Lost over 100 pounds

[Tooncesdryves]

Hi:
This is my first post on this site. I have been on cpap for about 13 years, and just recently had my 3rd in lab sleep study. Over the course of the last 2 years, I have lost over 100 pounds, and I'm still losing. I've lost the weight by eating a ton of fruits and vegetables and lean protein, etc. since losing the weight, I've been able to eliminate 7 prescriptions, 2 of which were for bp. I now take vitamins, minerals, fish oil, etc.

So, my current machine (Respironics Remstar pro M series)was set at 10. My 2nd sleep study was about 9 years ago, so after the weight loss, I requested a new sleep study, as I started to get daytime sleepiness and some nights, I had that "hard to breath with the rush of air coming at me" problem that I had 13 years ago when I first went on cpap. Also, I'm sleeping only 5ish hours a night and I don't wake up at night and I wear my mask the whole night. So, I just had my 3rd sleep study last Tuesday. I told the tech about the weight loss, and I was hoping that I could get the pressure lowered or possibly get rid of the machine. The next morning, he told me that the highest pressure I needed was an 8. The sleep doc can't get me in until Dec. 9th...so I went online and learned how to reduce the pressure...so I dialed down to 8 while I'm waiting for my appointment.

My cpap is not fully data capable, but when I went in to change the pressure, I found some other screens and 1 showed HPI of 2.5 average in last 7 days and 2.7 average in last 30 days. Are these just OSA's or do they track centrals as well? I'm worried about centrals because I read that too high of pressure can cause centrals. Also, I have cflex on this machine which I never used before or even knew what it was...but I read up on that and I set it to a 1 just to see what would happen. Also, during last week's sleep study, he started me out with level 4 (he said they start everyone out at 4 which does nothing and then they begin titration from there), and I had some mouth air leakage...so he changed me to a full face mask.

Ok...so my question is with all of these changes, weight, no more prescriptions, use of natural supplements, sleeping less hours, etc...what would be the best fully data capable cpap, bipap, auto, etc should I get as I'm still losing weight? One thing I've learned from reading many of your posts, is that we should be monitoring our nightly events, etc. so we can adjust treatment when needed. For 13 years, I had no idea of this. I didn't even know they had auto machines that would anticipate your nightly changes in pressure. I thought the sleep study would throw a level at you...they set your machine at 1 number and that's that. Jeeeeeeeeeeeez, I wish I knew about all of this year's ago...I could have at least been watching my AHI's to see if I've always been at 2.5, etc.

Also, I read that the auto is good at adjusting, but that it can start off too low and you lose benefit that way.

Help!

[Pugsy]

How old is your machine? The older ones didn't flag centrals separately but the newer machines in the PR S1 line from late 2009/2010 to now do flag centrals.

Congrats on the weight loss.

If you can figure out exactly which model machine you are using I can tell you more about it.
Robysue's thread on help figuring out machines might help.
viewtopic.php?f=1&t=72302&p=665165#p665165

[Tooncesdryves]

Hi Pugsy...thanks for answering. I looked at the bottom and its model 1022334. Also, my mask leakage is at 39%. Is that high? It sounds high to me. Also, I'm a 51 year old woman.

[Pugsy]

I think that model number goes with a M Series Pro...do you see Pro anywhere on the machine or humidifier and M on the machine or humidifier?

The leak rate of 39 is total leak and it's 39 L/min and that is actually quite low.
Your machine is reporting total leak which is different from excess leak.
Total leak is the masks expected/intentional vent/leak rate plus any excess leak.
Large leak territory for your machine is going to be up between 80 to 90 L/min total leak.
Your leak numbers are great if you stay well below 80 L/min.

The M series machine didn't flag centrals separately but it could sort of sense them and from what I was told by a Respironics tech if you had centrals it would put them in the OA or hyponea basket (usually hyponea) so the AHI would still reflect them in terms of numbers.
Your AHI is nice and low and if you are having centrals in great number the AHI would be higher.
I doubt that you are having centrals of any consequence.

It's probably time for a new machine though...might as well get one that flags centrals separately.
Or are you going to continue the weight loss and maybe try again to see if you can go off the machine?
Obviously right now you still need the machine.
If you wanted to...you could buy a gently used PR S1 machine out of pocket if your insurance won't play ball or if you have a high deductible. If you would be interested in doing that send me a PM.

I can get you the software (Encore) that will work with your current machine but you will need a special card reader that costs around $75 from cpap.com.
Software is free though.
If you are thinking a new machine sometime in the near future then I wouldn't put any money in the card reader...but if you plan on keeping this machine for a while and really want to know what the software says...you can still buy the card reader if you wish.

