Unsure about CPAP

[Miss Emerita]

Why thank you!

[Corgilicious]

Just joined this forum, but have been reading since I was diagnosed mid-January with a combo of OSA & CSA. Last night I had my titration & was so excited & hopeful. Came here today for some perspective since I feel like I've pulled a few all-nighters and feel horrible! Woke with a headache & I, like the OP, wasn't sure I should drive home. I didn't really think I had slept at all, but my technician assured me that I didn't have any episodes & even got some REM. I'm looking forward to the results & numbers. Thank you all for the words of encouragement to the OP and other words I've read. It helps to know that it is a journey and not a quick fix, but definitely worth the hassle.

[Okie bipap]

Welcome to the forum. Please start your own thread by clicking on the "Post New Topic" at the top of the page. You will get better response that way. You want to get a machine with full data capability once you start treatment. The most highly recommended machines are the ResMed Air Sense 10 Auto for Her and the Air Sense 10 Auto. These are auto adjusting machines with full data capability. Once you start a thread, keep all of you comments in that same thread until you get your treatment optimized. This will make it easier for the people helping you.

[Ht538]

Sooooo....dr’s Office called me Friday about my titration study. Apparently my assessment of no sleep was almost right. I did log a full 22minutes or broken sleep. My longest sleep period, yes longest, was 97 seconds. Needless to say, they didn’t get the data needed. We spent some time chatting about my experience that night and they are going to confer again with doc, but looks like they will be ordering equipment for me to use for a few months, then coming back to have the dr take another look at the data. This feels like it’s just drawing the whole thing out even further

If they didn’t get enough data then how will they set any pressure. I did notice that during the study there was a period where it seemed like the pressure was different on inhalation vs exhalation and that even when the pressure stayed constant as soon as I shifted to my back from my sides, I just couldn’t breathe again. How am I going to manage this at home when there’s no tech there adjusting anything?

Anyone else come home with inconclusive titration study results?

I am starting to feel like a sleep flunk out!

[kteague]

Inconclusive results happen. The sleep study setting is ripe for that result - strange bed, strange bedding, strange sticky pads and wires all over, strangers watching you sleep, etc. I've had a few sleep tests that the doc termed technically suboptimal. Even though I got some sleep, they couldn't capture REM sleep while supine, which is potentially one's worst case scenario. Even though I had in lab studies, my lack of success at home led to the doc oredering me a loaner machine for a few weeks to see if they could figure out from the data what was wrong. If they give you a data capable auto adjusting machine, you'll get tons of good info from that. Some insurances have actually gone to having patients determine their settings with a machine at home instead in a lab. It's a valid approach. The machine will be set to a range of pressures. They are designed to recognize if your breathing indicates you need more pressure and will incrementally increase it. The machine data will show if your pressure range needs any adjustments. What the machine doesn't do that the lab does is look for evidence of limb movements, another sleep disorder. If that's not suspect for you, you'll probably find your home sleep trial more productive than the lab one. Good luck with things.

[Ht538]

Does an at home machine capture hypopneas or just apnea? I only had 1 obstructive related apnea, the other two were central Apneas. All the other events were hypopneas. I’ve heard that the at home machines can miss osa and provide a false negative. I’m presuming because that is the way they capture the breathing events.

[Pugsy]

A home machine that will auto adjust (commonly refered to as apap) will record and respond to hyponeas as well as obstructive apneas.
Hyponeas are an important item they are all designed to fight. Hyponeas are essentially OAs that haven't quite grown up to make it to full OA category.
An apap machine will also respond to snores and flow limitations (which aren't part of the official AHI but indications the airway is trying to collapse) as well as OAs and hyponeas.
Apap machine won't respond to central apneas because the airway is already open and not blocked by airway tissues collapsing.

[Miss Emerita]

See if they'll trial you on a ResMed Airsense 10 Autoset. I think if you were to have initial settings of 7 to 20, with expiratory pressure relief (EPR) of 3 and no ramp, you'd learn a lot very quickly, especially if you use Oscar and post your charts here. The experts can then help you fine-tune your settings.

For what it's worth, I think for most people sleep-lab titration is a waste of time and money and a very discouraging introduction to apnea therapy. I'm a Kaiser patient, and Kaiser does not routinely do sleep-lab titration. They just send you home with an auto-adjusting machine, look at the data, and adjust accordingly. My biggest quarrel with their procedure is that they start patients with 4 to 20; 4 leaves most people feeling starved for air. My second-biggest quarrel is that they send you home for a week of this"titration" with a Philips machine, even though they issue the ResMed machines as the patients' "keeper" machines.

[Ht538]

Miss Emerita, you read their minds! I understand from the DME that I will be getting an Air Res Med Airsense Machine. She said there was no difference between the his and hers models.

I am assuming that this machine adapts to your inhaleS versus exhales as I was having a lot of issues sort of holding my breath when everything was constant. I know they take getting used to, but the breath holding thing is something I tend to do even now and when awake. Several people
Have mentioned it to me.

