Newbie Question Not Already Answered

[Swick]

Friends,

I was diagnosed with severe obstructive sleep apnea/hypopnea a few months ago. My AHI from the sleep study was 43.5/hr (About 80/hr sleeping on my back and about 20/hr on my side). My doctor(s) are not too spooled up on OSA and take the recommendations from my polysomnography as gospel. My prescribed setting is 9cm/H2O. Yesterday I met with a clinician who delivered my first/brand new "snore buster 2000" which is a ResMed S8 Autoset Spirit II machine with H4i humidifier and Mirage Micro nasal mask. This machine seems to be top quality, but the clinician has not enabled all the perks that the machine can do such as running it in APAP mode or enabling EPR. It is a pricey machine which I feel is only using the minimum features (CPAP only). After my first night with the machine, I slept with it for a little over 5 hours and had an AHI of 3.3. I felt a little more rested than before, but I am adapting still. From what I have read, an AHI of 3.3 is pretty good. I know that pressing the "down and right arrows" will allow me access to the clinicians menu. Is it worth enabling more of the features/capabilities? Should I just go with it for the mean time? I have spoken to a few people who have OSA and said that they felt much better after the first night of CPAP therapy. Should I have felt better and more refreshed after the first night?

Thanks for your help and support,
Derek

[cflame1]

give it at least a week... let your body adjust to the machine with the settings that the doc rx'd.

[dave21]

Hi There,

Basically anything below an AHI of 5 is good. If you click the image below in my signature it'll give you some additional information that you might find very useful.

The S8 is a good machine, I had the S8 AutoSet Spirit but traded up to the S9. On the S8 my AHI was on average 4.5 but with the S9 it's reduced to an average of 0.4 (mostly due to the way hypopneas are now scored). Any AHI below 5 means you are getting good solid treatment

Thanks
Dave

[GumbyCT]

Not sure which question you were referring to?

Should I have felt better and more refreshed after the first night?

Everyone one is different. Some feel better from the titration nite. Others need to get the right mask and/or leaks fixed and pressure right before feeling better. That process took me about 1yr.

Is it worth enabling more of the features/capabilities? Should I just go with it for the mean time?

While this is certainly a liberal forum advocating YOU take charge of your therapy, I doubt anyone would recommend change for the sake of change. Meaning, don't just go changing your settings without a reason. And even then you should write down each and every setting BEFORE you change anything. Write the settings down in your notebook. You do have a notebook, right?

Spend some time here searching and reading. Write down any questions you have so you can ask here, then ask your doc or DME too. Then read some more. Before you start making any changes you should know what to expect for an outcome and why. Be sure to also write any reasons for the change in your notebook, also.

Friends,

I was diagnosed with severe obstructive sleep apnea/hypopnea a few months ago. My AHI from the sleep study was 43.5/hr (About 80/hr sleeping on my back and about 20/hr on my side). My doctor(s) are not too spooled up on OSA and take the recommendations from my polysomnography as gospel. My prescribed setting is 9cm/H2O. Yesterday I met with a clinician who delivered my first/brand new "snore buster 2000" which is a ResMed S8 Autoset Spirit II machine with H4i humidifier and Mirage Micro nasal mask. This machine seems to be top quality, but the clinician has not enabled all the perks that the machine can do such as running it in APAP mode or enabling EPR. It is a pricey machine which I feel is only using the minimum features (CPAP only). After my first night with the machine, I slept with it for a little over 5 hours and had an AHI of 3.3. I felt a little more rested than before, but I am adapting still. From what I have read, an AHI of 3.3 is pretty good. I know that pressing the "down and right arrows" will allow me access to the clinicians menu. Is it worth enabling more of the features/capabilities? Should I just go with it for the mean time? I have spoken to a few people who have OSA and said that they felt much better after the first night of CPAP therapy. Should I have felt better and more refreshed after the first night?

Thanks for your help and support,
Derek

[brain_cloud]

Gumby is correct ecept for one small detail. He's the only one who has a notebook. The rest of us have Excel.

[Slinky]

Gumby is RIGHT ON w/advice!!!

Your reasoning when starting this post is exactly why I don't post information on how to change therapy settings publicly but rather PM them to those I feel have educated themselves enough to have good reason and understanding of why to consider making a change. The same holds true for sharing Clinicians Manuals. I also think it is one of the reasons why, for instance the Resmeds, there is the option of making the data available to the patient via a menu that doesn't allow making therapy changes intentionally or accidentally. Give us access to our data, but, evaluate each patient's knowledge or experience before giving them access to changing their therapy setting.

