New Member

Hello to All!
I am a new member of this cult in my mid 30s - got formally diagnosed with OSA (have been hearing (and ignoring) from my room partners/wife about my loud snoring for 8 years now).

Below were my sleep study numbers:
AHI: 62
O2: 65%
REM: 9%
Sleep efficiency: 70%

Strangely, I have no symptoms (literally) of OSA and still dont believe the SS results. The only reason I saw the doctor is because I woke up choked in the middle of the night a few many times (which I later learned was because of GERD and not OSA (well atleast not directly)). But it does explain the hypertension I have since this year. Otherwise, I am a fairly unsuspected candidate for this disease. Not overweight or obese; no smoking or drinking, not much neck obesity either.

Like others, it was a long journey from the first appointment with pulmonologist (05/13) to getting the cpap (08/19). I got an Aircurve 10 VAuto (running as APAP to start with) & Airfit P10. I have already read through all the newbie pages for all the hints/tips - thank you all for putting this together. I would not have taken this up without reading on this support forum.

So, I did start the therapy yesterday. I am doing home titration with the following settings:
IPAPmax: 16
EPAPmin: 4
PS: 0
Mode: VAuto
Humidity: 3 (distilled water)
Temp: 81F

Here is the sleep report (these are just from the panel, havent yet looked at the data on sleepyhead):
Sleep Events: 0.6/hr
AHI: 0.3/hr
Pressure: 10.8 (although, 2-3 times I woke up, I saw pressures, 11.4, 7 etc)
No leaks

The good:
- I had no issues with the DME or my ENT doctor
- I think I was able to tolerate pressure (was not able to do so during the sleep study. The difference is probably the mask (nasal during SS and pillows now)
- no wake ups due to high pressure (or changes)
- No sinus issues, headaches, lung pain etc

The Bad:
- I do notice some minor stomach bloating

Looking at the result (which I think are good) and my initial clinical symptoms (or lack of), I am inclined more towards thinking that my SS results were false.
However, the average pressure of 10.8 seems to indicate as if the machine did its job in preventing events.

I want to reinforce 1 tip I read on this forum - the key to success is finding the right mask and avoiding leaks. I am just amazed how good the Airfit P10 is - a must try for anyone starting their therapy! Unless you have fit issues or are a mouth breather, this one should be the first choice IMO!

I look forward to your experts thoughts and suggestions - Thanks!

The nice low AHI on the machine just means the machine is doing its job...it's not able to tell you how many apnea events it prevented. It just shows you how many slipped past its defenses.

The swallowing of air...fairly common complaint and if it becomes too much of a problem there are ways to deal with it and the first would be a minor change from APAP like mode with your PS of 0 to real bilevel with PS of maybe 2 to 4. It would likely help the aerophagia issues significantly by changing PS and maybe a couple of other little tweaks to the pressure.

Welcome to the forum. Don't doubt the sleep study AHI...as much as you might want to.
That O2 level is scary low and the AHI of 62 is way into the severe category.

+1

Get sleephead and look at your data! If you see the pressure going up and down all night then you had no events because the machine was WORKING to keep it that way.

Please trust me that you do not want to go the way I did, I was diagnosed after type II diabetes and double bypass and two stents. My wife had been telling me for years that she though I had sleep apnea and since I had no symptoms that I knew of, I did nothing. By the time you get to physical symptoms you wish you have never gotten to that point. Trust the data. Not breathing for over 10 seconds is pretty dang easy to spot and hard to make a mistake about.

Welcome! There are many knowledgable people here to help you. Best wishes as you learn.

Thank you Guys for the welcome!

Please find below the sleepyhead charts - any thoughts/suggestions?:

Welcome! I was shocked by a diagnosis of severe obstructive sleep apnea after my first sleep study. I had NO CLUE I had sleep apnea symptoms. I would trust the sleep study. It looks like your treatment is off to a great start and the doctor who prescribed your machine and settings did a great job. I hope treatment continues to go well and you feel the results in the form of better quality sleep.

Thanks MarylandCpaper!

I have been going through the usual states of denial - anger - acceptance etc states. Seems like a tall ask to do this forever, every single night of your life!

Once you start feeling better due to treatment, it becomes routine and many of us actually look forward to our time with the hose. Even when i can't sleep, I find the CPAP routine relaxing. I cannot sleep without CPAP. I don't believe it is an addiction, but an expectation the body has developed that adequate oxygen will be present before it allows me to sleep. Hence, I am 100% compliant in using my CPAP equipment, as I need the sleep and its benefits.

You have made a great start. This is a life-saving treatment, worth the inconvenience.

bones20 wrote:Thank you Guys for the welcome!

Please find below the sleepyhead charts - any thoughts/suggestions?:

if it were me, I'd raise the minimum pressure some more, so there was a bit less up and down.

+1

You are set wide open and at least for me 4 is too low. The machine is for sure doing it's job and quite well at that. By using CPAP you are doing a very important thing to protect your health BEFORE it can go south.

Thanks PaleRider and PoolQ!

I plan to increase PS to 3 which should increase IPAPmin to 7 (which is also around my median and mean)

bones20 wrote:Thanks PaleRider and PoolQ!

I plan to increase PS to 3 which should increase IPAPmin to 7 (which is also around my median and mean)

epapmin is what needs to change, not ps. it's the epap that keeps your airway open.

epapmin is 4 - do I need a higher exhale pressure? If I set PS to 3, this how it will look:
Start EPAP = 4
Start IPAP = 7 (the increased pressure as you suggest?)

PS. I see what you are saying, You are suggesting a higher EPAP to reduce the variation

Update: Night2:
I made the following changes
- Reduced the humidity to 2
- increased EPAPmin to 6

I noticed that I slept much quicker with this setting. This night was almost a natural feeling. The results are similar too.
The max pressure today was in the 10s.
AVG was still around 7
90% was around 10.something

I was playing around with pressure support as well at the beginning - 1, 2, 3 etc. I was not comfortable at all. I felt like a stop and go scenario while driving a car. Straight pressure is much better.
After playing around with the Cycle time, I was somewhat comfortable with PS 1& 2 after increasing the cycle time sensitivity to "very high"

I did take GASx today and that seems to have helped with Gas

bones20 wrote:After playing around with the Cycle time, I was somewhat comfortable with PS 1& 2 after increasing the cycle time sensitivity to "very high"

it's not cycle time, it's just cycle. trigger and cycle are what controls the machine shifting to the ipap pressure.

when you start to inhale, you TRIGGER the higher pressure, when you stop inhaling, it CYCLES back to the lower pressure.

the sensitivity of trigger and cycle are how easily the machine switches modes. a high cycle means that it very easily drops back to the lower pressure, a low cycle makes it wait for more of an exhale from you before dropping pressure.

make sense?