I'm so glad I found this site!

Hello everyone! Yes I am a newbie here and a newbie to using a CPAP... I do have some questions I hope you can help me with...

Here is my story, back in 2006 I had a sleep study and was told that I have sleep apnea. The sleep doc wrote me a script for a CPAP that I never got filled because both he and my family doctor suggested that I should have the corrective surgery. I was thinking about getting the surgery for a while but after reading many things online I decided not to do that, and at the time I think I thought I was "to cool" to actually get the CPAP. So I tried convincing myself that the apnea would magically fix it self and did absolutely nothing. I was wrong.

Fast forward to the end of 2008. I decided that I needed to actually do something about my never getting good sleep. So I tried contacting the sleep clinic that originally wrote my CPAP script. I called every day and left a message for a good week and a half and got no reply, still haven't to this day. So I then went to my family doctor and asked them to re-write me a script for the CPAP. By this point the doctor I was seeing their has moved on and I was now seeing a different doctor that didn't seem to have much knowledge on the subject. Regardless they wrote me the script and I am now using the machine.

The first few nights were hard, some nights I couldn't fall asleep and took the mask off. Other nights I feel asleep but woke up a couple hours later with the mask on the floor. How did that happen? Oh I must have ripped it off I assumed. It is getting a little better now though. I still sometimes take the mask off while sleeping, but I have had a few nights of wearing it all night and wake up feeling better than I used to. Though I still tend to go to bed to late and I have to be up by 530am for work. So I know I need to get to bed earlier to get better effects of the machine.....

Anyway, enough about that, so I was reading through the manual of my CPAP machine and learned that there was a system leak and Apy-Hyp Index feature on my machine that I could not access. That is how I found this wonderful site. I quickly learned how to access that and have, even thought I didn't have any clue to what Apy-Hyp index meant I was happy to see it. After reading on here more I realized what it meant and read on many posts that it should be 5 or less. This is my problem, mine says 14.6 for a 7 day average and 12.2 for a 30 day. Now I'm wondering if I need to get my pressure adjusted. Or do it myself since my family doctor didn't seem to really have much knowledge on the subject and the original sleep clinic is apparently out of business. Let me give you a run down on my numbers to date,

I have had and been attempting to use the machine for 28 days now.
Machine is set at 7.0cmH2o
I use the ramp starting @ 4.0 for 20 mins
and I use the C-Flex setting at 3
Humidifier setting is 1 sometimes 2

Therapy Usage
7day 4:30hours
30day 3:42hours

Sessions
7day 4 sessions
30day 14 sessions

System Leak
7day 31.4L/min
30day 28.9L/min

Apy-Hyp Index
7day AHI=14.6
30day AHI=12.2

Summary Data
Therapy Hours 103.5
Blower Hours 106.7
Total sessions 14

I think I may not totally understand the Apy-Hyp Index and System leak features, so help on that would be great
also the question if it sounds like I may need a higher pressure?
I also find that if I take a couple nasal decongestants and an allergy pill before going to bed, it helps me be able to breath with the machine a little easier, does anyone else do anything similar?

I greatly appreciate you taking the time to read this and give me any insight to using this CPAP. I really want to get the best benefits from this machine and figured this forum would be the best place to get some advice. Thanks for your time in advance!

Rick

Hello & Welcome, iitranceportii! Glad you found this forum—SO much useful info and everyone here is so willing to help!

Wow! What a story! I would never suggest anyone change their pressure without doctor advice, since that would be giving medical advice, but I can tell you that most of us here have done that. For me, my titrated pressure from my sleep study was 7. I used the machine for more than a year with no good results. Then, I found this forum, learned about data, found that my AHI average for the year had been in the 12 range! So, I got an auto titrating machine, found my pressure needed to be around 12.5, and my AHI has been averaging 0.4 ever since. And, I feel great now! Good luck!

"You are getting sleepy . . ."

