Kenny's CPAP Thread

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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tattooyu
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Re: Kenny's CPAP Thread

Post by tattooyu » Mon Feb 16, 2009 9:43 pm

rooster wrote:Do you mean he visits cpaptalk.com?
No, the hardware site https://www.cpap.com. I was so excited and engrossed in his equipment orientation, I forgot to ask about this site...my bad. I'll ask him the next time I speak with him.
TSSleepy wrote:to post your story Kenny! I eagerly await hearing how things turn out for you. I'm still waiting for my equipment, but it's very reassuring to read about other people going through the process.

And thanks to the people who are answering Kenny's questions! This thread answered questions I didn't even know to ask yet.
I am so grateful that this site, and the people on it, exists!
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rested gal
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Re: Kenny's CPAP Thread

Post by rested gal » Mon Feb 16, 2009 10:23 pm

tattooyu wrote:I interrupted him by saying, "What, you mean pressing the down and right arrows at the same time?" He laughed, but only after I promised not to mess with the pressure settings (except maybe the ramp).
ROTFL!

That was funny! You really DO have a good DME, Kenny!! He laughed instead of frowning and delivering a stern lecture. How cool is that! You've got a "good'un." Hang onto him. He deserves some homebaked cookies or somethin'!

My edit..to make the quote box work.
Last edited by rested gal on Tue Feb 17, 2009 11:27 am, edited 1 time in total.
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tattooyu
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Re: Kenny's CPAP Thread

Post by tattooyu » Tue Feb 17, 2009 11:05 am

rested gal wrote:That was funny! You really DO have a good DME, Kenny!! He laughed instead of frowning and delivering a stern lecture. How cool is that! You've got a "good'un." Hang onto him. He deserves some homebaked cookies or somethin'!
Definitely. I thinking bringing him some home made cookies is a great idea. You haven't tasted cookies until you've tasted my cookies!

So, I survived my first night with my new best/worst friend. I think it went really well for the first night. I don't feel all that rested, but I know my body is getting used to it. Since I don't have a card reader yet, I couldn't resist going into the clinical menu to look at my results. Here is what it said:

Total Usage: 7 hr, 28 min
Leakage: 0.0
AHI: 18.6
AI: 4.2
HI: 14.4

I think that's pretty good, especially the AI which I know is really important. I wonder what my O2 looked like last night? Does my machine record more detailed information like the length of the apneas as well?

Did I read somewhere that ResMed machines tend to overcount the HI events? I know I read that on here about some brand, but I don't remember which one.
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Re: Kenny's CPAP Thread

Post by birdshell » Tue Feb 17, 2009 11:15 am

Congratulations, Kenny! You have a great machine that will last you for a long time. It will, in the long run, no doubt save you money, too.

And, you have to LOVE that DME--Rested Gal Laura is right. You should refer him to your thread here, so he can read his praises. I had to learn how to reset my machine under duress, you know. My treatment was at risk.

I'm glad that you had a great experience in Vegas, too. I'm guessing it was a relief of sorts, knowing what is wrong and knowing that soon you will have a solution.

Welcome to the wide, wonderful, wacky (and sometimes weird) world of hoseheadedness. It is not always glamorous, but neither are a lot of other things. it is, however, an accomplishment. As the old history show was eponymously titled, "YOU are There".

Karen,
Glad to see another life improved through cpaptalk

P.S. Based on your user name, are you planning a suitable tattoo to celebrate the occasion?
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Re: Kenny's CPAP Thread

Post by Hawthorne » Tue Feb 17, 2009 11:26 am

That's a very good night for a first night,Kenny!

You are right. Resmeds do count more HI than other machines. They seem to include Flow Limitations in there as well.

Rested Gal suggests that you can cut the number of HI in half to get a more accurate picture. That would make your AHI 11.6. That's even better! If you keep going like last night, you will be feeling lots better soon!

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Re: Kenny's CPAP Thread

Post by rested gal » Tue Feb 17, 2009 11:45 am

On page 4,
tattooyu wrote:I just got back from my DME with my new machine. They titrated me at 10cm, and the titration results showed that my AHI went from 73 without the mask to an AHI of 4 with the mask!
I know you promised your good natured DME guy that you wouldn't mess with the pressure setting, so... how about giving him a call, tell him about your first night data:
tattooyu wrote:Total Usage: 7 hr, 28 min
Leakage: 0.0
AHI: 18.6
AI: 4.2
HI: 14.4
And ask him if it would be ok for you to raise the pressure to 11 or 12. He might want to check with the doctor first, or...depending on his working relationship with the doctor...the doctor might allow him to make some pressure adjustments at his discretion.

