Does number of apneas reduce with time?

Hi,

Third night on the CPAP, the technician had set the min pressure to 4, but the doctor had said between 6 and 10, so I changed it manually to start at 6.
I did make quite a difference in that it was more unpleasant, and was somehow more aware of my apneas, and felt like I was waking up more than the 2 previous nights. Also, I have no humidifier and my nose and throat got dry. I have a noisy AC going on (tropical climate )

My numbers for last night are:
Pressure: 10
Leak: 0.16
IAH: 17.7
IA: 7.3
IH: 10.4

My question is : should I play around with the settings some more or try this for a few nights and see if the number of episodes reduce with the same settings?
Do the number of episodes tend to reduce on their own or do I need to keep tweaking until I get under 5?


Thanks!

You may need to either use a humidifier and/or try out full face masks if your mouth is open when you sleep, letting out all the therapy air.

thesleepermustawake wrote:Leak: 0.16

You have a S9 machine coming???
What model machine are you using now? Another S9?? If so this leak number is a barely leaking number.
S9 machines report leaks in L/min and the number to avoid is 24 L/min. You have a long way to go before leaks of any kind (including mouth breathing leaks) are impacting therapy.

This number even with the S8 model machine is still a good leak number in that the S8 machine reports in L/sec and the number to avoid with a S8 machine would be 0.4 L/sec...and 0.16 would still be a very acceptable leak number even with S8 machine.

The leak number from the machine (be it S9 or S8 model) is a 95% number and all that means is that for 95% if the night your leaks were at OR below that number. People tend to forget the "or below' part of the definition.

The pressure number that comes off the machine's LCD displace is also a 95% number...same definition.
Are you reporting that the machine is showing 10 in the LCD as pressure number? If so then your machine is likely maxed out most of the night.

So can you please confirm which model machine you are using now...is it the S8 model or the S9 model?

To answer your question....there can be some reduction in events simply with time if the events are awake events that go away as we learn to sleep with the machine better but time doesn't fix sub optimal pressure when the machine settings simply aren't optimal and if your machine is maxing out at 10 cm for the bulk of the night. Then your pressure settings are sub optimal and no amount of time is going to fix it in this situation.

You need a humidifier ....at the pressures you are apparently going to need...your nose is going to get real mad at you if you dry it out.

Personally, the # of apneas went down slowly each week as my brain and body accepted the use of CPAP

it kind of leveled out after 3-4 months... at whichtime, then I started trying minor changes to my pressure settings to get them lower.

good luck

Daniel, that's what I suspected.

Pugsy: yes I'm currently using an S8 Autoset II which I rented while my new S9 arrives. Unfortunately I didn't order the humidifier :/ It was already quite expensive, but I'll try and order one as soon as I can afford it.

The LCD does show 10 for pressure.

I did add the make and model to my profile but it isn't showing up for some reason.

So you're saying I probably need more pressure? I could try changing the max pressure up a notch or 2.

thesleepermustawake wrote: I did add the make and model to my profile but it isn't showing up for some reason.

The S8 model machine has been discontinued and links to discontinued equipment no longer work and that's why it isn't showing up.
I thought maybe the results shown were from S8 model machine. Your leak is fine. If you are mouth breathing it isn't much and I wouldn't worry about it.

thesleepermustawake wrote: So you're saying I probably need more pressure?

Yes, probably a little more minimum and maximum since the pressure is probably maxing out for the bulk of the night. It's hard to know for sure without seeing the software reports since the 95% pressure number of 10 actually means for 95% of the night you were at or below that number...but in your situation if we were to see the software graphs it wouldn't surprise me to see it maxed out at 10 for most of the night.
The S8 model machines also historically often seemed to show a tendency to elevate the hyponea numbers.
Your S9 that is coming has a new/better/different algorithm which most likely will better address the hyponeas.
I don't have time to go into all the details on how the S8 does things though.

When is the estimated time frame for the S9's arrival?

Could you afford to perhaps pay shipping and maybe $50 US$ towards a humidifier? I have one that was used maybe a week and looks entirely new. I paid $50 for it just to have it for situations like this where someone may want or need one.

Which S9 model did you order? I forget if you told us.

Increasing your pressure is likely going to dry out the nasal mucosa even more. Also while the first knee jerk reaction is to increase the maximum range...often if the minimum is more optimally set then the maximum doesn't seem to come into play as often or as much. In other words if the machine is better set to prevent the airway collapse in the first place then the maximum often seems to stabilize and become lower and the 95% pressure number will actually be lower too.
The machine is in more of a prevent mode than a fix it after the fact mode.
So even if you do need a little more maximum...it might not be as much as one might think if that minimum was more optimally set. I have seen it happen often when the 95% numbers are high...raise the minimum and the 95% number actually lowers.

So I still think the minimum is something to look at increasing...not just the maximum (which may need a little more).
Thinking maybe a range of 8 minimum and 12 maximum and see what happens...but it is likely going to cause the nasal mucosa to dry out and be more uncomfortable. Despite living in a rain forest if you are using air conditioning the ambient humidity in your house isn't going to be nearly as humid as it is outside. Not all of Brazil is in the Amazon anyway....there's mountains where the air might be drier as well as areas where the humidity isn't equal to a rain forest humidity.
And finally, some people just need more humidity to keep their nasal mucosa and sinuses happy anyway. Not everyone can get by with minimal to none added moisture.

Send me a private message if you wish to talk about getting the humidifier I have.
It is for the S9 machine that you have coming...I don't have a humidifier for a S8 and you wouldn't want to put any money in it anyway.

The S8 model machine has been discontinued and links to discontinued equipment no longer work and that's why it isn't showing up

Ah, gotcha. Well, once I get the new one I'll update that.

When is the estimated time frame for the S9's arrival?

It should be a week.

Could you afford to perhaps pay shipping and maybe $50 US$ towards a humidifier?

Thank you for the generous offer! This one ( http://www.lumiarsaude.com.br/BASE-UMID ... I-RESMED/p ) is about 350 USD here.
It might not be worth it though, and it could get damaged.

Which S9 model did you order? I forget if you told us.

S9 autoset ( http://www.lumiarsaude.com.br/CPAP-S9-AUTOSET/p )

thesleepermustawake wrote:Hi,

Third night on the CPAP, the technician had set the min pressure to 4, but the doctor had said between 6 and 10, so I changed it manually to start at 6.
I did make quite a difference in that it was more unpleasant, and was somehow more aware of my apneas, and felt like I was waking up more than the 2 previous nights. Also, I have no humidifier and my nose and throat got dry. I have a noisy AC going on (tropical climate )

My numbers for last night are:
Pressure: 10
Leak: 0.16
IAH: 17.7
IA: 7.3
IH: 10.4

My question is : should I play around with the settings some more or try this for a few nights and see if the number of episodes reduce with the same settings?
Do the number of episodes tend to reduce on their own or do I need to keep tweaking until I get under 5?


Thanks!

To use the machine your body must develope a whole new set of "breathing reflexes".

Yes, this takes time.

Spend some quality time with the machine during the day, some of it on your bed learning to breath quietly (as if you were sleeping), some of it with minor distractions such as a book, music, or light TV. This allows a much broader spectrum of brain to work to solve the new skill of how to breath with a CPAP machine.

You think that the humidifier might get damaged in shipping?
I always insure things plus I have sent entire machines all over the world and never had a problem.
I can pack it so it will be safe..plus I always insure for damage and loss.
Let me know if you wish to get one of the extra S9 humidifiers that I have available.