First week on CPAP - the good and the not so good

[sleepyJen]

I have just about a full week under my belt with the CPAP....

The good:

Overall, it's been a much easier adjustment than I expected. The first night, with the Wisp mask, was awful. But, I went back to the Swift FX (need to update my profile) and it's been much easier.
I hardly notice the mask or really feel the air pressure - sometimes I have to open my mouth to convince myself that it's working. But I find the mask comfortable and I don't think I'm having issues with leaks. (that I notice)
This morning my husband woke me up saying "your machine isn't working" because he couldn't hear a thing - I had to take the mask off to show him it was indeed on.
Falling asleep right away and only waking up occasionally (usually because I have to adjust the mask or the air from the vent work me up)
Feeling a tiny bit better - definitely less foggy with a tiny bit more energy.

But the bad:

My AHI number keeps going up - from 0.71 and 0.72 the first two nights to 5.04, 6.19 and 7.50 the past three nights, with all sorts of events happening (the machine not registering large leaks or periodic breathing - still trying to sort out sleepyhead and understand it) Nothing has changed so I can't figure out why this is happening - I don't think I'm having leaks. I wonder if I could be mouth breath but I'm just not sure.
Still having headaches, but more of a pressure type than tension type.
All sorts of stomach issues - yes, the Aerophagia but oddly, not until usually later in the day. Two days this week about 5 pm I was doubled over in pain. It's gotten better, but I have more reflux like issues now. I've been drinking a lot of ginger ale in place of actually eating because of how my stomach has been.

I see my Dr in 2 weeks but if some of these things don't get better, I may need to call her sooner - the headaches are annoying and I'm tired of feeling like I'm going to throw up.

Overall, though, adapting and compliance were what I was worried about most and that's been going well, so I'm happy with that. I appreciate this forum and the wealth of knowledge so very much!

[Pugsy]

What is the event category breakdown for those higher than you want AHI nights?
How much is Obstructive apnea, hyponea and clear airway?
Can you post a typical detailed report so we can see what you are seeing?

[sleepyJen]

Hi Pugsy,

I'm not exactly sure what you need to see so here's a few screenshots - I hope this works....these are from last night....

[sleepyJen]

hmmm didn't work - I'll try again....

[sleepyJen]

Holy cow - I'm not usually so tech challenged but I finally got it

[Pugsy]

I don't know why your first few reports had a nice low AHI ...
but if your other not so good AHI reports look like this one then it looks like the pressure setting is not optimal.

SleepyHead is saying cpap mode at 9 cm...I don't see a pressure graph to confirm the settings.
The AHI graph is not need...nor is the snore graph because we have snores show on the Events graph.

The 2 most common reasons for needing more pressure are usually supine sleeping and/or REM stage sleep.
Maybe the low AHI nights you didn't sleep on your back (if that is what is happening here) or you didn't get much REM sleep initially..hard to know why but based on this report and if your others look like it....I suspect that the pressure setting is not quite optimal.

Are you using cpap mode at 9 cm? or apap mode?

[Bill44133]

Your snoring like crazy.. your not supposed to snore.. You need more pressure.

[sleepyJen]

Yes, pressure is set at cpap 9 cm - that hasn't changed at all. The only thing I changed (on the second night) was the C-flex to 3 from 2. My first 3 days are very different -

For example - this was night number 3 (what you saw already was night number 6)



I was worried about the snoring but my husband says I'm not (well, it's at least not waking him up like before)

I do think you are right that i might be sleeping on my back more - I know the first few nights I was more afraid to move, but as I've gotten more comfortable with the mask, I do believe I'm moving more and possibly on my back more

[Pugsy]

I think that with the snores and the other obstructive elements of the AHI (OA and hyponeas) that for some reason the pressure which may have been okay initially ...isn't okay now.
Maybe you are simply just getting more sleep also.
Whatever the reason...9 cm isn't working well now.
If you aren't comfortable changing it yourself then I wouldn't wait awfully long getting with the DME/doctor to get it done.
I don't see it changing much with time in this situation.

[jweeks]

This morning my husband woke me up saying "your machine isn't working" because he couldn't hear a thing - I had to take the mask off to show him it was indeed on.

Jen,

You have a keeper for a husband...it is sweet that he is so concerned about you, and accepting and supportive of getting started with your treatment. One thing you can do is show him the exhaust port on your mask. That way, he can put his finger above the port and feel the air coming out, then he will know that things are OK without having to wake you up.

My AHI number keeps going up - from 0.71 and 0.72 the first two nights to 5.04, 6.19 and 7.50 the past three nights, with all sorts of events happening (the machine not registering large leaks or periodic breathing - still trying to sort out sleepyhead and understand it) Nothing has changed so I can't figure out why this is happening - I don't think I'm having leaks.

I am curious why they put you on CPAP, especially when Sleepyhead says that you have an APAP machine. An auto range of something like 7 to 14 might help get you dialed in, but then again, I wouldn't pretend to second guess the professionals here. There might be a reason they gave you a fixed pressure at 9. Some folks have an issue that when they get comfortable with CPAP, they relax more, and that can cause the airway to get a little more droopy than before. That can suddenly make your sleep disorder worse, and require you to need a bit more pressure. You might be one of those lucky people. Sometimes just a 1/2 centimeter more of pressure can make a big difference.