Is EPR turned on for pressure relief during exhalation? If so, I think it's a good idea to increase prescribed pressure to correspond somewhat with the number of cm's of drop EPR gives. EPR 1 gives 1 cm drop, EPR 2 gives 2 cm drop, EPR 3 gives 3 cm drop. If I were prescribed a pressure of 10 and was going to use EPR 3, I'd want my pressure raised to at least 12 (or even 13.) I'm not a doctor, though..that's just what I'd do.

You got a perfect leak rate of 0 -- good for you!!!
Your AHI has certainly been reduced from the 73 you were diagnosed with. You're doing well!
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Re: Kenny's CPAP Thread

Post by tattooyu » Tue Feb 17, 2009 12:40 pm

rested gal wrote: I know you promised your good natured DME guy that you wouldn't mess with the pressure setting, so... how about giving him a call, tell him about your first night data:
tattooyu wrote:Total Usage: 7 hr, 28 min
Leakage: 0.0
AHI: 18.6
AI: 4.2
HI: 14.4
And ask him if it would be ok for you to raise the pressure to 11 or 12. He might want to check with the doctor first, or...depending on his working relationship with the doctor...the doctor might allow him to make some pressure adjustments at his discretion.
I'll give him a call today. I might just leave it alone for a bit until I get used to it more.

rested gal wrote:Is EPR turned on for pressure relief during exhalation? If so, I think it's a good idea to increase prescribed pressure to correspond somewhat with the number of cm's of drop EPR gives. EPR 1 gives 1 cm drop, EPR 2 gives 2 cm drop, EPR 3 gives 3 cm drop. If I were prescribed a pressure of 10 and was going to use EPR 3, I'd want my pressure raised to at least 12 (or even 13.) I'm not a doctor, though..that's just what I'd do.
Yes, I am using EPR at 3. I can't stand it any other way... yet. It make sense that it would average out to a lower pressure right? We'll see how this week goes first.
rested gal wrote:You got a perfect leak rate of 0 -- good for you!!!
Your AHI has certainly been reduced from the 73 you were diagnosed with. You're doing well!
I was surprised at that, because I know I fidgeted with the mask last night. I think I need to adjust the straps a bit. The tip of my nose is a little sore today.
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Re: Kenny's CPAP Thread

Post by SharkBait » Tue Feb 17, 2009 3:14 pm

tattooyu wrote: Total Usage: 7 hr, 28 min
Leakage: 0.0
AHI: 18.6
AI: 4.2
HI: 14.4
The best number out of that is 7hr 28 minutes. Great first night time wise. I think that AHI number can be improved upon, but one night isn't a whole lot of data points...

Way to go, man.
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Re: Kenny's CPAP Thread

Post by tattooyu » Tue Feb 17, 2009 3:28 pm

Thanks sharkbait. I thought I did pretty darn well myself keeping the mask on all night. I feel like I would benefit from the pressure being a little higher, but I don't want to change it myself just yet until I talk with the doctor. Also, I want a chance to get used to the machine for at least a week.

If I use rested gal's method of taking half the number of HI events for a ResMed, that would put my AHI at 11.4. We want it under 5, yes?

A few questions:
  1. Are the AI, HI and AHI numbers a total for the night, or the average events per hour?
  2. Why am I sweating in my neck/upper chest area with the CPAP on? This happened to me at both sleep studies as well, but I didn't find it listed in the common side effects.
  3. I had diarrhea again this morning. All three times I've been on a CPAP (1 at home, 2 at the sleep center), I've had bad digestive issues the next day. I have three theories about this:
    1. It's all purely coincidence.
    2. The extra oxygen in my body, and the relaxation, is making my bowels hyperactive temporarily until it adjusts.
    3. Aerophagia is causing the contents of my bowels have a more rapid transit time.
I'm really quite excited to see how much better I will start feeling once I adjust!
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Re: Kenny's CPAP Thread

Post by Kiralynx » Tue Feb 17, 2009 5:19 pm

tattooyu wrote:A few questions:
  1. Are the AI, HI and AHI numbers a total for the night, or the average events per hour?
  2. Why am I sweating in my neck/upper chest area with the CPAP on? This happened to me at both sleep studies as well, but I didn't find it listed in the common side effects.
  3. I had diarrhea again this morning. All three times I've been on a CPAP (1 at home, 2 at the sleep center), I've had bad digestive issues the next day. I have three theories about this:
    1. It's all purely coincidence.
    2. The extra oxygen in my body, and the relaxation, is making my bowels hyperactive temporarily until it adjusts.
    3. Aerophagia is causing the contents of my bowels have a more rapid transit time.
I'm really quite excited to see how much better I will start feeling once I adjust!
  1. It's events per hour... for instance, I had an AHI of 1.0 last night, with no apneas, abut an average a 1 hypopnea per hour.
  2. Stress, possibly.
  3. Stress can affect IBS very easily. Until CPAP is an ordinary part of your life (which it will be really soon now, if you can do that many hours on your first night!), it may have that effect. The other thing is that if you're stressing, you may be eating foods you shouldn't eat.

