around 10pm. Now that I'm on therapy, 9pm is stretching it. I'm just tuckered out. Usually up and around at 6-6:30 in the AM. I thought I'd have quite a bit more fuel in the tank by now.

Your body is still trying to catch up on what it missed.

[Gerryk]

I think you were comparing your numbers to numbers other people have posted on here. You can't do that, you need to compare your numbers from your original sleep study to your numbers now. You also need to remember that a machine isn't going to record things exactly the way they are recorded in a titration.

You said you are getting more sleep than before but your wiped out earlier. That happened to me and has happened to others. It's kind of like our bodies realize we are sleeping better and getting better rest and telling us go to bed early get more sleep now that we can rest.
Something else you may be doing a lot more and aren't used to that. Has your physical activity picked up?

Gerry

[GaryG]

With a pressure setting of 8 and an EPR of 3, you're "effective" pressure is 5. That is very low. What was your pressure during your titration study? I'd be inclined to leave the pressure at 8 and reduce the EPR down gradually.

Your numbers are fine, but its more important how you feel. Some folks do better with EPR, some do fine without it.

[fishhead]

I think you were comparing your numbers to numbers other people have posted on here. You can't do that, you need to compare your numbers from your original sleep study to your numbers now. You also need to remember that a machine isn't going to record things exactly the way they are recorded in a titration.

You said you are getting more sleep than before but your wiped out earlier. That happened to me and has happened to others. It's kind of like our bodies realize we are sleeping better and getting better rest and telling us go to bed early get more sleep now that we can rest.
Something else you may be doing a lot more and aren't used to that. Has your physical activity picked up?

Gerry

and

With a pressure setting of 8 and an EPR of 3, you're "effective" pressure is 5. That is very low. What was your pressure during your titration study? I'd be inclined to leave the pressure at 8 and reduce the EPR down gradually.

Your numbers are fine, but its more important how you feel. Some folks do better with EPR, some do fine without it.

well said, gentlemen.

any idea how long you've been suffering from sleep apnea? it may just take a little while longer. seems to me like progress comes in quantum leaps.

[BrianR4743]

rjjayrt, ozij, Gerry, Gary & fishhead.....

Thanks all. Your info has shed a lot of light and been real helpful. Been feeling like I've been flying blind for awhile. Not so much now.

It sure is easy to get buried in the numbers!

Have a great New Year!

Brian

[Gerryk]

Brian forget those numbers for now. Work on sleeping and feeling better. Once you feel more like your doing better then take a look at the numbers. If you want to look at any numbers, watch the leak numbers. If you are having problems with a leak, that can degrade your therapy some.

Gerry