Newbie in need of advice

Hi everyone,

This is my first post after spending a few months mining the forum for tips that have proven very useful. It really is great to have a place to come to and talk about all this! I apologise if my first post is a little rambling, I'll try to be concise.

I was diagnosed late last year with OSA and finally began therapy a couple of months ago. My sleep test showed an AHI in the 70s, which explains why I've always struggled with poor sleep and low levels of energy (I'm 33, btw). I was prescribed pressure of 9.

I began with a very basic CPAP machine that wasn't data-capable. My first night went quite well and I immediately felt more energetic the next morning. My partner was shocked that when I woke up I immediately got up and was singing a song. However, I soon noticed this abnormally energetic feeling subsided after a couple of days. I occasionally felt like I wasn't getting enough/too much air. Once I told my physician this, she requested an AutoCPAP, but due to problems with the insurance company, I ended up buying my own AutoCPAP (Dreamstation). It's a lot of money but it's going to last mew a long time and it's for my health, so I didn't mind investing.

My physician recommended setting pressure 6 - 11. I'm not entirely confident that was the best choice for me as I quickly saw I found it hard to breathe on 6 (not to mention the fact she seemed to have plucked the numbers from thin air over the phone) so I pushed the minimum up and am much more comfortable. I'm currently on 8.5 - 12, though I occasionally play around with it to test.

This leads me to another important fact: in general I have a tendency to mouth breathe I had an operation to fix a deviated septum but I guess the habit stuck while sleeping. I'm also quite sensitive in terms of allergies so my nose stuffs up quite easily. So, when I bought my AutoCPAP, I also got a Chin strap (Philips), to try to train myself to sleep with my mouth closed. On a side note, ever since I've slept with a CPAP, my morning sniffles and sneezes have all but disappeared. Not sure if it's a coincidence but at least in that sense it's been an unqualified success.

My issue is that my energy levels during the day really vary, and having looked at the data, my AHI with the new machine (which I have been using for about a week now) is hovering around 2.5-3.5. Last night was 3.76 and I really noticed that I felt less rested. I understand that anything below 5 is deemed normal, and just getting to here from the high 70s is a success, but I'd really like to work on maximising rest and getting the AHI down.

I'm attaching one good night and last night (the worst so far with the new machine). I've read the beginners' guide so hopefully it follows your recommendations on how to screenshot.

If anyone can give me some advice or share their impressions, be it on ways to improve sleep quality, lower the AHI or any other tips more generally, I'd appreciate it!

Thanks for taking the time to read!

Chris

First off, place your maximum pressure to 20 (maxed out). This will allow your machine in the autoset mode, to pressure up as needed to treat an apnea event. It will back down after treating the event and wait for the next apnea event to occur. I'd have to look, but my "set" pressure from my sleep test was a 9 or 10. My machine will hover around a 11 or 12 to treat an event, but on some nights it will go as high as 17 to treat a stubborn apnea event. My lower pressure is an 8, and like you, anything less will make feel like I'm suffocating.

Are you using nasal pillows... or a full face mask? You can mouth breath with a full face mask, but if you are using nasal pillows, you must keep your mouth closed.

Sheriff

Hello, Chris! Congratulations on starting PAP therapy -- you really brought those numbers down, didn't you?

While many in the medical community regard an AHI below 5 as representing success, it is reasonable to look for consistent results under 2 (good) or even 1 (excellent).

You have a fine machine there, but one of its characteristics is that its algorithm is quite conservative and doesn't up the pressure aggressively after obstructive events to head off new ones.

So in addition to raising the max to 20 (the machine isn't even going as high as your current max, so no need to worry about super-high pressures), I would recommend that you raise your minimum pressure. There's no reason to do anything drastic: try going up to a minimum of 8.5 for a couple of nights, and if that seems OK, then 9. Check back in any time -- people here will be glad to help.

Here are the instructions for getting to the menu that allows you to change pressure settings:

"Once the device is powered, press and hold both the control dial and the Ramp button on the device for at least 5 seconds. You are now in Provider Mode. To adjust a setting, rotate the control dial to your desired menu option, then press the control dial to select that setting. Rotate the control dial to change the setting. Press the control dial again to save the change. Select the "Home" icon to exit Provider Mode and return to Patient Mode."

Bear in mind, too, that it can take time to start feeling the daytime benefits of successful treatment. You are coping with a new night-time experience, and that may be messing with your "sleep architecture," meaning the normal succession of sleep stages that we are supposed to go through every 60 to 90 minutes.

But already you are launched on dramatically lowering your risks of future serious harm to your health -- well done!