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Re: Kenny's CPAP Thread

Post by tattooyu » Tue Feb 17, 2009 6:36 pm

Kiralynx wrote:
  1. It's events per hour... for instance, I had an AHI of 1.0 last night, with no apneas, abut an average a 1 hypopnea per hour.
  2. Stress, possibly.
  3. Stress can affect IBS very easily. Until CPAP is an ordinary part of your life (which it will be really soon now, if you can do that many hours on your first night!), it may have that effect. The other thing is that if you're stressing, you may be eating foods you shouldn't eat.
Ahhh, per hour. Well, it's definitely better. I'll see what kind of numbers I get this week. If it doesn't improve, then I'll probably need ask the doctor to bump up the pressure or turn on the auto-titration function with a max a few CMs higher than my titration.
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Re: Kenny's CPAP Thread

Post by DoriC » Tue Feb 17, 2009 7:09 pm

I think RG was referring to raising the minimum since your pressure is dropping about 3cm on EPR, but if I'm wrong she or someone else will correct me I'm sure. In my husband's case, once our "sleep doctor" recommended an auto setting of 8-18 "to just let the auto find the right setting" when his titration was 13, and "ramp at 6 for 30mins", I knew that didn't sound right and my husband was having a miserable time adjusting to the fluctuating pressures. Thanks to this forum I got up the courage to make small changes in settings gradually with LOTS of help from the "pros", but let me tell you I was absolutely petrified the first few times I touched that machine! We're 6 months in now and finally beginning to see daylight and you will too. 7 1/2hrs is great for your first night. Dori

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Re: Kenny's CPAP Thread

Post by roster » Wed Feb 18, 2009 7:09 am

tattooyu wrote:.......... We want it under 5, yes?

..........
I target my therapy differently from the medical profession's targets. My target is for the AI to be under 1.0. This will usually keep my HI even lower because my tendency is for full apneas and few hypopneas.

I look at the profession's target of under 5.0 like this: If my AHI is under 5.0, I could, for example, be having three apneas per hour. If I sleep seven hours, that is 21 apneas per night. How would you feel and how healthy would you be if you had 21 phone calls throughout the night every night? How would that be if you were choked and awoke to restart your breathing 21 times throughout the night? Not too good!
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Re: Kenny's CPAP Thread

Post by tattooyu » Wed Feb 18, 2009 10:52 am

rooster wrote:
tattooyu wrote:.......... We want it under 5, yes?

..........
I target my therapy differently from the medical profession's targets. My target is for the AI to be under 1.0. This will usually keep my HI even lower because my tendency is for full apneas and few hypopneas.

I look at the profession's target of under 5.0 like this: If my AHI is under 5.0, I could, for example, be having three apneas per hour. If I sleep seven hours, that is 21 apneas per night. How would you feel and how healthy would you be if you had 21 phone calls throughout the night every night? How would that be if you were choked and awoke to restart your breathing 21 times throughout the night? Not too good!
rooster,

I hear ya. I think the full apneas would probably be more important than the hypopneas, but I guess they both inhibit oxygen.

Last night...

I tried something different: I turned the EPR down from 3 to 2.

Usage: 7 hr, 11 min
AHI: 12.0
AI: 0.8
HI: 11.4

So, my numbers did improve, but my sleep definitely more restless. I even woke up a couple of times with a choking feeling. It might be due to the increase of exhalation pressure of the new EPR setting. I'm not sure, but I definitely am not giving up by a long shot. Even with the tossing and turning, I still feel better.

I forgot to add...

Leakage: 0.04 (is that acceptable?)
Last edited by tattooyu on Wed Feb 18, 2009 11:26 am, edited 1 time in total.
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Re: Kenny's CPAP Thread

Post by Kiralynx » Wed Feb 18, 2009 11:08 am

Kenny,

I do more hypopneas than apneas... and I was having clusters of them 2-3 hours apart which were causing me to wake up from severe hip pain.

Granted that Resmed scores more heavily on hypopneas than Respironics (not that either method is bad; it's just the way they score it), it can still be a question of distribution of the darn thing.

For instance, ten flags over ten hours for me still rates as an HI of 1.0, according to Encore Viewer. I may wake up feeling pretty decent. But ten flags in two clusters of five each, spaced 2-3 hours apart, and I'll wake up feeling like I've been beaten with an ugly stick. Yet technically, both of the nights have an HI of 1.0.

Do you yet have the software and cardreader for your machine?

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