Well, first off, if you are accessing all that data via the LCD screen - or via the software and cable reader - you have indicated the WRONG CPAP.

cpap.com wrote: ... The M Series Plus with SmartCard Module should not be considered when looking for Advanced Compliance Data. The unit only provides minimal information that can be reviewed directly off the machine's display. ...

Second, so what if the sleep clinic where you had your sleep evaluation/titration is out of business? They aren't the only sleep clinic in the country and I'd be willing to bet, not the only one in your county either. You have absolutely no idea if OSA is your only sleep disorder or if you have one or more other sleep disorders as well.

Slinky wrote:Well, first off, if you are accessing all that data via the LCD screen - or via the software and cable reader - you have indicated the WRONG CPAP.

cpap.com wrote: ... The M Series Plus with SmartCard Module should not be considered when looking for Advanced Compliance Data. The unit only provides minimal information that can be reviewed directly off the machine's display. ...

Second, so what if the sleep clinic where you had your sleep evaluation/titration is out of business? They aren't the only sleep clinic in the country and I'd be willing to bet, not the only one in your county either. You have absolutely no idea if OSA is your only sleep disorder or if you have one or more other sleep disorders as well.

Your right, I did have the wrong machine listed, there were many M Series and I accidentally choose the wrong one, It is updated now though, thanks for pointing that out. And your right, there are other sleep clinics near me, but the last time I went I got charged over 2000 dollars and unfortunately I can not afford that again right now. Times are tough in America, was just looking for some thoughts... Thanks though!

I would not be alarmed about the 'system leak' as I think you are. As it is a bit of a misnomer. More accurately, its the total flow rate of air the machine is reading. Check the literature provided with your mask. It should provide a graph of the performance of the mask; flow rate as a function of pressure. Your numbers seem about correct for a pressure of 7 cmH2O. Can you hear/feel the mask or hose leaking?

[quote="RipVW"]
Hello & Welcome, iitranceportii! Glad you found this forum—SO much useful info and everyone here is so willing to help!

Wow! What a story! I would never suggest anyone change their pressure without doctor advice, since that would be giving medical advice, but I can tell you that most of us here have done that. For me, my titrated pressure from my sleep study was 7. I used the machine for more than a year with no good results. Then, I found this forum, learned about data, found that my AHI average for the year had been in the 12 range! So, I got an auto titrating machine, found my pressure needed to be around 12.5, and my AHI has been averaging 0.4 ever since. And, I feel great now! Good luck!

Yea it kind of seems like I may need to do something similar to you. I think I may continue with my current pressure for another month or so while I'm still getting used to this thing, and if my AHI stays the same I may go talk to my doctor and see what they have to say. Glad to hear things are great for you! Thanks!

rogier40 wrote:I would not be alarmed about the 'system leak' as I think you are. As it is a bit of a misnomer. More accurately, its the total flow rate of air the machine is reading. Check the literature provided with your mask. It should provide a graph of the performance of the mask; flow rate as a function of pressure. Your numbers seem about correct for a pressure of 7 cmH2O. Can you hear/feel the mask or hose leaking?

Yea, from what I read around on different posts, I'm not that worried about the leak thing, I'm a little more concerned about this...
Apy-Hyp Index
7day AHI=14.6
30day AHI=12.2

Hi Rick,
Welcome on board!
Which "corrective" surgery was it that you decided no to have?
The reason I ask is because some of the surgeries - like making sure there's a clear air flow through your nose, or taking out your tonsils can be very beneficial. Others - those that have to do with cutting your palate don't do much good. And a third kind - a major kind of surgery that change the placement of your tongue and jaw is also very helpful - if nothing else works.

Do you know of any other breathing related problems you may have? Were those ever mentioned?

Any reason your machine is set at 7?

People have been know to self titrate themselves successfully, and you have a data tracking machine to help you on that trip - so you may as well try it.

You may be ripping off your mask in response to the fact you're still being choked about ever 5 minutes - in all probability because your pressure is not high enough.

It it were me, I'd start raising the pressure gradually, in 0.5 cm. increments. And stick to each change for 2 weeks to see how its working out. I would use the tracked AI + HI (called AHI when summed) and the way I feel to decide about the effects of each change. Keep a sleep log, https://www.healthatoz.com/ppdocs/us/cn ... eeplog.pdf, and be very systematic.

