First night on APAP

I received my machine yesterday and I got to sleep nicely with the mask very comfortable and showing excellent fit on the machines leak test. I went to bed at 11:00 and got to sleep in short order.

I typically wake up 2-3 times a night for a bathroom break but slept through the night until 5:30 AM where I REALLY needed a bathroom break.
I was totally awake at 5:30. I forced myself back to sleep . I believe that made me get too much sleep because I was more tired at 7:30 than I was at 5:30.

I checked the numbers:
Leak .12L/S
AHI 5.4
AI .3
HI 5.1

My doctor told me to set my machine at 4 min and 8 max.
Looks like the 95% pressure showed 6.4

All in all I think I got a good nights sleep but counting the yawns today will tell me for sure.

Best,
Phil
Thanks everyone for your help and support. Due to this forum I was able to set up the machine and interpret the results.

Best of luck to you.
Most people will tell you that numbers under ten are considered good. But if you can get those numbers lower and feel better why not? At least you are sleeping through the night.
Oh, those bathroom breaks from sleep you were taking? Those weren't really bathroom breaks, they were something for you to do when you woke up too much from the OSA. I remember waking up from OSA pre treatment and being foggy minded and thinking what's going on? Oh, I must have to go to the washroom.

Enjoy your sleep and as long as your feeling better than before just go with it for now until you begin to feel more comfortable with the treatment then look at it a little more in depth.

Gerry

peppi wrote:I checked the numbers:
Leak .12L/S
AHI 5.4
AI .3
HI 5.1

My doctor told me to set my machine at 4 min and 8 max.
Looks like the 95% pressure showed 6.4

Peppi,

To follow up on Gerry's comment, it is encouraging that your AI number is very, very low. That is great, especially for a new CPAP user. The HI events are not quite as damaging, and sometimes can be hard to get rid of. They might taper off as you get settled in. If they don't drop after 2 weeks, it would then be good for you to get your data downloaded and see your sleep doc or RT (or post it here if you have the software). An AHI of 5.4 is pretty good, but it is on the high side of 5.0, which is the upper limit for what is often considered to be effective therapy. I am suspecting that bumping your lower pressure up to 6 would help based on a suspicion that 4 is too low to be helpful, and the machine takes too long to ramp up when you need the pressure to put down a series of events. Some folks react funny to APAP pressure changes, and since you are at the low end of the pressure scale, you might want to consider doing a straight CPAP setting just above your 95% pressure. Again, work with your doctor and RT on this since making changes can have unexpected side effects.

-john-

jweeks wrote:Peppi,

To follow up on Gerry's comment, it is encouraging that your AI number is very, very low. That is great, especially for a new CPAP user.

I agree with both Gerry and John (jweeks) about how nice and low your AI number. The leak rate is nice and low too, especially for someone new to CPAP when adjusting and readjusting a mask is sometimes happening, letting a few more leaks through than will be the case later.

jweeks wrote: The HI events are not quite as damaging, and sometimes can be hard to get rid of. They might taper off as you get settled in. If they don't drop after 2 weeks, it would then be good for you to get your data downloaded and see your sleep doc or RT (or post it here if you have the software). An AHI of 5.4 is pretty good, but it is on the high side of 5.0, which is the upper limit for what is often considered to be effective therapy.

Personally I would not worry one bit about an AHI of 5.4 when using a ResMed machine, as you are, Peppi. I think the "AHI should be below 5.0" that we often see stated on the message board applies more to other brands of machines, particularly Respironics machines, and doesn't really apply to ResMed machines, IF the AI part of the AHI is very low and it's the HI part that is driving up the AHI number. That's just my non-medical opinion though.

I think those two brands use such different "definitions" of hypopnea, there can be drastic differences in the HI reported by either one, yet a person be getting exactly the same treatment effectiveness. That doesn't mean one brand reports hypopneas wrong and the other right. It's simply a difference in the amount of "flow limitation" each brand considers to be "hypopnea" instead of still just "flow limitation."

Anyway, I wouldn't worry for one moment about an AHI of 5.4 from a ResMed machine, when the AI (apnea index) was only 0.3 and it's the HI (hypopnea index) that was contributing the most to the AHI number.

If I saw an AHI of 5.4 from a Respironics machine, like jweeks, Gerry, and I use, yes, I'd probably do some tweaking to try to bring the AHI down below 5.0.

With a ResMed machine, however, I personally think an AHI below 10.0 is fine, if the AI is 1.0 or under and it's the HI raising the AHI number.

When I use a ResMed machine, I just mentally chop the HI in half then add that "half" to the AI to get a new, lower AHI. When I do that, my AHI is about equal to the AHI I normally get from my Respironics machines. What works for me might not apply to others at all, though.

