How do you know if CPAP is working?

I was recently diagnose after a home study with an AHI of 34. My nurse practitioner had referred me a few years ago when I kept telling her how tired I was but I ignored it My friend was diagnosed in September and was sharing with me how life changing it was for her. Her AHI was in the 90s! So that got me thinking..."hmmm...maybe I do have it..."

After all the hoops, my DME quoted me a copay of $800 (I have a $500 deductible) and then a monthly rental. After the sticker shock, I came to this board and learned what I could quickly and decided to try to go it on my own because no one had anything positive to say about the DME that my insurance required. So I picked up a S9 Escape Auto with 82 hours on it for $200. Man, oh, man...I obviously didn't read enough about it because now I realize that I shouldn't have purchased the machine. So I'm still looking for a deal on an Autoset or something similar because I have no clue what I'm doing obviously since I bought an Escape the first time around.

But in the meantime, I go to a cpap supply store and the people there let me try on a bunch of masks. I ended up getting the Airfit P10. So I got my checklist of tips (that I had compiled from this board). I downloaded the clinician manual and set the range to 5-15 per my prescription. I did a crazy nasal lavage, squirted my nasonex, and then watched a movie with the P10 on. The cpap store had showed me how to use my tongue to seal my airway so that I could have my mouth open etc without a leak. So I sat there and it wasn't too bad. Then it came time to sleep. Boy, oh, boy!!! Lying down with a mask is very different from sitting up with one. I have really long hair so the head gear was slipping and sliding around. Every time I turned to the side, the seal popped open. Once I had figured out how to mitigate all of those factors, I realized, I hated the mask and felt incredibly claustrophobic because I couldn't breathe through my mouth occasionally.

I ended up taking the mask off when it got too bad and put it back on after a few minutes. Three hours later (11:30pm) I was very, very sleepy so I thought I might be able to fall asleep even though I still felt claustrophobic. I did! I woke up at 6:45. BUT, I woke up about 4-5 times during the night. I never, ever wake up during the night. I sleep like I'm dead. I don't even remember why I woke up...I think I just adjusted my sleep position, wiggled my mask and fell back asleep but I honestly can't remember.

I don't halve a headache for the first time but other than that, I don't know if I did it right. I wish I could find an Autoset soon...

Can you tell me how you know if it's working (without data)? What kind of things do you notice about yourself that tells you that your CPAP is working?

Thanks so much in advance for any replies. This board has been incredibly helpful. Now, I just need to find an Autoset for around $300 and I'll be able to have all of those cool charts that you guys have.

In my case, I used to have bizarre nightmares about running, climbing, hurrying, or drowning.
I actually got very little sleep; and often woke with a headache.
I guess I'm lucky, because all that is gone, which encourages me to never skip a night,
The absence of a headache is indicative of other things happening inside your body, all are good.
Since you have AHI available, you could start a journal, and start inching the lower pressure up.
3-5 nights on each setting. It is not impossible to titrate on this machine, but takes a bit of time.
The S9 Escape Auto can give very good therapy, but lacks the bells and whistles of the Autoset.

While the S9 Escape Auto isn't a full data machine it does have at least the AHI available and while I don't think SH will work with it ResScan will plus there is the AHI data available on the screen.

Here's the manual so you can see the data on the screen....you have to go into the clinical setup menu and set Sleep Quality to "On". Bear in mind you need to check the LCD before 12 Noon per the machine's clock (probably should check the machine clock while you are in the setup menu area) and also delete any prior user data on the machine and SD card because it will skew your data.
All this is explained in the manual including where the reset data menu choice.
http://www.apneuvereniging.nl/forum/pdf ... manual.pdf
It's for the AutoSet and Elite but the way to get to the setup menu is the same on all S9 machines and so is the reset therapy data thing.

What size nasal pillow were you trying? If you can try a size larger.
Also instead of 5 to 15 settings try 6 or 7 instead of 5...leave the 15 alone for now.
Turn EPR on and set it to 3 full time.
With all these changes see if you still feel the claustrophobia issues.
Practice while watching TV or reading a book.

