Waking up gasping and more hypopneas

UphillRun · Post by **UphillRun** » Sun Aug 09, 2020 8:03 am

Hello all,
I'm a new cpap user and hoping someone can look at my charts and let me know if this is normal or not. I've only had my cpap for 3 nights, but all nights I've been waking up after about an hour and a half, gasping for air. I've been worried that my pressure is too high...in part because prior to cpap I've typically slept 4-5 hours before waking up like that (whereas with cpap it happens after 1.5 hours). Also during my initial sleep study (without cpap) I only had 1 hypopnea the entire night and now i have multiple in a short period. Would very much appreciate if someone can provide insight as to whether it is possibly too high or if there could be something else going on.

Initial sleep study (no cpap):
Overall RDI: 11.0
RDI during REM: 28.3
Overall AHI: 1.9 (9 apneas, 1 hypopnea)
AHI during REM: 7.8

Night 1 with CPAP
CFlex+ setting=2
Mask=Nasal pillow
This night was very fragmented because I took off mask at some point and then put it back on around 3ish

: Screen Shot 2020-08-09 at 10.01.36 AM.png (188.29 KiB) Viewed 1238 times

Night 2 with CPAP
CFlex+ setting=3
Mask=Dreamwear full face

: Screen Shot 2020-08-09 at 9.58.38 AM.png (176.15 KiB) Viewed 1238 times

Night 3 with CPPA
CFlex+ setting=3
Mask=Dreamwear full face

: Screen Shot 2020-08-09 at 10.00.03 AM.png (189.15 KiB) Viewed 1238 times

Julie · Post by **Julie** » Sun Aug 09, 2020 8:34 am

You apparently have an auto machine, why are you on plain cpap - and at the relatively low pressure of 7?

UphillRun · Post by **UphillRun** » Sun Aug 09, 2020 8:43 am

I don't actually have the auto...I have the Dreamstation Go (not the auto), but that wasn't an option on the dropdown menu when I was setting my profile . And 7 was what my the doctor recommended based on a CPAP titration study they had me do after the initial study.

Dog Slobber · Post by **Dog Slobber** » Sun Aug 09, 2020 9:17 am

UphillRun wrote: ↑
Sun Aug 09, 2020 8:43 am
I don't actually have the auto...I have the Dreamstation Go (not the auto), but that wasn't an option on the dropdown menu when I was setting my profile .

Your signature states you have yer DreamStation Go Auto CPAP Machine

If you have the Fixed model (400), then don't put the wrong version in your signature, instead put the correct one using text.

UphillRun · Post by **UphillRun** » Sun Aug 09, 2020 9:23 am

Dog Slobber wrote: ↑
Sun Aug 09, 2020 9:17 am

UphillRun wrote: ↑
Sun Aug 09, 2020 8:43 am
I don't actually have the auto...I have the Dreamstation Go (not the auto), but that wasn't an option on the dropdown menu when I was setting my profile .
Your signature states you have yer DreamStation Go Auto CPAP Machine

If you have the Fixed model (400), then don't put the wrong version in your signature, instead put the correct one using text.

Ok corrected.

Cannuck 1 · Post by **Cannuck 1** » Sun Aug 09, 2020 10:35 am

I have to agree that your set pressure is to low and you have Flex activated which lowers your exhaling pressure so you are very close to OA or H problems. It is to bad you could not crank up your volume to 10 cmH20 and then you could use your flex at 3. I would try shutting off flex and see your Cpap nurse or Dr to see if they can accommodate you better.

Miss Emerita · Post by **Miss Emerita** » Sun Aug 09, 2020 10:47 am

Welcome, UphillRun! Congratulations on starting therapy for your respiratory disturbances. I'm impressed that you're already using Oscar, and it's good that you're already able to do some sleeping with your machine/mask.

Your current settings have completely eliminated obstructive apneas, which is good. You can think of hypopneas as wanna-be obstructive apneas; they are partial obstructions of the airway. In effect, using CPAP has helped you trade in your fully obstructive events for some partially obstructive events, and that is progress.

Further progress will mean raising your pressure some. Without experimenting, you won't know how much. Your pressure on exhale (which is when full and partial obstructions almost always occur) is quite low, averaging around 5.4 cm. Your exhale pressure is lower than your official pressure of 7 because you are using C-flex+, which drops your pressure when the machine thinks you will be starting to exhale.