Here are some more topics about definitions and about making AHI comparisons between Repironics and ResMed machines:

Chart posted by Velbor showing the differing definitions used by the different manufacturers:
April 2, 2009
viewtopic.php?p=356255#p356255


High HI affecting AHI rating. Should I be worried - topic started by ChrisC
Mar. 30, 2009
viewtopic.php?p=355205


Alternative ways to decrease the AHI - topic started by christo
Dec. 21, 2008
viewtopic.php?p=324087#p324087


I need to stop chasing 0 AHI. - topic started by fortomorrow
Dec. 4, 2008
viewtopic.php?p=319432#p319432


Hubby's AHI sucks... - topic started by Debjax
Feb. 15, 2009
viewtopic.php?p=339278#p339278

jweeks wrote: I am suspecting that bumping your lower pressure up to 6 would help based on a suspicion that 4 is too low to be helpful, and the machine takes too long to ramp up when you need the pressure to put down a series of events. Some folks react funny to APAP pressure changes, and since you are at the low end of the pressure scale, you might want to consider doing a straight CPAP setting just above your 95% pressure. -john-

I agree with jweeks that the machine might serve you better if you set the minimum at 6 instead of the current 4. I don't think there'd be any harm whatsoever in trying a minimum pressure of 6, as John suggests, for a range of 6 - 8.

Or even try straight CPAP at 7 or 8 as John suggested. Your doctor obviously thinks a pressure of 8 would not be a problem for you.

Using an autopap at a range of 6-8 is essentially like using straight CPAP anyway. But for some people, every little bit of "less" pressure helps them -- helping to prevent aerophagia, if a person is prone to that, or helping to keep mask leaks under control. Neither of those things seem to be a problem for you, however, Peppi.

John & Laura:
I am setting the machine for a range of 6-8 tonight.
As the day went on I started yawning around 4:00PM so Im still a bit tired.
Of course its much better than before where I was yawning continuously from the moment I woke up!

It may take a few weeks for me to catch up on sleep since I suspect Ive had apnea for a few years.

Thanks for the advice, I'll try that and see what my numbers look like tomorrow.

Best,
Phil

Phil, it wouldn't hurt to increase the upper limit, as you'll only go there if you need to. might want to consider 6-10 or 6-12. However, you're doing well even at your lower pressure, so I don't think you can go wrong. My advice is, whatever you do, stay there for a minimum of 3 days to a week, to get some numbers. Consider getting the Res Scan software (available from cpapaustralia.com). To really tweak its worth it to see how the pressure increases impact the apneas, as well as reviewing leaks. A 95 percentile number on the LCD can be a bit misleading with leaks, as sometimes leaks are just very small spikes.

6:30 AM and I'm wide awake! Slept like a baby and feel totally alert. Even my eyesight is super sharp and clear. Went to sleep at 11:00PM.
Wow, havent felt this good in years.
I set the machine for 5.8 - 9 and what is wierd is the numbers got worse but I slept even better than the previous night .
I'll take your advice and leave the machine at these numbers for a few weeks and see how it goes:

press 7.2 vs 6.9 the night before
leak .10 vs .12 l/s
AHI 6.9 vs 5.4
AI 1.0 vs .3
HI 5.9 vs 5.1

I changed settling from 30 to 10. Not sure what that does, I didnt notice any change.

The min pres. of 5.8 felt more comfortable. The min of 4.0 made me feel like I was sucking for air where as this was just a natural inhale. The EPR set at 3 also works nicely with a natural exhale .
The swift mask is super comfortable, I hardly feel it on my face.
I turned the humidifier down from 2 to 1. The air was too humid and I had no problems with dryness so I think I will leave it there.

Can anyone tell me why the machine stays on all the time? even when I turn it off? The air stops but the machine still makes a slight sound.
I turned the autostart off and it still says warming on the display.
I have to unplug it to get it to totally turn off.


Thanks for the help.

Best,
Phil

Don't know the answer to your question, but congratulations! You're doing fantastic for just two nights. I've had two weeks, and it just keeps getting better.

And I'm glad I'm not the only one whose eyesight seems to have improved using my APAP. Maybe it's just my imagination, but it sure seems to me like I'm seeing more clearly.

Best of luck to you!

Pam

Phil, don't get discouraged if you get tired and yawn in the afternoon. Before CPAP you said you were yawning from the time you woke up in the am. I would say that is a huge improvement and only in one night. You may or may not have heard the term sleep deficit. Some people experts and lay people believe you can never make up lost sleep while others believe you can. I believe you can in the fact that your not tired all the time like before. You have lost that sleep and can't go back and make it up but you can sleep better from now on so you won't be tired.

Good luck

Gerry

peppi wrote:Can anyone tell me why the machine stays on all the time? even when I turn it off? The air stops but the machine still makes a slight sound. I turned the autostart off and it still says warming on the display. I have to unplug it to get it to totally turn off.

The Autoset II runs for like 15 min at a very low level after you shut it off to safely cool down the humidifier. It's completely normal, and something you want to let it do.