Trying CPAP

Thanks to the responses I got on my previous post here, and reading about everyone's positive experiences with cpap I have decided to take the plunge and try it. I purchased the Airsense 10 Autoset for Her based on recommendations here. Reading some of the DME horror stories here, I'd have to say I had a good experience. My DME was quick to recommend the Airsense 10 and more than willing to work with me when I asked for the Autoset for Her.

My machine was originally set up not to show AHI. Thankfully, one Google search later I was able to change that!

My prescribed range is 4-20, which I noted is the minimum to maximum range the machine supports. I never had a successful titration study, so I have no idea where I should be. Now, searching here, it looks like too high of a pressure can cause central apneas? Should I be concerned about that? Is it fairly standard to set the range for the full supported range? Should I changed it to a tighter range once I have more data on what pressures I actually need? Do other machines have a larger range? Do I need to worry about the machine inaccurately reading an apnea- or are they usually pretty accurate?

I have been trying to wear the cpap for at least a bit of time everytime I sleep. I typically have been managing 20-30 minutes before giving up. I work 14 hour shifts and usually only can sleep 7 hours before shifts, so I hate to waste too much time tossing and turning. I have managed to fall asleep with the mask on once so far, for just over an hour. I woke up thinking someone was attacking me in full out terror mode. It took me almost an hour to calm down enough to fall back asleep (without the mask). My heart was pounding out of my chest. Everytime I put the mask on I can feel my heart rate accelerating. The hour I acrually fell asleep my AHI was 0 for that, but I'm sure I didn't enter REM, or anywhere close.

I feel like I have a hard time exhaling even wth EPR on. I notice this has a setting of 1-3. Which end of that gives you more relief?

Does the AHI on the machine reflect the degree of OSA I have in general, or just the degree that treatment is successful?

Thanks again for all of the answers to my endless questions!

You got a great machine!

It is normal when doing at-home titration to start with the settings wide open (4-20). Many people feel like they're not getting enough air when they're inhaling at the lowest pressure(s) and they'll bump that minimum pressure up a little.

You don't need to worry about centrals unless a whole bunch of them start showing up. It's not all that common for centrals to become a significant problem, and a few centrals are normal.

The machine is pretty accurate, certainly enough to tell you whether your apnea is well controlled or if something needs attention.

Re the exhale relief (EPR), 3 would be the maximum relief -- that's a 3 cm drop in the pressure when you exhale.

You will be able to narrow that range of pressures once you've got some data collected. If you want to start tracking we suggest you download SleepyHead -- it's free and user friendly. Look for forum member Pugsy and use the link in her signature box to get the software.

Sounds like you're having some anxiety with the strange sensations of the mask and machine. That's normal. Time will help. You can also help yourself by spending a little time using the machine while awake -- watch TV, listen to music, whatever you find relaxing.

The AHI you see on your machine display is your treated AHI.

Thank you! From what I've read, Sleepyhead doesn't work with the 10 yet, but Rescan does.

Hello and welcome to the world of cpap. The AHI your machine reports are the events that the machine could not effectively address. Generally speaking, you shouldn't have to worry about that upper pressure since the machine should go only as high as you need, unless you have large leaks that give it trouble. I wouldn't worry about high pressure and centrals unless a reason develops. Yes, it's a possibility, but not a probability. The good news is you're becoming well informed. The bad news is you're learning things on a broad scale and much of it you will never need to know in your own personal use. Some good starter points to focus on are learning how to get your data and what it means. Once you know what pressure takes care of your events you can narrow your pressure range. It may be you already need to raise that lower number. Could be the reason why you wake up feeling as you describe, if the lower pressure can't raise fast enough to meet your needs. Your data should show you if that's the case. Lowering the top of the range to just above what your data shows you need should help your concern over the pressure going high and causing a problem.

With your schedule and limited sleep time it's understandable that you're not in a position to just tough it out. Maybe when you've got a night or two off you can be more aggressive with forcing the issue. Don't be discouraged about it not going easy immediately. That has absolutely no bearing on your future ability to succeed and thrive on this therapy. Good luck going forward.

Thatgirl wrote:From what I've read, Sleepyhead doesn't work with the 10 yet, but Rescan does.

According to the SleepyHead website you can now use SleepyHead with the A10 machine. Version 9.8.- http://sleepfiles.com/SH/index.html?TestingVersions

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Thatgirl wrote:Thank you! From what I've read, Sleepyhead doesn't work with the 10 yet, but Rescan does.

you're a few months behind on your reading.

Awesome! I'll download Sleepyheads today! Can't believe how quick the open source community is!

Welcome to the forum.
Did you find the clinician/provider manual for your machine? If not you can request it here.
http://www.apneaboard.com/adjust-cpap-p ... tup-manual
It will explain some of the features for your machine in better detail.

You won't be able to judge EPR benefit while awake if the machine is starting out at 4 cm pressure because EPR does a per cm drop during exhale....1 per setting with a setting of 1 being a 1 cm drop and a setting of 3 being a 3 cm drop...but it won't/can't drop below 4 cm because that's as low as the machine can go. This is while awake...your machine shouldn't increase the pressure from the starting minimum until apnea events or warning signs drive the pressure up. You may or may not be all that comfortable with the starting 4 cm pressure...for some people they feel like they are suffocating when the pressure is that low but others are good with it. If you are comfortable with it and your reports look good there is no urgent need to change that minimum.

High pressures don't always cause centrals and for people who do have centrals caused by cpap pressure it doesn't always have to be a high pressure. I have seen people develop centrals with as little as 6 cm cpap pressure.
Actually the number of people who develop centrals (at any pressure) because of cpap is relatively small and I wouldn't worry about centrals and pressures unless you see a truck load of centrals.
I routinely would see pressures of 18 cm when I used apap and never had any extra centrals.
It's normal to have an occasional central...so don't panic if you see a handful of them. It's normal to have sleep onset centrals and it is also possible for the machine to mistake awake breathing irregularities for centrals.

It might help to fill out your profile so we also know what mask you are using.
Some folks feel very clostrophobic with a full face mask others love it, I currently prefer the Wisp nasal mask which is one of the smallest available.
The mask is the toughest part to get right. Everyone is different and finding the right mask and getting it properly adjusted as a newbe is not easy, but once you master it therapy can be a life saver.

I did get the clinician manual from "that other forum." That was a huge game changer. Definitely understood the settings and everything more after reading it. I couldn't believe how basic the patient manual was.

I am using a full face mask, since I tend to sleep with my mouth open. I'm thinking I would like to try either the tap pap or a hybrid one, though.

Updated my profile with equipment.