AHI

[KC5cychris]

I was wondering if anyone has been using ( expiratory pressure relief) EPR ( RESMED ) in their therapy? I was curious to see if therapists were setting EPR since it has to be done in the clinical settings for RESMED. If using.. can you notably feel a difference?

hay maskfitter

I use EPR mine is set at 2 the DME had it set at 3 when I started he said exhasperation does not need as much pressure. I also read that in a few places as well so give it a go if it helps get you started in the right direction

Chris

[yogariffic]

I don't understand this business about it taking a long time. I felt better the morning after the first time I used a CPAP. (Better enough that I made my own to use until the official one came through.) I vaguely recall that improvements continued for a few days after starting. But I think the double vision while driving went away immediately. On the other hand, I think feeling generally "with it" continued to improve for a month or more. But most of the improvement, I think, was very quick.

Wow. That's amazing. I have been using my CPAP for 7 weeks and I am still exhausted. Doctor sent me back for a daytime sleep study which came back "Unremarkable" and "showing no signs of sleepiness". WHAT? I go back to see him Monday.

[Wulfman]

I don't understand this business about it taking a long time. I felt better the morning after the first time I used a CPAP. (Better enough that I made my own to use until the official one came through.) I vaguely recall that improvements continued for a few days after starting. But I think the double vision while driving went away immediately. On the other hand, I think feeling generally "with it" continued to improve for a month or more. But most of the improvement, I think, was very quick.

Wow. That's amazing. I have been using my CPAP for 7 weeks and I am still exhausted. Doctor sent me back for a daytime sleep study which came back "Unremarkable" and "showing no signs of sleepiness". WHAT? I go back to see him Monday.

Do you use a nasal mask and do you wake up with a dry mouth?
If you're using a nasal mask and losing/leaking your therapy air out your mouth while you sleep (a common problem), you're not going to be improving your "exhausted" feeling anytime soon.
Having the correct pressure and getting ENOUGH sleep are also important to making this therapy work. If you've had untreated sleep apnea for many years, you may also have a very large "sleep debt" to pay off, too.

It's not all rocket science but it is "baby steps".


Den

[VA R.N.]

I was shocked to read the negative post on this subject related to "The VA". The VA is large department of the Federal government and while there are many VA hospitals and outpatient clinics that see and treat patients, like any other business or health care system, some are better than others. I work in a large VA hospital in Florida and I have worked with the pulmonary doctor's there. They are board certified and have treated sleeping disorders and pulmonary patients for years, all having critical care experience that is current. Our hospital is among the top three VA hospitals in the nation and I am proud to say that our patients get optimal treatment compared to any private hospital in our area, as I have worked in both areas (private and federal-in Florida). So as not to downgrade the optimum services veterans get it is only fair not to Generalize the VA, so the readers assume it is the entire VA system!

[KAZ]

What RG said! I came to this board right having been set up with a base machine set at a pressure of 20. After spending some time here I gave my machine back and bought a Bi Pap Auto, and with step by step guidance from Rested Gal I set my machine up and it has worked perfectly for me this last three years running at a pressure of 14.2, and with an AHI of sub 2.0/100% compliance. I've never felt better so take your treatment into your own hands. Thank you RG for all that you did to assist me. Regards

[So Well]

I was shocked to read the negative post on this subject related to "The VA".

Do you ever read any news? Here is the VA's own report on just some of the sorry conditions they found at their physical plants http://www.usatoday.com/news/washington ... titialskip 83 pages of small print.

If they let their hospital buildings get in that shape, are you going to tell me that their practice of medicine is stellar?

We do a very poor job of treating our injured servicemen and women.

There may be little cubbies of excellence in the system, but you should not be surprised to see criticism of the VA.

[charliemack]

What a "crap shoot". After days of searching the internet for "average AHI readings" I have concluded that :

1. One comes out of a sleep study anxious to get results and start treatment only to be hindered by the doctor who only knows how to read the graphs but doesn't know how to set the various CPAP machines to achieve the treatment necessary.

2. There are so many variables that are measured during a sleep study that are used to set a CPAP machine pressure. How can a $1,000 CPAP machine give those same results.

3. There are many patients taking control of setting their own machine. How many is unknown as not all belong to a forum.

4. There is no "average AHI" only what is written in some book. What does that mean? <5 may be a target but may never mean what is obtained or needed.

[ResmedUser]

I don't understand this business about it taking a long time. I felt better the morning after the first time I used a CPAP. (Better enough that I made my own to use until the official one came through.) I vaguely recall that improvements continued for a few days after starting. But I think the double vision while driving went away immediately. On the other hand, I think feeling generally "with it" continued to improve for a month or more. But most of the improvement, I think, was very quick.

It should indeed not "take time" for you to feel good, solid, positive effects of CPAP or APAP. When I was first started on CPAP over three years ago, positive effects were felt immediately. I did great for three and a half years, except for a few intermittent periods where I would wear out my mask or get a hole in my hose and lose therapy efficacy. Id get new replacement gear (hose or mask) and voila, within a day or two Id be good to go again.

Your DME should have you on the proper mask within the first week to two weeks. I was started on a nasal mask, a very good nasal mask and was waking up with dry mouth and air rushing out my mouth like crazy. My DME at the time, who were top notch, said, "you need a full face mask" and they gave me a Resmed Quattro FFM. My first night on it I hated it. After that I went back to the nasal mask and that was bad too. I sucked it up and spent at least an hour tightening up that Quattro FFM wear I would not get leaks and within a week I was cruising into good quality sleep land. I adjusted to CPAP within about a month (fully adjusted that is).

It should not take that long to "get it right" if you have good support IRL.

