Vinny's therapy Thread 3rd sleep Doc

[Vinny V]

Hi guy,

New to cpap (45) days
been to the Dr. twice already since everyday using I wake feeling like im coming down with somthing..( if you now what i mean) the Dr. said my WBC is a bit low but otherwise it may be the body dealing with the Cpap.

he said my AHI is good mostly below 1 . but keep going and we will see what happens. but i should try to get more sleep im at 6 hours or so right now..

I downloaded the sleepyhead and notice i have a lot of rera stuff happening when i brought it up to the DR he wanted to know how i know this, i told him about sleepyhead and a friend that also uses cpap..well his attitude really changed and he was like don't you worry about that stuff, we check your numbers remotely and when you come in and if anything concerns us we will let you know.
All you need to do is use the machine all the time any time sleep is possible do you understand me......

and do not go changing your settings willy nilly.. just because settings work for one person does not mean they work for you, we base your settings on your 2 sleep test which contains lots of data.. so just relax and do what we tell you..

so should I not worry about the rera stuff, (my friend says he would like to see less rera's ) has switched me from cpap 10 setting to auto cpap starting at 10 and raising the limit every couple days ( we just started) to see how high the machine goes until we find my sweet spot, he said sleep is different every night and i might need just a little more pressure to get rid of the rera since my AHI are good, right now he started me 10 min -11 max and he said 90% of the time i was at 10.5 ( so far ) only breifly hit 11...

what do you guys think.. Thanks

Vinny

[zonker]

Hi guy,

New to cpap (45) days

welcome aboard! if you would like, you could share your charts here using the attachment feature of the forum. that way, you will get advice tailored to your specific needs.

see my link in sig to find out how to post your charts.

good luck!

[Vinny V]

Hi guy,

New to cpap (45) days

welcome aboard! if you would like, you could share your charts here using the attachment feature of the forum. that way, you will get advice tailored to your specific needs.

see my link in sig to find out how to post your charts.

good luck!

Thanks, I'm not in front of my desktop now but I took a picture to show a friend I will post it and hope it's ok

IMG_20190405_073118_hdr.jpg (613.85 KiB) Viewed 10653 times

[zonker]

Thanks, I'm not in front of my desktop now but I took a picture to show a friend I will post it and hope it's ok


IMG_20190405_073118_hdr.jpg

ah, nice work around! now we will have to wait patiently for one of the experts to log in and see what they have to say about rera.

but i'm telling you, that's a good looking chart.

[Vinny V]

Thanks, I'm not in front of my desktop now but I took a picture to show a friend I will post it and hope it's ok


IMG_20190405_073118_hdr.jpg

ah, nice work around! now we will have to wait patiently for one of the experts to log in and see what they have to say about rera.

but i'm telling you, that's a good looking chart.

Thanks

Tonight we a notching the pressure up a bit since I did hit 11 a few times..see what happens
thanks,,

my friend is concerned about the 8 rera's i had that night ( and many nights) which even thought my AHI is low can really ruin the quality of sleep and make recovery take longer.. (he says)

[Vinny V]

Last nights data...RERA's seem to be the dominant event...

IMG_4286.jpg (122.56 KiB) Viewed 10584 times

[Pugsy]

So how did you sleep last night?
Do you remember many awakenings?
How are you feeling in general?

Go here and learn about how to distinguish arousal breathing
http://freecpapadvice.com/sleepyhead-free-software

Though if you are sleeping good and feeling good I don't know that I would worry about a handful of RERAs.
Your fragmented sleep concerns me more than the RERAs....I see multiple breaks in the therapy line...any special reason why?

Oh....you might redo your image...it's upside down.

[Vinny V]

So how did you sleep last night?
Do you remember many awakenings?
How are you feeling in general?

Go here and learn about how to distinguish arousal breathing
http://freecpapadvice.com/sleepyhead-free-software

Though if you are sleeping good and feeling good I don't know that I would worry about a handful of RERAs.
Your fragmented sleep concerns me more than the RERAs....I see multiple breaks in the therapy line...any special reason why?

Oh....you might redo your image...it's upside down.

Not sleeping good or feeling good this morning very nauseous..
Overall since cpap I always feel like I'm coming down with something...

I have trouble since cpap sleeping straight thru the night going back to sleep when I'm awakened is also problematic since I started, then I get frustrated over not sleeping And I makes it harder to go back to sleep.. I think getting used to no longer sleeping in the positions I'm comfortable with may be playing a role in my sleep issues ( somewhat)
And since cpap I use the bathroom more..



My mask has been waking me recently as well .first month it fit great nice loose no leaks now the last few weeks it leaks and makes noises all night I have strap it on so tight it hurts my neck...


