APAP Users...My APAP Trial

OK, my sleep center doc will loan me an APAP that I pick it up next Thursday and have it for 5 nights. I've also asked for a recording oximeter; the one they loan out only records one night's data...sure wish it'd record more than 1 night so we can really tell if my nightly episodes are events or not, desaturation will tell for sure.

For my recently developed mouth leaks, Doc suggested we up my pressure which I vetoed because even after nearly 2 yrs exhaling against pressure (mine is 11) is still disconcerting and upping pressure might increase my leaks. That exhalation pressure is so strong that I set a ramp ( pressure re-set to 8 ) for 5 mins as I'm usually asleep before full pressure kicks in. I still occasionally get sore around my lower ribcage...I'm wondering if I over-tighten those muscles to exhale...surely after this long my muscles woulda gotten used to this? In the mornings, occasionally my breathing is weird, sometimes feels like I'm not getting enough air (shallow breathing) and occasionally I'll yawn (deep breaths) like crazy for several minutes, like yesterday following 5 episodes in the early morning and 3 last night. After I've been up while, breathing seems to settle again or at least I'm no longer aware of it.

After he gets the data and a chance to analyze it, compare to sleep study (ideally we'd have done another one but living on unemployment precludes that option), then we'll discuss options. Doc seems to support my taking an active approach to my apnea therapy...mentioned again that my apnea and its side kicks might all go away when I lose all my excess wt. He seems sincere whenever he says this so I gotta have some faith he might be right...he's been a pulmonologist for a long time as well as director of sleep lab. Oh, he did say he wished his two earlier patients took as proactive a stance towards their apnea as I do. I said he had my sympathy, apnea is challenging for patient and doc...what's a doc to do? Scare patients into becoming so anxious they can't sleep or not share enough information letting patients remain ignorant or being able to deny the seriousness of this potentially fatal condition? It's a partnership and a lotta folks want immediate resolution (ain't gonna happen) or just don't want to get educated and tweak equipment, settings, etcetera for optimal treatment.

Now, my question:
Anything I need to ask about using the APAP? They have several brands, I asked for ResMes as the controls in pics I've seen look like those on my Escape...which I get will depend on what's available next Thursday. I only have 5 nights with it and the goal is twofold: to determine if I'm really having events and to see if my sleep is more refreshing using an APAP with exhalation pressure relief.

Thanks for any suggestions! I'll post any info I can get from the LED for comments-analysis-suggestions so I can make the best of my 5 days...who knows how long it might be until I can afford another machine .

I am on a two week APAP trial and I have not done as well as on my CPAP at the latest pressure. I had gotten my AHI down to 1-2 on the CPAP at 15 and the APAP is running 12 at 90%, but my AHI was up to 12 night before last and almost 7 last night. So, I don't think it is helping me much. But, I guess the results are interesting. I get my machine back next Monday and see the doc on Wednesday. I will be interested in what she has to say.

Yoda wrote:I am on a two week APAP trial and I have not done as well as on my CPAP at the latest pressure. I had gotten my AHI down to 1-2 on the CPAP at 15 and the APAP is running 12 at 90%, but my AHI was up to 12 night before last and almost 7 last night. So, I don't think it is helping me much. But, I guess the results are interesting. I get my machine back next Monday and see the doc on Wednesday. I will be interested in what she has to say.

Yoda,
You have the software, yes?? Can you post last night's data graph and let someone see if they see anything that might be contributing to things? It might hold some clues. I know that mine sure did when I started.
If you can't get the hang of posting the images send me a private message and I will see if I can help you out.
Brenda

I'm told that the ResMed is will show higher AHI than a Respironics at identical conditions so beware of that.

I've had a Resmed Autoset Advantage and now an Autoset II. At first I didn't like EPR but now have it set at 2 and have no reason to change it. I check my results each morning, usually wake up the same pressure, 11.2 or so, but my high pressures are a low of 12 to a high of 15.

You will probably want the initial pressure set to whatever your CPAP is set for and then have the maximum pressure allowed to go to 20cm or at least a couple cm's more than what your present maximum is set for.

Be aware that the EPR is adjustable in three levels and also can be set for only during the settling time or constantly. I don't know if five days is enough time to try it. I'd say a month is more like it. It took me that long before I'm finally happy with the settings. FWIW, I can't see why one would have a CPAP over an APAP. CPAP seems like old technology to me.

Husky Lover wrote:...I don't know if five days is enough time to try it. I'd say a month is more like it. It took me that long before I'm finally happy with the settings...

I agree! From what i've read here, it takes some time to tweak to optimal settings.

He'd like to do another sleep study BUT that's not an option, my co-pay is waaaaaay outta my current budget (on unemployment) so this 5-day loaner with the 1 night of oximeter recoding we hope will help determine if these are events I'm having at night. When I had my second echocardiogram to see if my untreated apnea had damaged heart and to document any changes since CPAP benefits finally kicked in, my cardiologist said he believes these awakenings are the result of normal hormonal flucuations/blood sugar swings that occur in the early morning. All I know is I have pronounced circles under my eyes again, I don't wake up refreshed anymore, and I'm tired, irritable, easily confused, and my friends and mom say I've turned into an impatient meany again .

I so want a full data capable machine to tweak to optimal as I continue to lose. Apnea doc says the 50# loss could have affected the pressure I need now. And I have lots more #s to lose. The data might support ungrading to an APAP as I might need the variable breath to breath pressure now; if so, we gotta fight with insurance to pay for this as my co-pay will likely make me faint .

Thanks for the comments.

Will post data next wk as I copy from LED for comments/suggestions.