Mikey

[Greg S]

Wow, my AHI on my cpap info says I average 0.7AHI

That sounds really low, can this be for real? I mean, I do really sleep better than I ever have before.

[NightMonkey]

Wow, my AHI on my cpap info says I average 0.7AHI

That sounds really low, can this be for real? I mean, I do really sleep better than I ever have before.

An AHI that low is an indication that you are breathing well while using CPAP. It does not measure how well you are sleeping.

Do you feel rested when awakening in the morning and are you energetic all day?

[Gator5]

Mine is 3.0. 2.9 on 30 day average. I have been home from middle east for almost 3years and recently Dec 2010 retired from Army. I have been on CPAP since 2007 with zero relief. I went to doctors again and then to another who finally seemed to know what he is doing. Then he says let's try Nuvigil thinking I might have narcolepsy and it's doing nothing but making my brain race but feels like I'm dragging my body. Any ideas or help needed. I am tired of being exhausted every waking minute of the day. Thank you all for what I've read so far.

[tony72]

I don't understand this business about it taking a long time. I felt better the morning after the first time I used a CPAP. (Better enough that I made my own to use until the official one came through.) I vaguely recall that improvements continued for a few days after starting. But I think the double vision while driving went away immediately. On the other hand, I think feeling generally "with it" continued to improve for a month or more. But most of the improvement, I think, was very quick.

I felt better the next day after starting,don't forget to do it even for 1 night you will feel lousy.
I

[Allcare]

Just started treatment last night with resmed. The machine varies throughout the night based on my sleep. When I woke after a 9 hour sleep, it has a reading telling me my mask fit was good throughout the night and my AHI was 0.3

[NightMonkey]

Just started treatment last night with resmed. The machine varies throughout the night based on my sleep. When I woke after a 9 hour sleep, it has a reading telling me my mask fit was good throughout the night and my AHI was 0.3

Sounds like you hit a grand slam. Congratulations.

Let us know how you feel throughout today compared to pretreatmen days.

[Tip10]

So I take it my experience with my sleep doc is not typical??
That's really a shame because, IMHO, this is how it really OUGHT to work EVERY TIME.

Saw Sleep Doc -- she suspected OSA based on referral from my other doc. Explained in detail sleep study, how it worked and what they expected to see from it.

1 week later had sleep study.

2 days after study saw sleep doc to discuss results and course of action. Discussed machines, masks, etc. Untreated numbers from study AHI > 90, desats to 65% or so.

2 days later call from DME, immediate appointment and went to office for machine delivery and demo/training. Shown all functions and how to get into all menu's etc. Told what doc's recommendations were and what I should be careful about changing. Advised to follow doc's recommendations till follow-up with doc to give her a good baseline and then work with her on best changes to make.

1 week in got a call from Nurse at sleep doc wanting to know how things were going. Told her I was struggling finding mask -- she asked me to stop by office and we talked about masks and she provided me with loaners of two different varieties (was on FF she provided pillows and nasal) said to try them for a couple of weeks and then decide. BTW she spent about 30-45 minutes with me about half on the masks and about half on the therapy in general and how was I doing etc.

1 week later returned the masks with my compliments on their service -- called my DME and got new mask (switched to nasal).

2 months in, saw sleep doc -- discussed how things were progressing and what to expect. Numbers looked good (AHI consistently 2-2.5 range), asked if I was still struggling and told her no I was adjusting pretty well. Asked if there was any questions/concerns I had, etc. Listened and we discussed them.

About 2 1/2 months in, I called sleep doc about script for masks and travel machine -- spoke with nurse and she asked for details -- generic type scripts arrived in the mail 3 days later.

6 months in, saw sleep doc again for follow up. Went over numbers (they were consistently < 2.0), concerns, how I was feeling, etc. She was really interested in mask (was using SleepWeaver at the time) and asked if I would mind if she called in some colleagues to see the mask and if I'd mind putting it on for them to check out as they'd never seen one before. Did so. Was told they would be pulling some in for evaluation. Told me next appointment would be in 6 months but to call at any time with any questions/concerns/changes/etc.

1 Year in saw sleep doc again -- AHI numbers consistently in the 1.0 - 1.5 range.

Now at about 15 month mark numbers are consistently < 1.0 (just recently had a week where of the 7 nights 3 were 0.0's!! -- I'm beginning to love the Aloha -- never had 0.0's before and now have maybe a total of 5 or 6 since I started using it.)

Next scheduled appointment 6 months after 1 year appointment -- said if things still going well would probably go to annual checks but was available anytime there were issues or problems.

Oh, I suppose I forgot the important part -- MY SLEEP DOC HAS SEVERE OSA...... I think it makes a difference, a BIG difference.

Oh yeah, bottom line, energy levels up, afternoon sleepiness mostly gone (rest is result of simply NOT getting enough sleep -- with current work schedules only manage 5-6 hours a night -- need more!) overall quality of life TONS better. Have I had it pretty easy -- yeah I have but having a Doc who cared, listened and responded certainly helped immensely with the initial transition period -- she didn't pull any punches -- told me it wasn't going to be easy to adjust, I wasn't going to like it, was likely to suffer some depression because of it but that I needed to do this because of what OSA was doing to my body. She told me up front there were going to be days I hated it, was pissed off at it, wanted to chuck it out the window and that when I had those I was SUPPOSED to call her up and cuss her out over it -- and then all she asked was after I finished cussing her out to listen to her for a bit and we'd talk and figure out a way to make it work. Told me in that second appointment (the one after study) that she had OSA and talked about her experiences with it and adjusting to it and talked about DME's and her experiences (and yeah she had major mask fights with them -- mouth breather -- needs/uses full face -- could not get DME to give her full face they insisted "everybody" can use nasal....).