I do not know why the image is upside down...it's normal on my end...

Thanks

[Pugsy]

I don't know why you are using such a high minimum pressure and then limiting the max. Part of the machine hitting 11 cm is nothing more than pressure probes testing...
Might be part of the reason for the nausea...aerophagia from the pressure. I think you are using more minimum than you need to use...so more pressure all night long causing belly issues.

You mention fighting sleeping position changes...you should be able to sleep in any position that you want to...what change did you make?

How come the full face mask? Is your nose chronically congested?

The fragmented sleep and wake ups and inability to go back to sleep....sleep maintenance insomnia
is more worrisome than the RERAs. In an effort to kill all RERAs with more pressure you may be shooting yourself in the foot in terms of sleep in general.

[Vinny V]

I don't know why you are using such a high minimum pressure and then limiting the max. Part of the machine hitting 11 cm is nothing more than pressure probes testing...
Might be part of the reason for the nausea...aerophagia from the pressure. I think you are using more minimum than you need to use...so more pressure all night long causing belly issues.

You mention fighting sleeping position changes...you should be able to sleep in any position that you want to...what change did you make?

How come the full face mask? Is your nose chronically congested?

The fragmented sleep and wake ups and inability to go back to sleep....sleep maintenance insomnia
is more worrisome than the RERAs. In an effort to kill all RERAs with more pressure you may be shooting yourself in the foot in terms of sleep in general.

Thanks for your feedback..

Pressure settings:
My cpap titration sleep study fixed my pressure at 10.
but ive been to the doctor 2 times in the past 45 days due to issues, not feeling good nausea headaches etc.
he told me what i posted at the beginning of the thread.

Recently my friend who has been on cpap for decades was checking on my progress.. and felt I should be doing better or at least noticing slight improvements. ( which im not)
He does not like fixed pressures, he says the body is different every day and sleep is never the same, sticking to one pressure is foolish at least you should give the machine a bit of wiggle room of a few points to work with when you need it so he started at me at 10min since that was the prescription setting for my straight cpap and told me to notch up .5 every few days to see how high the machine goes. and how i feel ( he will check back in a few days)

He told me he was 8 setting for years and struggled to have improvement and a new lady friend was an RT and schooled him on atuopap, he run 8-10 now and has never felt better in the decades on cpap

Do you think I should go back to the setting the Dr. gave me. Straight 10 on cpap??


Sleeping Positions:

due to the mask I cant sleep how i used to since it i have the mask on my face..just very uncomfortable in the positions i like mostly face into pillow....

Mask Choice:
no real congestion ( its actually better since the cpap air if filtered)
The RT at the DME discussed how i sleep etc. and choose my current mask as being what he felt was best. but he didnt give me many options....
I told him on the test they used a nasal mask but it was so small it pressed my nose down and made it hard to breathe, and he did not have any bigger sizes and that i was not allowed to try any on.... once i opened it it was mine. so i went with his recommendation.

Sleep Issues:

Before the cpap they were basically non existent I would go lights outs dead to the world for 7,8,9 hours or more but wake up feeling like crap..


I appreciate the feedback and I hope the post was not to long... and answered your questions ok

[zonker]

He told me he was 8 setting for years and struggled to have improvement and a new lady friend was an RT and schooled him on atuopap, he run 8-10 now and has never felt better in the decades on cpap

you are in good hands with pugsy and i have nothing to add to her advice. but the line i quoted jumped out at me.

your friend was very lucky in that he got the help he needed. however, each of us is different in our cpap journey. what works for me won't necessarily work for thee. for instance, i use a minimum pressure of 13.8 and a max of 20. that's what works for me. would i recommend it for you? no. because i am not you.

just thought i'd drop that on you. now back to pugsy who will give you good info relative to your treatment.

good luck!

[babydinosnoreless]

Finding the right mask can make all the difference in your sleep quality. It did for me. I went from a full face mask down to an N-20 nasal mask and it made a world of difference. It sounds like your dme is being kind of jerky if you were not given the option to try on and test masks. Many dme's will let you try on multiple masks. My dme was a jerk at first and just tossed a dreamwear at me without giving me many options but the nice people here have helped me out by sending me masks to try and taught me to stand up to my dme to get what I need. Are you in the US ? If so I have a Activa with one open cushion and two sealed cushions in standard size that I only tried for a few weeks. I have a couple of other things but I am afraid they might be too small as I am female and they are in a small size. Anyway if you want the Activa I am more than happy to pay it forward and send it to you. Just send me a Private Message with your address and I will send it out

[Vinny V]