Raising your pressure may help to reduce hypopneas, and it may also help you with the wake-ups gasping for air. Many people find that at low pressures they feel a bit air-starved.

So I'd like to suggest that you raise your pressure from 7 to 7.5. I *think* these instructions will get you to the menu that will enable you to do that. Let us know if they don't work for your machine:

"Once the device is powered, the home screen appears (it is a large box on the screen with four little boxes you can select by turning the control wheel). Turn the wheel to toggle between the 4 options and highlight "setup". Once setup is highlighted press and hold both the control wheel and ramp button on the device for at least 5 seconds. You will hear a double beep and the provider mode screen will appear. Also, you should remove the smart card prior to making adjustments, otherwise it will revert to the previous settings."

The other thing I think will be helpful to you is to set your machine up during the day or evening outside your bedroom and use it while you're doing something distracting, e.g., watching TV or reading. This speeds up your adaptation to the new experience.

And while you're doing that, I would recommend trying out various options for flex, including turning it off. Really, what you want is what will make you feel most comfortable. Turn the ramp off so that you'll experience the various flex settings right away as you play around with them.

Please keep us posted!

http://www.apneaboard.com/wiki/index.php?title=C-Flex

UphillRun · Post by **UphillRun** » Sun Aug 09, 2020 11:32 am

Miss Emerita wrote: ↑
Sun Aug 09, 2020 10:47 am
Welcome, UphillRun! Congratulations on starting therapy for your respiratory disturbances. I'm impressed that you're already using Oscar, and it's good that you're already able to do some sleeping with your machine/mask.

Your current settings have completely eliminated obstructive apneas, which is good. You can think of hypopneas as wanna-be obstructive apneas; they are partial obstructions of the airway. In effect, using CPAP has helped you trade in your fully obstructive events for some partially obstructive events, and that is progress.

Further progress will mean raising your pressure some. Without experimenting, you won't know how much. Your pressure on exhale (which is when full and partial obstructions almost always occur) is quite low, averaging around 5.4 cm. Your exhale pressure is lower than your official pressure of 7 because you are using C-flex+, which drops your pressure when the machine thinks you will be starting to exhale.

Raising your pressure may help to reduce hypopneas, and it may also help you with the wake-ups gasping for air. Many people find that at low pressures they feel a bit air-starved.

So I'd like to suggest that you raise your pressure from 7 to 7.5. I *think* these instructions will get you to the menu that will enable you to do that. Let us know if they don't work for your machine:

"Once the device is powered, the home screen appears (it is a large box on the screen with four little boxes you can select by turning the control wheel). Turn the wheel to toggle between the 4 options and highlight "setup". Once setup is highlighted press and hold both the control wheel and ramp button on the device for at least 5 seconds. You will hear a double beep and the provider mode screen will appear. Also, you should remove the smart card prior to making adjustments, otherwise it will revert to the previous settings."

The other thing I think will be helpful to you is to set your machine up during the day or evening outside your bedroom and use it while you're doing something distracting, e.g., watching TV or reading. This speeds up your adaptation to the new experience.

And while you're doing that, I would recommend trying out various options for flex, including turning it off. Really, what you want is what will make you feel most comfortable. Turn the ramp off so that you'll experience the various flex settings right away as you play around with them.

Please keep us posted!

http://www.apneaboard.com/wiki/index.php?title=C-Flex

Thank you both for the detailed replies! So glad to have a forum where there's such immediate and great feedback. I hadn't thought of turning off CFlex+, I will definitely try that as well as the small increase in pressure. Another thing that just occurred to me...I think that I may be waking up earlier in the night than I'm used to be cause I'm flipping from my side position to my back earlier in the night, perhaps due to not being used to wearing the mask. I may try a positional therapy device to see if I can stay on my side longer in conjunction with the cpap

UphillRun · Post by **UphillRun** » Wed Aug 12, 2020 7:01 am

Hey everyone, so I turned off cflex+ which solved my low EPAP. Upped my pressure to 7.5.However still having hypopneas and waking up after approx 1.5 hours as a result. I did however get my cpap fixed exchanged for the auto version. Any thoughts on what pressure range I should set it to (ie my min and max)? Thanks in advance

Waking up gasping and more hypopneas

Waking up gasping and more hypopneas

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Machine	Mask

Additional Comments: OSCAR 1.1 software, Rescan 5.9,ceiling pressure max 11CM +Floor Min pressure 8 CM range,EPR-3