New CPAP user struggles - don't know what to do

Someone else will explain about CA's better than I can, but regular C-and Apaps don't address them properly and a different type of machine does it better, called an ASV.

dooger54 wrote:

Wulfman... wrote:Still waiting to see the reports from the nights with the "prescribed" setting of 8 cm. (straight pressure)


Den

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Did not sleep with straight pressure of 8. I asked Doctor what to set machine at and he advised a range to take advantage of auto function.

What exactly do the CA's mean? I know clean airway but don't really understand them. Why would that mean buying a new machine? Just bought this one and my insurance doesn't pay!!

I suspected that when I saw this thread title. And, you didn't listen to my advice in your previous threads.

"CA" COULD mean Central Apneas........but these machines can be confused with certain breathing patterns and misinterpreting the breathing and lumping them into the CA category.
Do you have a copy of your sleep study? If you had any Central Apneas in the sleep study, they should be noted on the report.

IF a person is susceptible to Central Apneas, running a range of pressure may not be a good idea. And, when just starting therapy, there are going to be many "obstacles" that the new user has to figure out. Ranges of pressure complicate those situations (like this one) and can become a nightmare trying to figure out what caused what. At this point, I doubt that they ARE Centrals.

Edit to add: "CA" is also an abbreviation of "Clear Airway". Does not necessarily mean Central Apnea, so don't get all panicky about this. If you haven't gotten a copy of your sleep study, get it and ask your doctor questions if necessary.

Now, you've got a friggin' mess and don't have a clue what to do........RIGHT?
So......what ARE you going to do?


Den

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EDIT : Den beat me with his post ... He is correct the machine is probably confused ... and flagging them wrong.

CA's ... mean the your throat was not obstructed .. so your chest did not try to breath ... either you were awake and did not breath or you were asleep and you unconscious brain did not tell you diaphragm to breath.
So raising the pressure will not do any good.
Your chart also shows periods of CSR .... Cheyen-Stokes Respiration

Both CA's and CSR problems are gereraly treated with a Bipap/Vpap or even an ASV machine

https://www.youtube.com/watch?v=zrcXQhFK6ro

https://en.wikipedia.org/wiki/Cheyne%E2 ... espiration

Since you have just started with Therapy ... I would not do anything right now .. except try to control leaks, and get some more time with the therapy and get accustom to the complete process.

I suspected that when I saw this thread title. And, you didn't listen to my advice in your previous threads.

Now, you've got a friggin' mess and don't have a clue what to do........RIGHT?
So......what ARE you going to do?


Den

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When I asked advice here about where to set my machine I had not talked to my doctor yet. The day I received my machine the doctor called and advised me to set I using the auto function with a range. While I really appreciate the advice here - you would have me go against my doctors advice???

Not sure what other advice you say I haven't listened to?

No need to get defensive on me. Just trying to do the best I can and stay positive.

I will set the machine at 8 tonight and see what happens.

Thanks.

dooger54 wrote:

I suspected that when I saw this thread title. And, you didn't listen to my advice in your previous threads.

Now, you've got a friggin' mess and don't have a clue what to do........RIGHT?
So......what ARE you going to do?


Den

.

When I asked advice here about where to set my machine I had not talked to my doctor yet. The day I received my machine the doctor called and advised me to set I using the auto function with a range. While I really appreciate the advice here - you would have me go against my doctors advice???

Not sure what other advice you say I haven't listened to?

No need to get defensive on me. Just trying to do the best I can and stay positive.

I will set the machine at 8 tonight and see what happens.

Thanks.

Many of us have disregarded our doctor's advice in some way. I was actually prescribed 18 cm. of pressure even though my sleep study titration stopped at 16. I tried 18 cm. for less than an hour before changing to 10 cm. so I could try to get some sleep with it. It turned out to be pretty close to what worked well for me. After meeting with him for a follow-up appointment.......I fired him. He was a very nasty person.

Good. The range hasn't worked well up to this point.

Remember.......this is YOUR machine........YOUR therapy........nobody is going to care more about it than YOU.
The sooner you take control of it, the better off you'll be.