BTW...the morning headache leaving was the first sign that my therapy was working. The other stuff came much later but that absence of the morning killer headache told me at least something was working...maybe not optimally but working.

If you have a Windows computer you can use ResScan software and at least see the AHI and how the pressure was doing. You may or may not need more minimum pressure.
http://montfordhouse.com/cpap/resscan_tutorial/ Tutorial
you can find out how to get ResScan if you want it here
http://www.apneaboard.com/forums/Thread ... 397#pid397
But to be honest the AHI and pressure numbers on the LCD screen will help you a lot.

So...erase prior user data first. If you leave the SD card in the S9 while you do the erase thing I think it also erases the SD card for you (or it did for me when I didn't mean for it to).

Your S9 Escape Auto may not be the ideal machine but there is some data available so that you aren't flying totally blind. Once you find another machine it will make a nice back up or travel machine.

There is no easy way around getting used to the mask. It is just something we all have to adapt to. Having said that, you can experiment with the different types to see what works best for you.

I can definitely tell a difference. Better sleep. Not as sleepy during the day. Not as grouchy. Especially after a random bad night like last night. They are going to happen. But today reminded me of how thankful I am to have started treatment and to have mostly good days.

I think once you get your therapy tweaked to your needs, you are going to feel like a new person. I'm only about halfway there, but I'd never go back.

Thank you all for your feedback, advice, and encouragement! I took today off just in case my first night was awful (I'm a teacher and didn't want the young humans to suffer). I didn't realize how long my headaches lasted until I didn't have one! Although now that I think about it, I regularly take ibuprofen with my morning coffee. Gah...so clueless! I went back to my cpap supply store today because I realized that my unit doesn't have a filter in it! And it didn't accept my random SD card so the store gave me a Resmed one even though I didn't buy the machine through them (although I did buy the mask). They've been super helpful and kind. I inserted the card into the machine and I don't think it recorded because when I uploaded to sleepyhead (I use macs), it showed my time used last night as 11.5 hours (hahaha! All those movies I sat through trying to acclimate) but 0 AHIs.

I'm going to increase my min setting to 7 tonight along with all the other helpful suggestions. And I found an autoset so I should have that soon! And now I have a working SD card so I'll feel more confident in the number. Also, I have a snoring app that I use on my phone and I am always in the epic snoring category with a score between 92-98% (in terms of percentage of sleep time was spent snoring) and it shows 25%. But when I listened to the recordings, it was all coughing. That's good, right? Should I increase the humidifier? I have it set to 3.5 and my nose and throat felt fine this morning.

Thank you so much everyone..couldn't do it without this board. Now on to night #2!

bahanas wrote:Thank you all for your feedback, advice, and encouragement! I took today off just in case my first night was awful (I'm a teacher and didn't want the young humans to suffer). I didn't realize how long my headaches lasted until I didn't have one! Although now that I think about it, I regularly take ibuprofen with my morning coffee. Gah...so clueless! I went back to my cpap supply store today because I realized that my unit doesn't have a filter in it! And it didn't accept my random SD card so the store gave me a Resmed one even though I didn't buy the machine through them (although I did buy the mask). They've been super helpful and kind. I inserted the card into the machine and I don't think it recorded because when I uploaded to sleepyhead (I use macs), it showed my time used last night as 11.5 hours (hahaha! All those movies I sat through trying to acclimate) but 0 AHIs.

I'm going to increase my min setting to 7 tonight along with all the other helpful suggestions. And I found an autoset so I should have that soon! And now I have a working SD card so I'll feel more confident in the number. Also, I have a snoring app that I use on my phone and I am always in the epic snoring category with a score between 92-98% (in terms of percentage of sleep time was spent snoring) and it shows 25%. But when I listened to the recordings, it was all coughing. That's good, right? Should I increase the humidifier? I have it set to 3.5 and my nose and throat felt fine this morning.

Thank you so much everyone..couldn't do it without this board. Now on to night #2!

Congrats on finding another machine so quickly. If your nose and throat are fine, don't mess with the humidity. You are using distilled water, right?

Your snoring should go WAY down while you are receiving treatment. And Sleepyhead has a separate line for snoring and vibratory snoring (whatever that is, lol).

