Hello from the snoremaster

[snoremaster]

Hi everyone. New to the forum, and soon to be new to CPAP treatment. I'm a 34 year old married man who has a bad snoring problem. A buddy told me of the pillar procedure http://www.restoremedical.com/Pillar-Procedure/ to stop snoring. SImple outpatient deal which would hopefully make my wife happy. Of course the ear/nose/throat doctor orders a sleep study. Horrible night. Anyhow, I knew I was in trouble once the tech woke me up to put the mask on.

Anyhow, I'm still reading all the newbie stuff here - so I'm not going to ask a bunch of questions when the basics are here. If anyone is inclined, maybe you could tell me how "bad" my case is. The sleep study says "The respiratory disturbance index was 138.3 per hour, and the apnea/hypoapnea index (AHI) during sleep was 93.3 per hour. There were 54 total apneas, including 3 central and 0 mixed apneas. The oxygen saturation throughout the study was 98%. The Average Spo2 in baseline sleep was 94.9%, the the minimum SpO2 during sleep before CPAP initiation was 85%"

It goes on to say that I responded perfectly to BIPAP @ pressures of 10/6 ....

Anyhow, thanks for any early input / advice.

SM

[brazospearl]

Welcome to the forum, snoremaster! Read all you can here, it'll really help you. It appears that you had a pretty fair number of events, and the centrals are distressing. Give serious consideration to the bipap, it might be the best for you. The success rates on the surgery you mentioned aren't particularly high, so do a LOT more research before you go that way. Let us know about your progress!

[snoremaster]

Thanks brazospearl.

Pillar is out - Doc does not do it to treat anything other than zero apnea snoring.

Also I see that the number of apneas isn't that relevant without a duration. It was 54 apneas in 72 minutes, which after googling severe apnea, I see that mine is considered severe Thanks for the reply.

SM

[pdean44]

Welcome the forums. Great bunch of folks here. I started my journey looking for a way to stop snoring. My wife and i were no longer sleeping in the same room for the last month. I had no idea that I had sleep apnea at that time. I just wanted to solve the snoring issue. I had a lot of problems with day time sleeiness. I just though they were a by product of the arthritis meds I was taking. My doctor suggested i get a sleep study done to get to the bottom of my snoring problem.

After 2 sleep studies i was sent home with a machine. Not only has it stopped the snoring i am feeling so much better now in the morning when I get up. More energy and just feel better.

I gathered as much info as i could before i went to the studies. It is good that you are doing that now. the folks here can guide you on what to expect and provide a lot of information on the equipment you will be using.

Welcome aboard! I look forward to hearing from you

[Janknitz]

Your O2 sats were good, but the AHI's are pretty high. As you've discovered, anything over 30 in an hour is considered severe. I've seen much higher than 93 AHI, but yours are "up there". Mine was 77 and the doctor went postal (my O2 sats were also dropping down a lot).

The good news is that it's very treatable and that on xPAP you will not snore. Most likely there are conditions bothering you that you don't notice now, but you will appreciate when they are GONE as a result of good therapy.

Keep studying up and feel free to ask any questions you may have. There's a lot of info here, but it's not always easy to find the specific thing you are looking for. We are here to help

[Julie]

Just one thing here - someone said "the centrals are distressing". Well, 3 during the study is nothing at all! That's low compared to many or most, and it signifies nothing at all. Only if yours were in the higher two figures should you be concerned, so don't go chasing red herrings , a few during your test is perfectly normal and nothing to be distressed about.

[sleepmba]

Snoremaster,
I do sleep studies on people. You mentioned surgery and then you said the ENT didn't want to do it for your case. That is actually a blessing in disguise. I run sleep studies on people before and after those surgeries and the difference is not impressive. Statistics show that about half of the people have success with the surgical option. Also, sometimes they will work for only a few years. The flesh in the airway will tend to go back where it was.
Anyway, BiPAP is a good thing. The only hurdle you may have to jump now is finding a comfortable mask. There are many out there. Researching will pay off in your hunt for the "perfect" mask. You are in the right place for info. Check out my blog for info about BiPAP/CPAP. I am continuously adding topics to it. Also, on that page there are many companies advertising that have many masks for you to look at.
Good luck and keep us posted.

