Newbie Story (Studies with results, Equipment and more)

[xdman911]

Well I first went to my Primary Care doctor about some ongoing medical Issues. High Blood Pressure and Gout. While there I discussed some concerns of mine: daytime sleepiness, hard time getting out of bed, severe migraines in the morning. Then I discussed my wife's concerns: Gasping while sleeping, pausing while breathing and severe snoring. The doctor immediately said it sounds like you have sleep apnea. Sleep apnea at 25 YOA. I was skeptical but he wanted to schedule a sleep study. I called AvMed to see if I had to have an authorization and as long as they were in-network, no authorization was required. I scheduled my first sleep study for May 29, 2013.

Sleep Study #1:

Went in at 10:00 PM. They place was pretty decent; I was expecting a small hospital bed with all these hoses and tubes. It was a full sized bed with small pillows (I brought my own thank goodness). I started by filling out a short survey and then the technician got started hooking up all the little wires. The glue was horrid the next day to get off. But the good thing was that none of the wires came off so the technician did not have to wake me up to put them back on. My night of sleep was horrible. I couldn't get comfortable at all and it was a little warm. I opted to leave my T-Shirt on for the test. Once all the wires are hooked up it became the point of no return. ((Sure wished I took it off)). Needless to say the guy in the other room was a pain in the rear . He was up all night talking and saying he was going home and the technician had to convince him to stay. I was tossing and turning all night, which is unlike me; I usually sleep like a rock. That morning around 5 AM the technician came in and work me up. I usually sleep until 8 or so. I was extremely tired due to the lack of sleep. Went home and showered twice to get the glue off.

Sleep Study #1 Results:

Lights Out: 10:10 AM
Lights On: 5:07 AM
Total Recording Time: 417.00 mins
Total Sleep Time: 355.5 mins

Sleep Stages and Times:

N1 - 67 mins
N2 - 207 mins
N3 - 39.5 mins
REM - 42 mins

Total of 2 REM Cycles

REM1 - 21 mins @ 11:26 PM
REM2 - 26 mins @ 3:14 AM

Central Apneas: 1
Obstructive Apneas: 49
Hypopneas: 176
Max Duration: 62.5 seconds (that's a long time with no air )
Mean Duration of OA: 14.8 secs
Mean Duration of Hypopneas: 17.7

Snoring Episodes: 26

Oximetry Data:
Avg O2 Awake: 97%
Avg O2 REM: 96%
Avg O2 Non-REM: 94%
Lowest O2: 79%
Number of Desaturations: REM: 22 NonREM: 214

Diagnosis: Sleep Apnea/Hypopnea Syndrome; AHI 38.1

Glad that was over. Now back to the Primary Care Physician; time for the other part of the sleep study. This time I was prepared. Went to bed extremely late the night before and woke up early. I really regretted that later in the day when I was ready for a nap. This time no shirt; I have a hard time sleeping when its hot. Arrived at 10 PM on June 26th. Same scenario as last time all the wires and that horrid glue again. . This time I had to sleep with the CPAP Machine. We went over the different masks and I opted for the nasal mask. It was definitely a different experience. The pressure was a little much, the technician turned it all the way down. Definitely slept better. Probably from the lack thereof that night before:

Now for the Results

Lights Out: 10:31 AM
Lights On: 5:07 AM
Total Recording Time:3967.00 mins
Total Sleep Time: 363.0 mins

Sleep Stages and Times:

N1 - 25 mins
N2 - 165 mins
N3 - 78.5 mins
REM - 94.5 mins (Much more REM Sleep than the first visit)

Total of 3 REM Cycles

REM1 - 9 mins
REM2 - 34.5 mins
REM3 - 62 mins

Central Apneas: 2
Obstructive Apneas: 0
Hypopneas: 29
Max Duration: 10 seconds
Mean Duration of Hypopneas: 10 seconds

Snoring Episodes: 2 (My wife would be so happy)

Oximetry Data:
Avg O2 Awake: 97%
Avg O2 REM: 97%
Avg O2 Non-REM: 96%
Lowest O2: 88%
Number of Desaturations: REM: 8 NonREM: 37 (NON-REM NUMBER MUCH BETTER WITH CPAP)

Pressure Distribution:
CPAP# Duration Sleep Time REM NREM #CA #OA #HYP AHI
4 66.5 66 0 66 0 0 11 10
5 27.6 27.6 9 18.6 0 0 14 30.4
6 29.2 29.2 0 29.2 0 0 4 8.2
7 105.5 104 34.5 69.5 2 0 0 1.20
8 141.5 135 51 84 0 0 0 0


Now that was over. I actually felt rested when I awoke. Went home and did the double shower again (that glue is horrid) Now I had to schedule the appointment with the pulmonologist (Also board certified sleep doctor). Went over results and prescribed a chest x-ray to check for clear lungs and a breathing study??? (Don't know what that's for but its a month from now). Got the call from Baycare Homecare DME to schedule for my machine. The therapist showed up with my machine, humidifier, and 3 masks. She brought the kind I wore during the study, nasal pillows and a nasal interface (Wisp). We went over the machine operation, setting I could change (RAMP was def. on the list), cleaning and maintenance. Then we looked at all the different masks. I tried the nasal pillows but the pressure flared my nostrils and it was a weird feeling so that was a no. Then I tried on the Wisp. Small and comfortable. So I went with that. She explained that my insurance purchased the machine outright. No Co-pay or authorization required ($950.00 for a machine ) . All CPAP supplies are covered 100% with no copays or deductibles. I did have to call AvMed to get a replacement schedule. It pretty much matched the Medicare Schedule in the booklet she gave me. Now I was almost all set. Had to go get some distilled water.