I am a die hard side sleeper (think fetal cocoon with blankets). Since I’ll get to try several masks I am looking for options to consider. I tried the dreamwear nasal pillow mask for the titration. I liked the hose being at the head so that I could still have my hands curled up near my face. That said, I felt like all I could do was hear myself breathe. Is this because the air flowed on the sides of my face or indicative of some other issue. While i think I could eventually get used to the noise (I spent several years stationed on a ship), my daughter is aT1 diabetic and I need to be able to hear her blood sugar alarms from my phone during the night. They are pretty loud but I’m really concerned I’ll miss them especially in deeper sleep.

Any recommendations on alternatives? Would a full face mask help with the inhale/exhale issue?

Thanks again for everyone being responsive and helpful. The idea of CPAP although I am a slender 45yo non-snorer w/almost too low BP is slowly sinking in...so I really want to give this a solid effort!

[Pugsy]

She said there was no difference between the his and hers models.

Well.....actually there is a difference and a fairly substantial one. Whether or not that difference would be of use to you is unknown at this time though.

See the clinical manual here.
https://www.respshop.com/manuals/ResMed ... %20her.pdf

The regular ResMed AirSense 10 AutoSet has 2 modes of operation..2 machines in one.
1...cpap mode or fixed pressure
2...apap mode or auto adjusting pressure mode

The "for Her" ResMed AirSense 10 AutoSet has 3 modes of operation...3 machines in one
1...cpap mode or fixed pressure
2...apap mode or auto adjusting pressure mode
AND a 3rd apap or auto adjusting mode with a different auto adjusting algorithm
That 3rd algorithm may or may not be of use to use but it would be a shame if you did better with it and didn't have it available to at least try.

[Ht538]

Thanks for the cue to dig a little further. I did some asking with the DME rep and they will get me the “her” version. Squeaky wheels DO get greased

Another odd question for the group - for most folks CPAP seems to be of great relief to their partners who generally have put up with snoring or some other form of noisy breathing prior to PAP. ironically, in my situation, until CPAP, I was the quiet one and he’s the snorer. He is a relatively light sleeper. Has it been a difficult adjustment for the significant others now that they are sleeping with a noisy CPAP user who was completely quiet before the treatment.

We are also big nighttime snugglers, not just at bedtime but throughout the night...how does that work with a damn hose in the way. It’s like we are being driven apart whereas most folks are able to get closer, in some cases eliminating sleeping in separate rooms because of CPAP. We are very close now and I feel like this will just push us apart. It’s not like he’s trading some white noise and air blowing for disruptive snoring. This won’t be an improvement.

This all just seems to be so backwards from all the other folks out there. And as I am getting closer to getting this machine I am getting more unsure about managing all the obstacles I’ll have to maneuver to adapt this into my life. Just getting through the hurdle of adapting and a period of even less sleep than now is daunting in itself.

I am really, really anxious.

[busymummy]

I have mild apnea and have been on cpap therapy for two months. The first night was really hard but it got better quickly. It’s very important to stick with it because you will acclimate faster. The masks need to be fitted properly but are designed to be as comfortable as possible. My device has a humidifier and heated hose and breathing in the moist warm air is very soothing.

You will likely sleep better and feel better and over time will come to appreciate cpap therapy.

[Ht538]

So tonight is the big night...I’ve had the mask on a bit and it’s not bothering me too bad...apparently all that headgear for braces as a teenager was more helpful than I thought!

I also recently started wearing breathe right strips at night and they have made a HUGE difference in my ability to breathe well at night through my nose. Actually wondering if that’s been some of my issue all along. Just that change and I felt like I was getting better sleep. Hopefully the CPAP takes it up another notch.

Many of you have talked about software....is that something separate. I have the AirSense app on my phone and the SD cards in the machine, but not sure where the software aspect comes in. I’m a total data geek engineer so I think seeing the data will help reassure me everything is working even if I don’t see much change right away.

[jimbud]

Many of you have talked about software....is that something separate. I have the AirSense app on my phone and the SD cards in the machine, but not sure where the software aspect comes in. I’m a total data geek engineer so I think seeing the data will help reassure me everything is working even if I don’t see much change right away.

Get Oscar and geek it up.

https://www.sleepfiles.com/OSCAR/

Read, learn and enjoy.

JPB

[Ht538]

So I wore the mask for a while before bed, did some reading with it on and felt pretty comfortable. Had been up since 0500 and took 3mg melatonin at 2130. At 2230 did a 10 min meditation wind down and was feeling good. Mask was sealing well, felt like k was getting the hang of the breathing. And then I couldn’t get to sleep. I was feeling comfy and relaxed in my bed, felt like I was starting to doze, but didn’t actually fall asleep. I kept getting cramps in my feet as well. Sometime I get one or two but this was maybe half a dozen times. I also felt like I was holding my breath. Air sense says 8.5 events per hour, but I was awake the whole time so assuming that was from me moving around and the breath holding. Mask seal was 5/5.

I have to be up to get kids to school at 6 and needed to be safe to drive so at 0030 I ended up taking off the mask
Immediately fell asleep. Besides being tired this am I am super sweaty...really weird.

Anybody get the sweats or hold their breath?

I’ll be trying again tonight, but really frustrated that as good as I felt I didn’t sleep. I am hoping to get to the 4 hr min tonight....hopefully with some sleep involved!