My first night on APAP

[LandKurt]

After a month on CPAP with a REMstar Plus I convinced my doctor and DME to give me a REMstar Auto, since I didn't sleep well during my sleep study and wasn't convinced my titrated pressure of 10 cms/H2O was correct. I picked up the new machine yesterday which the sleep center set to a pressure range of 6 to 12. I had already purchased a card reader online and had the EcorePro software installed and ready to go.

The first thing I did this morning was to download the card and see what the auto thought about my pressure. It was rather anticlimactic to see the 90% value at exactly 10, identical to my sleep study a month and a half ago. It did spend 21.5 minutes at a pressure of 11, but never decided to go up to the maximum of 12. A single night doesn't conclusively prove anything, and I'll certainly be looking at further data from more nights, but I don't expect any surprises now.

I don't know whether to be relieved or not. Since a month of CPAP use hadn't done much to change my energy level, I half expected to find I needed a higher pressure than the sleep study indicated. Since I didn't get very comfortable during the study and never got into REM sleep it seemed reasonable to assume I hadn't show the full extent of my apnea problem. Then again, I wasn't excited by the prospect of using a higher pressure and probably having greater mask problems.

I guess I'm one of the many that doesn't respond instantly and dramatically to CPAP treatment. After all, the sleep study only classified me as having moderate OSA with an AHI of 25 or 30 (all hypopneas and no apneas). My tiredness isn't severe, no falling asleep at the wheel or during conversations. What fatigue I have may not come from the OSA at all. It seems that my wife is getting more rest due to the machine than I am (the study classified my snoring as severe).

So for me the APAP seems to be an incremental improvement rather than a dramatic one. But this is likely a game of small improvements anyway. Anyone expecting or demanding big instant changes is going to get frustrated and give up entirely. So onward in my search for minor gains. I suppose my next step is to look for a better mask. Though my current Comfort Classic is reasonable, there is always room for improvement.

[NightHawkeye]

Congratulations on the new APAP Landkurt! I'm sure you won't regret getting it.

I guess I'm one of the many that doesn't respond instantly and dramatically to CPAP treatment. After all, the sleep study only classified me as having moderate OSA with an AHI of 25 or 30 (all hypopneas and no apneas).

That would agree with the data I see from my oximeter. Hypopneas by themselves rarely cause much difference in oxygen saturation and as I've been able to swap apneas for hypopneas, I do sleep better. It's those nasty apneas which cause so much grief. Many people have even questioned the wisdom of using an index like AHI, but it seems to be firmly entrenched right now.

Regards,
Bill

[LandKurt]

That would agree with the data I see from my oximeter. Hypopneas by themselves rarely cause much difference in oxygen saturation and as I've been able to swap apneas for hypopneas, I do sleep better. It's those nasty apneas which cause so much grief. Many people have even questioned the wisdom of using an index like AHI, but it seems to be firmly entrenched right now.

While I don't have a copy of the sleep study, I did get a chance to glance at it in the doctor's office. I recall 58 hypopneas and 0 apneas. The doctor pointed out that my oxygen saturation went as low as 82%, but I don't know how often it went near that. So I guess you don't have to completely stop breathing to have problems.

I can see how measuring 02 sat. would be very useful when combined with the CPAP data. My machine recorded 0 apneas last night, and only 4 hypopneas, along with a handful of flow limitations and lots of snores (whatever it considers snores anyway, my wife doesn't seem to think I'm snoring anymore). Oxygen saturation would be a great sanity check to go with the 0.6 AHI the Auto computed for last night. It's a shame those monitors aren't easier to get ahold of.