Newbie Help!

[kenrose]

Hi, I got my sleep study a few weeks ago and the results were a little scary. I had 30 sleep interrupts per hour (4 hour test) and my O2 level dropped to 69% ! When the sleep tech put me on CPaP the next 4 hours were spent in deep REM with no cycle time. I woke up feeling groggy and was warned by the tech that I would feel this way for a while. Its been 10 days or so, I am on 12lbs of pressure, ordinary cpap with a heated humidifyer. Have to use flonase which has some uncomfortable side effects but oh well. I am 3yrs post CabG and I am certain that my recovery was severly hampered by apnea. My question is really this. I feel a little better, I have no problems with the pressure or cpap but how do I know its working as well as it can? I live alone and have no idea if I am mouth breathing etc.Do any of these machines auto adjust (and do I need them considering the pressure doesn't bother me in the least, and do they record sleep data of some kind so my doc and I have some clue as to what is going on besides me trying to tell if I am less sleepy than before.
Thanks for any help and suggestions for resources
Ken

[LDuyer]

Hi Ken,

And welcome!

We may need a few questions answered first, to help you. Like, what type/brand of machine do you have, type of mask (I'm assuming it's a nose mask from what you said). And I gather you've been on your cpap for much of the 4 weeks now.

Some machines do have the software that can help you check what's happening. I don't have that, but I understand the auto cpap does that and I believe maybe one of the bipaps, not sure. My machine has a computer card, but it only records usage, not how I'm doing. So you might want to read up on the auto.

Is your machine bought? or rented? Rested Gal here, she has suggested to me that I might borrow or rent an auto to self-diagnose how I'm doing, if I really need my high pressure (18).

Also, have you revisited your doctor since starting your cpap? Your oxygen level was very bad. Mine was too. Were you given supplemental oxygen? If your oxygen levels were that low, then you should be having early followup visits with your doctor to check your level.

As to the mouth breathing. All I can say is that when my mouth does open, I can tell, and it would wake me up. You get this bizarre sensation of air rushing out of your mouth like you're some alien of something. But, yes, I would guess it is possible you're breathing some through your mouth. Perhaps someone could suggest something. I know some use chinstraps to help keep their mouths shut. While that sounds awful to me, it might be something to try, if only to test if you are mouth breathing.

Anyhow. Hang in there, and keep us posted. It's good you feel somewhat better. I bet that means it's working. But it's a concern we all have, and an important one. Oh, another question..... how did you get your equipment? Was it preselected and delivered to you? Did you purchase it yourself and how? Did you got to a local DME (supplier)? Perhaps there's a way of renting an auto.


Linda

[rested gal]

I feel a little better, I have no problems with the pressure or cpap but how do I know its working as well as it can? I live alone and have no idea if I am mouth breathing etc.

That's great that you are feeling "a little better" and are having no problems with the pressure.

Some would probably say, "If it ain't broke, don't fix it." I personally would feel like I was driving in the dark with no lights unless I had a machine and software to show me my overnight data, on my own computer the next morning.

An autopap with software can be set for a range of pressure, and has these advantages over a straight cpap at a single pressure:

1. Lets you take a look at how the treatment is going as often as you wish...see data about pressures used, AHI for the night, leak rate, and more.

2. The autopap will "read" your breathing and adjust itself automatically to deliver what you actually need to keep your throat open. (Pressure needs can change throughout the night, depending on sleep position, stage of sleep, etc.)

3. If a person gains/loses weight over time, or has changing "other" medical conditions, pressure needs can change. The autopap can automatically change with you, eliminating the uncertainty, "Is this pressure really right for me?" Also can eliminate the need for another sleep study down the road, since using an autopap is kind of like having a mini sleep study every night.

So....yes, if a person lives alone and is the least bit nosy about how his/her own treatment is going, an autopap can be a wonderful way handle all this.

If it turned out you felt better on straight cpap than on autopap, you could always set the autopap to run at a single pressure and provide overnight data. And, you'd still have a machine that you could set back to auto any time you wanted to, to check what pressure you needed. Autopap and Cpap - all in one machine. Very flexible.

As for wondering if you might be mouth breathing or leaking air out the mouth, generally the most obvious sign of that would be a dry mouth in the morning, despite using a heated humidifier.

If you had a machine that could give leak data, that could reassure you -- or send up a red flag. Of course, if big leaks showed up in the software data, you wouldn't necessarily know if it was a mask leak or mouth leak.

Mask leaks usually are more noticeable to me. Noisy air leaks whooshing out against my face from a mask that's not sealing well tend to wake me up. I'm more apt to just sleep right on through mouth breathing or mouth air leaking, but as Linda mentioned, massive gushes of air out the mouth could be a real wake-up.

A very nice respiratory therapist who posts on this message board (yeah, you, Christine ) said that her place provides an overnight recording pulse oximeter free of charge, if a doctor orders it. That might be worth looking into, for an occasional overnight check of your SPO2 levels while using your machine. Perhaps your DME would do that free, or at least let you rent one for a night. Could give you reassurance that your treatment was, indeed, keeping your oxygen levels up well while you sleep.

[LDuyer]

See Ken?

I knew Rested Gal would come to your rescue!
She comes with a disclaimer, but she knows what she's talking about.
(pssst, don't tell her I said so!)

Let us know how things progress!


Linda

[kenrose]

thanks for the help, I will keep posting. It is a relief to find this board
Ken