Can anybody help me?

[RobbieG]

Hi All,

I haven't posted in a while but have been keeping up with all the topics.

After using my machine for two years and been feeling much better, I've been having quite a bit of fragmented sleep for a couple of months. I've been awakenined from apneas feeling like pre-therapy days, along like feeling like I'm suffocating with the mask on. My machine (not Auto, though I think I'm getting one) is set at 7.5.

My DME gave me an apap yesterday to use to see if I need a pressure adjustment.

I usually fall asleep on my back but turn over onto my stomach and sleep this way most of the night. Now, that seems to trigger a hypopnia that wakes me.

Does anybody have any idea whats going-on? Is it just a matter of pressure adjustment? I have multiple sclerosis and have wondered if centrals may be the cause of my problems.

I'd appreciate anyone's feedback. I value your advice.

Rob

[Babette]

Might be your mask. When is the last time you got a new mask? Are your seals breaking down? Maybe you just need to try a DIFFERENT style of mask.

In my experience, there are constant variations. I'll get everything set, and it will work fine for awhile, then it will go south in one area or another, and I have to readjust. Starting with an APAP is a great idea. You should also look at your stats and see if you are having large leaks, which could indicate mouth breathing. You might need to work on sealing your mouth better, or using a different style of mask.

Good luck!
Barbara

[Goofproof]

The type of machine you are using is shown as a Classic Filter Cover, they do not make much pressure, that's why you need to fill in your profile in text not icony. If your machine, (or Filter Cover), can use the software and reader to collect data, it is very useful in tweaking your treatment. Jim

[ozij]

Does anybody have any idea whats going-on? Is it just a matter of pressure adjustment? I have multiple sclerosis and have wondered if centrals may be the cause of my problems.

I'd appreciate anyone's feedback. I value your advice.

Rob

Robbie, with your MS it may not be just a matter of pressure adjustment - it may be a problem of weakened muscles impacting your ability to breathe deeply enough. You have to speak to someone who knows how MS may impact your breathing - especially when you're asleep. One you have all the necssary info about the present condition of your lungs/breathing, we will all be much wiser, and may be able to consider which machine and/or what settings will serve you better than what you have presently.

O.

[mindy]

Rob,

The APAP should give you some idea of what's going on even though most don't specifically identify centrals. If you find your pressure is continually going up and "chasing" apneas, that could be flow limitations or centrals, imho. It sounds like first step is to see results of APAP. I would suspect that multiple sclerosis could be having an effect that could involve either obstructive or central apneas. If you have a good doc, I'd consult with him/her. Perhaps you might need another sleep study.

Mindy

[Raj]

Rob, your inverted sleeping position could be an important factor here. On your stomach, you most likely have your head to one side (unless you sleep on a masseur couch with a cutout where your head goes). This twist may be crimping your airway. I'd suggest you try to train yourself to sleep on your side and see if that resolves the issue. One way to do this is to place pillows or bolsters that aren't too tall to either side of you, lie on your side, and drape your free arm over the pillow. In that position and so long as you keep your free arm in place, your body will have difficulty turning belly down.

I hope this helps or you find another solution quickly.

[RobbieG]

Thanks everybody. I appreciate the comments. I think that after the week on the apap that it will hopefully point me in the right direction. I wonder if I do have leaks, which I don't think I have. I'll call my neurologist after the holiday to get her feedback or if she or my DME recommends another PSG. I'll let you know how I make out. Happy New Year!

Rob

[Goofproof]

A lot would depend on how your APAP is set up. They may have set it up in the 4cm to 20 cm failure mode.... Jim

[Racurl]

4 to 20 Cm "Failure Mode"? What the heck is that?

My DME set my Apap at 5 -15 Cm. Does this qualify as a failure mode?

[nate fry]

If you gainded weight between the time you got the cpap and now I would bet thats the problem. Plus apnea naturally gets worse as we age or atleast thats what my ent doc says.

[mindy]

4 to 20 Cm "Failure Mode"? What the heck is that?

My DME set my Apap at 5 -15 Cm. Does this qualify as a failure mode?

An APAP set at 4 to 20 cm is the maximum possible range --- it's not calibrated to the individual's therapy needs and so some feel it's a "cop out". In addition, some people have difficulty breathing at a pressure of 4 or 5. If you're titrated pressure is around 6-8 (strictly IMHO!) and you don't have the problem some of us have with pressure going as high as it can, it would probably work. But for some it may not work well. I'll bet someone will have a better answer than this.

Mindy

[Georgio]

Most report they have difficulty breathing at 4 or 5......consider setting the bottom at at 6 or 7.....the DME's don't know this.

Good luck.....

Georgio

[birdshell]

Please bear in mind that I am far from being an expert in this field, and your MS may complicate everything, too. (MS can be tricky, can it not?)

That said: If you haven't had a repeat of your sleep study (PSG or polysomnogram), then it is quite possible that you do need a bit more pressure. Without a data-capable machine, the need for pressure can only be determined by a PSG. It can also diagnose added problems that may have occurred with time, or that were masked by your original sleep disordered breathing.

After using CPAP for a while, the swelling from the irritation of snoring (and other breathing problems?) may be reduced. Then the floppy tissues may be impeding the airflow. Thus, your therapy may require more pressure.

I am not an expert by any means, but do know that my pressure was increased by 3-4 cm per year and that the first yearly PSG diagnosed PLMD. The PLMD wouldn't have been caught by an APAP; it was disguised from the original PSG and titration by my apneas.

All of these explanations are second-hand versions of what was explained to me, so please take that into consideration. Your MS is going to be a factor, and I daresay you must have help and support from an informed sleep specialist--or at least a doctor who is willing to work with you and research the needed information for you. All the best to you, and I am glad that you have continued to lurk!

Karen,
Who feels somewhat suffocated at 4 cm, or even 5

[Goofproof]

4 to 20 Cm "Failure Mode"? What the heck is that?

My DME set my Apap at 5 -15 Cm. Does this qualify as a failure mode?

For me it would be, by the time it climbed from 5 to 15 I could be dead ten minutes. I'd want it set 2 cm under your CPAP pressure and 2 CM over it. Then I would use the data to fine tune it. Jim

Unless the person that did you sleep test was a flaming moron, which is possibly.