New: Help! Too many ahi's

I couldn't take it anymore so I bought the hybrid face mask.

stejoel wrote:The problem was that I've a had a terrible phobia of medical procedures and tests since I was young.

With the kind of data showing on your IntelliPAP reports, I really, really, really think you should go have a PSG sleep study in a sleep lab. Easy for me to say, because I don't have the kind of phobia you have.

A sleep study is painless. Well, if they have a comfortable bed. Really, there are no needle sticks, nothing painful at all -- and believe me, I'm THE biggest wimp about even the slightest pain at all. Static electricity from a car door or door knob in the house makes me jump and cringe. Nothing that's attached to you for a sleep study is painful in any way.

Perhaps your psychiatrist could work with you to help you be able to spend just one night getting a sleep study done. You've already acclimated yourself to using "CPAP" and a mask. Heck, you've even stuck a piece of tape on your mouth. You've got the hard part out of the way! Everything you've done so far (and I truly do applaud your trying to do something about sleep apnea yourself) is much more uncomfortable than a sleep study is.

It doesn't have to be done in a hospital, if that kind of environment would be unacceptable to you. There are many good free standing sleep clinics. Visit some of them to see what the rooms look like.

One night. Just one. Take your own pillow, make a nest in the bed, watch TV until time to sleep. Think of it as a night in a comfortable motel. The data that will be gathered in that one night could make all the difference in the world to how your treatment should be adjusted. Would save you a lot of time and grief in trying to figure out how best to treat your sleep apnea.

My very non-professional opinon after looking at those reports you posted... it may take a great deal more pressure than starting down at 10 to hold your airway open. It may be that a bilevel machine would be better for you. The respiratory rate on your report of 20 and 21 breaths per minute seems a little fast to me, but I really don't know anything about that kind of stuff. Lotta things on your reports that would make me (if I were you) try to figure out a way to go for a real sleep study. Just for one night. Physically painless. Truly.

If that's totally out of the question, then at least ask your psychiatrist if he could arrange with an accredited sleep lab that has portable home testing equipment to let you do a "home sleep study." That won't be as good as an attended PSG (Type I) at a sleep lab, but if the right portable home sleep study equipment (Type II, monitoring seven or more channels) is what the lab would give you to use for a night at home, that will give MUCH more valuable information than what you can see from the software of any treatment machine.

Good luck, stejoel. Keep thinking about it. Just one night. One.

Well, I got the hybrid mask and my leak rate soared into the 80's. Not to mention my nostrils are severely traumatized now. Whoa is me. I am soooo tired but I can't sleep!

So now I have the quattro mask and it really helps with the leaks. The only problem is it doesn't lower the ahi's (about 15-20 per hour) at any pressure. What do I do now?

stejoel wrote:So now I have the quattro mask and it really helps with the leaks. The only problem is it doesn't lower the ahi's (about 15-20 per hour) at any pressure. What do I do now?

I second what Rested Gal has to say. A night in a sleep clinic is pretty much a night's stay at a hotel. I've stayed in worse hotels, I can assure you. The only thing different is a person comes in and puts some wires onto you with a little tape. But it's not "hospital"-like at all. Mine had a nice flat screen TV on the wall, and most important for me a nice little lamp on the nightstand so I showed up with a nice long book and settled in for some reading. I went to bed at about 10:00 PM and probably read until 12:30 AM. Yeah, it's not home and it did take me a bit to get to sleep, but I've never read the entire night and sure enough I did finally fall asleep and they got some really good data.

You might post the reports with the latest mask. But I agree as far as the hybrid is concerned. As much as I absolutely love my nasal pillows on the Swift LT, I couldn't get the hybrid to work for me...

stejoel wrote:So now I have the quattro mask and it really helps with the leaks. The only problem is it doesn't lower the ahi's (about 15-20 per hour) at any pressure. What do I do now?

You slow down.
You make only one change a week.

You've change two mask within a week - nothing wrong about that - but there's no way you can learn anything about anything when you've tried those two masks "at any pressure".

I second what others said about a sleep study, but if you're not going to go that way, then you have to start dealing with this systematically. I'm not a professional in medicine, or sleep apnea, or anything like that, but here's what I'd do:

I would let the machine try to diagnose my pressure, starting at the lowest bearable minimum - and letting it have its head up to 20. I don't think a wide open range is good for therapy - but this if for titration, and a week at a wide open range would make be feel better about choosing the minimum for the rest of the self study.

Make only one change at a time.
Stick to the changed condition for a week at least - unless its results are exceptionally dreadful.

Then look at all the data - what does the machine report as the 90% pressure? That number means you've spent 90% of the night at that pressure, or beneath it.

I'd set the minimum close to that pressure if tolerable - maybe 2 cms. less. And stick to that for a week or two.

Keep us updated.

Its going to be a slow process - but that's the way it has to be done when all the data you have is from you rmachine.

Welcome to the forum, and good luck!
O.

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I would let the machine try to diagnose my pressure, starting at the lowest bearable minimum - and letting it have its head up to 20. I don't think a wide open range is good for therapy - but this if for titration, and a week at a wide open range would make be feel better about choosing the minimum for the rest of the self study.

I agree and I've tried doing this. What happens is as soon as I fall asleep the pressure goes to max in about 5 minutes and the ahi's are worse than at much lower pressures. Then mask wakes me up because it leaking and whistling and flapping from blowing at 20 and that's all the testing In can do at that time. Could it be that the intellipap algorithm?

i note that several very expereinced users have suggested that you really should have a sleep study done so that you can properly assessed and get started with the correct therapy and you seem to be avoiding those suggestions completely! restedgal has even given you information about how to get a decent home study done! I understand that you have a phobia regarding medical procedures but having a sleep study done really is not that different to what you are using now except that you cannot possibly monitor the equipment continuosly and make changes to see what effect they have. the sleep study means having a few monitors attached but they are what is needed to get complete data so you know what treatment is needed- at the moment you have jumped to different masks and now you sound like you are considering jumping to a different machine! this trial and error method is going to cost you a fortune and could take you a long time to find what works. I am new to all this stuff but you have advice and yet have chosen to avoid the best advice you have been given by some very experienced people- if you want this to work so that you can start to feel better you need to get some expert help not this trial and error approach- the sleeps lab that i went to was not a medical environment either, as the others have said, maybe like a motel- they deilberately aim to get them as "homey" as possible as a clinical environment is not going to induce comfortable sleep. they used an adjustable bed but one like you would use at home rather than a hospital bed, the room was made to look like a bedroom rather than a clinic and even the machine and monitoring gear was placed in a discrete manner to make the set up as natural as possible.

sorry if i sound mean but i think you are letting your phobia jeopordise your treatment

ozij wrote:I would let the machine try to diagnose my pressure, starting at the lowest bearable minimum - and letting it have its head up to 20. I don't think a wide open range is good for therapy - but this if for titration, and a week at a wide open range would make be feel better about choosing the minimum for the rest of the self study.

stejoel wrote: I agree and I've tried doing this. What happens is as soon as I fall asleep the pressure goes to max in about 5 minutes and the ahi's are worse than at much lower pressures. Then mask wakes me up because it leaking and whistling and flapping from blowing at 20 and that's all the testing In can do at that time. Could it be that the intellipap algorithm?

Which mask did you try it with?

It could be the leaks in an unfitting mask and the mask attempting to compensate for those leaks by raising the pressure.
It could be the algorithm
It could by your real need fo high pressure.

If you're convinced it is not the machine attempting to compensate for mask leaks, then set your minimimum at 11 of 12.

O.