Finding the right mask can make all the difference in your sleep quality. It did for me. I went from a full face mask down to an N-20 nasal mask and it made a world of difference. It sounds like your dme is being kind of jerky if you were not given the option to try on and test masks. Many dme's will let you try on multiple masks. My dme was a jerk at first and just tossed a dreamwear at me without giving me many options but the nice people here have helped me out by sending me masks to try and taught me to stand up to my dme to get what I need. Are you in the US ? If so I have a Activa with one open cushion and two sealed cushions in standard size that I only tried for a few weeks. I have a couple of other things but I am afraid they might be too small as I am female and they are in a small size. Anyway if you want the Activa I am more than happy to pay it forward and send it to you. Just send me a Private Message with your address and I will send it out

What kind of mask is an Activa... I googled and they look like full face masks ?? if im looking at the right thing

[babydinosnoreless]

Finding the right mask can make all the difference in your sleep quality. It did for me. I went from a full face mask down to an N-20 nasal mask and it made a world of difference. It sounds like your dme is being kind of jerky if you were not given the option to try on and test masks. Many dme's will let you try on multiple masks. My dme was a jerk at first and just tossed a dreamwear at me without giving me many options but the nice people here have helped me out by sending me masks to try and taught me to stand up to my dme to get what I need. Are you in the US ? If so I have a Activa with one open cushion and two sealed cushions in standard size that I only tried for a few weeks. I have a couple of other things but I am afraid they might be too small as I am female and they are in a small size. Anyway if you want the Activa I am more than happy to pay it forward and send it to you. Just send me a Private Message with your address and I will send it out

What kind of mask is an Activa... I googled and they look like full face masks ?? if im looking at the right thing

Yes it is a full face mask. Different masks fit in different ways. If you are lucky you find the one that fits best to your face.

[Pugsy]

Often titration studies come out with a recommended pressure that is a worst case scenario pressure setting...cover any needed increases in pressure for sleeping on your back or maybe REM stage sleep. Both supine sleeping and REM stage sleep can cause OSA to worsen and/or need more pressure than might be needed in other sleeping positions or other sleep stages. So you end up with a fixed pressure recommendation that you may or may not need for other parts of the night.

My OSA is worse in REM and sometimes I might need 6 to 8 cm more pressure in REM than I do on non REM sleep. REM makes up about 20% of the night and I don't know about your but I sure don't want to use 6 cm more all night long just so I have 20% of the night covered.
I don't know why they came up with the fixed setting of 10 cm recommendation for you. Maybe it was a worse case scenario thing....

I don't know that your nausea is related to aerophagia or not but it might be....and no...I don't recommend you go back to fixed at 10 cm.
If it is aerophagia that is causing the nausea then using 10 cm all night isn't really any different than what you are doing now with the minimum of 10.
Actually I would suggest reducing the minimum and see what happens.

Turn off the pie chart....File/Preferences/Appearance tab and remove the check mark for "show pie chart"...this will let some useful statistics to come into view.
And I don't know what to tell you but your image is upside for me and I can't read it upside down.

Actually I would suggest minimum of 8 and max of 12 and lets see what the machine even wants to do. Right now you have its hands tied so tight it can't really do what it is designed to do.
So I want to see
1....if the nausea reduces
2....just what the machine wants to do per the auto adjusting algorithm

I wouldn't suggest a full face mask unless someone just had to mouth breathe due to nasal congestion.
I normally suggest that they start with a mask that is more minimal and easier to manage and easy to sleep in any position that the person wants to sleep in. Something like a nasal pillow mask....ResMed AirFit P10 or ResMed Swift FX....or maybe one of the nasal cushion masks that just goes under the nose and not across the bridge of the nose such as the DreamWear Nasal cushion mask or the ResMed N30i. With any of these masks you could comfortably sleep on your stomach since that is your preferred and usual position.
This whole cpap stuff is sleep disturbing enough without forcing a person to sleep in a position that they are simply not used to.

Go here and take a stroll through the nasal masks and nasal pillow masks
https://www.cpap.com/cpap-masks
Make a list of the ones that look interesting to you....come back to me with that list and I will see if I happen to have one you can have to try and it won't cost you anything but postage. I have some masks donated by other forum members that they either didn't like or no longer need because they changed masks. I will see if I happen to have one that you are interested in.

For right now just put the RERA question on the back burner....with your reported issues with staying asleep and wake ups it is very possible that those aren't even real asleep events anyway.
Let's target your comfort and your sleep quality first. If you don't sleep so great it doesn't really matter how good the numbers are or aren't.

Don't compare your pressure needs with that of your friend....means nothing. Everything about cpap comes with a huge YMMV sticker.