Slowly but surely, I think?

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
LoneRider
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Slowly but surely, I think?

Post by LoneRider » Thu Oct 20, 2005 6:33 am

Again thanks for all help, especially how *not* to set the pressure on the Remstar.

After seeing, I think, moderate relief with the Remstar, and kicking up the pressure (to 9) looking for that magic CPAP high, I went to see the doctor again, he really wanted me to continue using the Remstar and see how that went, but I hate not knowing. He also had the results from the titration study, which of course said I should look for an alternative therapy. And well maybe if they where not using a 10 year old clunker of a CPAP machine that sounded worse than an old hard drive that was on it last days, and fitting the Activa so tight on my face you could not get a couple of fingers under the strap it might have been better, sorry had to rant.

So I got my 420e last night, and here is what it said after the first night:

Apneas: 0
Apneas/CE: 1 (so I had a single Central Sleep Apnea, hmm)
Hypopneas: 3
Hypopneas(FL): 0
Acoustical: 16 (2.4/hr)
Runs: 3

Now the kicker is, I was at 6cm of pressure for 86% of the time, with a 90% pressure of 7cm.

I also slept better last night as well, I think I sorta woke up for about a minute or two, but that was it.

It just seems weird, don't know how to put it, but it seems like a waste, using the CPAP with pressure that low???

My Blood pressure is a bit lower, but the doc also put me on a new medication as well, so it is had to isolate the factors when you change more than one variable at a time.

As far as my mental state, I think I might be a bit better, some days have been better than others, but I still have fog up there. Of course, I am still not completely used to the mask, and a pressure of 6-7cm of pressure will help that.

Just a reminder, my original sleep study showed 58 Hypopneas and 2 Apneas over 222 minutes (just under 4 hours), so according to those I am definitely better.

I guess I am going to have to be more patient, I do think I feel better, but it is definitely not something that is jumping up and slapping me in the face better.

Any thoughts out there??

cheers,
Tom


jcobb607
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Location: Northwest Mississippi

Post by jcobb607 » Thu Oct 20, 2005 6:43 am

I don't know about it being a waste with pressure that low. My pressure is set at 7cm. My study showed an average of 30 hypopneas per hour. Before cpap, at night trying to sleep, my sinus' would congest and I would have to breathe mostly from my mouth. In the morning I would have sinus headaches and stuffy nose. These past two nights and mornings, my sinus' are clear. I don't call that a waste for me to be able to breathe. I just hope that it will get to a point that I can sleep all night. I wouldn't care if the pressure was at 5cm, as long as I can sleep.


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WAFlowers
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Re: Slowly but surely, I think?

Post by WAFlowers » Thu Oct 20, 2005 9:13 am

LoneRider wrote:So I got my 420e last night, and here is what it said after the first night:

Apneas: 0
Apneas/CE: 1 (so I had a single Central Sleep Apnea, hmm)
Hypopneas: 3
Hypopneas(FL): 0
Acoustical: 16 (2.4/hr)
Runs: 3
So what are you complaining about? Obviously the treatment is working!

I'd use the software to change the setting to allow for 0.5 pressure increments (can only be changed with the software) and bump your lower pressure up by 0.5. I bet doing this would reduce those "acoustical" events (snores).
Now the kicker is, I was at 6cm of pressure for 86% of the time, with a 90% pressure of 7cm.

I also slept better last night as well, I think I sorta woke up for about a minute or two, but that was it.

It just seems weird, don't know how to put it, but it seems like a waste, using the CPAP with pressure that low???
The pressure needed for treatment has no, as in zero (0), correlation to the severity of the apnea condition. If it makes you better, I spend most of my night down around 7 with only brief excursions up to 8.5. And I have absolutely no doubt that the treatment is working for me!
My Blood pressure is a bit lower, but the doc also put me on a new medication as well, so it is had to isolate the factors when you change more than one variable at a time.
Give it time. Even BP doesn't respond overnight, although I suspect (no evidence though) that it responds quickly to proper CPAP treatment.
As far as my mental state, I think I might be a bit better, some days have been better than others, but I still have fog up there. Of course, I am still not completely used to the mask, and a pressure of 6-7cm of pressure will help that.
The weekend is coming. Get your settings tweaked as I suggested, then Friday night just let yourself go to sleep. If you wake up at 5:30, don't get upset. Just relax, let yourself drift and hopefully go back to sleep. When you eventually wake up naturally just imagine how much energy you'll have to get everything accomplished. You won't have to get up early to try and have more time.
Just a reminder, my original sleep study showed 58 Hypopneas and 2 Apneas over 222 minutes (just under 4 hours), so according to those I am definitely better.
Exactly! You've gone from moderate apena (untreated) to "perfect" (AHI approaching 0).
I guess I am going to have to be more patient, I do think I feel better, but it is definitely not something that is jumping up and slapping me in the face better.
Although you aren't having apneic events you may be getting micro-arousals from the unnatural action of wearing a mask. If so, that will fade with time. It's amazing what we can get used to!
Any thoughts out there??
Lots, but that just proves that the treatment works. Before CPAP, I had no thoughts.

Although I was getting good treatment, until I got the humidifier level turned up high enough I was still restless and having disturbed sleep. I was quite surprised that breathing sufficiently moistened would have such a profound effect on the quality of my sleep!

A last question: what is your pressure range set to? I might be able to offer more specific suggestions if I knew that.