Den

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I am pretty new to this. Started out with nasal pillows. Did not feel like they remained in place all night. Switched to FFM about a week into therapy. I didn't want to take any chances on leaks or add any variables to the equation until I find out what combinations of pressure worked for me. Still working on it. Which leads to......

Changing pressures/ranges without express "permission" of your doctor. After my sleep study, 6.5 hours of very uncomfortable tossing and turning, they got enough data to tell me I had severe apnea. Did they get enough to properly prescribe a setting. I don't think so. The initial prescription was a fixed 6.0. This brought my AHI down from the high 30's to low 20's. Once I finally figured out the Sleepyhead software, it became clear to me that the initial prescription was a shot in the dark. Just something to get me started. After reading up on here and learning how to post my charts, I went with a suggestion of going to auto with a range of 14.5 to 20. That brought my AHI down to a 4-6 range. There are proponents and opponents of experimenting on your own on this board. Only you can decide what you want to do. In my particular case, my appointments with the treating physician are running about 2 1/2 months apart. So I could have wasted an extra six weeks at the 6.0 setting with little benefit.....OR.....I can take my Sleepyhead charts to my appointment tomorrow and at least point the doctor in the right direction.

In all honesty, I believe there are some long-term posters here that have a more intuitive grasp of the ins and outs of sleep apnea than my doctors. My best advice for you is get a comfortable mask that works, read up and educate yourself on the condition.....Pugsy's Pointers is a great place to start, and don't get wrapped around the CA issue unless your sleep study tagged that as an issue in your case.

Results from last night are below. Please note I did not have a good night, went to bed and couldn't get to sleep for about 1 1/2 hours. Then I woke up and couldn't get back to sleep so I got out of bed at about 2:30 and came back to bed about 4:30. But, overall it looks as is the setting of my pressure to a constant 8 did definitely help. I will be curious to see what it looks like after a decent nights sleep. Will try again tonight.




I am continuing to experience leak issues with my pillows. I am almost positive that it is my mouth opening. The first set of data prior to 2:30 was with my chin strap, and after 4:30 without. So the chin strap definitely helped but I still woke up with air escaping my mouth. I picked up some 3M tape today and will try to tape my mouth shut tonight. Will be interesting as I have a goatee with facial hair above and below my lips.

I think I will order a FFM tomorrow and try that. Am somewhat worried about getting a good fit because of my facial hair. But will try.

I looked back over my titration results, I have a copy of them. No occurance of Cheyne Stokes breathing then.

My initial sleep study was a 3 night home study by Accusom. Night one I had AHI of 36.2, night 2 was 30.5 and night 3 was 26.8. Average 31.1.

Total number of apneas for all three nights was 429, of which 408 were classified as obstuctive.

Glad to hear/see you had somewhat of a better night.
Too many variables can make it problematic trying to figure out what causes what.
I try to advise adhering to the K.I.S.S. principle when users start out. It's hard enough getting used to this new way of sleeping to complicate it with other problems.

Hang in there and "endeavor to persevere".


Den

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I empathise with your dilemma and abandoned CPAP myself after having exactly your reaction when first attempted some years ago.

But I was forced to go back and try again 5 years later and found it just as challenging. But it is not surprising that CPAP gives problems at the start. What can be worse than looking forward to relaxing sleep but having to have to dress up like Darth Vader with an intrusive mask, often with uncomfortable straps, ..... No wonder the brain revolts.

And that is the clue. Just as it takes time for the brain to adjust to glasses (been there experienced that), to hearing aides (ditto), it takes time for the grey matter to accept a blast of air over the face while sleeping. But trust me, the brain does slowly adapt.

However full sympathy for the struggle you have with your brain. Just bear in mind it has been with you for decades and is used to your earlier sleep mode so is revolting about the drastic challenges CPAP is generating.

Hang in there. It might not seem so at the moment, but eventually you will get better sleep. But do not expect it to cure all ills. You could be lucky and eventually find it opens up your life, but it might not. All it might do is to help with your sleep apnea, but that is no small success and will lessen other potential medical problems!

John

Dooger54, how did the 3M tape work out for you?

Anybody else with success using 3M tape for mouth?

I am going to try that.