If you have a positional aspect to your apnea, sleeping more on your back can certainly cause an effect like you see. As an experiment, you could try forcing yourself to sleep on your side for a night. I know I do much better if I sleep on my right side than my left side, so even which side you pick can make a difference.

It is not unusual to need tweaking after you get started.

-john-

[cpapVAL]

The stomach issues are a bit strange. Could just be caused by excess air from having too many pillows so you are sleeping propped? That causes your chin to go down and so traps the air a bit more in your stomach/system. Just a thought if you are using a pile of pillows. I certainly always have and it helped (was annoying to get rid of them) but helped with the cpap.

Good luck to you

[Bill44133]

I think that with the snores and the other obstructive elements of the AHI (OA and hyponeas) that for some reason the pressure which may have been okay initially ...isn't okay now.
Maybe you are simply just getting more sleep also.
Whatever the reason...9 cm isn't working well now.
If you aren't comfortable changing it yourself then I wouldn't wait awfully long getting with the DME/doctor to get it done.
I don't see it changing much with time in this situation.

The air pressure from the cpap is not enough to hold the airway open. That is why you are snoring and your AHI keeps getting worse.
I would bump that 9 to 10 and try that for a few days, and if your AHI is still over 5 bump it up to 11.
You are going to have to fine tune it till you can find what is gonna work for you.

I started my therapy on April 30, 2013, and I had to change my settings 10 times finally settling in October. After I found optimum settings
I let my Neurologist know what I did and showed her my sleep reports. She agreed 100%. The doctor update the DME.

I wish you Good Luck!

[sleepyJen]

You have a keeper for a husband...it is sweet that he is so concerned about you, and accepting and supportive of getting started with your treatment. One thing you can do is show him the exhaust port on your mask. That way, he can put his finger above the port and feel the air coming out, then he will know that things are OK without having to wake you up.

Agreed! He's been great with this - he had a night or two where he found it hard to sleep because he could hear me breathing in and out through the mask, but for the most part, he's just been more interested in what he needs to know and what he can do to help.

I am curious why they put you on CPAP, especially when Sleepyhead says that you have an APAP machine. An auto range of something like 7 to 14 might help get you dialed in, but then again, I wouldn't pretend to second guess the professionals here. There might be a reason they gave you a fixed pressure at 9. Some folks have an issue that when they get comfortable with CPAP, they relax more, and that can cause the airway to get a little more droopy than before. That can suddenly make your sleep disorder worse, and require you to need a bit more pressure. You might be one of those lucky people. Sometimes just a 1/2 centimeter more of pressure can make a big difference.

If you have a positional aspect to your apnea, sleeping more on your back can certainly cause an effect like you see. As an experiment, you could try forcing yourself to sleep on your side for a night. I know I do much better if I sleep on my right side than my left side, so even which side you pick can make a difference.

Funny, after reading this I dug out my sleep study report - no one has really talked to me about all of this, to be honest. I only ended up with a copy because my neurologist wanted one (I was seeing him for my headaches/neck pain) and my reg Dr gave it to me to send to him, so I made a copy. I can't make heads or tails of a lot of it, but one thing I can see is that I only had obstructive events and my lowest saturation levels (64%!) when I was on my back. I had the majority of hypopnea events on my left side. I don't know if it means anything but I found it interesting. I never would have classified myself as a back sleeper but it said I spent 84% of the study sleeping on my back. Not sure how I spent the titration study, but I definitely think I need to work on trying to sleep on my side more.

If things don't improve, or continue to decline, I will call the Dr or DME by Tuesday. I want to get this going in the right direction so I'd rather not delay. I'm a chicken to change it myself, to be honest, though.

[Donn2390]

I must live in a bubble, or at least not very well informed. I have no clue what any of you are talking about..! Last night was the third week on my machine, I have have never heard of AHI nubers, pressure setting, or any of the tech stuff being discussed here. The guy came over, set up the machine and left. I put it on every night and go to sleep. Why do I need to know all this tech stuff, and where would I get that informtion if I did care? I do sleep better, about an hour longer every night, and do wake up groggy. I guess I need a CPAP education???
The only problem I've noticed is the bridge of my nose looks like someone punched me. It's red and sore where the mask makes contact..

[Julie]

Donn - I suggest you first start your own thread, not have your business get lost in this one, and then we'll try to help you... you need to know all the stuff because if what you do is ineffective, you're not getting treated and wasting money and time.

You're obviously having some issues that we can definitely help with, but need some more info to do that. Can you first register as a forum member, after which you can then click on User Ctl Panel (small heading under main Cpap logo), then go to Profile and fill out the full name and model # of your machine (Resmed is not enough) and mask in text please rather than icons, and they'll now appear under ever post you make so we'll know what you're working with when we have some advice or further questions. We can then explain about the numbers etc., and you'll be part of your treatment and not just a passenger.