[snoremaster]

Thanks everyone. I'm anxious to get started.

I do wonder how much the severity of OSA relates to our physical condition.

18 months ago I was really working out a lot. Lifting and a solid amount of cardio (one hour, 4x week of cardio). My wife reported then that my snoring was much more tolerable. Not gone ... but tolerable. I had completely unrelated surgery last autumn which stopped the exercise - and I'm only getting back into the workout regimen this past month. The bottom line is that I weigh 215 lbs now, where normally I'm around 185. Should I lose the weight and do the study again - or should I expect relatively the same results?

Thanks all - I can already see that I stumbled on a wealth of expertise here on this forum.

SM

[sleepmba]

Snoremaster,
In the sleep studies I've performed, I've seen before and after of weight loss. Typically, someone needs less pressure when they lose weight. I've actually seen somebody that lost enough weight to where they didn't need xPAP anymore! Check out my blog under "CPAP Forever?"

It is definately worth getting another sleep study once you've lost weight.

[snoremaster]

thanks sleepmba - and everyone. I have the home care person coming out next week .... we'll see - here we go.

SM

[snoremaster]

So a quick update - I've had two nights on the machine so far. The first night I did not sleep at all with the mask. I battled until 4am and gave it up. Last night I slept for 6.5 hours on it - and didn't wake up once. I just got my encore software and see that my AHI was a hair over 5 - a big improvement, but not quiet where I want the numbers to be. No leaks reported. I don't want to jump the gun on changing pressures - but just so I'm prepared - what would you recommend I do?

Also - the machine can be set to auto bipap. I guess that's where you set the max inhale / exhale - an it adjusts lower than that as needed? Anyhow, the good news is that my mask is perfect for me. Really really doable - so I'm pleased. A relatively successful start here.

[brazospearl]

Congratulations! It sounds like you're off to a great start. Give it a little more time before you fiddle with your pressure; since you're sleeping better you might have fewer events right where you are.

[rested gal]

I don't want to jump the gun on changing pressures - but just so I'm prepared - what would you recommend I do?

I'm not a doctor, but if I were going to change anything, I'd still keep the machine in just bilevel mode (not changing to auto bilevel) and I'd raise the EPAP pressure (currently EPAP is 6, you wrote) to 7 or 8.

If I raised the EPAP, then in order to maintain a comfortable difference in the exhale/inhale pressures, I'd set the IPAP at whatever it takes to keep at least a 3 cm difference between those two pressures.

For example, if I raised the EPAP to 7, I'd keep the IPAP set at 10 (as it is now for you.) If I raised the EPAP to 8 , I'd set the IPAP at 11.

Just a one or two cm increase in the EPAP pressure might lower your AHI, even though the AHI of 5 you're getting now is fine.

Here's an interesting topic you might find useful:

Moogy's thread about hints and tips:

Oct 30, 2006 subject: Please Share Misc Helpful Hints
viewtopic.php?t=14746

[snoremaster]

Thank you, that makes good sense. I will let it go for the next couple of nights to see if the AHI maintains - and perhaps try a small adjustment upwards after the weekend.

Having this software is absolutely invaluable. How can anyone assess therapy without a data capable machine?

[sleepmba]

Snoremaster,
I recommend you keep it where it is for now. When a person has untreated sleep apnea, their airway is usually irritated and a little swollen because of all the breathing events and snoring. Your airway is still trying to "heal". Give the therapy a little time to sooth your airway.

Also, you still have some "getting used to" left to do. When you are more accustomed to it, your AHI will probably go down too.

The machine you have with all the data is good, but probably not 100% accurate. I'd leave room for some error in the AHI count. I would say it is fairly accurate though depending on the individual.

Keep us posted.