Get ready to learn how to post screenshots of your Sleepyhead reports, and the pros here can suggest tips on maximizing your treatment.

Keep the positive attitude, you're doing great!!!

You will know it within a week or two of being on it. Once you get the right kind of mask in the beginning to go with the correct titrated pressure setting, you will know. Fatigue dissipates, depending on the severity you might find you no longer are sleepy all the time during the daytime, irritability mostly goes away (and will quickly come back if you stop using your CPAP or your CPAP equipment breaks on you), you start having dreams again, your sleep starts feeling deeper like when you were young again, you start waking up in the morning feeling rested again, you stop moving around in your sleep all the time, if you are a male you might start getting night time and AM erections again like a healthy male (depending on your age and how far gone you are by the time you get put on CPAP), your mood improves, your memory improves, your blood pressure gets under control.

Your old personality starts coming back. In other words, you start feeling like a human being again.

Hi MrGrumpy, I wish I was as lucky as you. I'm a month in and still feel like crap. I hope I start feeling better soon.
I did have a good night last week, was able to get a long stretch of solid sleep but fatigue still hit a few hours later.

Oops, my machine is indeed an auto. Just realized you were asking for ppl who don't use an auto. Sorry for misunderstanding.

One thing that helped me a lot with the P10 was adding a hose clip and clipping it to my shirt. That really allowed me to toss and turn more without losing the seal.

I did find this data capable machine listed on Craigslist this AM.

http://buffalo.craigslist.org/hab/5410591629.html

I don't know this person, so I know nothing about it other than what's listed. I also don't know much about the F&P machines, but I don't think they have the reputation the Resmeds do? Maybe someone more experienced can chime in.

Here's an S9 Autoset for $300. No mention of how many hours used on this one, though. And this one doesn't specify that it will ship.

http://rochester.craigslist.org/hab/5406419980.html

My first clue was that I stopped waking up with a racing heart rate and/or a splitting headache. (occasional full-blown migraine)

My autoset is being delivered tomorrow afternoon so I'll be able to switch over tomorrow!

I did have my second night yesterday and used the mask for 7 hours. I wouldn't call it a rough night but I definitely woke up several times. Some of the wake ups, I struggled to fall back asleep so I just focused on slow breathing and eventually I was able to fall back asleep. I definitely recall waking up at 2ish (I checked my phone because I thought it was time to get up!). I haven't had any dreams yet but maybe that's a good thing because I have a very vivid imagination!

I installed rescan and was able to pull the following data:

AHI 7.3
Pressure: Median 9.0, 95th% 11.0, Max 13 (I have my range set to 7-15)

When I go into my summary graphs, the AHI & AI says 7.3 & 0.

Would anyone mind tutoring me on what the significance of the 7.3 vs the 0 is? I've done a search but don't quite understand where the 7.3 is coming from if I have no AIs.

Thank you! I think I feel better already but I'm not sure because I just ignored feeling tired and grumpy for so long. Definitely second morning in a row that I haven't had to take ibuprofen. Oh wait! The past few days, I haven't even had coffee until late morning and that was just because I missed the flavor. Normally, it's a must have. It must be working!!

AHI includes Apneas and Hypopneas while AI is apneas so it looks like your events were mostly hypopnea and not apnea. This is from the Glossary at the end of this link from ResMed. It's for the S9 Series and Rescan. http://www.resmed.com/us/dam/documents/ ... er_eng.pdf

Apnea Indices
For all indices, the value shown for
Statistics is the total number of events
divided by Daily Usage.
• AHI — Apnea–Hypopnea Index
The total number of events is calculated
by adding the number of apnea and
hypopnea events.
For graphs, the AHI count is
incremented at the occurrence of every
event and reset every hour.
• AI – Apnea Index
• HI – Hypopnea Index
• CAI – Central Apnea Index
• OAI – Obstructive Apnea Index
• UAI – Unknown Apnea Index

Gasper62 wrote: . . . waking up with a racing heart rate and/or a splitting headache.) . .

I had forgotten about the racing heart! I had that a LOT. and not any more.

Totally missed that you found a way to get an Autoset- awesome!