The CPAPer formerly known as WAFlowers

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WAFlowers
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Post by WAFlowers » Thu Oct 20, 2005 9:38 am

Another thought.

How did you find breathing out against the pressure with the 420e. I know you were concerned about the lack of something specific like CFLEX, although that seemed to lead to stacked breaths with you.

Did the 420e's pressure sensing and rapid response to breathing give you the relief you needed as I described in my email? (I hope so!)

The CPAPer formerly known as WAFlowers

LoneRider
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Location: Allen, TX

Post by LoneRider » Thu Oct 20, 2005 12:31 pm

WAFlowers wrote:How did you find breathing out against the pressure with the 420e. I know you were concerned about the lack of something specific like CFLEX, although that seemed to lead to stacked breaths with you.

Did the 420e's pressure sensing and rapid response to breathing give you the relief you needed as I described in my email? (I hope so!)


At 6cm there was obsoletely no problem, at 8cm, can't remember a lot of difference to tell you the truth.

One thing though, the 420e was fairly loud when I exhaled, Stacy was noting that it was whistling when I exhaled? Very quiet when I inhaled though. As well, the swift mask seemed quieter with the 420e over the Remstar. I found that to be very interesting. Of course, all observations are subjective, and I remove the nose piece for cleaning every day, so there may be other variables at play.

Either way, the extra noise when I exhale is disconcerting!

cheers,
Tom


LoneRider
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Re: Slowly but surely, I think?

Post by LoneRider » Thu Oct 20, 2005 12:35 pm

WAFlowers wrote:
LoneRider wrote:So I got my 420e last night, and here is what it said after the first night:

Apneas: 0
Apneas/CE: 1 (so I had a single Central Sleep Apnea, hmm)
Hypopneas: 3
Hypopneas(FL): 0
Acoustical: 16 (2.4/hr)
Runs: 3
So what are you complaining about? Obviously the treatment is working!
Don't have the time to fully reply, I will try later. Thanks for the thoughts. As you (of all people here, you would know), I am an instant gratificaiton kind of guy, well at least in some things. So when I put my mind to getting something done or fixed I want to get it done, like now, so have to take time to get used to the treatment, and allow my body to react may take time.

I wish I had a pulsoximiter (sp??) at home, it would be cool to see how my O2 saturation is doing. All it takes in money right

cheers,
Tom


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WAFlowers
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Re: Slowly but surely, I think?

Post by WAFlowers » Thu Oct 20, 2005 12:47 pm

LoneRider wrote:I wish I had a pulsoximiter (sp??) at home, it would be cool to see how my O2 saturation is doing. All it takes in money right
Don't we all? All it it takes is money ... and a Rx.

I never understood why a non-invasive measuring tool would need a doc's orders. That is like saying you need a Rx for a bathroom scale (in my mind)!
The CPAPer formerly known as WAFlowers

LoneRider
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Re: Slowly but surely, I think?

Post by LoneRider » Fri Oct 21, 2005 6:11 am

What a difference a night makes, night before last:
LoneRider wrote:
Apneas: 0
Apneas/CE: 1 (so I had a single Central Sleep Apnea, hmm)
Hypopneas: 3
Hypopneas(FL): 0
Acoustical: 16 (2.4/hr)
Runs: 3


last night

Apneas: 3
Apneas/CE: 1
Hypopneas: 6
Hypopneas(FL): 0
Acoustical: 57 (9.1/hr)
Runs: 2

Very interesting, 90% pressure is 9.0 cm of pressure.

Even with all of that, I had a really, really, really weird dream, but wait, I had a dream! so by definition, it was a good dream!

For tonight I am going to up the minimum pressure to 8, from 6.

I must have let myself relax a lot more last night, and thus allowed myself to go into a deeper sleep?

And I think I feel a bit better this morning, I think.

cheers,
Tom

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WAFlowers
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Post by WAFlowers » Fri Oct 21, 2005 9:01 am

Tom, that is the way it goes. Yes, it does sound like you got into deeper sleep and some REM. It wouldn't surprise me if you'll experience a bit of REM rebound of the weekend.

The deeper sleep and REM likely correlates with the increased snores. A higher min pressure should take care of that for you and give you an even better nights sleep.

BTW, how many hours sleep did you get last night? Still waking on your own at some ungodly hour?
The CPAPer formerly known as WAFlowers

regisb50
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Location: Delaware

Noise levels

Post by regisb50 » Sat Oct 22, 2005 7:16 am

LoneRider wrote: One thing though, the 420e was fairly loud when I exhaled, Stacy was noting that it was whistling when I exhaled? Very quiet when I inhaled though. As well, the swift mask seemed quieter with the 420e over the Remstar. I found that to be very interesting. Of course, all observations are subjective, and I remove the nose piece for cleaning every day, so there may be other variables at play.

Either way, the extra noise when I exhale is disconcerting!
Noise levels... Originally my wife was so relieved when I stopped snoring using the CPAP unit that the noise of the unit was a fair price. I used various masks, and my original Healthdyne system for 7 years. I was convinced that noise was a necessary evil.

I am now using a Remstar Auto with the Comfort Curve mask that fits UNDER the nose. The reduction in noise was awesome. The CPAP unit is almost impossible to hear, and the new masks sounds a little Darth Vader like when I exhale, but it is so quiet.

My old masks hissed and burped. My diagnstic pressure is 14, and I run the Remstar with a minimum pressure of 10. At the higher pressure settings hissing has always been a major problem for me, but the new system seems to have addressed this problem quite well.