Insomnia w/ CPAP?

cflame1 · Post by **cflame1** » Sun Jan 27, 2008 4:01 pm

AFLEX is newer... CFLEX is older. CFLEX is pressure relief in exhale... AFLEX is inhale and exhale.

Wulfman · Post by **Wulfman** » Sun Jan 27, 2008 4:20 pm

dutchbrown wrote:Good info... thanks... I will repost my settings. However, I just looked and I was mistaken about the unit I put in my profile. I actually have one that isn't listed... the RemStar Auto M-series A-flex (btw, what is the difference between C-flex and A-flex? Which is better?)

I wondered about that.....

Here's a list for the M Series w/A-Flex

Den

Respironics M Series Auto with C-flex/A-Flex:

1. Hold down the <- -> buttons while plugging in the power on the back, wait 2 beeps, release buttons.
2. Press the + key. <- -> buttons move to next field, -/+ keys decrement/increment
3. Check the following field(s):

-Therapy Mode = AFLEX (CFLEX/AFLEX)

-Auto:Max = XX (default=20.0cm)

-Auto:Min = X.X (default=4.0cm)

-CFlex/AFLEX Setting = X (options are off, 1, 2 or 3)

-AutoRamp Time = XX (options are 05 to 45 min)

-AutoRamp Pressure = X.Xcm (4cm->AutoMin)

-Mask Alert Feature = ON (On/Off)

-Auto Off Feature = Off (On/off)

-Split Night Time = Off (off, 120, 180, 240)

-Show AHI/Leak Feature = ON (On/Off)

Press On/Off button to exit.

Guest · Post by **Guest** » Mon Jan 28, 2008 12:00 pm

These are my settings... anything jump out at anyone? To me, just by feel, it seems as if my max is too hight, min too low. BTW, my average pressure is between 9 and 11 (9 last week, 11 for the month including with the previous mask which I've had more problems with.)

Also, I'm almost thinking the "ramp" makes it harder for me to go to sleep.

I'm still having problems though waking up in the middle of the night getting more stuffed up then mouth breathing and waking up, but I'm going to try a higher humidity setting and maybe a longer lasting decongestant?

-Therapy Mode = AFLEX

-Auto:Max = 20cm

-Auto:Min = 5cm

-CFlex/AFLEX Setting = 3 (is on AFLEX, not CFLEX)

-AutoRamp Time = 5 min

-AutoRamp Pressure = 4cm

-Mask Alert Feature = OFF

-Auto Off Feature = ON

-Split Night Time = Off (off, 120, 180, 240)

-Show AHI/Leak Feature = OFF

Wulfman · Post by **Wulfman** » Mon Jan 28, 2008 12:19 pm

Anonymous wrote:These are my settings... anything jump out at anyone? To me, just by feel, it seems as if my max is too hight, min too low. BTW, my average pressure is between 9 and 11 (9 last week, 11 for the month including with the previous mask which I've had more problems with.)

Also, I'm almost thinking the "ramp" makes it harder for me to go to sleep.

I'm still having problems though waking up in the middle of the night getting more stuffed up then mouth breathing and waking up, but I'm going to try a higher humidity setting and maybe a longer lasting decongestant?

-Therapy Mode = AFLEX

-Auto:Max = 15 cm

-Auto:Min = 9 cm

-CFlex/AFLEX Setting = 3 (is on AFLEX, not CFLEX) (you might experiment with a setting of "2")

-AutoRamp Time = 5 min (if you don't want/need Ramp, I'd turn it off)

-AutoRamp Pressure = 7cm (see above comment)

-Mask Alert Feature = OFF

-Auto Off Feature = Off

-Split Night Time = Off (off, 120, 180, 240)

-Show AHI/Leak Feature = On

These are my thoughts/suggestions in Red. You could probably even go up to 10 on the minimum pressure. As far as your congestion, you might have too much humidity.....? Be carefull what decongestants you're taking.

Den

dutchbrown · Post by **dutchbrown** » Mon Jan 28, 2008 4:14 pm

Wulfman wrote: These are my thoughts/suggestions in Red. You could probably even go up to 10 on the minimum pressure. As far as your congestion, you might have too much humidity.....? Be carefull what decongestants you're taking.

Den

Thanks for the feedback, most of it makes sense. Do have a couple questions... first about the humidity and decongestants... I know that if it's to humid it'll make me congested, but wouldn't I get condensation? Also, what it is about the decongestants that I should be careful about? (seriously...)

Last question... why do you think I should try a Aflex setting of 2? I thought 3 had the most "relief" on exhale, so should help the most accidentally forcing exhales out the mouth... ??

Again, thanks for all the help...