And, Swick, I am NOT picking on you. I well remember when I got my first "toy", a Resmed S8 Elite w/EPR. And then the Resmed S8 AutoSet Vantage.

[GumbyCT]

Gumby is correct ecept for one small detail. He's the only one who has a notebook. The rest of us have Excel.

I forgot to say - keep the Notebook (and pencil) right by the CPAP machine.

ps. Excel is far to complicated for any O2 and sleep deprived noob. With Excel you will have to give lessons too.

[Patrick A]

Gumby is correct ecept for one small detail. He's the only one who has a notebook. The rest of us have Excel.

I forgot to say - keep the Notebook (and pencil) right by the CPAP machine.

ps. Excel is far to complicated for any O2 and sleep deprived noob. With Excel you will have to give lessons too.

Great point. GumbyCT

[DreamOn]

I keep track of my results daily. I also change things up now and then (humidity, mask, pressure, etc.), so this log sheet that I created helps me remember what worked and what didn't:

[image deleted]

I suppose the same thing could be created in Excel, but it's just quicker for me to write it down on paper when I get up in the morning.

[GumbyCT]

I keep track of my results daily. I also change things up now and then (humidity, mask, pressure, etc.), so this log sheet that I created helps me remember what worked and what didn't:
<Removed>
I suppose the same thing could be created in Excel, but it's just quicker for me to write it down on paper when I get up in the morning.

Exactly my point. This is an 'Excel'lent example too.

Which reminds me I did use Excel to print out a page but all I used on mine was each setting in my machine. My AHI info is kept in Encore.

I then put it in a clipboard which is/was kept in my dresser until the sock fairy took it. Come to think - I haven't seen it in a while now.

ps. Should there be a column for "My Mood"?.

[ZQuest]

I keep track of my results daily. I also change things up now and then (humidity, mask, pressure, etc.), so this log sheet that I created helps me remember what worked and what didn't:



I suppose the same thing could be created in Excel, but it's just quicker for me to write it down on paper when I get up in the morning.

Yes it is an Excellent Example i hope,that you dont mind if i copy it,i do keep a log but nothing so well done this is more like a sleep report,and i like it a lot THANKS!! z

[brazospearl]

Welcome to the forum, Derek! You are fortunate to have been provided an excellent machine. Your AHI is great for a first night. Should you change any settings right away? Probably not. Should you know how to change them? You betcha! Collect your data for at least a week, then decide if you need to make changes. DreamOn's chart is REAL comprehensive, so don't think you have to go quite that far--many of us just record pressure, leak rate, AI, HI, and AHI. And, for the record, I write mine down by hand on paper...just sayin'. Anyway, glad to have you with us, and let us know how things go!

[DreamOn]

ps. Should there be a column for "My Mood"?.

"My Mood" goes under "Next Day Notes".

But because you are very special, Gumby, I made a custom log sheet just for you. Simple to use too. You just check the box(es) that apply each day:

[DreamOn]

Derek, I want to welcome you to the forum. Sorry that your thread went off on a tangent, and I have contributed to that. We do tend to get a little silly around here from time to time. We DO welcome all questions! We are here to support each other.

As others have pointed out, the time it takes to feel the full effects of CPAP therapy varies widely from person to person. I felt positive results from the very first night, but for many others it takes months. Sometimes we need extra sleep for a while to pay back the "sleep debt". Some of us have bad sleep habits that we have to unlearn. It can take a while just to acclimate to the mask and machine too. Sometimes the initial pressure isn't correct and needs adjustment later.

AHI of 3.3 is very good (less than 5.0 is generally considered to be effective therapy). The most important component of AHI is AI (average hourly apnea index), as it's the apneas that do the most damage due to oxygen deprivation. So, AI as close to zero as possible is ideal. Another thing to look at is your machine-reported "leak rate". If it's too high (with the ResMed machines that's above 24 l/min, which is 0.4 l/sec), then therapy can be affected. Leaks can come from the mask seal or from therapy air escaping from the mouth, a common problem for some who use nasal or nasal pillows masks.

Sleep quality (and machine results) can vary from night to night, for many different reasons. Give things a few weeks to settle in and then you can consider making changes, if needed. I have used CPAP with great success, while others do better with APAP. It's very individual. It looks like you're off to a great start with your current settings!

I hope we're addressing your questions fully. If not, please let us know!

[GumbyCT]

ps. Should there be a column for "My Mood"?.

"My Mood" goes under "Next Day Notes".

But because you are very special, Gumby, I made a custom log sheet just for you.

I guess that shoulda been "Your Mood".
People always misunderstand me when I'm not direct and to the point.

Thank you for the thoughts.
You are soo sweet - today.