Some people - not the majority - respond with more apneas when their pressure it too high.

Nasal congestion can have a bad effect on cpap therapy. Nasal irrigation - as shown here http://www.neilmed.com can be very helpful. I use neilmed's bottle, but make my own solution by adding 1/4 teaspoon salt (without additives) and about 1/8 teaspoon baking soda to the 8 oz. sized bottle. Sometimes I need to do the irrigation twice in a row.

You asked about anti-allergy medication. The following may give you some useful info on that.
viewtopic/t36483/viewtopic.php?p=319026#p319026

Good luck!
O.

Oh yeah! No insurance or insufficient insurance can make a WORLD OF DIFFERENCE!!! Ozij is a pretty savvy PAPper. I'd give her suggestions a try. Betchya you can improve your situation considerably if you try Ozij's suggestions. Including those about surgery - IF IT COMES TO THAT. Good luck and God bless!

iitranceportii wrote:Your right, I did have the wrong machine listed, there were many M Series and I accidentally choose the wrong one, It is updated now though, thanks for pointing that out. And your right, there are other sleep clinics near me, but the last time I went I got charged over 2000 dollars and unfortunately I can not afford that again right now. Times are tough in America, was just looking for some thoughts... Thanks though!

OSA severely impacts our memories.
Listing the wrong equipment is very common.
I always prefer the poster also enter their equipment and pressure in the post because equipment is OFTEN changed and not changed in the posters profile.

To be clear equipment includes mask and machine plus software, if used.

The machine make and model will be clearly written across the top of the machine. Pencil and paper can be helpful in getting this correct.

The mask will have a label on the back of headgear indicating make and model. Included with the mask is a brochure that will have a graph showing the leak rate at several pressures.

Always list your pressure AND leak rate with the name of your mask.

While you are at it -
make sure you are logged in - go up to top left side of page
select Control Panel
Profile tab
Edit equipment
change How would you like your equipment displayed from Image to Text
Select Submit
All those pictures look alike

Double check to be sure it matches exactly what is written across the top of your machine and you select the correct equipment and mask. The make & model of the mask are on a tag on the back of the Headgear and in the included brochures.

Indicating your pressure and leak rate is also very useful.

Welcome,
GumbyCT

Rick,

I noticed that you have only used your machine for 14 days out of the last month. And I also noticed that your ramp starts at 4. Most of us can't even breathe at a setting of 4, especially if you have any nasal restrictions, which I'm guessing you have because your doctor recomended surgery. Do you know what you prescribed pressure is? If your prescribed pressure is 7, you may not even need to use the ramp. That may be why you can't get to sleep with your CPAP and pull it off in the night. You can't breathe! I start mine at 13, with no problems. Try losing the ramp and following Ozij's instructions. Keep us informed of your progress. You are on the right track, but you have to keep that mask on. Do as much reading on this forum as you can. There is so much to learn and you are in charge of your own therapy.

Bev

Welcome! In addition to the more technical advice you've received, I'd like to add a few other thoughts.