Wulfman · Post by **Wulfman** » Mon Jan 28, 2008 4:33 pm

dutchbrown wrote:
Wulfman wrote: These are my thoughts/suggestions in Red. You could probably even go up to 10 on the minimum pressure. As far as your congestion, you might have too much humidity.....? Be carefull what decongestants you're taking.

Den
Thanks for the feedback, most of it makes sense. Do have a couple questions... first about the humidity and decongestants... I know that if it's to humid it'll make me congested, but wouldn't I get condensation? Also, what it is about the decongestants that I should be careful about? (seriously...)

Last question... why do you think I should try a Aflex setting of 2? I thought 3 had the most "relief" on exhale, so should help the most accidentally forcing exhales out the mouth... ??

Again, thanks for all the help...

The condensation is created by the temperature differences between the air and water temps. Cool room temps and warm water in the humidifier is what will create "rainout".
I'm just saying that you should be willing to experiment with some of these settings......like, lower the humidifier setting.....try a different A-Flex setting......determine for yourself what's "comfortable" for YOU.

I've never used nasal decongestants (except for something like Tylenol Sinus when I was "sick"), but I there have been discussions on the forum about some of them and the one that sticks in my mind is Afrin.....as one you shouldn't take for more than a couple of times. It creats more problems than it solves if taken too many times.

Maybe someone else can chime in here on what may be "good" to use.

Den

dutchbrown · Post by **dutchbrown** » Mon Jan 28, 2008 7:17 pm

Ok, that all makes sense. (I'm an engineer so I tend to try and find the "logic" in everything. )

and regarding nasal decongestants, I know Afrin and other nasal sprays have what is called a "rebound" effect, where it gets better initially but after the 1st day when it wears off your congestion is worse... and it is noticeably worse after the 3rd straight day of use.

However, I use the pill form of nasal decongestants (like pseudoephidrine)... just wondering if there is any drawback from the use of these? I typically use "single medicine" medicines, meaning i don't use pre-combined medicines because they often have too many medicines in them, especially tylenol/acetaminophen... which I typically stay away from due to it's effect on the liver. I have allergies so I sometimes take an antihistamine (benedryl or zyrtec) and another nasal decongestant... now I'm wondering how those may effect my CPAP therapy?

I am going to change my settings tonight as my wife said I was snoring with the mask on when I fell asleep last night (actually fell asleep fairly quickly) so obviously the min setting isn't enough and I don't seem to need the heavy ramp.

thanks again...

lifeartist59 · Post by **lifeartist59** » Mon Jan 28, 2008 9:35 pm

I was actually releived to read these posts. The original post sounded as thought I wrote it, I have similar issues I am working through. I also read one post that asked if they kept the mask on during the periods of wakefulness and if they just put it back on as they started to fall back into sleep. I seem to do this almost unconciously some nights. I wake up, take the mask off because I can't go back to sleep and then put it back on when I feel tired again. Sometimes I miss what I have termed "the window" for this, and fall asleep without it. I don't do that often, good thing. But I feel a lot better reading these, thanks everybody!

dutchbrown · Post by **dutchbrown** » Wed Jan 30, 2008 9:28 am

Just a quick update... I have adjusted my settings to go from 8-15 with a start ramp at 7. I still think 15 is too high a top end but I know I'm going to piss off the sleep center anyway by lowering it from 20 so I decided to be conservative. I think my constant pressure has settled into the 9-11 area.

I actually had a 'near' sleep through the night last two nights. First night, I woke up once with the machine maxing at 15 and I couldn't keep my mouth closed. I think I was mouth leaking and it ramped it up to compensate. I rigged a chin strap from the Optiflex onto my ComfortGel and last night I only woke up briefly once or twice last night... even had to get up early due to my wife finding a leaking pipe in our basement (from the -20F temps last night).

My AHI dropped to about 5.5 (was 6.8 previously), leak about 30. I think I can improve it a little more by using a tiny bit of denture cream just to make my lips "sticky" so they don't puff occasionally. Anyway, had a truly good night sleep (I think) last night, so hopefully that continues. I am going to try and find a little better way to rig the chin strap but.... whatever works, right?

I am still debating getting a FF and trying it to see if it works. I have a mustache and beard/goatee but it's not too long (thick though) and I don't have sealing problems with the nasal mask at my typical pressures over the mustache so if I can deal with the claustrophobia, I may switch until I can train myself to not mouth leak (get some allergy help, etc). Ideally I'd like to get my constant pressure set up and train my mouth further to not leak and still use the nasal mask long term (at least when my nasal passages are not clogged lol).

Oh, I also changed my flex setting to 2, not sure that makes too much of a difference.

Any other data I should look at at my recheck? (I do not yet have a reader myself)

Mask

Insomnia w/ CPAP?

sleeping less and falling back to sleep issues