First Night Sleep:

I thought it made me look like an Alien. Forced myself to stay up after my wife went to sleep so she wouldn't see me. No problems through the night. I actually felt rested when I woke up. Usually I have to convince myself to roll out of bed. Cleaned my mask, emptied the humidifier and set it to dry. Not bad. Now I got to wondering: That little memory card in the back; what was on it. Then I found CPAPTalk and heard about sleephead and Encore. Right now I'm on day 5 and already have both software's and interpreting the data. I noticed that changing my C-Flex setting helped adjust some of my episodes (OA/CA/Hyp)

This is my story and thanks for letting me share it with you:

XDMAN

[robysue]

xdman911,

Welcome to the forum.

Your diagnostic study sounds pretty typical and not nearly as bad as some peoples' are.

Your titration study sounds like it went very smoothly, which makes many of us green with envy.

And your first night on CPAP? It sounds like you just might be a duck---as in someone who takes to CPAPing like a duck to water. I for one am green with envy

As for the wife and her reaction to your mask: She'll likely have no problems accepting your mask because:

1) No more snoring to keep her awake
2) You'll have lots more energy during the day (and evening) for all kinds of things

Finally, your signature says you have a PR System One Pro with C-Flex+. That's a full data machine, which is good. If you're interested in tracking your data, search the forum for SleepyHead and Encore.

Also click on the link in my signature about PR machines for Newbies so that you can figure out whether your machine is the new Series 60 System One or the older (Series 50) one. That will help you find the correct link for your machine in your profile.

[xdman911]

Thanks robysue. I did select my machine (Series 60) but it wont show up so I typed it in. Someone said some of the links are broken that's why it won't show up. I already have both Encore and Sleepyhead software. I am interpreting them like a pro; once I figured out all the terms and definitions.

Thank You,

XDMAN

[Janknitz]

Welcome! It sounds like you are doing very well.

I tried the nasal pillows but the pressure flared my nostrils and it was a weird feeling so that was a no.

It's good the Wisp is working for you, but I just wanted to point out that if the "pressure flared my nostrils" the mask was NOT fit correctly. There should be very little pressure against the nostrils, that means the straps were pulled too tight OR the pillows were shoved into your nose instead of resting gently outside them. Nasal pillow masks are generally very comfortable, so if you ever get tired of the Wisp it may be worth trying them again--PROPERLY FIT.

[Pugsy]

That's odd...the PR S1 Pro 60 Series cpap with CFlex model 460 machine link should work.
Now the PR S1 Pro CPAP with CFlex model 450 (it's on the bottom of the blower unit) has been broken since that model has been discontinued.

[xdman911]

Welcome! It sounds like you are doing very well.

I tried the nasal pillows but the pressure flared my nostrils and it was a weird feeling so that was a no.

It's good the Wisp is working for you, but I just wanted to point out that if the "pressure flared my nostrils" the mask was NOT fit correctly. There should be very little pressure against the nostrils, that means the straps were pulled too tight OR the pillows were shoved into your nose instead of resting gently outside them. Nasal pillow masks are generally very comfortable, so if you ever get tired of the Wisp it may be worth trying them again--PROPERLY FIT.

Thanks Janknitz,

My Insurance covers a new mask every 3 months so maybe I will rotate and try something new

[xdman911]

That's odd...the PR S1 Pro 60 Series cpap with CFlex model 460 machine link should work.
Now the PR S1 Pro CPAP with CFlex model 450 (it's on the bottom of the blower unit) has been broken since that model has been discontinued.

Yup. Selected the wrong one. The Series 60 Machine does not show it with C-Flex+

[Pugsy]

Yup. Selected the wrong one. The Series 60 Machine does not show it with C-Flex+

Don't know why they didn't include the CFlex in the choice unless they ran out of room maybe.
All the PR S1 Pro machines have CFlex...both the 450 and 460 models. The only model that doesn't have some sort of Flex exhale relief is the model 150/160 if they make a 160.

[robysue]

All the PR S1 Pro machines have CFlex...both the 450 and 460 models. The only model that doesn't have some sort of Flex exhale relief is the model 150/160 if they make a 160.

Well, I don't know if they intend on making a 160 or not. But they've just recently released the "SE" (model number 220), which costs about $100 less than the 260 and has Series 60 in its name since it uses the Series 60 humidifier. The PR pages say the SE has "Flex", but nowhere could I find a description of what "Flex" was relative to C-Flex. The SE is a dumb brick in terms of efficacy data, so I wonder if they've found a way to dumb down C-Flex somehow.

But the SE does have a [irony] cool looking LED display [/irony] to better keep you awake at night by lighting up your bedroom.

[Pugsy]

But the SE does have a [irony] cool looking LED display [/irony] to better keep you awake at night by lighting up your bedroom.

Yeah, and I just love the way that they talk about the Flex thing on the SE being the coolest thing since sliced bread and I am pretty sure it really is just CFlex and that has been around since the Legacy series. Big whoopie.

[xdman911]

I was fitted for a Sm/Med size Wisp Mask but I tried the Lg. last night and liked it better. Still adjusting thr head gear nightly to get the perfect fit. Anyone else having any luck with this mask. Still waking up in the middle of the night from some minor leaks. Overall its good. this is night 7 tonight.

[oak]

hi if you do a search, there are a couple of recent threads about the wisp. good luck with it