- Sleeping inclined. I sleep at a slight incline which helps me keep my AHI consistently under 2.0. If I sleep flat, the numbers are around 4 or 5. I'll take less events any way I can even if by only a small amount.
- Mask. I used the ComfortGel as my first mask after my sleep study and found problems. I found the ComfortGel heavy, lots of moisture in mask, and most problematic was that side sleeping disturbed the seal so it leaked. I now use the ComfortLite 2 and find it works very well for me. Each person has to find the mask that works for them. Respironics and ResMed both have (or had when I utilized it) a warranty so that if the mask doesn't work for you, you can try another. I think it was 30 days. Your sleep therapist (usually works in a DME's office) or other staff at your DME should know this and help you come up with the right mask for you. They are well aware that most people don't stay with their first mask and that it can take several to find a good fit.
- Pillow. I use a Tempurpedic pillow. It both allows for indentation of the mask without unseating the mask easily and stays put where you want it to be indented. I just push my hand into the pillow where my mask goes and it fills into the mask and stays put. This has helped with unseating the mask and resulting leaks (I had this pillow when using the ComfortGel and that mask unseated even with the Tempurpedic pillow).
- Hose hanger and cover. A cover can help the hoses ridges not get caught on bedroom furniture and pull on your mask which would unseat it causing leaks. It also helps with condensation or rainout. I use the HoseBuddy Travel https://www.cpap.com/productpage/travel ... ystem.html Using a hose hanger can control the hose so that it doesn't get caught in covers or otherwise unseat your mask.
- Lab rat. Something I learned but am not even as good at as others on this forum is the art of being a lab rat. That is a term used for someone who uses inventive methods to solve an XPAP problem. Using a strip of panty hose to hold a mask just a bit closer to the face to reduce leaks is an example of someone being a lab rat.

Best wishes and again, welcome!

ozij wrote:Hi Rick,
Welcome on board!
Which "corrective" surgery was it that you decided no to have?
The reason I ask is because some of the surgeries - like making sure there's a clear air flow through your nose, or taking out your tonsils can be very beneficial. Others - those that have to do with cutting your palate don't do much good. And a third kind - a major kind of surgery that change the placement of your tongue and jaw is also very helpful - if nothing else works.

Do you know of any other breathing related problems you may have? Were those ever mentioned?

Any reason your machine is set at 7?

People have been know to self titrate themselves successfully, and you have a data tracking machine to help you on that trip - so you may as well try it.

You may be ripping off your mask in response to the fact you're still being choked about ever 5 minutes - in all probability because your pressure is not high enough.

It it were me, I'd start raising the pressure gradually, in 0.5 cm. increments. And stick to each change for 2 weeks to see how its working out. I would use the tracked AI + HI (called AHI when summed) and the way I feel to decide about the effects of each change. Keep a sleep log, https://www.healthatoz.com/ppdocs/us/cn ... eeplog.pdf, and be very systematic.

Some people - not the majority - respond with more apneas when their pressure it too high.

Nasal congestion can have a bad effect on cpap therapy. Nasal irrigation - as shown here http://www.neilmed.com can be very helpful. I use neilmed's bottle, but make my own solution by adding 1/4 teaspoon salt (without additives) and about 1/8 teaspoon baking soda to the 8 oz. sized bottle. Sometimes I need to do the irrigation twice in a row.

You asked about anti-allergy medication. The following may give you some useful info on that.
viewtopic/t36483/viewtopic.php?p=319026#p319026

Good luck!
O.

Thanks for the reply! As far as the surgery, I forget the actual name of it because it was a couple years ago, but it was one where they cut the palate. Now that you mention the airflow through the nose, since I have been using this machine I have really noticed sometimes the airflow is very poor through one side of my nose. I think I will get that checked out in the near future, it may help some. As far as I know I have no other breathing related problems.

The machine is set at 7 because that was the original suggested setting a couple years ago. Im starting to think it needs to be a little higher, so I may take your advice and go at it slowly and over time perhaps I can get that AHI lower! Thanks for your time it is much appreciated.

OutaSync wrote:Rick,

I noticed that you have only used your machine for 14 days out of the last month. And I also noticed that your ramp starts at 4. Most of us can't even breathe at a setting of 4, especially if you have any nasal restrictions, which I'm guessing you have because your doctor recomended surgery. Do you know what you prescribed pressure is? If your prescribed pressure is 7, you may not even need to use the ramp. That may be why you can't get to sleep with your CPAP and pull it off in the night. You can't breathe! I start mine at 13, with no problems. Try losing the ramp and following Ozij's instructions. Keep us informed of your progress. You are on the right track, but you have to keep that mask on. Do as much reading on this forum as you can. There is so much to learn and you are in charge of your own therapy.

Bev

Thanks Bev, I did try not using the ramp the last couple nights and it wasn't to bad. I probably don't need to use that anymore!