Waking up every hour or two with new APAP

I had a sleep study done in 1998 and have been on the same cpap machine since then. I'm so used to wearing the mask, in the past I have put it on and disconnected the hose when the power goes out to feel "comfortable".
About a month ago got a new prescription without a full sleep study due to high insurance deductible.
Since using the new auto machine I'm only sleeping a hour or two at a time, but I'm not getting sleepy in the afternoon like I used too.
I'm going to post some screenshots from Sleepyhead to see if someone might be able to tell me why I'm waking up so often.
Thanks

jokerl90 wrote:I had a sleep study done in 1998 and have been on the same cpap machine since then. I'm so used to wearing the mask, in the past I have put it on and disconnected the hose when the power goes out to feel "comfortable".
About a month ago got a new prescription without a full sleep study due to high insurance deductible.
Since using the new auto machine I'm only sleeping a hour or two at a time, but I'm not getting sleepy in the afternoon like I used too.
I'm going to post some screenshots from Sleepyhead to see if someone might be able to tell me why I'm waking up so often.
Thanks

It's your pressure range. The minimum is too low and the snoring and flow limitations are jacking your pressures up till it wakes you up and you have to reset your machine.

What pressure were you using in your old machine? Try setting this one to the same settings as that one and see how your therapy works with that.

In addition, sleep stages "cycle" at about 90 - 120 minutes. Your breathing can change during those cycles and stages and cause more events.


Den

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The old machine is a Respironics Tranquility Quest. It still works, not sure if it's blowing the same pressure as when it was new, the squirrel is getting pretty old, had to put new bearings in the wheel couple years ago....
The original pressure in '98 was 7CM H2O. I've put on about 40 pounds since then.
"It's your pressure range. The minimum is too low and the snoring and flow limitations are jacking your pressures up till it wakes you up and you have to reset your machine." I just recently read something that said the same thing, wanted to verify it.
Would changing the minimum from 5 to say 7 or 8 make a difference?
I have a appointment with the sleep doctor in a couple of weeks, they want me to bring the machine and memory card with me. It would be nice to get it closer to correct now and let them make the final settings then.
Thanks again for the replies!!!

jokerl90 wrote:Would changing the minimum from 5 to say 7 or 8 make a difference?

absolutely.

jokerl90 wrote:The old machine is a Respironics Tranquility Quest. It still works, not sure if it's blowing the same pressure as when it was new, the squirrel is getting pretty old, had to put new bearings in the wheel couple years ago....
The original pressure in '98 was 7CM H2O. I've put on about 40 pounds since then.
"It's your pressure range. The minimum is too low and the snoring and flow limitations are jacking your pressures up till it wakes you up and you have to reset your machine." I just recently read something that said the same thing, wanted to verify it.
Would changing the minimum from 5 to say 7 or 8 make a difference?
I have a appointment with the sleep doctor in a couple of weeks, they want me to bring the machine and memory card with me. It would be nice to get it closer to correct now and let them make the final settings then.
Thanks again for the replies!!!

Like I said, I would set this machine up with the same (single) pressure setting as your old one.......for awhile (maybe a week) and monitor your therapy with software (Sleepyhead) to see how your old machine and setting was working. Your old machine didn't have data-capability, so it would be beneficial to at least see how well your therapy was working. Then, you might set your minimum to your old pressure and set the upper pressure to maybe 12 cm......for another week and monitor the results.
The most important setting with a range of pressures is the minimum. It needs to be set where it eliminates most of the events. For some people, they can leave the upper pressure setting wide open but for others, the pressures may rise on flow limitations and snores but there may be no apneas to prevent........just breathing anomalies. So, they may need to set a limit or even use straight pressure if the pressure changes disturb their sleep. For some people, the pressure changes don't bother them, but for others it does. The user needs to determine that and adjust accordingly.


Den

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Changed machine from APAP to CPAP , set pressure to 7CM (from the '98 sleep study). I feel like I had a better night. Not sure if Sleepyhead thinks I did, I'm mostly guessing when I look at it

Do/did you sleep on your back a lot last night?

Obviously 7 cm fixed isn't enough to deal with the snores. It does appear to be enough to deal with the OAs/hyponeas, etc.
But with the snores, and RERAs and those snores....all points to not quite optimal settings.

The FL or Flow limitation flagging is turned off in cpap mode so we don't know if you would have had many FLs flagged or not but given the snores and RERAs...I bet there would have been considerable.

You have 2 choices....continue to used fixed cpap mode and have to use more pressure all night (don't know how much it will take to kill the snores but probably 1 or 2 cm more) or use auto mode and set minimum to 7 and max to maybe 10 and see what happens with the snores and/or your sleep quality if changing pressures impact your sleep or not.

I start off on one side or the other, but during the night I will end up on my back.
I don't think 1 or 2 cm more all night would bother me.
I would like to find out if the pressure changes are part of the problem.
Tonight I'll switch to auto at 7 and 10 to see how it goes. This will also turn on the FL flagging.
Thanks!

Here is screenshot from last night.
I feel like I had a better night with the machine set as a CPAP. Did wake up with dry mouth this morning.
Machine set to APAP 7cm min/10cm max.

Screenshot from last night. Pressure is 8 min/12 max.
If I'm learning anything, I need to bump the max pressure up to 13 or 14. At about 21:30 the pressure was maxed and snoring shows up then the same at about 00:45.
I'm sure there is more to it than snoring, on 7/9 I had 9-Hypopnea's and 7-Obstructive events. Last night, the 10th I had 3-Hypopnea's and 3-Obstructive events. Looks like progress.
Am I learning anything?

jokerl90 wrote:Screenshot from last night. Pressure is 8 min/12 max.
If I'm learning anything, I need to bump the max pressure up to 13 or 14. At about 21:30 the pressure was maxed and snoring shows up then the same at about 00:45.
I'm sure there is more to it than snoring, on 7/9 I had 9-Hypopnea's and 7-Obstructive events. Last night, the 10th I had 3-Hypopnea's and 3-Obstructive events. Looks like progress.

it does look like progress, I'd raise the minimum a cm, and raise the max a lot. are you sleeping any better yet?

for *most* people, once they get the lower pressure set right, the upper pressure doesn't matter, the machine will raise or lower pressures as your needs change during the night, but you want the lower pressure high enough to take care of the majority of events, and just leave the auto feature for exceptions such as REM sleep, or rolling on your back, situations that often require more pressure to take care of.

jokerl90 wrote:Am I learning anything?

you'll have to tell us that

HAHA just remembered about the min pressure being the important one,rush to edit post and you beat me to it!
Sleeping better? I can't decide, the recent night I had the machine set to cpap felt like the best night I had in a while. This morning I felt like crap, but it was 3:30 in the morning. (getting up for work) I was surprised that I only woke up twice, thought it was more.

jokerl90 wrote:HAHA just remembered about the min pressure being the important one,rush to edit post and you beat me to it!
Sleeping better? I can't decide, the recent night I had the machine set to cpap felt like the best night I had in a while. This morning I felt like crap, but it was 3:30 in the morning. (getting up for work) I was surprised that I only woke up twice, thought it was more.

whether it's straight pressure, or auto adjusting, you still need more to cut down on the snoring and events, though they're not a lot of them, the machine is working pretty hard to respond to what's happening... it's not taking care of you as well when the pressure's jumping around that much.