So you have several options...Quite honestly...with the low AHI and low leak rate and you have a Pro machine...I don't know that you are in desperate need of the data that the Pro M series shows.

[Tooncesdryves]

Thanks Pugsy...I am continuing with the weight loss, so I'm looking for a machine that will adapt as I keep changing, and one that will show me (read outs, etc) whether or not I still need a cpap...so does that mean I need a bipap?

[Pugsy]

whether or not I still need a cpap...so does that mean I need a bipap?

I think maybe you were thinking apap and not bipap.
All the name brand apaps are full data...not all the cpap only machines are full data.
bipaps are bilevel machines where 2 pressures are used and it doesn't sound like you particularly need 2 pressures.

APAP is where the single pressure will auto adjust as the machine senses the need.
CPAP (which is what you have now) is a fixed single pressure that can't auto adjust.

Since you have been using CPAP for so long you probably don't really, really need APAP but APAP capable machines are like having 2 machines in 1...as they have apap and cpap modes available where a CPAP only machine has only cpap mode.

I always suggest getting apap capable if at all possible...never know when that auto adjusting mode might come in handy. They do cost a little more though...so if money is really tight and insurance isn't paying...cpap will get the job done.

Actually in your situation...the Respironics PR S1 Pro or the new DreamStation Pro has limited apap capabilities and might be all you need. It's a fixed cpap machine but has 30 days of apap mode available which can be reset a few times.
But right now with the DreamStation model line being just released last month...there are some really good deals available on the PR S1 APAP machines.

[archangle]

BRAVO! on the weight loss.

There is a list of good machines in the Useful Links section in my signature line at the bottom of this post.

I would avoid the DreamStation machines until the free SleepyHead program is updated to work with it, or at least there is a new version of the manufacturer's Encore Basic program available. There's an online sleepmapper or dreammapper program for the DreamStation, but EncoreBasic is much better and SleepyHead is MUCH better.

I'd also wait for there to be more time to be sure the DreamStation doesn't have any new model problems.

[chunkyfrog]

When I tried on a new mask Monday (it didn't work), the DME hooked it to a new Dreamstation.
Nice; nicer still when we can see the data ourselves.

[herefishy]

You say the new machine was nice - could you sense a difference? Or just nice that the RT could see data?

[Tooncesdryves7]

Thanks Archangle...so no dreamstation

[archangle]

Thanks Archangle...so no dreamstation

Probably a good machine, but we don't (yet) have access to the software to read the full data we get from the preferred models. No SleepyHead, and not even the manufacturer's Encore Basic, which pales in comparison to SleepyHead, anyway.

[Toonces]

Hi All:

So I finally had my doc visit to discuss results from my sleep study from a month ago. My results were AHI 2 events per hour including 12 Aeneas and hypopneas (1obstructive, 6 central and 5 hypopneas). Centrals were post arousal in nature.

With all of the changes I've had, the doc wanted to see what my Apneas would be without the cpap, but my sleep study was ordered as a titration only from my primary care doc...so now I'm having an in home sleep study...has anyone here had an I home sleep study...I have not had one.

Thanks

[LSAT]

Hi All:

So I finally had my doc visit to discuss results from my sleep study from a month ago. My results were AHI 2 events per hour including 12 Aeneas and hypopneas (1obstructive, 6 central and 5 hypopneas). Centrals were post arousal in nature.

With all of the changes I've had, the doc wanted to see what my Apneas would be without the cpap, but my sleep study was ordered as a titration only from my primary care doc...so now I'm having an in home sleep study...has anyone here had an I home sleep study...I have not had one.

Thanks

It's not necessary to repeat this information on 3 different posts. Stick to one post and you will get answers.

[Toonces]

Thanks LSAT...I'm still new to the message board

[Dingdongdiddlydoo]

I'm able to tolerate the bipap more than the CPAP ..in spite of all my problems when I tired the CPAP I dreaded going to bed..though I have some similar problems I don't have the fear.
Yes your mask should be in the good zone and not leak, you might ask for a whole new mask setup and headgear that goes with machine. I would def get a prescription to go to a place or have resp therapist to come to your house.and try a few masks.
I also agree an old machine is just not worth it..ask your dr! Be assertive. I am not happy and still suffering meeting compliance but my mask is not leaking haha only good thing. And I wear a chin strap so I don't have ' leakage which I think includes mouth breathing. Oy vey !