DR. Visit

[Exterminator]

Went to the DR. today and got a copy of my sleep study while there. It says the AHI index was 64.1 per hour with extremely severe oxyhemoglobin desaturation to 79%. That is worse than what the DME had told me, they said it was 50.
So anyway I told her about my not being able to sleep on my back without having trouble so she said she would have my DME to bump my pressure up to 10. I told her not to bother since I already know how to do it myself. This surprised her and said she usually didn't have this type of conversation with patients since most of them are much older than me. Anyway she said go ahead and to call if I didn't feel any better and we may bump it again. I kind of think she was impressed I came with my data from the card printed out.

[LaurieP]

I have been on CPAP since May 5th. I found this website right away and it has been amazing. I went to my 1st follow up with the knowledge that I had received from this board. My Doctor has been amazing!!! She did what I asked and changed my pressure to what I was using at that time. I also asked not to go back to the DME and she was totally fine with that. The last follow up I had changed my pressure again and she once again was totally fine with the reports I bought her and now I don't have to see her for a year.

It's great that you have found an amazing doctor also and have taken control of your own treatment. I believe you will be most successful!!!

Laurie

[rested gal]

she said she would have my DME to bump my pressure up to 10. I told her not to bother since I already know how to do it myself. This surprised her and said she usually didn't have this type of conversation with patients since most of them are much older than me.

You should have told her that the "older" ones you know (on cpaptalk) don't bother to go back to the doctor at all.... they just bump their own pressure up themselves and handle their own therapy quite well themselves.

Seriously, it sounds like you have a good, cooperative doctor. Good for you!

[Exterminator]

Somewhat disappointed, 1st night of pressure at 10 on my back not what I had hoped for.

[Pad A Cheek]

Exterminator,

I applaud the fact that you are taking charge and working with your sleep doctor to achieve the very best results. However, I have a question for you, if you don't mind.

If you have trouble sleeping on your back, why try to sleep on your back at all? The reason I ask this, is because too many people are confused when the sleep techs want them to sleep on their backs for the titration they think this is the way they are SUPPOSE to sleep.
The sleep techs try to have you sleep on your back because that is the most likely position that you are going to have the worst Apnea scores. They are trying to titrate the worst case scenario by having you sleep on your back. Most of us have learned a long time ago, pre CPAP treatment, that sleeping on our backs is not good. Personally I sleep on my stomach.

So if you have trouble sleeping on your back, why not sleep on your side?
I do wish you the very best going forward, and many many nights of restful sleep.

Karen

[Sheriff Buford]

Rested Gal: You go girl!!!!

Sheriff

[Exterminator]

If you have trouble sleeping on your back, why try to sleep on your back at all? The reason I ask this, is because too many people are confused when the sleep techs want them to sleep on their backs for the titration they think this is the way they are SUPPOSE to sleep. Karen

I get good results at 9 pounds sleeping on my side the problem is that for some reason side sleeping causes me pretty bad pain in both hips that lasts through most of the day. I went to 10 pounds to try and get on my back so I don't hurt at work all day.

[nudave]

Interesting thing I found. Before I believe you had most of your events while you were snoring, now its the opposite.

[Pugsy]

Some people need quite a bit more pressure to prevent the events when they are on their backs. Since sleeping on your back is necessary for pain relief then you may simply need a bit more pressure. Your profile shows APAP machine. Is this correct? If so, you could try APAP with a bit of a range and let the machine take care of the added pressure needed when on your back. If you don't have APAP machine then you may just need a little more straight cpap pressure. Maybe just 0.5 cm.

[Exterminator]

Some people need quite a bit more pressure to prevent the events when they are on their backs. Since sleeping on your back is necessary for pain relief then you may simply need a bit more pressure. Your profile shows APAP machine. Is this correct? If so, you could try APAP with a bit of a range and let the machine take care of the added pressure needed when on your back. If you don't have APAP machine then you may just need a little more straight cpap pressure. Maybe just 0.5 cm.

My machine is the A-Flex so it will do auto right?
I will go to 10.5 tonight and see if that does any good.

[mayondair]

I have apnea that is somewhat positional, more events on R side, I find auto with a narrow range comfortable and effective, currently using 11-15. Go to the cliinical menu, mode, select auto, set minimum range( you might try 10) set maximum range ( maybe 13 or 14) . A rule of thumb would be 2 or 3 cm either side of titrated pressure. To wide a range, or to low a minimum and the machine is to slow to respond to events . Kathy

[Pugsy]

My machine is the A-Flex so it will do auto right?
I will go to 10.5 tonight and see if that does any good.

Yes, if it has A-Flex it will do auto (APAP). Something to consider. I am worse in REM sleep (documented on sleep study) and I use my machine in APAP mode because sometimes I need a lot more pressure to deal with those REM events.
It works for me. I prefer to use it that way because sometimes I need up to 18 cm pressure (but not often) and I wouldn't want to use that all the time. Instead I let the machine go there if it needs to and the rest of the time it stays around 10 to 12 cm.

Let's see what 10.5 cm brings. Sometimes just a little more makes a huge difference.

Should you wish to experiment with APAP the minimum is the most critical setting and I would suggest 10 cm minimum.

[rested gal]

Pugsy is giving you good advice... what she suggests is a very good way to go about it. Getting the minimum pressure up to where it can truly prevent most events when you're sleeping on your back, Exterminator, is the important pressure to work on.

My machine is the A-Flex so it will do auto right?

Right. Of course, the machine would have to be set for auto mode in the therapy setup menu if you want it to do "auto." Auto mode is also the only way you'd see "A-Flex" as an option when going through the setup menu.

I will go to 10.5 tonight and see if that does any good.

You can tiptoe your way up to the pressure you need when you're on your back, or...

What I'd do if it were me (a bit more impatient)... I'd just go on and set the minimum pressure for, say, 12 cm H2O. Range 12 - 20. If 12 didn't take care of supine sleep position, I'd go to 13, then 14, etc. If 12 did take care of it, I'd try 11 to see if that did as well.

[Exterminator]

A nap on my back on auto... minimum 9 max 13. As you see 16 minutes were at 9 then it headed to the sky.

[mayondair]

I'd always listen to RestedGal Kathy